Abstract
BackgroundCommunity dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process.MethodsAt conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting’s five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework.ResultsThis qualitative analysis suggested the intervention was regarded as: 1) cost-effective and clinically useful relative to prior practices, 2) a strong fit with existing service structure and staffing resources, 3) procedurally uncomplicated, with staff consistently implementing it as intended, 4) providing site-specific data to sufficiently inform decisions about its sustainment, and 5) offering palpable benefits to staff-patient interactions.ConclusionsThe current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.
Highlights
Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use
Relative advantage Managerial views of the collaboratively-designed contingency management (CM) intervention were generally quite positive, and this was reflected in sentiments regarding its advantages relative to prior practices in the Opiate treatment program (OTP) setting
Caveats notwithstanding, the principal contribution of this work is its qualitative mapping of managerial impressions—gathered amidst successful adoption of a collaboratively-designed CM intervention—to concepts of a well-known implementation framework
Summary
Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. Issues of cost, logistical compatibility, and philosophical incongruence are common points of reticence toward CM by the addiction treatment community [8,9,10]. These concerns appear to weigh heavily on stakeholders in many settings, as evidenced by the 12 % rate of CM sustainment among CTN-affiliate community treatment programs in the years following these CTN trials [11].
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