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Treating Depression and Substance Use: A Randomized Controlled Trial
Few integrated substance use and depression treatments have been developed for delivery in outpatient substance abuse treatment settings. To meet the call for more "transportable" interventions, we conducted a pilot study to test a group cognitive–behavioral therapy (CBT) for depression and substance use that was designed for delivery by outpatient substance abuse treatment counselors. Seventy-three outpatient clients were randomized to usual care enhanced with group CBT or usual care alone and assessed at three time points (baseline and 3 and 6 months postbaseline). Our results demonstrated that the treatment was acceptable and feasible for delivery by substance abuse treatment staff despite challenges with recruiting clients. Both depressive symptoms and substance use were reduced by the intervention but were not significantly different from the control group. These results suggest that further research is warranted to enhance the effectiveness of treatment for co-occurring disorders in these settings.
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Promoting Evidence-Based Practices: The Adoption of a Prevention Support System in Community Settings
Prevention support systems (PSSs) are designed to help communities implement evidence-based practices (EBPs). Little is known about the factors that influence their adoption. In this article, the authors examined adoption of a PSS for substance abuse prevention called Getting To Outcomes (GTO) among staff in two community coalitions with varying levels of exposure to it over a 2-year period. A multistage regression model was used to determine the relative predictive power of organizational, innovation-related, and practitioner characteristics on adoption. Findings indicate that GTO adoption occurred through increased exposure, especially via staff training. Perceptions of the system's complexity moderated this effect. Individuals with high GTO exposure were less likely to adopt it if they perceived it as complex. Other organizational, innovation-related, and practitioner characteristics did not predict adoption. Results from this study are useful for understanding the factors associated with PSS adoption and suggest ways to increase their use in typical delivery settings.
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