Category: Psychology

Posts by Jano Klimas about talking therapies, counselling, counselling research and psychosocial interventions.

Hospital teaching team keeps fighting opioid crisis

Overdose grafitti

Which student learns best with hospital teams fighting opioid crisis? Understanding how students learn is perhaps the most important way to improve addiction training.

In a new article published by the Substance Abuse journal,  we report findings suggesting that the completion of an elective with a hospital-based Addiction Medicine Consult Team appeared to improve knowledge of medical students more than of other types of students. Read more below or listen to the podcast.

Firstly, we found that both emerging and established physicians appear to be responsive to this type of training.  Secondly, the learner self-assessment can provide valuable feedback to the consultants. Then, consultants can focus more on the students who learn less.

Keep fighting opioid crisis through training

The study sample was drawn from medical students, residents and physicians who took part in a month-long rotation with a hospital-based addiction medicine consult team in Vancouver, Canada. The addiction rotation includes full-time clinical training involving intake assessment and treatment planning. And referrals to community agencies and starting people on evidence-based medications for substance use disorders. The students take part in didactic lectures, bedside teaching, journal clubs and some prepare papers for submission to peer-reviewed journals. Each year, about 80 learners go through the program. Furthermore, learners rate their knowledge before and after the training.

At the end, all learners reported increased knowledge. One group, however, learned more than the others – the medical students. This two-year study confirms that a structured clinical training program can lead to an increased knowledge on addiction and that medical students benefit from it the most.

For more info read the full article at:

Gorfinkel, L., Klimas, J., Ahamad, K., Mead, A., McLean, M., Fairgrieve, C., Nolan, S., Small, W., Cullen, W., Wood, E., Fairbairn, N. (2019) In-hospital training in addiction medicine:  A mixed methods study of health care provider benefits and differences. Substance Abuse (Published online Jan 28) doi: 10.1080/08897077.2018.1561596

If interested, you can also read: What can hospital teams teach medical students about addiction to help curb the opioid overdose epidemic?

Hospital teaching teams confront iatrogenic opioid addiction

 

Or visit a post that talks about this research as it was presented at the Canadian Society for Addiction Medicine link here

Canadian Society of Addiction Medicine, CSAM conference

Excellent scale assesses needs across four countries

ruler

What is the smartest scale for asking clinicians about their training needs?

In a new article published by the Journal of Substance Abuse Treatment, we report findings from a study that looked at a new scale, the training needs assessment. Read more or watch podcast below:

We wanted to find out whether a new tool – Training Need Assessment – does what it’s set to do, measure training needs.

QUICK FACT:  Addiction Medicine (AM) rarely uses Training Need Assessments (TNA).

How we did the study?

We did a cross-sectional study in four countries (Indonesia, Ireland, Lithuania and the Netherlands). 483 health professionals working in addiction care completed AM-TNA. To assess the factor structure, we used explorative factor analysis. Reliability was tested using Cronbach’s Alpha, ANOVA determined the discriminative validity.

What has the scale found?

  • Tailored training of health professionals is one of the elements to narrow the “scientific knowledge-addiction treatment” gap. Addiction Medicine (AM) rarely uses Training Need Assessments (TNA). The AM-TNA scale is a reliable, valid instrument to measure addiction medicine training needs. The AM-TNA helps to determine the profile of future addiction specialist.

The Training Need Assessment is a reliable, valid instrument to measure addiction medicine training needs.

Why is the scale important?

The AM-TNA proved reliable and valid. Additionally, the AM training needs in the non-clinical domain appeared positively related to the overall level of AM proficiency. Furthermore, researchers should study whether the AM-TNA can also measure changes in AM competencies over time and compare different health professionals. Finally, the AM-TNA assists tailoring training to national, individual and group addiction priorities.

