Substance use disorders
Conditions
Interventions
The intervention of the study is de CRA Plus Training. As an addition to the existing CRA training model, we set up a standardized training for therapists after completing basic certification. The bas
Sponsors
Nu funding.
Eligibility
Inclusion criteria
Inclusion criteria: In order to be eligible to participate in this study, a therapist must meet the following criteria: · No previous experience with CRA, · =18 months since start of working at IrisZorg, · Completed CRA certification within 12 months after completing the CRA basic training, · Working at an outpatient facility, · Working with adult patients, · Written informed consent. In order to be eligible to participate in this study, a patient must meet the following criteria: · A primary diagnosis of substance use (meeting the DSM-5 criteria), · Age 18+, · Sufficient Dutch language proficiency, · Written informed consent.
Exclusion criteria
Exclusion criteria: For therapist subjects there are no additional exclusion criteria. Patients who suffer from severe, current (since intake) psychiatric symptoms (especially manic, psychotic, suicidal and aggressive symptoms) that may endanger themselves or others and jeopardize study adherence will be excluded.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main study parameter is CRA treatment adherence in terms of the mean number of individual CRA procedures completed by therapists in sessions with each individual patient (range 0-12). Adherence is measured by therapists self-reported adherence per session. The CRA Session Report is used for measuring CRA treatment adherence. Therapists report their use of CRA procedures every session. The treatment trajectories will differ in length. Measurements are made up to a maximum of one year. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. CRA competence in terms of the quality of the therapist’s performance of procedures as reported on the CRA Procedure Checklist by independent raters which is part of the CRA coding manual. Each procedure component receives a numeric score (1: poor performance, 2: needs improvement, 3: satisfactory, 4: very good and 5: excellent) which represents the quality of certain measurable and observable therapist behaviours. The competence score is the average score for each therapist on each procedure in a given session with a given patient. Competence scores of all sessions that are rated in the context of fidelity monitoring will be calculated. In this context, six sessions per therapist are rated. These sessions are selected by randomisation every other month during 1 year. 2. Patient outcome, measured during treatment initiation (T0) and then every three months for up to a year (T1, T2, T3, T4): -The number of total units of substance use consumed in the past 30 days as rated by the Measurements in Addictions for Triage and Evaluation (MATE 1) -The severity of patient-reported problematic substance use during the past twelve months as rated by the Measurements in Addictions for Triage and Evaluation (MATE 1) -Patient-reported quality of life as rated by the Community Reinforcement ApproachHappiness Scale (CRA-HS) -Patient-reported severity of symptoms related to depression, anxiety and stress in the past 7 days as rated by the Measurements in Addictions for Triage and Evaluation (MATE 1) 3. Working alliance: Patients assess the working alliance every session. The Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) are used for this. The ORS is filled in by the patient at the start of the session and the SRS is filled in at the end of the session. Patients' treatment trajectories will differ in length. Measurements are made up to a maximum of one year. | — |
Contacts
Public ContactAnneleen Kraan
IrisZorg
Outcome results
None listed