Improving Substance Abuse Treatment

Michele (Mickey) Eliason, PhD, is an adjunct professor at the Institute for Health and Aging at the University of California, San Francisco. She also teaches courses about sexuality and gender at San Francisco State University. Formerly, she was a faculty member in the College of Nursing at the University of Iowa for nearly 20 years. Dr. Eliason has been an applied researcher in the substance abuse treatment field for over 15 years, and is particularly interested in diverse populations including women and sexual/gender minority clients. Her interest in the evidence-based practice movement came out of a four year involvement with the Iowa Practice Improvement Collaborative, funded by CSAT to develop a statewide practice-research collaboration. This highly rewarding experience highlighted the complex barriers to implementing evidence-based practices in the poorly funded and stigmatized settings of community based treatment programs.

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• AcknowledgmentsCh 1: IntroductionChallengesA Working Definition of Evidence-Based PracticeOverview of the BookCh 2: What Are Evidence-Based Practices?Bias in Research StudiesWhat Is Treatment as Usual?Research-Practice GapsBridging the GapTypes of Research-Based PracticesClinical Practice Guidelines/Consensus DocumentsEvidence-Based PracticesPractice ImprovementsSome Challenges to the Evidence-Based Practice MovementConclusionsCh 3: Determining What Is Evidence-BasedWhat Is "Evidence"?Three Efforts to Develop Criteria for Evidence-Based PracticeThe Iowa ExperienceThe Oregon MandateThe Federal Response: National Registry of Effective Practices and Programs (NREPP)ConclusionsAddendum: Suggestions for Developing CriteriaCh 4: Adoption and Implementation of Evidence-Based PracticesAssessment of Readiness to ChangeInstituting Organizational ChangeChallenges to ImplementationTraining IssuesClient VariationProvider/Staff VariationProgram/Agency VariationBuy-InCommitmentNegative Attitudes/Lack of Knowledge About ResearchLack of Practice-Research Partnerships/CollaborationsLack of ResourcesOrganizational StructureThe Practice ItselfStigmaConclusionsCh 5: Evaluation of Evidence-Based PracticesProcess Evaluation (Fidelity)Outcome EvaluationProgram EvaluationConclusionsCh 6: A Research Primer: Overview, Hypotheses, and VariablesWhy Is Research Important?Types of ResearchQuantitative and QualitativeLaboratory and Field StudiesThe Research Process (Step by Step)Research Questions/HypothesesVariablesConclusionsCh 7: Research MethodsTwo Basic Types of Research DesignsThe Gold Standard: Randomized Clinical TrialsOther Research DesignsSelecting a SampleGeneralizability of SamplesInstitutional Review BoardsLoss of ConfidentialityRisk-Benefit AnalysesMisrepresentation of Risks or BenefitsCoercionSafeguardsResearch Procedures/Data CollectionCross-Sectional Versus Longitudinal DesignsData Collection MethodsConclusionsCh 8: Data Analysis and InterpretationDescriptive StatisticsReliability and Validity of Measurement ToolsInterpreting Descriptive StatisticsInferential StatisticsOther Statistical MethodsMethods for Understanding Inferential StatisticsExample: Interpretation of a Clinical TrialSampleMethodOutcome MeasuresResultsInterpretation/ApplicationConclusionsCh 9: Qualitative Research, Dissemination, and FundingIntroduction to Qualitative ResearchQualitative MethodsAnother Example of Qualitative Research in Substance AbuseData Reporting and DisseminationFunding SourcesConclusionsCh 10: Conclusions and Future DirectionsBarriers to Conducting Research in Substance Abuse Treatment and Prevention AgenciesMajor Themes Identified in This BookImplications for the FieldRecommendationsConclusionsGlossary of Key TermsReferences and Web ResourcesAppendix A: Text of Oregon LawIndexAbout the Author