1. National Frontier and Rural ATTC
National Addiction Workforce Work-Group
December 10, 2012

4. Serve as the national subject expert and
key resource to PROMOTE the awareness
and implementation of telehealth
technologies

6. PREPARE pre-service addiction treatment
and allied health students on using
telehealth technologies by developing and
disseminating academic curricula for
infusion into existing courses;

7. Create addiction treatment telehealth
competencies and develop policy
recommendations for national license
portability to encourage the addiction
treatment and recovery workforce to
ADOPT the use of telehealth services;

8. Use state-of-the-art culturally-relevant
training and technical assistance activities
to help the frontier/rural addiction
treatment and recovery workforce
IMPLEMENT telehealth services.

9. Definitions
Telehealth ‘refers to the use of
telecommunications and information
technologies to provide access to health
information and services across a
geographical distance.’
Telemedicine –’Use of medical
information exchanged from one site to
another via electronic communications to
improve patients’ health status’

10. Telehealth is not about technology itself but is a
bridge to relationship with the patient in order to
provide care. Shore, 2012

11. Definitions
• Synchronous communications-
Telephone counseling
• Asynchronous Communications-
email or web-based programs
• Some web-based programs include
both type of communications

12. National Addiction Workforce Group
Purpose: To assist/advise NFAR
staff on issues relating to
frontier/rural addiction
treatment workforce-
retention, recruitment, and
training.

13. National Addiction Workforce Group
Membership:
NASADAD
SAAS
ATTCs
Workforce researchers
Rural/frontier treatment providers
State Treatment Providers Associations

14. National Addiction Workforce Group
Commitment:
First Year 4 meetings

15. NASADAD Survey
• In 2009, Addiction treatment
providers in 16 states reported
offering treatment services using
telehealth (16 states out of the 37 states that
responded to the survey)
• 25 states reported providing
mental health treatment services
using telehealth

16. Brief Review of Research

17. Telehealth Research
• 141 Randomized Control Trials
– 148 telemedicine interventions with
nearly 37,000 patients
– 108 of the trials were favorable toward
telemedicine intervention
– 38 trials showed no statistical differences

18. CBT4CBT is a computer-based
version of cognitive behavioral
therapy (CBT) used in conjunction with
standard clinical care for current
substance users. Six modules and
follow up assignments focus on key
concepts in substance use, including
cravings, problem solving and decision
making skills.

20. TES is an interactive, web-based
program theoretically grounded in the
evidence-based Community
Reinforcement Approach (CRA) to
behavior therapy
Theoretical Approach: Community
Reinforcement Approach (CRA) behavior
therapy; contingency management (CM)
Target Substance: Poly-substance use

21. Mōtiv8 is a web based
contingency management program
for smoking cessation using a home
monitoring system
Subjects log onto a website and use video recording
software to record and submit videos of breath carbon
monoxide (CO) samples. The Mōtiv8 application uses a
web-based interface for collecting data, automating
immediate voucher (incentive) delivery, and some
versions of the application include a group support
forum.

22. MES is a computer-based brief
intervention with the goal of facilitating
self-change, treatment engagement,
and/or motivation to change via a single
intervention session.
Theoretical Approach:
Motivational intervention
Target Substance: Multiple substances,
poly-substance use

23. cMET/CBT/CM is a computer-
delivered intervention for cannabis
use disorders, incorporating features
of three evidence-based treatments:
cognitive behavioral therapy (CBT),
motivational enhancement therapy
(MET), and contingency management
(CM). Nine sessions presented over
12 weeks offer computer-assisted
instruction

24. MyStudentBody is an interactive, web-
based brief intervention for alcohol use
in college student populations
Theoretical Approach: Screening and
Brief intervention
Target Substance: Alcohol

25. McClure, Acquanta, Harding, & Stitzer
In Press
• Surveyed 8 urban clinics in Baltimore
(266 patients)
• Client’s Access to:
–Mobile Phone- 91%
– Text Messaging- 79%
– Internet/Email/Computer 39-45%

26. Training Substance Abuse Clinicians in
Motivational Interviewing Using Live
Supervision via Teleconferencing
Teleconferencing supervision (TCS)
was developed to provide remote, live
supervision for training MI
TCS shows promise for promoting new
counseling behaviors following
participation in workshop training.
Smith, et al., 2012 Journal of Consulting and Clinical Psychology;80(3):450-464

27. Needs Assessment
Goals
Determine the
•use of telehealth by treatment providers,
especially those in frontier/rural areas
•regulations/issues regarding telehealth
•interest in/use of telehealth recovery support
services
•use of telehealth in providing clinical supervision
to addiction treatment clinical staff

28. Methodology
Target populations
• SSAs and/or NTNs
• State credentialing boards
• Recovery community programs
• Clinical Supervisors from all 10 regions

29. Collect quantitative and qualitative data regarding
•use of telehealth in providing addiction treatment
services, clinical supervision, and recovery support
•interest among treatment provider administrators
in offering telehealth from a business practice
perspective
•training/TA needs