Josephine M DeMarce1,2, Maryann Gnys1,2, Susan D Raffa1,3, Mandy Kumpula1,2, Bradley E Karlin1,4. 1. Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs Central Office, Washington, DC, USA. 2. VISN 6 Mental Illness Research, Education and Clinical Center, Durham Veterans Affairs Mental Center, Durham, North Carolina, USA. 3. Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA. 4. Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Abstract
BACKGROUND: As part of the nation's largest dissemination and implementation of evidence-based psychotherapies (EBPs) and the promotion of EBPs for substance use disorders (SUDs), the Veterans Health Administration (VHA) is working to nationally implement Cognitive Behavioral Therapy for SUD (CBT-SUD). The current manuscript describes the approach to system-wide training and reports Veteran outcomes associated with CBT-SUD implementation. Methods: Four-hundred fifty-eight Veterans with a range of treatment goals received treatment through the Department of Veterans Affairs (VA) CBT-SUD Training Program. Veteran outcomes related to substance use, substance use-related problems, and quality of life were assessed with the Brief Addiction Monitor, the Short Inventory of Problems, and the World Health Organization Quality of Life-BREF. Results: Statistically significant reductions in alcohol use, heavy alcohol use, other drug use, and substance use-related problems, as well as significant improvements in quality of life, were observed over the course of treatment. Conclusions: Program evaluation findings suggest that large-scale training in and implementation of EBPs for SUDs is associated with improvements in substance use and other functional outcomes. Limitations from this real-world implementation project, including the lack of a control group and missing post-treatment data, are discussed.
BACKGROUND: As part of the nation's largest dissemination and implementation of evidence-based psychotherapies (EBPs) and the promotion of EBPs for substance use disorders (SUDs), the Veterans Health Administration (VHA) is working to nationally implement Cognitive Behavioral Therapy for SUD (CBT-SUD). The current manuscript describes the approach to system-wide training and reports Veteran outcomes associated with CBT-SUD implementation. Methods: Four-hundred fifty-eight Veterans with a range of treatment goals received treatment through the Department of Veterans Affairs (VA) CBT-SUD Training Program. Veteran outcomes related to substance use, substance use-related problems, and quality of life were assessed with the Brief Addiction Monitor, the Short Inventory of Problems, and the World Health Organization Quality of Life-BREF. Results: Statistically significant reductions in alcohol use, heavy alcohol use, other drug use, and substance use-related problems, as well as significant improvements in quality of life, were observed over the course of treatment. Conclusions: Program evaluation findings suggest that large-scale training in and implementation of EBPs for SUDs is associated with improvements in substance use and other functional outcomes. Limitations from this real-world implementation project, including the lack of a control group and missing post-treatment data, are discussed.
Authors: Deborah S Hasin; Andrew J Saxon; Carol Malte; Mark Olfson; Katherine M Keyes; Jaimie L Gradus; Magdalena Cerdá; Charles C Maynard; Salomeh Keyhani; Silvia S Martins; David S Fink; Ofir Livne; Zachary Mannes; Melanie M Wall Journal: Am J Psychiatry Date: 2022-07-28 Impact factor: 19.242