Implementation of Integrated Dual Disorders Treatment in Eight California Programs

Abstract

Objectives. Over a 31/2-year period, 4 California counties implemented one of SAMHSA's evidence-based practices, integrated dual disorders treatment (IDDT). The project was a test of the SAMHSA implementation resource kit, which provides a clear statement of the intervention for a variety of stakeholders and prescribes implementation strategies. An additional dissemination strategy was also tested. Method. An IDDT fidelity scale, other scales measuring organizational functioning, and semistructured interviews with stakeholders were used to evaluate the implementation. Results. Six of the 8 sites sustained implementation of the model, 1 to a very high degree of fidelity and 3 others to an adequate level of fidelity. Successful implementation was predicted by the Organizational Readiness for Change scale. The long time required by most programs to achieve high fidelity caused vulnerability to staff turnover, which occurred at each administrative level. However, one program developed an implementation strategy that achieved very high fidelity within a year. In 2 of the 4 counties, IDDT is being further disseminated.