Top

Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-07-2011 | Original Paper

Training Addiction Counselors to Implement CBT for Depression

Authors: Kimberly A. Hepner, Sarah B. Hunter, Susan M. Paddock, Annie J. Zhou, Katherine E. Watkins

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 4/2011

Abstract

Many clients in publicly funded substance abuse treatment programs suffer from depression yet lack access to effective mental health treatment. This study sought to examine whether addiction counselors could be effectively trained to deliver group CBT for depression and to ascertain client perceptions of the treatment. Five counselors were trained in the therapy and treated 113 clients with depression symptoms. Counselors demonstrated high fidelity to the therapy and client perceptions of the therapy were positive. Our results suggest that training addiction counselors to deliver group CBT for depression is a promising integrated treatment approach for co-occurring depression and substance disorders.

Barber, J. P., Liese, B., & Abrams, M. J. (2003). Development of the Cognitive Therapy Adherence and Competence Scale. Psychotherapy Research, 13(2), 205–221.CrossRef

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Beidas, R. S., & Kendall, P. C. (2010). Training clinicians in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science & Practice, 17, 1–30.CrossRef

Bright, J. I., Baker, K. D., & Neimeyer, R. A. (1999). Professional and paraprofessional group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions. Journal of Consulting and Clinical Psychology, 67(4), 491–501.PubMedCrossRef

Browne, W. J., Goldstein, H., & Rasbash, J. (2001). Multiple membership multiple classification (MMMC) models. Statistical Modeling, 1(2), 103–124.CrossRef

Busseri, M. A., & Tyler, J. D. (2003). Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form. Psychological Assessment, 15(2), 193–197.PubMedCrossRef

Byrt, T., Bishop, J., & Carlin, J. (1993). Bias, prevalence and kappa. Journal of Clinical Epidemiology, 46, 423–429.PubMedCrossRef

Carey, K. (2000). A multilevel modeling approach to analysis of patient costs under managed care. Health Economics, 9, 435–446.PubMedCrossRef

Clark, H. W., Power, A. K., Le Fauve, C. E., & Lopez, E. I. (2008). Policy and practice implications of epidemiological surveys on co-occurring mental and substance use disorders. Journal of Substance Abuse Treatment, 34(1), 3–13.PubMedCrossRef

Dawson, D. A., Grant, B. F., Stinson, F. S., & Zhou, Y. (2005). Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the U.S. general population. Alcoholism, Clinical and Experimental Research, 29(5), 844–854.PubMedCrossRef

Dennis, M. L., White, M. K., Titus, J. C., & Unsicker, J. I. (2006). Short Blessed Scale Exam. Global appraisal of individual needs: Trainer’s training manual and resources (July 2006 version). Bloomington, IL: Chestnut Health Systems.

Druss, B. G., & Rosenheck, R. A. (1999). Patterns of health care costs associated with depression and substance abuse in a national sample. Psychiatric Services, 50, 214–218.PubMed

Friedmann, P. D., Alexander, J. A., & D’Aunno, T. A. (1999a). Organizational correlates of access to primary care and mental health services in drug abuse treatment units. Journal of Substance Abuse Treatment, 16(1), 71–80.PubMedCrossRef

Friedmann, P. D., Alexander, J. A., Jin, L., & D’Aunno, T. A. (1999b). On-site primary care and mental health services in outpatient drug abuse treatment units. Journal of Behavioral Health Services and Research, 26(1), 80–94.PubMedCrossRef

Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., et al. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(8), 807–816.PubMedCrossRef

Grella, C. E., & Hser, Y. I. (1997). A county survey of mental health services in drug treatment programs. Psychiatric Services, 48(7), 950–952.PubMed

Grella, C. E., & Stein, J. A. (2006). Impact of program services on treatment outcomes of patients with comorbid mental and substance use disorders. Psychiatric Services, 57(7), 1007–1015.PubMedCrossRef

Harris, K. M., & Edlund, M. J. (2005). Use of mental health care and substance abuse treatment among adults with co-occurring disorders. Psychiatric Services, 56(8), 954–959.PubMedCrossRef

Hepner, K. A., Miranda, J. M., Woo, S. M., Watkins, K. E., Lagomasino, I. T., Wiseman, S. H., & Muñoz, R. F. (2011a). Building recovery by improving goals, habits, and thoughts (BRIGHT): A group cognitive behavioral therapy for depression in clients with co-occurring alcohol and drug use problems—group leaders manual. Santa Monica, CA: RAND Corporation, TR-977/1-NIAAA. http://www.rand.org/pubs/technical_reports/TR977z1.html.

Hepner, K. A., Stern, S., Paddock, S. M., Hunter, S. B., Osilla, K. C., & Watkins, K. E. (2011b). A fidelity coding guide for a group cognitive behavioral therapy for depression. Santa Monica, CA: RAND Corporation, TR-980-NIDA/NIAAA. http://www.rand.org/pubs/technical_reports/TR980.html.

Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36(2), 223–233.CrossRef

Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology, 61(4), 561–573.PubMedCrossRef

Jaycox, L. H., Langley, A. K., Stein, B. D., Wong, M., Sharma, P., Scott, M., et al. (2009). Support for students exposed to trauma: A pilot study. School Mental Health, 1(2), 49–60.PubMedCrossRef

Kramer, C. Y. (1956). Extension of multiple range tests to group means with unequal numbers of replications. Biometrics, 12, 309–310.CrossRef

Landis, J., & Koch, G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.PubMedCrossRef

McGovern, M. P., Xie, H., Segal, S. R., Siembab, L., & Drake, R. E. (2006). Addiction treatment services and co-occurring disorders: Prevalence estimates, treatment practices, and barriers. Journal of Substance Abuse Treatment, 31(3), 267–275.PubMedCrossRef

McLellan, A. T., Carise, D., & Kleber, H. D. (2003). Can the national addiction treatment infrastructure support the public’s demand for quality care? Journal of Substance Abuse Treatment, 25(2), 117–121.PubMedCrossRef

Miller, W. R., Sorensen, J. L., Selzer, J. A., & Brigham, G. S. (2006). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal of Substance Abuse Treatment, 31(1), 25–39.PubMedCrossRef

Miranda, J., Chung, J. Y., Green, B. L., Krupnick, J., Siddique, J., Revicki, D. A., et al. (2003). Treating depression in predominantly low-income young minority women: A randomized controlled trial. Journal of the American Medical Association, 290(1), 57–65.PubMedCrossRef

Montgomery, E. C., Kunik, M. E., Wilson, N., Stanley, M. A., & Weiss, B. (2010). Can paraprofessionals deliver cognitive-behavioral therapy to treat anxiety and depressive symptoms? Bulletin of the Menninger Clinic, 74(1), 45–62.PubMedCrossRef

Morgenstern, J., Morgan, T. J., McCrady, B. S., Keller, D. S., & Carroll, K. M. (2001). Manual-guided cognitive-behavioral therapy training: A promising method for disseminating empirically supported substance abuse treatments to the practice community. Psychology of Addictive Behaviors, 15(2), 83–88.PubMedCrossRef

Muñoz, R., Ippen, C., Rao, S., Le, H., & Dwyer, E. (2000). Manual for group cognitive-behavioral therapy of major depression: A reality management approach. San Francisco, CA: Cognitive Behavioral Depression Clinic, San Francisco General Hospital, University of California.

Muñoz, R. F., & Mendelson, T. (2005). Toward evidence-based interventions for diverse populations: The San Francisco General Hospital prevention and treatment manuals. Journal of Consulting and Clinical Psychology, 73(5), 790–799.PubMedCrossRef

Oei, T. P., & Dingle, G. (2008). The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders. Journal of Affective Disorders, 107(1–3), 5–21.PubMedCrossRef

Perepletchikova, F., & Kazdin, A. E. (2005). Treatment Integrity and therapeutic change: Issues and research recommendations. Clinical Psychology: Science and Practice, 12(4), 365–383.CrossRef

Rakovshik, S., & McManus, G. (2010). Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance. Clinical Psychology Review, 30, 496–516.PubMedCrossRef

Roche, A. M., Todd, C. L., & O’Connor, J. (2007). Clinical supervision in the alcohol and other drugs field: An imperative or an option? Drug and Alcohol Review, 26(3), 241–249.PubMedCrossRef

Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: Getting started and moving on from Stage 1. Clinical Psychology Science and Practice, 8(2), 133–142.CrossRef

Sholomskas, D. E., Syracuse-Siewert, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F., & Carroll, K. M. (2005). We don’t train in vain: A dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 73, 106–115.PubMedCrossRef

Sloan, K., Kivlahan, D., & Saxon, A. (2000). Detecting bipolar disorder among treatment-seeking substance abusers. The American Journal of Drug and Alcohol Abuse, 26(1), 13–23.PubMedCrossRef

Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. Journal of the American Medical Association, 282(18), 1737–1744.PubMedCrossRef

Thompson, L. W., Gallagher, D., Nies, G., & Epstein, D. (1983). Evaluation of the effectiveness of professionals and nonprofessionals as instructors of “coping with depression” classes for elders. Gerontologist, 23(4), 390–396.PubMed

Walters, E., Kessler, R., Nelson, C., & Mroczek, D. (1998). Composite International Diagnostic Interview (CIDI) 2.1. Geneva: World Health Organization (WHO).

Ware, J., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.PubMedCrossRef

Watkins, K. E., Burnam, A., Kung, F.-Y., & Paddock, S. (2001). A national survey of care for persons with co-occurring mental and substance use disorders. Psychiatric Services, 52(8), 1062–1068.PubMedCrossRef

Watkins, K. E., Hunter, S. B., Hepner, K. A., Paddock, S., De La Cruz, E., Zhou, A., et al. (in press). An effectiveness trial of group cognitive behavioral therapy for patients with persistent depressive symptoms in substance abuse treatment. Archives of General Psychiatry.

Wells, K. B., Sherbourne, C., Schoenbaum, M., Duan, N., Meredith, L., Unutzer, J., et al. (2000). Impact of disseminating quality improvement programs for depression in managed primary care: A randomized controlled trial. Journal of the American Medical Association, 283(2), 212–220.PubMedCrossRef

Wells, K., Sturm, R., & Burnam, M. A. (2001). Healthcare for communities (HCC) psychoticism screener. Healthcare for communities HCC1 questionnaire. http://www.hsrcenter.ucla.edu/research/hcc.shtml.

Title: Training Addiction Counselors to Implement CBT for Depression
Authors: Kimberly A. Hepner
Sarah B. Hunter
Susan M. Paddock
Annie J. Zhou
Katherine E. Watkins
Publication date: 01-07-2011
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 4/2011
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-011-0359-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Training Addiction Counselors to Implement CBT for Depression

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2011

Training Research: Practical Recommendations for Maximum Impact

The Science of Training in Evidence-Based Treatments in the Context of Implementation Programs: Current Status and Prospects for the Future

Therapist Training in Empirically Supported Treatments: A Review of Evaluation Methods for Short- and Long-Term Outcomes

Effects of Workshop Training for Providers Under Mandated Use of an Evidence-Based Practice

A Pilot Study Disseminating Cognitive Behavioral Therapy for Depression: Therapist Factors and Perceptions of Barriers to Implementation

Developing the Mental Health Workforce: Review and Application of Training Approaches from Multiple Disciplines