Strategies for Training Counselors in Evidence-Based Treatments
NIDA
Evidence-based treatments (EBTs) for substance abuse and dependence have demonstrated superiority over treatment as usual when applied with strict fidelity in controlled clinical trials. Effective counselor training is critical if substance abuse programs are to realize these interventions’ full potential to enhance client outcomes in community practice. Although few empirical evaluations of training in EBTs have been conducted to date, the existing data warrant tentative conclusions concern- ing the appropriate roles and effectiveness of workshops, clinical supervision, distance learning, and blended learning. Among several outstanding research issues are questions of benchmarks for counselors’ performance in training and the relationships between such performance and clients’ substance abuse outcomes.
More than a decade ago, the Institute of Medicine (1998) challenged addiction professionals to implement evidence-based treatments (EBTs) in community programs. Although EBTs have been defined in various ways (Miller, Zweben, and Johnsen, 2005), in general they are treatments that have been shown to improve client outcomes in more than one randomized clinical trial (Chambless and Ollendick, 2001). In practice, counselors use their clinical expertise to apply these treatments in a manner that addresses their clients’ unique characteristics, cultures, and preferences (American Psychological Association Presidential Task Force on Evidence-Based Practices, 2006). EBTs may be pharmacological (i.e., methadone, buprenorphine, naltrexone, and disulfiram) or psychosocial (i.e., cognitive-behavioral therapy, contingency management, motivational interviewing, and 12-step facilitation) and typically are the best treatments counselors have to offer clients.
