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Of Note

July 1, 2006
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Managed Care Entity and Provider Partner on Meth Treatment Approach

Managed behavioral healthcare company ValueOptions has partnered with the Arizona Department of Behavioral Health Services and a Maricopa County addiction treatment agency to establish a methamphetamine treatment strategy linked to the county's drug court program. Officials involved with the partnership say that the “center of excellence” approach to meth treatment in Maricopa County differs from that used in other regions of the state in its direct attempt to divert offenders from the county corrections system to treatment.

ValueOptions administers the regional behavioral health authority for Maricopa County's public managed care system. Its treatment partner for the methamphetamine center of excellence is the provider agency Community Bridges. The agency's CEO, Frank Scarpati, says of the partnership, “By leveraging each group's resources we anticipate a more positive outcome through lower relapse rates, decreased criminal activity, and longer periods of stability.” The treatment approach combines detoxification, short-term housing, and an intensive outpatient program, with an emphasis on peer support in the residential phase. ValueOptions expects to enroll 250 people in the meth treatment program in the effort's first year.

Counselors Among Targetsof Foundation's Workforce Effort

A new national initiative established by the Robert Wood Johnson Foundation seeks to support improvements in the way healthcare institutions, including addiction treatment agencies, train their direct-care workers. The four-year, $15.3 million initiative is called Jobs to Careers: Promoting Work-Based Learning for Quality Care. Programs supported through the effort will redesign systems for healthcare agencies' training of frontline workers, with an emphasis on work-based learning efforts that formalize and reward learning that takes place within one's job.

“We need to think differently and build systems to develop skills, build careers, recognize and reward these workers, especially as we face new public health challenges and an aging population,” says Victor Capoccia, PhD, senior program officer at the foundation. Up to eight three-year grants are being awarded in the first round of program funding, for which the application deadline has passed. Grantees generally will be eligible to receive up to $425,000 over the grant period.

The initiative will encourage partnerships among employers, educational institutions, and other community organizations to establish new models of worker education and training. The Robert Wood Johnson Foundation is collaborating with The Hitachi Foundation on this project. For more information about the initiative, visit http://www.jtcp.org

CBT, Incentives Work Wellfor Marijuana Clients

A study of 90 adults diagnosed with marijuana dependence has found that a combination of cognitive-behavioral therapy and vouchers that could be redeemed for movie passes and other items worked better in encouraging abstinence than either of those approaches offered alone. Results of the study were published in the April 2006 issue of the Journal of Clinical and Consulting Psychology.

Researchers at the University of Arkansas and University of Vermont randomized the study participants to either a voucher group (participants received vouchers for negative drug tests at various points in treatment), a CBT group, or a group receiving both approaches. After three months of treatment, 43% of the latter group was no longer using marijuana, compared with 40% of the voucher-only group and 30% of the CBT-only group. At 12-month follow-up, the gap in results was larger: 37% abstinence in the combination group, 17% in the voucher group, and 23% in the CBT group.

Researchers concluded that for patients in the study, cognitive-behavioral therapy appeared to enhance the maintenance of the reward effect during treatment. Patients receiving vouchers were eligible to collect a maximum of $570 worth of earnings, which could be redeemed for items such as movie tickets and sports and recreation equipment. In CBT sessions for patients receiving vouchers, therapists discussed how patients could use the vouchers to support treatment goals of productive lifestyle changes.

Data Highlight Problemof Alcohol Abuse in Older Adults

Nearly half of substance abuse treatment admissions among adults ages 50 and older in 2003 were specifically for alcohol abuse, and a good percentage of these admissions were of first-time visitors to a treatment program, according to a report from the Substance Abuse and Mental Health Services Administration (SAMHSA). Data taken from the 2003 Treatment Episode Data Set showed that 48% of 164,000 treatment admissions in this age group in 2003 were for alcohol abuse problems, with men accounting for 80% of these alcohol-related admissions. Those admitted specifically for alcohol abuse were more likely to be first-time treatment participants than were older adults admitted for other reasons (45%, as opposed to 33%).

In addition, the analysis found that older adults with alcohol-specific problems were less likely than other adults in treatment to have sought the assistance themselves. “Alcohol abuse among older adults is something few want to talk about, and a problem for which even fewer seek treatment on their own,” says SAMHSA Administrator Charles Curie. He adds, “Health care providers tend not to ask older patients about alcohol abuse if it wasn't a problem in their lives in earlier years.”

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