Barriers to Implementing Individualized Substance Abuse Treatment: Qualitative Findings from the CASPAR Replication Studies.
Problem-to-services matching is critical to patient-centered care. Further, the extent to which substance abuse treatment is individualized to meet specific client needs is a key predictor of success and represents "best practice" in substance abuse treatment. The CASPAR Resource Guide, an electronic database of local free and low-cost services, is an evidence-based tool designed to help counselors easily and quickly provide offsite referrals to services not available in most community treatment programs to increase problem-to-service matching. This paper examines system-level barriers to using the CASPAR Resource Guide among 30 counselors and 21 site directors across 16 sites in two different studies. Results from qualitative implementation analyses found that key program components needed to support the implementation of this evidence-based practice (e.g., individualized treatment planning, individual treatment sessions, and individual counselor supervision) were lacking, which jeopardized successful adoption of the CASPAR research interventions and prompted a redesign of the studies in order to enhance each program's ability to support individualized care.
, PhD and , PhD are Research Scientists at the Treatment Research Institute (TRI). , BA and , MA are the project coordinators for the CASPAR replication projects at TRI. , PhD developed the CASPAR Resource Guide and is Principal Investigator on the CASPAR projects. She is also a Senior Research Scientist at TRI, Adjunct Professor at the University of Pennsylvania, and the Chief Clinical Officer at Phoenix House.
Amy A
AA
Mericle
Kathryn
K
Casaletto
Dan
D
Knoblach
Adam C
AC
Brooks
Deni
D
Carise