Health Services Research & Development (HSR&D) Center for Health Care Evaluation, VA Palo Alto Health Care System, CA, USA.
Psychol Addict Behav. 2011 Jun;25(2):225-37. doi: 10.1037/a0022398.
Implementing evidence-based psychosocial or behavioral treatments for clients with substance use disorders (SUDs) presents significant challenges. In this article, we first identify the treatments for which there is some consensus that sufficient empirical support exists to designate them as "evidence-based," and then briefly consider the nature of that evidence. Following that, we review data from a Substance Abuse and Mental Health Services Administration survey on the extent to which these evidence-based treatments (EBTs) are used in SUD treatment in the United States. The main focus of the article is a review of 21 studies attempting to implement EBTs from which we glean information on factors associated with more and less successful implementation. We conclude that more conceptually driven, organizationally focused (not just individual-provider-focused) approaches to implementation are needed and that, at least with some providers in some organizational contexts, it may be more effective to implement evidence-based practices or processes (EBPs) rather than EBTs.
为有物质使用障碍（SUD）的患者实施基于证据的心理社会或行为治疗存在重大挑战。在本文中，我们首先确定了一些治疗方法，这些方法已经达成一定共识，即有足够的经验证据支持将其指定为“基于证据的”，然后简要考虑这些证据的性质。之后，我们回顾了美国药物滥用和心理健康服务管理局（Substance Abuse and Mental Health Services Administration）关于这些基于证据的治疗方法（EBTs）在美国 SUD 治疗中使用程度的调查数据。本文的主要重点是对 21 项试图实施 EBTs 的研究进行综述，从中我们收集了与更成功和不成功实施相关的因素信息。我们的结论是，需要更加注重概念驱动、组织聚焦（不仅仅是关注个体提供者）的实施方法，并且至少对于某些组织环境中的某些提供者来说，实施基于证据的实践或流程（EBPs）可能比实施 EBTs 更有效。
