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Welcome
National Frontier and Rural ATTCAdvisory Board Meeting
Nancy A. Roget, MSPrincipal Investigator/Project Director
2.28.13
Serve as the national subject expert and key resource to PROMOTE the awareness and implementation of
telehealth technologies
Original Advisory Board Members
Last Round of Funding Board Members
NFAR ATTC BOARD MEMBERS
Goals of Advisory Board Meeting
• Formally Introduce NFAR ATTC• Build Relationships with Advisory Board
Members• Solicit Feedback and Guidance on Proposed
Deliverables• Utilize Advisory Board Members Expertise
to Enhance Proposed Products
Unofficial Goals
Which Technology Enhances Your Work and Expands the Possibilities
University of Nevada, Reno
5.3 million dollar annual budget
20 grants & contracts
CASAT
Center for the Application of Substance Abuse Technologies (CASAT)
Orvis BuildingUniversity of Nevada, Reno
NFAR Staff
History of the ATTC Network
History of the
ATTCs
Thanks to Dr. Anne Helene Skinstad
CSAT funds first 11 “Addiction Training Centers” (ATCs) Coverage: 19 US States and Puerto Rico
Program expanded to cover 4 additional states in 1995
ATTC History: We’ve been around for a while
1993
1995 Addiction Training Centers become ATTCs– SAMHSA decided not to support students over the ATTC
budget (About $ 200,000 removed from individual ATTC centers’ budgets)
– Criminal Justice Supplement added to several of center’s budgets
– Virginia Commonwealth University’s responsibility expanded to include Maryland and North Carolina
– Northwest Frontier’s responsibility expanded to include Hawaii
– Iowa ATC received a subcontract through Governor State University, became the ATC of Iowa
• Developed a 60 SH MA program in Substance Abuse and Mental Health Counseling (CACREP Approved in 2001)
ATTC History
CSAT re-names the program from ATCs to “Addiction Technology Transfer Centers”
(ATTCs) to better reflect the scope of work
1996
ATTC Network from 1998 - 2001
ATTC History1998CSAT establishes the ATTC Network, with
the creation of the ATTC National Office
13 Regional Centers and a National Office covering 39 states, the District of Columbia, Puerto Rico and the US Virgin Islands
1998The ATTC Curriculum Committee writes
the Addiction Counseling Competencies, which CSAT publishes as TAP 21
ATTC History
2000The ATTC Network published The
Change Book: A Blueprint for Technology Transfer
2001NIDA and SAMHSA enter into an interagency agreement to form the NIDA/SAMHSA Blending Initiative
ATTC Network from 2002 -2007
ATTC History
2005First NIDA/SAMHSA “Blending Product”
released, Buprenorphine Treatment: A Training for Multidisciplinary Professionals.
2006With significant involvement from the ATTCs,
SAMHSA publishes an updated version of TAP 21: The Addiction Counseling Competencies.
BUPRENORPHINE TREATMENT: A TRAINING FOR MULTIDISCIPLINARY ADDICTION PROFESSIONALS
Module I - Introduction
ATTC History
2011: ATTC Network Technology Transfer Workgroup publishes “Research to practice in addiction treatment: key terms and a field-driven model of technology transfer,” in the Journal of Substance Abuse Treatment.
2012: ATTC Network completes national workforce study, “Vital Signs: Taking the Pulse of the Addiction Treatment Profession.”
2011: SAMHSA & State Department create the first international ATTC, the Vietnam HIV ATTC.
ATTC Network from 2012 - 2017
Four National Focus Areas
• National American Indian & Alaska Native ATTCemail: [email protected]
• National Frontier & Rural ATTC email: [email protected]• National Hispanic & Latino ATTC
email: [email protected]• National Screening, Brief Intervention & Referral to
Treatment ATTC
email: [email protected]
National Frontier & Rural
ATTC
National American Indian & Alaska Native
ATTCNational
SBIRTATTC
National Hispanic & Latino
ATTC
Almost 20 Years…..
Serve as the national subject expert
and key resource to
PROMOTE the awareness and implementation of telehealth
technologies
DefinitionsTelehealth ‘refers to the use of
telecommunications and information technologies to provide access to health information and services across a geographical distance.’
Telemedicine ‘use of medical information exchanged from one site to another via electronic communications to improve patients’ health status’
Definitions
• Synchronous communications telephone counseling
• Asynchronous Communications email or web-based programs
• Some web-based programs include both type of communications
1879
Telemedicine/Telehealth
• Annually, 10 million patients receive telemedicine services.
• In 2011, the Veteran Administration alone provided 6,700 patients with telemental health services.
