Knowledge Application Programs (KAPS) in Faith-based Reentry Community Substance Abuse Treatment Settings Saturday May 17, 2013 Cheryl A. Branch, MS, Community Trainer, UCLA-ISAP PSATTC 2012-2013 Faith-based Education & Training Series
Dec 23, 2015
Knowledge Application Programs (KAPS)
in Faith-based Reentry Community Substance Abuse Treatment Settings
Saturday May 17, 2013
Cheryl A. Branch, MS, Community Trainer, UCLA-ISAP PSATTC 2012-2013 Faith-based Education &
Training Series
Faith-based Organizations The next generation of prison ministries is
here. In response to the call for national action to reduce alcohol & drug abuse health disparities LAM congregations developed a plan to promote EBPs in small to mid size AOD treatment and counseling providers in South LA and partnered with UCLA PSATTC. Knowledge Application Programs (KAPs) are an
opportunity for FBOs to participate and practice EBPs
Bridging The Gap
In California, publicly funded addiction services are impacted by increasingly a need to understand Prisoner Reentry
Current offense violent/serious/
sex-related
Current offense is not violent/serious/
sex-related, but prior offense(s) was
Neither current offense nor prior offense was violent/serious/sex-
related
State prison
Parole
PRCS (Post-release Community
Supervision)
County Sentence
(Local Prison Term)
(1170(h)
Jail only
Jail + Mandatory Supervision
Mandatory Supervision
only
Realignment Sentencing Created New Populations in California
The Landscape for Addressing the Alcohol and Drug Treatment and Health Care Needs of the Reentry Population Has Changed
• Recession of 2008 had a major impact on counties’ health care safety nets
????????So, how do you decide what to do?
So, how do you decide what to do?
Prison and Parole Tend to Have a Number of Chronic Health Conditions
Physical Health (Lifetime)
State Local
Prison Parole PRCSLocal
Custody
Asthma 14% 19% 11%* 13%
Diabetes 4% 2% 5% 6%
Hypertension 19% 20% 16% 16%
Hepatitis 14% 14% 13% 10%
Tuberculosis 14% 8% 7% 11%
HIV 1% 1% 0% 1%
Dental Problems Since Admission
55%^ 48%^ 39%* 41%
Any physical disability
43%^ 40%^ 34% 33%
^Indicates differences between Prison vs. Parole statistically significant at .05 level.
PRCS and Local Custody Tend to Be Physically Healthier Than Prison/Parole Populations
Physical Health (Lifetime)
State Local
Prison Parole PRCSLocal
Custody
Asthma 14% 19%* 11%* 13%
Diabetes 4% 2% 5% 6%
Hypertension 19% 20% 16% 16%
Hepatitis 14% 14% 13% 10%
Tuberculosis 14% 8% 7% 11%
HIV 1% 1% 0% 1%
Dental Problems Since Admission
55% 48%* 39%* 41%
Any physical disability
43% 40% 34% 33%
*Indicates differences between Parole vs. PRCS statistically significant. State vs. Local also significant.
There Is More Serious Mental Illness Among the Parole Population
MH Disorder/Substance Abuse
State Local
Prison Parole PRCSLocal
Custody
Ever Diagnosed with MH Disorder
30%^ 40%^ 20% 18%
. . . with Manic 11%^ 29%^ 5% 4%
. . . with Schizophrenia
8%^ 18%^ 1% 1%
. . . with Depression 22%^ 31%^ 13% 12%
. . . with Anxiety 9%^ 17%^ 7% 3%
Drug Abuse 53% 57% 64% 61%
Drug Dependence 40% 46% 53% 41%^Indicates differences between Prison vs. Parole statistically significant at .05 level.
County Clients Tend to Have More Treatment Needs with Respect to Drug Abuse/Dependence
MH Disorder/Substance Abuse
State Local
Prison Parole PRCSLocal
Custody
Ever Diagnosed with MH Disorder
30% 40%* 20%* 18%
. . . with Manic 11% 29%* 5%* 4%
. . . with Schizophrenia
8% 18%* 1%* 1%
. . . with Depression 22% 31%* 13%* 12%
. . . with Anxiety 9% 17%* 7%* 3%
Drug Abuse 53% 57% 64% 61%
Drug Dependence 40% 46% 53% 41%
*Indicates differences between Parole vs. PRCS statistically significant. All State vs. Local differences also significant.
