Welcome

National Frontier and Rural ATTCAdvisory Board Meeting

Nancy A. Roget, MSPrincipal Investigator/Project Director

2.28.13

Serve as the national subject expert and key resource to PROMOTE the awareness and implementation of

telehealth technologies

Original Advisory Board Members

Last Round of Funding Board Members

NFAR ATTC BOARD MEMBERS

Goals of Advisory Board Meeting

• Formally Introduce NFAR ATTC• Build Relationships with Advisory Board

Members• Solicit Feedback and Guidance on Proposed

Deliverables• Utilize Advisory Board Members Expertise

to Enhance Proposed Products

Unofficial Goals

Which Technology Enhances Your Work and Expands the Possibilities

University of Nevada, Reno

5.3 million dollar annual budget

20 grants & contracts

CASAT

Center for the Application of Substance Abuse Technologies (CASAT)

Orvis BuildingUniversity of Nevada, Reno

NFAR Staff

History of the ATTC Network

History of the

ATTCs

Thanks to Dr. Anne Helene Skinstad

CSAT funds first 11 “Addiction Training Centers” (ATCs) Coverage: 19 US States and Puerto Rico

Program expanded to cover 4 additional states in 1995

ATTC History: We’ve been around for a while

1993

1995 Addiction Training Centers become ATTCs– SAMHSA decided not to support students over the ATTC

budget (About $ 200,000 removed from individual ATTC centers’ budgets)

– Criminal Justice Supplement added to several of center’s budgets

– Virginia Commonwealth University’s responsibility expanded to include Maryland and North Carolina

– Northwest Frontier’s responsibility expanded to include Hawaii

– Iowa ATC received a subcontract through Governor State University, became the ATC of Iowa

• Developed a 60 SH MA program in Substance Abuse and Mental Health Counseling (CACREP Approved in 2001)

ATTC History

CSAT re-names the program from ATCs to “Addiction Technology Transfer Centers”

(ATTCs) to better reflect the scope of work

1996

ATTC Network from 1998 - 2001

ATTC History1998CSAT establishes the ATTC Network, with

the creation of the ATTC National Office

13 Regional Centers and a National Office covering 39 states, the District of Columbia, Puerto Rico and the US Virgin Islands

1998The ATTC Curriculum Committee writes

the Addiction Counseling Competencies, which CSAT publishes as TAP 21

ATTC History

2000The ATTC Network published The

Change Book: A Blueprint for Technology Transfer

2001NIDA and SAMHSA enter into an interagency agreement to form the NIDA/SAMHSA Blending Initiative

ATTC Network from 2002 -2007

ATTC History

2005First NIDA/SAMHSA “Blending Product”

released, Buprenorphine Treatment: A Training for Multidisciplinary Professionals.

2006With significant involvement from the ATTCs,

SAMHSA publishes an updated version of TAP 21: The Addiction Counseling Competencies.

BUPRENORPHINE TREATMENT: A TRAINING FOR MULTIDISCIPLINARY ADDICTION PROFESSIONALS

Module I - Introduction

ATTC History

2011: ATTC Network Technology Transfer Workgroup publishes “Research to practice in addiction treatment: key terms and a field-driven model of technology transfer,” in the Journal of Substance Abuse Treatment.

2012: ATTC Network completes national workforce study, “Vital Signs: Taking the Pulse of the Addiction Treatment Profession.”

2011: SAMHSA & State Department create the first international ATTC, the Vietnam HIV ATTC.

ATTC Network from 2012 - 2017

Four National Focus Areas

• National American Indian & Alaska Native ATTCemail: americanindianalaskanative@attcnetwork.org

• National Frontier & Rural ATTC email: frontierrural@attcnetwork.org• National Hispanic & Latino ATTC

email: hispanic@attcnetwork.org• National Screening, Brief Intervention & Referral to

Treatment ATTC

email: sbirt@attcnetwork.org

National Frontier & Rural

ATTC

National American Indian & Alaska Native

ATTCNational

SBIRTATTC

National Hispanic & Latino

ATTC

Almost 20 Years…..

Serve as the national subject expert

and key resource to

PROMOTE the awareness and implementation of telehealth

technologies

DefinitionsTelehealth ‘refers to the use of

telecommunications and information technologies to provide access to health information and services across a geographical distance.’

Telemedicine ‘use of medical information exchanged from one site to another via electronic communications to improve patients’ health status’

Definitions

• Synchronous communications telephone counseling

• Asynchronous Communications email or web-based programs

• Some web-based programs include both type of communications

1879

Telemedicine/Telehealth

• Annually, 10 million patients receive telemedicine services.

• In 2011, the Veteran Administration alone provided 6,700 patients with telemental health services.

