School of Health and Society, University of Wollongong, NSW, Australia.
Lives Lived Well, Australia.
J Subst Abuse Treat. 2021 May;124:108310. doi: 10.1016/j.jsat.2021.108310. Epub 2021 Jan 26.
Cognitive remediation (CR) programs are new to substance treatment and research needs to evaluate their implementation. The context of implementation, specifically staff perceptions, is critical to changing practice. The aim of this study was to identify treatment staff members' perceptions about the benefits and challenges of a new CR intervention in their workplace. The study conducted semi-structured interviews with staff at a residential substance treatment center when the CR program was first being implemented and again six months later. The study interviewed eight staff members in each round (>50% of staff members in the unit) from all role designations. A critical perspective shaped a thematic analysis of challenges to implementation. The study identified benefits of the CR program to clients and staff. However, only one staff member participated in training to deliver the program. In principle, staff members support the program, but this does not necessarily translate into active involvement, even when the study conducted staff engagement activities. CR programs are likely to improve functional outcomes for people in substance rehabilitation programs. However, this study suggests that staff accepting and valuing a new intervention is not enough to sustain it. For CR programs to be feasible, management should schedule and support staff training, and facilitate staff participation in that training. Organizational factors are likely to play a significant role in implementation success or failure, and further research should explore how the organizational culture of alcohol and other drug services impacts the implementation of CR therapy.
认知矫正（CR）项目在物质治疗中是新的，需要评估其实施情况。实施的背景，特别是工作人员的看法，对改变实践至关重要。本研究的目的是确定治疗人员对其工作场所新的 CR 干预措施的益处和挑战的看法。在 CR 项目首次实施时以及六个月后，该研究对居住物质治疗中心的工作人员进行了半结构化访谈。在每一轮中，研究都采访了来自所有指定角色的八名工作人员（单位中工作人员的 50%以上）。批判性观点对实施挑战进行了主题分析。该研究确定了 CR 计划对客户和工作人员的益处。然而，只有一名工作人员参加了提供该计划的培训。原则上，工作人员支持该计划，但这并不一定转化为积极参与，即使研究开展了工作人员参与活动。CR 计划可能会提高物质康复计划中人们的功能结果。然而，本研究表明，工作人员接受和重视新的干预措施不足以维持它。为了使 CR 计划可行，管理层应安排和支持员工培训，并促进员工参与该培训。组织因素可能在实施成功或失败中发挥重要作用，应进一步研究探讨酒精和其他药物服务的组织文化如何影响 CR 治疗的实施。