Understanding the ‘New Normal’ in FB Reentry Community Treatment Settings
In the new ones, the infrastructure will have to include internal systems that: support performance monitoring systems assess impact of fidelity vs. adaptation on
outcomes of treatment provider use of both KAP and non-KAP products, and provide
input to the scientific community regarding new research priorities and service gaps for the substance abuse treatment field.
Solutions
Knowledge Application Program (KAP)
SAMHSA's Knowledge Application Program (KAP) provides substance abuse treatment professionals (i.e. Faith-based Counselors, Prevention Specialists) with publications, online education, and other resources that contain information on best treatment practices.
www.kap.samhsa.gov You can access these resources online and no- cost! Some materials available for non-English speaking
populations
Knowledge Application Programs (KAPS)
The KAP approach integrates science-based health communications, social marketing, and knowledge transfer activities into an evidence-based dissemination practice which includes: Developing a culturally competent Knowledge Transfer Model
based on proven dissemination principles and practices Developing products and processes to present research
findings, best practices, and promising practices to the field
Using partnerships with organizations as an effective service practice and as a strategy in creating effective distribution channels.
LAM is practicing the KAP approach to community education and professional development for faith-based clergy and laity addiction counselors
SAMHSA Center for Mental Health Services - Knowledge Application
Program (CMHS/KAP)
- Dedicated to supporting product development and dissemination through providing innovative use of media and marketing that will advance the adoption of evidenced -based and promising practices in servicing persons with mental illnesses and/or substance use disorders.
Different Types of KAPs
SAMHSA Protocol (TIP) Series SAMHSA Technical Assistance
Publications (TAPs) Periodicals ATTC’s Local quarterly LAC SAPC training Local ONTRACK Program Resources
(state)
How Are Evidence-Based Practices Documented?
Gold Standard Multiple randomized clinical trials
Second Tier Consensus reviews of available science
Third Tier Expert opinion based on clinical observation
Process Benchmarking In Action
• How do they do it?
• The identification
of “best practices?”
In Plain Terms, Please
It’s about: Critical Thinking, Standardized Approaches Collective Work Teams Lots of Reading and Writing Disciplined Procedures & Systems Follow the Plan—all the time Balancing idea each client is different and the same
It is not your program’s daily schedule
Evidence-Based Practices for Alcohol Treatment
Brief intervention Social skills training Motivational enhancement Community reinforcement Behavioral contracting
Scientifically-Based Approaches to Addiction Treatment
Cognitive–behavioral interventions Community reinforcement Motivational enhancement therapy 12-step facilitation Contingency management Pharmacological therapies Systems treatment
What Does All This Mean?
We have an opportunity to improve treatment services.
There are effective and cost-efficient treatments available for alcohol and drug dependence.
Need solutions for Changing Environment in local agencies (i.e. SAPC, DMH, DPSS, Probation, LAUSD, Courts)
In SummaryIn Summary
Summary
Defined evidence-based practice Considered barriers to adoption Noted counselor endorsements and
recommendations for manuals Described an evidence-based practice model Discussed how manuals fit within that model
Sources of Evidence-Based Information on the Web
Managed Care samhsa.gov/mcnew
Dual Disorders dartmouth.edu/~psychrc
Stimulant Treatment matrixcenter.com
Drug Abuse Treatment ibr.tcu.edu
Sources of Evidence-Based Information on the Web
Drug Abuse Treatment nida.nih.gov
Alcoholism Treatment niaaa.nih.gov
Addiction Medicine asam.org
HIV/AIDS cdc.gov/idu/
Sources of Evidence-Based Information on the Web
Prevention unr.edu/westcapt
Technology Transfer nattc.org
Addiction Science utexas.edu/research/asrec http://gainscenter.samhsa.gov/topical_resources/e
bps.asp http://www.nrepp.samhsa.gov/Learnlanding.aspx http://store.samhsa.gov/list/series?
name=Evidence-Based-Practices-KITs
An Evidence-Based Treatment Model for Improving Practice1
Core Components of Comprehensive Services
MedicalMental Health
Vocational
Educational
LegalAIDS / HIV
Risks
Financial
Housing & Transportation
Child Care
Family
Continuing Care
Case Manageme
nt
Urine Monitoring
Self-Help(AA/NA)
Pharmaco-therapy
Group/Individual Counseling
AbstinenceBasedIntake
Assessment
Treatment Plans
CoreTreatment
Elements of a Treatment Process Model
SufficientRetentionSufficientRetention?
