Table 1.
Research studies focused on attitudes toward EBTs.
| Author(s)/Year | Article Title | Sample | Study Aim(s) | Key Finding(s) |
|---|---|---|---|---|
| Swift, Duncan, Nirenberg, & Femino (1998)a | Alcoholic patients’ experience and attitudes on pharmacotherapy for alcoholism | 127 patients from three treatment settings | Assessed patient attitudes regarding use of medications for alcoholism | * 29% felt disulfiram was helpful for alcoholics, while only 14% felt naltrexone was helpful. * 33% had taken disulfiram, while only 6% reported having taken naltrexone before. * 29% believed disulfiram was helpful for alcoholics, while only 14% believed naltrexone was helpful for alcoholics. * Belief that medication would be helpful was best predictor of willingness to disulfiram or naltrexone. |
| Rychtarik, Connors, Dermen, & Stasiewicz (2000)a | Alcoholic anonymous and the use of medications to prevent relapse: An anonymous survey of member attitudes | 277 members of alcoholics anonymous (AA) | Assessed attitudes of AA members toward medications to prevent relapse and their experiences with medication use | * 73% of members reported use of medications to prevent relapse either was or might be a good idea. * AA meeting attendance was negatively related to attitudes toward use of medications for relapse prevention. |
| Forman, Bovasso, & Woody (2001)c | Staff beliefs about addiction treatment | 317 CTN staff members | Assessed staff beliefs about addiction treatment | * 80% of staff agreed “new approaches” should be used more. * 39% of staff agreed naltrexone should be used more. |
| Godley, White, Diamond, Passetti, & Titus (2001)b | Therapist reactions to manual-guided therapies for the treatment of adolescent marijuana users | 19 clinicians (16 therapists and 3 case managers) | Examined reactions to the use of a manual guided intervention for adolescents | * 100% of clinicians indicated that the manuals provided structure and consistency to their therapeutic work. * 42% of clinicians indicated that the manuals restricted their ability to respond to individual client needs. |
| Ball et al. (2002)b | Characteristics, beliefs, and practices of community clinicians trained to provide manual- guided therapy for substance abusers | 66 clinicians from 11 community treatment programs associated with the CTN network | Assessed clinicians who had volunteered to be trained in Motivational Interviewing or Motivational Enhancement Therapy prior to training | * 65% of clinicians were female, 77% were Caucasian, and 52% had master’s degree. * Clinicians reported not having one dominant theoretical orientation. * Clinicians reported beliefs and techniques generally consistent with their stated theoretical orientations and recovery status. |
| Hubbard & Mulvey (2003)b | TIPs evaluation project retrospective study: wave 1 and 2 | Substance abuse directors, supervisors, and counselors. Wave 1 (N = 3,267) and Wave 2 (N = 1,028) | Assessed knowledge, attitudes, use, and impact regarding TIPs | * Despite 100% of Single State Agency Directors being aware of TIP series, less than 50% of other staff were aware of TIP series. * Despite generally positive attitudes toward TIPs, there was less positive attitudes about the ability to implement TIPs in practice. * Staff resistance was the most frequently cited barrier to implementing TIPs. |
| Mark, Kranzler, Song et al. (2003)a | Physicians’ opinions about medications to treat alcoholism | 1,388 substance abuse specialist physicians | Examined physicians’ opinions about and use of disulfiram and naltrexone | * More than 66% of physicians were confident in their knowledge about naltrexone and disulfiram. * Significantly more physicians indicated there was strong evidence in favor of using naltrexone versus disulfiram. * Physicians estimated naltrexone had a small-to-medium effect size. |
| McGovern, Fox, Xie, & Drake (2004)c | A survey of clinical practices and readiness to adopt evidence-based practices: Dissemination research in an addiction treatment system | 110 staff (21 directors and 89 clinicians) from 24 public addiction programs | Assessed clinicians characteristics, current practices, as well as their knowledge and attitudes toward evidence-based practices | * Clinicians reported being more motivated to adopt evidence-based practices, such as twelve-step facilitation, cognitive behavioral therapy, motivation interviewing, and relapse therapy, relative to others such as, contingency management, behavioral couples therapy, or pharmacotherapies. |
| McCarty, Rieckmann, Green, Gallon, & Knusden (2004)a | Training rural practitioners to use buprenorphine: Using The Change Book to facilitate technology transfer | 51 individuals (17 physicians, 4 pharmacists, 2 nurse practitioners, and 28 drug abuse counselors and administrators) from seven counties | Assessed the impact of using The Change Book to structure the change process for the Opiate Medication Initiative for Rural Oregon Residents (OMIROR) project | * Nearly 100% of participants indicated being satisfied with the training. * Training significantly increased attitudes and beliefs regarding buprenorphine’s effectiveness, ability to save lives, impact on patients’ health, and ability to block heroin cravings. |
