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Merging Task-Centered Social Work and Motivational Interviewing in Outpatient Medication Assisted Substance Abuse Treatment: Model Development for Social Work Practice

机译:在门诊药物辅助药物滥用治疗中合并以任务为中心的社会工作和动机访谈:社会工作实践的模型开发

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摘要

To advance social work practice and decrease the research practice gap, this dissertation followed a model development paradigm consisting of several phases. Based on the task-centered model of social work practice and motivational interviewing, a new combined model was construed. The two underlying models were analyzed and synthesized, using technical eclecticism as the integrative approach. The resulting combined model was described by guidelines and manualized. To test the combined model in an applied setting, a study was designed in collaboration with social workers at a substance abuse counseling center. There, the combined model intervention was implemented in an outpatient medication assisted treatment program dispensing methadone and buprenorphine to a mainly African-American population. The agency program aimed at detoxification, but also provided methadone maintenance. It offered additional groups and acupuncture. Ten clients and four social work practitioners participated in the intervention study. The study used a mixed-method approach in data collection and analysis. Client practitioner verbal interaction was recorded using digital audio recording. The digital audio files were loaded directly into Atlas.ti software to be used for analysis. Qualitative data analysis with Atlas.ti was performed for two research tasks, a) assessing implementation fidelity of the manual based intervention and b) exploring model development aspects to improve model guidelines. Treatment fidelity was analyzed through deductive coding and frequency counts. Model development analysis was performed similar to a grounded theory model and used content analysis and constant comparison methodologies. Addiction Severity Index and Readiness Ruler, urine drug screens, problem change, and task accomplishment ratings were used as quantitative outcome measures to produce time series data in order to chart individual case progress in a single system design. After testing the intervention, a focus group with participating practitioners was conducted. Overall beneficence with clients improving and progressing successfully in the program was found. The integration of the underlying models was deemed successful. Their elements were found to be complementary and intricately linked. Crucial for successful implementation is that the program environment supports and accepts client choices. Model guidelines were reviewed and improved for further field testing.
机译:为了促进社会工作实践和缩小研究实践差距,本文遵循了一个由多个阶段组成的模型开发范式。基于以任务为中心的社会工作实践和动机访谈模型,构建了一个新的组合模型。使用技术折衷主义作为综合方法,对两个基础模型进行了分析和综合。所得组合模型已通过指南进行了描述并进行了手动处理。为了在实际应用中测试组合模型,在吸毒咨询中心与社会工作者合作设计了一项研究。在那里,在门诊药物辅助治疗计划中实施了联合模型干预,该计划将美沙酮和丁丙诺啡分配给主要是非裔美国人。该机构计划的目标是排毒,但也提供美沙酮维持治疗的服务。它提供了更多的团体和针灸。十名客户和四名社会工作从业人员参加了干预研究。该研究在数据收集和分析中使用了混合方法。使用数字音频记录来记录客户从业人员的言语互动。数字音频文件直接加载到Atlas.ti软件中进行分析。使用Atlas.ti对两个研究任务进行了定性数据分析,a)评估基于手动干预的实施保真度,b)探索模型开发方面以改进模型指南。通过演绎编码和频率计数分析治疗保真度。执行模型开发分析的方法类似于扎根的理论模型,并使用内容分析和常量比较方法。成瘾严重性指数和准备就绪标尺,尿液药物筛查,问题变更和任务完成率被用作定量结果指标,以生成时间序列数据,以便在单个系统设计中绘制单个病例的进展情况。在对干预措施进行测试之后,与参与者进行了焦点小组讨论。发现客户在该计划中成功改进和进步的总体收益。基本模型的集成被认为是成功的。他们的元素被发现是互补的且错综复杂的。成功实施的关键是程序环境支持并接受客户端的选择。审查并改进了模型指南,以进行进一步的现场测试。

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    Fassler Andreas;

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  • 年度 2007
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