title: Dissemination of a computer-based psychological treatment in a drug and alcohol clinical service: an observational study.
abstract: BACKGROUND
  There is emerging evidence for the potential of computer-based psychological treatments (CBPT) as an add-on to usual clinical practice in the management of health problems.
  
  
  OBJECTIVE
  The study set out to observe if, when, and how clinicians working in a publically funded alcohol/other drug (AOD) clinical service might utilize SHADE (Self-Help for Alcohol and other drug use and DEpression), a CBPT program for comorbid depression and alcohol or cannabis use, in their clinical practice.
  
  
  METHODS
  Thirteen clinicians working within an AOD service on the Central Coast of New South Wales, Australia, were recruited. At baseline, all 13 clinicians were assessed for their computer anxiety and openness to innovation. Clinicians referred current clients to the study, with consenting and eligible clients (N = 35) completing a baseline and 15-week follow-up clinical assessment. The assessment comprised a range of mental health and AOD measures administered by an independent research assistant. Over the course of the study, clinicians submitted session checklists detailing information about session content, including the context and extent to which SHADE was used for each client.
  
  
  RESULTS
  Descriptive statistics showed that clinicians employed the SHADE program in a variety of ways. When SHADE modules were used, they were generally introduced in the early phase of treatment, on average, around session 4 (M = 3.77, SD = 5.26, range 1-36). However, only 12 of the 35 clients whose session checklists were available were exposed to the SHADE modules; this, despite 28/35 clients indicating that they would be willing to use CBPT during their current treatment program.
  
  
  CONCLUSIONS
  Treatment seekers in the AOD service of the current trial were generally open to receiving CBPT like SHADE; however, clinicians tended to use SHADE with only 34 percent of clients. This indicates the importance of providing ongoing support and encouragement to clinicians, in addition to an initial training session, to encourage the adoption of innovative technologies into clinical practice, and perhaps to engage clients in a discussion about CBPT more routinely.
  
  
  BACKGROUND
  Australian Clinical Trial Registration Number ACTRN12611000382976.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia. f.kaylambkin@unsw.edu.au.
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Kay-Lambkin
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Simpson
authors.forename: Jenny
authors.initials: J
authors.lastname: Bowman
authors.forename: Steven
authors.initials: S
authors.lastname: Childs
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D057189:Checklist; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D004059:Diffusion of Innovation; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D033181:Information Dissemination; D007318:Inservice Training; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D009517:New South Wales; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000523:psychology; D012984:Software; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted
chemical_list: D013287:Illicit Drugs
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