Telehealth Research

• 141 Randomized Control Trials–148 telemedicine interventions with

nearly 37,000 patients–108 of the trials were favorable toward

telemedicine intervention–38 trials showed no statistical

differences

Telehealth is not about technology itself but is a bridge to relationship with the patient

in order to provide care. (Shore, 2012)

Telehealth as it Relates to Treatment and Recovery for SUDs

4

Video Conferencing

Brief Review of Research

TES is an interactive, web-based program theoretically grounded in the

evidence-based Community Reinforcement Approach (CRA) to

behavior therapy

Theoretical Approach: Community Reinforcement Approach (CRA) behavior therapy; contingency management (CM)

Target Substance: Poly-substance use

Mōtiv8 is a web based contingency management program for smoking cessation using a home monitoring

system

Subjects log onto a website and use video recording software to record and submit videos of breath carbon monoxide (CO) samples. The Mōtiv8 application uses a

web-based interface for collecting data, automating immediate voucher (incentive) delivery, and some versions

of the application include a group support forum.

MES is a computer-based brief intervention with the goal of facilitating

self-change, treatment engagement, and/or motivation to change via a single

intervention session.Theoretical Approach:

Motivational interventionTarget Substance: Multiple substances,

poly-substance use

cMET/CBT/CM is a computer-delivered intervention for cannabis

use disorders, incorporating features of three evidence-based treatments: cognitive behavioral therapy (CBT), motivational enhancement therapy

(MET), and contingency management (CM). Nine sessions presented over 12 weeks offer computer-assisted

instruction

MyStudentBody is an interactive, web-based brief intervention for alcohol use

in college student populations

Theoretical Approach: Screening and Brief intervention

Target Substance: Alcohol

McClure, Acquanta, Harding, & Stitzer In Press

• Surveyed 8 urban clinics in Baltimore (266 patients)

• Client’s Access to:–Mobile Phone- 91%– Text Messaging- 79%– Internet/Email/Computer 39-45%

Training Substance Abuse Clinicians in Motivational Interviewing Using Live

Supervision via TeleconferencingTeleconferencing supervision (TCS)

was developed to provide remote, live supervision for training MI

TCS shows promise for promoting new counseling behaviors following

participation in workshop training. (Smith, et al., 2012 Journal of Consulting and Clinical Psychology;80(3):450-464)

NASADAD Survey

• In 2009, Addiction Treatment Providers in 16 states reported offering treatment services using telehealth

(16 states out of the 37 states that responded to the survey)

• 25 states reported providing mental health treatment services using telehealth

Summary of Goals

Create addiction treatment telehealth competencies and develop policy recommendations for national license portability to encourage the addiction treatment and recovery

workforce to ADOPT the use of telehealth services

Use state-of-the-art culturally-relevant training and technical assistance activities

to help the frontier/rural addiction treatment and recovery workforce

IMPLEMENT telehealth services

We need to embrace

RECOVERY

White, 2011

Recovery is contagious. Get close to it.

Stay close to it. Catch it. Keep catching it. Pass it on

PREPARE pre-service addiction treatment and allied health students on

using telehealth technologies by developing and disseminating academic

curricula for infusion into existing courses

Key Collaborators• NASADAD• SAAS-Treatment Provider Associations• HRSA Regional/National Telehealth Centers• Telehealth Experts• Regional Addiction Educators Groups• Project Echo at UNR• Telehealth Experts• NAADAC• IC&RC

Year 1 Key Events

Year 1 Key Events• Build compendium through Literature Searches• Develop Graphics/Marketing Themes• Conduct Telehealth Needs Assessments• Develop Curricula• Present at National Conferences• Present at Regional Summer Institutes• Sponsor two TOTs• Conduct State Presentations 2 x each ATTC Region• Sponsor Early Adopters Summit

Drive target population to our website

Drive target population to our website

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2 UpcomngTrainingsBrief Introductory Training

Administrators Training

Utilize Video

It’s the Relationship with Stakeholders and Customers that is MOST Important

Groundswell: Bernoff & Li, 2009

Year 2-5• Film and Disseminate Two Telehealth Workshops• Develop Clinical Supervisor Curriculum• Annotate Bibliographies• Create Marketing Videos• Host Webinars of Curricula• Build Addiction Educators Curriculum and Sponsor Training• Sponsor Telehealth Competencies Workgroup and Develop a

Product• Create and Implement Peer Recovery Curriculum• Develop Addiction Treatment Curricula

Who is Our Audience?

Addiction Treatment Counselors

The majority of the Substance Abuse Treatment Workforce is …

Clinical Directors

Direct Care Staff

Gender Female (59%) Female (67%)

Ethnicity White (86%) White (64%)

Age 50+ (60%) [Avg. 52] 35+ (64%)

Employment Full time (95%) Full time (77%)

Serve as the national subject expert

and key resource to

PROMOTE the awareness and implementation of telehealth

technologies

Download this PowerPoint Presentation from our website

www.attcnetwork.org/frontierrural