Telehealth Research
• 141 Randomized Control Trials–148 telemedicine interventions with
nearly 37,000 patients–108 of the trials were favorable toward
telemedicine intervention–38 trials showed no statistical
differences
Telehealth is not about technology itself but is a bridge to relationship with the patient
in order to provide care. (Shore, 2012)
Telehealth as it Relates to Treatment and Recovery for SUDs
4
Video Conferencing
Brief Review of Research
TES is an interactive, web-based program theoretically grounded in the
evidence-based Community Reinforcement Approach (CRA) to
behavior therapy
Theoretical Approach: Community Reinforcement Approach (CRA) behavior therapy; contingency management (CM)
Target Substance: Poly-substance use
Mōtiv8 is a web based contingency management program for smoking cessation using a home monitoring
system
Subjects log onto a website and use video recording software to record and submit videos of breath carbon monoxide (CO) samples. The Mōtiv8 application uses a
web-based interface for collecting data, automating immediate voucher (incentive) delivery, and some versions
of the application include a group support forum.
MES is a computer-based brief intervention with the goal of facilitating
self-change, treatment engagement, and/or motivation to change via a single
intervention session.Theoretical Approach:
Motivational interventionTarget Substance: Multiple substances,
poly-substance use
cMET/CBT/CM is a computer-delivered intervention for cannabis
use disorders, incorporating features of three evidence-based treatments: cognitive behavioral therapy (CBT), motivational enhancement therapy
(MET), and contingency management (CM). Nine sessions presented over 12 weeks offer computer-assisted
instruction
MyStudentBody is an interactive, web-based brief intervention for alcohol use
in college student populations
Theoretical Approach: Screening and Brief intervention
Target Substance: Alcohol
McClure, Acquanta, Harding, & Stitzer In Press
• Surveyed 8 urban clinics in Baltimore (266 patients)
• Client’s Access to:–Mobile Phone- 91%– Text Messaging- 79%– Internet/Email/Computer 39-45%
Training Substance Abuse Clinicians in Motivational Interviewing Using Live
Supervision via TeleconferencingTeleconferencing supervision (TCS)
was developed to provide remote, live supervision for training MI
TCS shows promise for promoting new counseling behaviors following
participation in workshop training. (Smith, et al., 2012 Journal of Consulting and Clinical Psychology;80(3):450-464)
NASADAD Survey
• In 2009, Addiction Treatment Providers in 16 states reported offering treatment services using telehealth
(16 states out of the 37 states that responded to the survey)
• 25 states reported providing mental health treatment services using telehealth
Summary of Goals
Create addiction treatment telehealth competencies and develop policy recommendations for national license portability to encourage the addiction treatment and recovery
workforce to ADOPT the use of telehealth services
Use state-of-the-art culturally-relevant training and technical assistance activities
to help the frontier/rural addiction treatment and recovery workforce
IMPLEMENT telehealth services
We need to embrace
RECOVERY
White, 2011
Recovery is contagious. Get close to it.
Stay close to it. Catch it. Keep catching it. Pass it on
PREPARE pre-service addiction treatment and allied health students on
using telehealth technologies by developing and disseminating academic
curricula for infusion into existing courses
Key Collaborators• NASADAD• SAAS-Treatment Provider Associations• HRSA Regional/National Telehealth Centers• Telehealth Experts• Regional Addiction Educators Groups• Project Echo at UNR• Telehealth Experts• NAADAC• IC&RC
Year 1 Key Events
Year 1 Key Events• Build compendium through Literature Searches• Develop Graphics/Marketing Themes• Conduct Telehealth Needs Assessments• Develop Curricula• Present at National Conferences• Present at Regional Summer Institutes• Sponsor two TOTs• Conduct State Presentations 2 x each ATTC Region• Sponsor Early Adopters Summit
Drive target population to our website
Drive target population to our website
76
2 UpcomngTrainingsBrief Introductory Training
Administrators Training
Utilize Video
It’s the Relationship with Stakeholders and Customers that is MOST Important
Groundswell: Bernoff & Li, 2009
Year 2-5• Film and Disseminate Two Telehealth Workshops• Develop Clinical Supervisor Curriculum• Annotate Bibliographies• Create Marketing Videos• Host Webinars of Curricula• Build Addiction Educators Curriculum and Sponsor Training• Sponsor Telehealth Competencies Workgroup and Develop a
Product• Create and Implement Peer Recovery Curriculum• Develop Addiction Treatment Curricula
Who is Our Audience?
Addiction Treatment Counselors
The majority of the Substance Abuse Treatment Workforce is …
Clinical Directors
Direct Care Staff
Gender Female (59%) Female (67%)
Ethnicity White (86%) White (64%)
Age 50+ (60%) [Avg. 52] 35+ (64%)
Employment Full time (95%) Full time (77%)
Serve as the national subject expert
and key resource to
PROMOTE the awareness and implementation of telehealth
technologies
Download this PowerPoint Presentation from our website
www.attcnetwork.org/frontierrural