| West et al. (2004)a | Challenges in increasing access to buprenorphine treatment for opiate addiction | 1,203 psychiatrists | Assessed psychiatrists’ comfort using office-based opiate agonist treatment (OBOT) and to identify factors associated with OBOT comfort | * 81% of psychiatrists reported not being comfortable providing OBOT. * Males, addiction-certified psychiatrists, those treating substance abuse patients, and those non not treating any patients under a capitated payment arrangement were significantly more comfortable providing OBOT. |
| Willenbring et al. (2004)c | Beliefs about evidence-based practices in addiction treatment: A survey of Veterans Administration program leaders | 174 substance abuse treatment programs | Assessed program leaders knowledge, attitudes, and behaviors related to evidence-based practices practice guidelines, and barriers to implementation of practice guidelines | * 46% agreed naltrexone should be routinely recommended. * 93% agreed cognitive behavioral relapse prevention should be routinely recommended. * Top perceived barriers to implementation were lack of administrative support, insufficient staff time, and lack of staff skills or knowledge. |
| Arfken, Agius, Dickson, Anderson, & Hegedus (2005)c | Clinicians’ beliefs and awareness of substance abuse treatments in research- and non- research affiliated programs | 162 clinicians at 15 substance abuse treatment programs | Examined if clinicians in research and non- research affiliated programs have similar beliefs and awareness about treatment innovations | * Research affiliated clinicians reported significantly lower beliefs that spirituality should be emphasized in addiction treatment. * Research affiliated clinicians reported significantly higher awareness of using buprenorphine to assist with opiate detoxification. |
| Knudsen, Ducharme, Roman, & Link (2005)a | Buprenorphine diffusion: the attitudes of substance abuse treatment counselors | 2,298 counselors in private and public community-based treatment programs | Examined the extent to which buprenorphine was adopted, as well as examined correlates of buprenorphine adoption | * 86% of counselors were unaware of the effectiveness of buprenorphine, indicating a lack of diffusion. * Significant predictors of more positive attitudes toward buprenorphine included: higher education and experience, less endorsement of 12-step, and being Caucasian. |
| Toriello et al. (2005)c | The relationship between addictions counselors’ clinical orientations and their readiness to change counseling techniques | 212 substance abuse clinicians and administrators | Examined the relationship between clinical orientation and readiness to change counseling techniques | * Cluster analysis identified three types of clinical orientations (i.e., traditional, non-traditional, or multiform). * Clinical orientation was not found to be significantly associated with readiness to change. * Women and individual who were not African American reported the highest readiness for change. |
| Kirby, Benishek, Dugosh, & Kerwin (2006) b | Substance abuse treatment providers’ beliefs and objections regarding contingency management: Implications for dissemination | 383 treatment providers | Determine the prevalence of specific beliefs community treatment providers hold regarding contingency management | * Overall, a higher percentage of participants agreed with statements reflecting positive opinions than with statements reflecting objections and concerns about limitations. * Participants held significantly more positive beliefs about for social incentives (e.g., printed certificates, verbal complement) than tangible incentives (e.g., give certificates, retail items). * Both types of incentives were viewed more positivley by those who had advanced degrees, were supervisors, had more addictions experience, or had experience with tangible incentives. |
| Fuller et al. (2007)c | Organizational readiness for change and opinions toward treatment innovations | Over 2,000 staff from 205 treatment units within the CTN network | Examined multilevel relationships between several scales included as part of the ORC instrument and attitudes toward several treatment practices | * 6 of the 18 ORC scales (e.g., Mission, Program Needs, Influence) were significantly related to opinions toward treatment manual/evidence-based treatments. * 3 of the 18 ORC scales (i.e., Growth, Internet, and Program Needs) were significantly related to opinions toward medications. |
| Henggeler et al. (2007)b | If you build it, they will come: Statewide practitioner interest in contingency management for youths | 432 substance abuse and mental health practitioners | Examine the extent of interest and predictors of voluntary attendance to a workshop on contingency management | * 80% of eligible participants attended the workshop. * Workshop attendance was significantly higher by participants who reported greater program motivation for change, better organizational climates, and lower program resources. * Demographic characteristics, attitudes towards treatment manuals or evidence- based practices were not significantly associated with workshop attendance. |
