Adapting, Implementing, and Maintaining a Group Cognitive Behavioral Therapy Program at an Inpatient Addiction Treatment Facility

Abstract

Background

Quality training is an oft-cited barrier to effective implementation and ongoing delivery of high-quality evidence-based practice (EBP) across fields. This is especially true in the addiction field, but there is little cited evidence for optimal methods to improve EBP in inpatient addiction facilities with minimal resources.

Objective

The current paper focuses on evaluating the state of our facility’s group CBT manual and clinical training on the manual in a “realistic” (ie, non-RCT, non-grant-funded) inpatient addiction treatment setting.

Methods

Five full-time clinicians volunteered to take part in the study (woman = 60%; M_age = 36.20 years). The study involved a mix of semi-structured interviews and surveys designed to measure seven outcomes (barriers, feasibility, useability, appropriateness, acceptability, burden, trialability).

Results

Three themes emerged from the data that impacted the group CBT manual: training, timing, and functionality. Addressing these themes allowed for a new, optimal manual and training procedure to be put into place.

Conclusion

The current study highlights that under-resourced inpatient addiction facilities can still methodically utilize implementation approaches to study their EBP, namely CBT. Such an approach will ensure that the highest quality care is being delivered to patients and actively addresses known training barriers that prevent proper EBP delivery.

Plain Language Summary

• Quality training is a barrier when implementing evidenced-based practice to treat substance use disorders.

• CBT is a manualized evidence-based practice that is performed at inpatient addiction facilities.

• An evaluation of the CBT manual was made by an inpatient addiction facility to identify barriers of implementation of EBPs.

• Identified barriers included training, timing, and functionality.

Keywords:

• cognitive behavioral therapy
• addiction
• evidence-based practice
• inpatient
• substance use disorders

Statement on Informed Consent

Based on the Health and Human Services’ Common Rule (45 CFR 46), this study does not constitute human subject research. Ethics approval was not required, and informed consent was not acquired. This project was done with the intent of internal education and quality control. The data collected were minimal and non-identifiable. Further, the purpose of publishing the results of this study is to focus on the process such that other facilities may benefit; we are not significantly contributing to the field of addiction science from a prospective, hypothesis-driven perspective.

Acknowledgments

We would like to acknowledge all who worked tirelessly to make Wellbridge a reality and who continue to realize its purpose on a daily basis. This includes our clinical, nursing, admissions, administrative, food service, housekeeping, and maintenance staff.

Author Contributions

All authors contributed to data analysis, drafting, or revising of the article, have agreed on the journal to which the article will be submitted, gave final approval for the final version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Dr Nehal Vadhan reports personal fees from Cutback Coach, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

This project did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.