Randomized Trial of Web-Based Training to Promote Counselor Use of Cognitive Behavioral Therapy Skills in Client Sessions.

Randomized trial of web-based training to promote counselor use of cognitive behavioral therapy skills in client sessions.

Subst Abus. 2013 Apr-Jun; 34(2): 179-87
Larson MJ, Amodeo M, Locastro JS, Muroff J, Smith L, Gerstenberger E

ABSTRACT Background and Methods: The authors designed and delivered an innovative Web course on cognitive behavioral therapy (CBT), a specific empirically based treatment, to a diverse group of addiction counselors and supervisors in 54 addiction units across the country, and conducted a randomized controlled trial of its effectiveness with 127 counselors. The primary focus of the trial was to assess “adequate adherence to CBT practice” after training as judged by raters blinded to training condition who listened to audiotapes of actual client sessions. Counselors who passed were judged to satisfy 2 criteria: (a) low pass or greater on at least 1 of 3 “CBT-generic skills” assessing session structure; and (b) low pass or greater on at least 1 of 3 “CBT-specific skills” related to use of functional analysis, cognitive skills practice, or behavioral skills practice. Results: Although the counselors’ use of CBT skills in sessions increased after Web course training, it was not statistically significant and not larger than the gain of control-group counselors trained with a written CBT manual. HubMed – addiction


Dissemination and implementation of cognitive behavioral therapy for stimulant dependence: a randomized trial comparison of 3 approaches.

Subst Abus. 2013 Apr-Jun; 34(2): 108-17
Rawson RA, Rataemane S, Rataemane L, Ntlhe N, Fox RS, McCuller J, Brecht ML

ABSTRACT Background: This study evaluated the effectiveness of 3 approaches to transferring cognitive behavioral therapy (CBT) to addiction clinicians in the Republic of South Africa (RSA). Methods: Clinicians (N = 143) were assigned to 3 training conditions: ( 1 ) an in vivo (IV) approach in which clinicians received in-person training and coaching; ( 2 ) a distance learning (DL) approach providing training via videoconference and coaching through teleconferencing; and ( 3 ) a control condition (C) providing a manual and 2-hour orientation. Results: Frequency of use of CBT skills increased significantly with the IV and DL approaches compared with the C approach, and the IV approach facilitated greater use of CBT skills than the DL approach. During the active phase of the study, skill quality declined significantly for clinicians trained in the C condition, whereas those in the DL approach maintained skill quality and those in the IV approach improved skill quality. After coaching was discontinued, clinicians in the IV and DL approaches declined in skill quality. However, those in the IV approach maintained a higher level of skill quality compared with the other approaches. Cost of the IV condition was double that of the DL condition and 10 times greater than the C condition. Conclusions: In vivo supervision and distance learning methods appear to be effective dissemination and implementation strategies, and distance learning has significant potential to be less costly. HubMed – addiction


Lifetime prevalence of alcohol and substance use in egypt: a community survey.

Subst Abus. 2013 Apr-Jun; 34(2): 97-104
Hamdi E, Gawad T, Khoweiled A, Sidrak AE, Amer D, Mamdouh R, Fathi H, Loza N

ABSTRACT Objective: The aim of this study was to determine the prevalence of substance use and addiction in Egypt and study its sociodemographic correlates. Method: A total of 44,000 subjects were interviewed from 8 governorates by stratified sampling. A questionnaire derived from the Addiction Severity Index (ASI) was individually administered. Results: The lifetime prevalence of any substance use varies between 7.25% and 14.5%. One-month prevalence varies between 5.4% and 11.5% when adjusted to different population parameters. A total of 4832 subjects were identified as using illicit substances at least once in their life (9.6%), including 1329 experimental and social use (3.3%), 1860 regular use (4.64%), and 629 substance dependence (1.6%). The prevalence of substance use in males is 13.2% and 1.1% in females. Prevalence increases significantly in males of Bedouin origin, in seaside governorates, with lesser levels of education, and in certain occupations. The 15-19 age group showed the highest onset of substance use. Cannabis is the drug mostly misused in Egypt; alcohol is a distant second. Conclusions: The prevalence of substance use is lower than Western countries and higher compared with a 1996 survey. The true population prevalence is probably higher due to underreporting. The demographic pattern reflects availability and accessibility to drugs. HubMed – addiction


Loneliness, self-esteem, and life satisfaction as predictors of Internet addiction: A cross-sectional study among Turkish university students.

Scand J Psychol. 2013 Apr 12;
Bozoglan B, Demirer V, Sahin I

This study investigated the relationship among loneliness, self-esteem, life satisfaction, and Internet addiction. Participants were 384 university students (114 males, 270 females) from 18 to 24 years old from the faculty of education in Turkey. The Internet Addiction, UCLA Loneliness, Self-esteem, and Life Satisfaction scales were distributed to about 1000 university students, and 38.4% completed the survey (see Appendix A and B). It was found that loneliness, self-esteem, and life satisfaction explained 38% of the total variance in Internet addiction. Loneliness was the most important variable associated with Internet addiction and its subscales. Loneliness and self-esteem together explained time-management problems and interpersonal and health problems while loneliness, self-esteem, and life satisfaction together explained only the interpersonal and health problems subscales. HubMed – addiction


Delivering stepped care for depression in general practice: Results of a survey amongst general practitioners in the Netherlands.

Eur J Gen Pract. 2013 Apr 12;
Sinnema H, Franx G, Spijker J, Ruiter M, van Haastrecht H, Verhaak P, Nuyen J

Background: Revised guidelines for depression recommend a stepped care approach. Little is known about the implementation of the stepped care model by general practitioners (GPs) in daily practice. Objectives: To evaluate the performance of Dutch GPs in their general practice regarding important elements of the stepped care model (identification, severity assessment and stepped care treatment allocation) shortly before the revised Dutch multidisciplinary guideline for Depressive Disorders was published. Methods: Data was collected through a self-report questionnaire sent to 500 randomly selected GPs. Multivariate logistic regression analyses were employed to investigate whether GP-related characteristics were associated with GPs’ self-reported performance. Results: The study involved 194 GPs (response rate: 39%). Responses indicated that 37% paid systematic attention to depression identification, 33% used a screening instrument, and 63% determined the severity of newly diagnosed depression, generally without using an instrument. Most GPs (72%) indicated to allocate stepped care treatment to the majority of their patients newly diagnosed with depression. However, more than 40% indicated to start with antidepressants, either alone or in combination with psychotherapy. Assessing the severity of newly diagnosed depression and clinical experience were positively associated with allocating stepped care treatment. Structural collaboration with mental health professionals was positively associated with assessing severity. Conclusion: Delivering stepped care for depression in daily general practice could be further improved. Collaboration with mental health professionals and routine severity assessment of diagnosed depression are positively associated with allocating stepped care. HubMed – addiction