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. Author manuscript; available in PMC: 2010 Jun 9.
Published in final edited form as: Psychiatr Serv. 2010 Feb;61(2):184–188. doi: 10.1176/appi.ps.61.2.184
Phase I: treatment centers
  1. Name of organization

  2. Number of treatment sites

  3. Type of treatment provided (inpatient, outpatient, or both)

  4. Primary treatment focus (mental illness, addictions, or both [separately or integrated])

  5. Specific addictions services (inpatient detoxification or outpatient opiate treatment)

  6. Patient population (primarily children, primarily adults, or both)

  7. Number of unfilled physician positions (full-time equivalents)

  8. Number of individual physicians on staff

  9. Names and contact information of physicians

  10. Number of nonphysician prescribers on staff

Phase II: individual physicians
  1. Physician identifier code

  2. Age

  3. Clinical specialty by residency training

  4. Primary clinical role (psychiatric care, general addiction, treatment of opiate addictions, combination of psychiatric illness and addictions, or medical care)

  5. Number of hours per week at this center

  6. Site of residency training (in state, out of state, or other)

  7. American Board of Psychiatry and Neurology (ABPN) certification in psychiatry

  8. ABPN certification in addiction psychiatry

  9. ABPN certification in child psychiatry

  10. American Society for Addiction Medicine certification