| Knudsen, Ducharme, & Roman (2007)a | Research network involvement and addiction treatment center staff: Counselor attitudes toward buprenorphine | 2,306 counselors (561 CTN affiliated and 1,745 non-CTN affiliated) | Compared counselor’s ratings of buprenorphine acceptability | * CTN-affiliated counselors reported significantly greater acceptability of buprenorphine compared to non-CTN affiliated counselors. * Counselors reporting greater receipt of buprenorphine training and greater use of buprenorphine at their center were significantly associated with greater ratings of buprenorphine acceptability. |
| McCarty et al. (2007)c | Direct care workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs | 3,698 staff from 384 treatment units within 106 CTN community treatment programs | Examined characteristics and attitudes of CTN workforce who had completed an organizational, treatment unit, and workforce survey | * 66% of CTN workforce include women * 36% of CTN workforce have Masters or Doctoral Degree * Managers/supervisors were most supportive of EBTs |
| Rieckmann, Daley, Fuller, Thomas, & McCarty (2007)a | Client and counselor attitudes toward the use of medications for treatment of opioid dependence | 376 counselors and 1,083 clients from outpatient, methadone, and residential treatment programs | Examined counselor and client attitudes, social norms, and intentions regarding methadone, buprenorphine, clonidine, and ibogaine | * Counselor and client attitudes, social norms, and intentions significantly differed across program type. * Attitudes and social norms were significant predictors of intention to use each medication, with social norms generally being the strongest predictor. |
| Saldana, Chapman, Henggeler, & Rowland (2007)b | The Organizational Readiness for Change scale in adolescent programs: Criterion validity | 543 community- based therapists | Examined the association between the several domains of the Organizational Readiness for Change (ORC), the Evidence-Based Practice Attitude Scale (EBPAS), and Attitudes toward treatment manuals at both the therapist and agency level | * Overall therapist-level responses on the ORC provided better estimates of therapists attitudes toward evidence- based practices and treatment manuals. * Therapist openness to evidence-based practices was significantly associated with more positive ratings on several ORC domains (i.e., Staff Attributes, Training Exposure & Utilization, and Motivational Readiness for Change). |
| Thomas & Miller (2007)a | Knowledge and attitudes about pharmacotherapy for alcoholism: A survey of counselors and administrators in community-based addiction treatment centers | 84 staff (66 counselors and 18 administrators from six addiction treatment centers | Examined predictors of positive attitudes about adjunctive pharmacotherapies | * 77% of staff reported that referring clients to receive medications to help control drinking urges has no effect. * 65% of staff agreed that pharmacologic interventions work best only if accompanied by psychosocial interventions. * 9% agreed pharmacologic interventions have convincingly been shown to be useful in the treatment of alcohol dependence. |
| Roose, Kunins, Sohler, Elam, & Cunningham (2008)a | Nurse practitioner and physician assistant interest in prescribing buprenorphine | 511 physicians, nurse practitioners, of interest in and physician assistants | Assessed the level prescribing buprenorphine | * 40% indicated an interest in prescribing buprenorphine. * nonphysician providers and generalist physicians were significantly more likely to be interested in prescribing buprenorphine compared to infectious disease specialists. |
| King et al. (in press) a | Implementing methadone medical maintenance in community-based clinics: Disseminating evidence-based treatment | 84 staff from 5 methadone maintenance clinics | Examined the impact of seminar presentations and on-site consultation on changes in attitudes toward methadone medical maintenance (MMM) and an adaptive stepped care model to deliver it | * Staffs post -seminar attitudes were significantly higher compared to baseline regarding that MMM schedules 1) allow patients adequate amount and frequency of counseling contact, and 2) allow more time for patients to be involved in posiitve rehabilitation oriented activities. * Staffs post -seminar attitudes were significantly higher compared to baseline regarding that patients should be assigned to the lowest intensity of counseling contact necessary to maintain good clinical functioning. |
| Thomas, Miller, Randall, & Book (in press)a | Improving acceptance of naltrexone in community addiction treatment centers: A pilot study | 84 counselors and administrators from 6 community-based addiction treatment agencies (n = 47 for control and n = 37 for intervention group) | Examine the impact of an intervention to improve knowledge and attitudes about naltrexone | * Participants in the intervention condition reported significantly higher knowledge at follow-up compared to the control group. * At follow-up 50% of intervention group rated naltrexone as ““essential”“ compared to 29% of the control group, but did not reach statistical significance. * Satisfaction with the intervention and self-reported use of the information was significantly higher among individual in the intervention group. |
Note: Sub-classification are indicated by superscripts
a
pharmacological EBTs only;
b
psychosocial EBTs only; both pharmacological and psychosocial EBTs).