PatientFactorsPatientFactors
PsychologicalFunctioning,
Motivation,
& ProblemSeverity
Cognitive and behavioralcomponents with therapeutic impact
Post-treatment
DrugUse
DrugUse
CrimeCrime
SocialRelations
SocialRelations
Detox
OP-DF
TC/Res
OP-MM
TCU Treatment Process Model
SufficientRetentionSufficientRetention
Posttreatment
DrugUse
DrugUse
CrimeCrime
SocialRelations
SocialRelations
PatientAttributesat Intake
PatientAttributesat Intake
Motiv
Simpson, 2001 (Addiction)
Early Engageme
nt
Early Recover
y
ProgramParticipation
ProgramParticipation
TherapeuticRelationship
TherapeuticRelationship
BehavioralChange
BehavioralChange
Psycho-SocialChange
Psycho-SocialChange
Engagement
AdequateStay in Tx
Posttreatment
DrugUse
DrugUse
CrimeCrime
SocialRelations
SocialRelations
ProgramParticipation
TherapeuticRelationship
BehavioralChange
CognitiveChange
PatientReadiness
for Tx
“Sequence” of Recovery Stages
Targeted InterventionsGet Focused!!
SufficientRetentionSufficientRetention
Early Engageme
nt
Early Recover
y
Posttreatment
DrugUse
DrugUse
CrimeCrime
SocialRelations
SocialRelations
ProgramParticipation
ProgramParticipation
TherapeuticRelationship
TherapeuticRelationship
BehavioralChange
BehavioralChange
Psycho-SocialChange
Psycho-SocialChange
PatientAttributesat Intake
PatientAttributesat Intake
Motiv
Interventions Should Maintain This Process
SufficientRetention
Early Engagemen
t
Early Recovery
Posttreatment
DrugUse
Crime
SocialRelations
ProgramParticipation
TherapeuticRelationship
BehavioralChange
Psycho-SocialChange
PatientAttributesat Intake
Motiv
Induction to Treatment(Motivational Enhancement)
ProblemRecognition
Desirefor Help
Readinessfor Treatment
SufficientRetention
Early Engagemen
t
Early Recovery
Posttreatment
DrugUse
Crime
SocialRelations
ProgramParticipation
TherapeuticRelationship
BehavioralChange
Psycho-SocialChange
PatientAttributesat Intake
Motiv
Counseling Enhancements
(Cognitive “Mapping”)
SufficientRetention
Early Engagemen
t
Early Recovery
Posttreatment
DrugUse
Crime
SocialRelations
ProgramParticipation
TherapeuticRelationship
BehavioralChange
Psycho-SocialChange
PatientAttributesat Intake
Motiv
Contingency Management(Token Rewards)
SufficientRetention
Early Engagemen
t
Early Recovery
Posttreatment
DrugUse
Crime
SocialRelations
ProgramParticipation
TherapeuticRelationship
BehavioralChange
Psycho-SocialChange
PatientAttributesat Intake
Motiv
Specialized Interventions (Skills-Based Counseling Manuals)
SupportiveNetworks
SufficientRetentionSufficientRetention
Early Engageme
nt
Early Recover
y
Posttreatment
DrugUse
DrugUse
CrimeCrime
SocialRelations
SocialRelations
ProgramParticipation
ProgramParticipation
TherapeuticRelationship
TherapeuticRelationship
BehavioralChange
BehavioralChange
Psycho-SocialChange
Psycho-SocialChange
PatientAttributesat Intake
PatientAttributesat Intake
Motiv
Evidence-Based Treatment Model
EnhancedCounseling
BehavioralStrategies
Social SkillsTraining
Family &Friends
SupportiveNetworks
SupportiveNetworks
Induction Personal Health Services
Social Support Services
ProgramCharacteristics
ProgramCharacteristics
StaffAttributes
& Skills
StaffAttributes
& Skills
Simpson, 2001 (Addiction)
How to Order KAPs
To order publications, contact SAMHSA at
http://store.samhsa.gov or 1-877-SAMHSA-7
(1-877-726-4727) (English and Español) or call 800-487-4889
(TDD hearing impaired) and ask for an information specialist