Volume 1, Issue 3

Heather GothamLearning the Most About the Substance Abuse Treatment Workforce, Including Technology Transfer Roles
By Heather J. Gotham, Ph.D.
University of Missouri - Kansas City

The Murphy-Hubbard interim report to the ATTC does a great job of reviewing what is known about the addiction workforce and outlining ways in which the proposed ATTC Network Workforce Survey can help gather needed information. In particular, having current national estimates of the demographics of addiction counselors by treatment modality, geographic location, and organizational characteristics will be a huge step toward understanding the field through having solid data about the workforce. From this basic information, we will be better able to forecast workforce shortages, design recruitment and retention strategies, and, as an ATTC Network, focus our efforts on what the field most needs.

In addition to those mentioned in the report, there are several other areas in which a better understanding of the current workforce and agency practices would benefit the field. These areas are described with the caveat that the proposed ATTC Network workforce survey will be conducted at the level of program directors, not program staff.

  • Workforce needs for direct care staff other than counselors. In addition to describing addiction counselors, it would be helpful to understand other members of the addiction workforce, including peer recovery support staff, addiction techs, community support workers, case managers, co-occurring specialists, vocational rehabilitation staff, etc. As the field shifts from an acute care model into a recovery oriented system of care, the roles of these non-counselors within addiction treatment programs will increase. It is essential to understand the workforce development needs of these staff members.
  • Workforce needs for clinical supervisors. Similar to the previous point, it would be helpful to have a better understanding of the roles of clinical supervisors. Much current attention is being focused on clinical supervision (e.g., CSAT’s Competencies for Substance Abuse Treatment Clinical Supervisors, TAP 21-A, on-line courses in clinical supervision, the NIDA/SAMHSA Blending Product Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency [MIA:STEP]). What are agency requirements for clinical supervisors? What are their job duties? What types of supervision are provided and how often?
  • Reasons why agencies have difficulty filling open positions. Including items that assess program directors’ recent experiences in filling staff positions would highlight gaps in the workforce and/or workforce development needs. These can include items regarding the minimum qualifications for addiction counselors (e.g., training/education, experience, applied skills, certification, social/interpersonal skills) and how often these requirements are not being met by applicants. Other items could assess program directors’ understanding of why qualified counselors are not interested in jobs at the agency (e.g., salary, hours, caseload), or other reasons why there might be a limited applicant pool (e.g., rural location).

How can the survey aid in our knowledge of the substance abuse treatment workforce as a conduit for technology transfer?

The ATTC Network Technology Transfer Workgroup recently defined technology transfer as “a multidimensional process that intentionally promotes the use of an innovation. Technology transfer begins during the development of an innovation, continues through its dissemination, and extends into its early implementation. This process requires multiple stakeholders and resources, and involves activities related to the translation and adoption of an innovation. Technology transfer is designed to accelerate the diffusion of an innovation.”

The addiction treatment workforce has numerous roles to play in the process of technology transfer (Gotham, 2006), including: as direct service providers who use evidence-based practices (EBPs) in their work with clients; as opinion leaders and as champions who help disseminate EBPs and influence the attitudes and behavior of staff toward adopting EBPs; as clinical supervisors who provide targeted supervision specific to the EBPs as well as assess and provide feedback regarding clinician’s fidelity to EBPs; as change agents who lead the clinical and administrative implementation of EBPs in their agency; and as program directors/administrators who serve as sponsor, mentor, critic, and institutional leader for all aspects of technology transfer (Van de Ven, Polley, Garud, & Venkataraman, 1999).

The upcoming survey could enhance our knowledge of technology transfer-related workforce issues directly by assessing factors such as whether agency staff play the various technology transfer roles in the agency, what EBPs are currently being used in agencies and whether new staff are required to have previous training/expertise in any EBPs, and what types of training/expertise program directors would like to have included in pre-service educational and training programs for addiction counselors. It would be very helpful to assess agency use of specific implementation strategies (e.g., Fixsen et al., 2005).

Without turning the focus of the survey too specifically on technology transfer, we may gain knowledge about technology transfer indirectly by having a better understanding of the level of education and expertise of addiction treatment staff, the make-up of treatment teams (e.g., other addiction workforce professionals and paraprofessionals), and the use of management and supervision strategies. This information, when combined with other data, may assist federal agencies, states, and other parties who mandate the use of EBPs in planning how best to roll-out technology transfer efforts.



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