Magill Molly, Martino Steve, Wampold Bruce E
Brown University, Center for Alcohol and Addiction Studies, Providence, RI, United States of America.
Yale University, New Haven, CT, United States of America.
J Subst Abuse Treat. 2020 Sep;116:108063. doi: 10.1016/j.jsat.2020.108063. Epub 2020 Jun 23.
This work builds on previous efforts to delineate cross-cutting factors of evidence-based therapies. In this report, we target a single therapeutic factor-skills training for addictive behavior change-and we operationalize this factor in a manner that will aid clinical training and quality control. Specifically, we identify principles, which we defined as broader understandings on the part of the therapist that must be kept in mind when implementing a specific therapeutic practice. We define a practice as discrete action step or specific type of intervention that the therapist uses when addressing skills training content with clients.
We conducted a literature review and qualitative content analysis of 30 source documents (i.e., therapy manuals, literature reviews, and government issued practice guidelines) and videos (i.e., therapy demonstration videos). We performed analysis of source materials in NVIVO.
We identified 10 principles and 30 therapeutic practices. Together, the principles suggest that skills training in evidence-based addiction therapies can be characterized as a client-centered approach to teaching and behavioral practice. The identified practices fell into four function themes: 1) client-centered goal-setting, 2) building client self-efficacy, 3) engaging in teaching, and 4) engaging in practice.
When the identified principles and practices are combined, they can inform a fidelity-based approach to behavioral skills training that is applicable to a wide range of alcohol or other drug (AOD) content topics, therapeutic modalities, and implementation settings. We discuss future implications regarding standardized training and fidelity assessment.
这项工作建立在先前确定循证疗法交叉因素的努力之上。在本报告中，我们针对成瘾行为改变的单一治疗因素——技能训练，并以有助于临床培训和质量控制的方式对该因素进行操作化。具体而言，我们确定了一些原则，我们将其定义为治疗师在实施特定治疗实践时必须牢记的更广泛的理解。我们将一种实践定义为治疗师在与客户讨论技能训练内容时使用的离散行动步骤或特定类型的干预。
我们对30份源文件（即治疗手册、文献综述和政府发布的实践指南）和视频（即治疗示范视频）进行了文献综述和定性内容分析。我们在NVIVO中对源材料进行了分析。
我们确定了10条原则和30种治疗实践。这些原则共同表明，循证成瘾疗法中的技能训练可以被描述为一种以客户为中心的教学和行为实践方法。确定的实践分为四个功能主题：1）以客户为中心的目标设定，2）建立客户自我效能感，3）参与教学，4）参与实践。
当所确定的原则和实践相结合时，它们可以为基于保真度的行为技能训练方法提供信息，该方法适用于广泛的酒精或其他药物（AOD）内容主题、治疗方式和实施环境。我们讨论了关于标准化培训和保真度评估的未来影响。