Reference: Pinxten, W.J.L. et al. (2019) Excellent reliability and validity of the Addiction Medicine Training Need Assessment Scale across four countries.  Journal of Substance Abuse Treatment , Volume 99 , 61 – 66

For more info read the full article in the Journal of Substance Abuse Treatment 99 (2019) 61–66 https://doi.org/10.1016/j.jsat.2019.01.009

Read more about this topic in a post from 2017: What are the core skills of an addiction expert?

What are the core skills of an addiction expert?

You can also read a related post from 2015: International Society of Addiction Medicine | Congress #isam2015

International Society of Addiction Medicine | Congress #isam2015

Updating alcohol Cochrane literature review

Cochrane

Updating Cochrane systematic reviews makes them most useful and fresh for readers. We updated our review on concurrent alcohol and drug problems again.

Cochrane podcast

Which new studies we found?

We found seven studies that examined 825 people with drug problems. Six of the studies were funded by the National Institutes for Health or by the Health Research Board; one study did not report its funding source.

One study focused on the way people think and act versus an approach based on Alcoholics Anonymous. It aimed to motivate the person to develop a desire to stop using drugs or alcohol.

Three studies looked at a counselling style for helping people to explore and resolve doubts about changing their behaviour (group, individual and intensive formats). Their controls were education, or less intensive counselling, or assessment-only.

Two Irish studies and one Swiss study looked at practices that aimed to identify an alcohol problem and motivate the person to do something about it versus usual treatment.

This study has been made into a podcast available at Cochrane.org news item at https://www.cochrane.org/news/podcast-which-talking-therapies-work-people-who-use-drugs-and-also-have-alcohol-problems

and a Network news item https://mhn.cochrane.org/news/podcast-which-talking-therapies-work-people-who-use-drugs-and-also-have-alcohol-problems Listen to the podcast below:

Updating Cochrane Review – Key results

The Swiss and Irish studies were directly compared. They took place in general practices (one trial) or methadone clinics (two trials). They included 170 participants with a mean age of 37 years. All participants had positive alcohol screening test upon entry to the trial. At the end, the scores between groups were similar (average difference in scores: -0.6, 1.7 and -2, respectively).
One study found that a brief motivational intervention led to a reduction of alcohol use (by seven or more days in the past month at 6 months).

It remains uncertain whether talking therapies affect drinking and drug-using in people who have problems with both alcohol and other drugs. We lack high quality studies.

Cited cochrane review: Klimas J, Fairgrieve C, Tobin H, Field C-A, O’Gorman CSM, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C, Cullen W. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews 2018, Issue 11

Read a summary of the previous version of this review here

Which talking therapies work for drug users with alcohol problems? A Cochrane update

Addiction social work fellowship launched

man and boy

Addiction social work fellowship launched!

Substance use disorders disproportionately contribute to the global social and economic burden of disease.

Sadly, their treatment has been inadequate in large part due to an enduring research to practice gap. Here, the competencies for treating and preventing substance use disorders are often lacking from social work education curricula.

Addiction social work fellowship launched in Canada

Recently, the British Columbia Centre on Substance Use started a new interdisciplinary fellowship in addiction social work, nursing and medicine in Vancouver, Canada. We describe the new fellowship program and outline initial impact of the training on knowledge and skills in addiction social work from our qualitative evaluation of the fellowship.

“The Addiction Social Work Fellowship program accepts two positions in Social Work annually. The program strives for excellence in clinical training, scholarship, research, and advocacy and includes specialty training in inpatient and outpatient addiction services, as well as related concurrent disorders training. The program prepares Fellows to work clinically in the field of addictions and take leadership roles in academic and/or research settings.” (www.bccsu.ca)

 

To read the whole story, please visit the journal website https://www.tandfonline.com/loi/wswp20 or lookup the paper using the following citation:

Callon, C., Reel, B., Bosma, H., Durante, E., Johnson, C., Wood, E., Klimas, J.  (In Press) Addiction Social Work Fellowship in Addiction Medicine: A Novel Programme in a Canadian setting. (Early Online July 30th) Journal of Social Work Practice in the Addictions 

If you enjoyed reading this post, you may also enjoy reading about the fellowship here.