Wednesday, August 27, 2014

Barriers to Success


This survey of 100 mental health professionals across the country identified several barriers to addiction treatment success including socioeconomic status, patient resistance to the spiritual elements of 12-Step, and inadequate program resources.  Another point to consider as a barrier to successful treatment is having adequately trained clinicians. Similarly, few medical doctors have training in addiction yet many of them will go on to prescribe addictive pharmacological agents (e.g., Percoset, Klonopin).  It is generally assumed that the clinical skills developed during doctoral or master’s level training are generalizable enough to apply in addiction work. It is simply not the case. As such, many clinicians struggle to engage addicted persons in treatment. In turn, this dilemma, which might reflect deficits in training, plays a critical role in the overall success of treatment.

A program's treatment success depends on a delicate balance between employing well-trained professionals and the delivery of high quality services to its patients.  Services that are evidenced-based and supportive in nature generally do well. Computer-based CBT, motivational interviewing, and community reinforcement models (e.g., Community Reinforcement and Family Training; CRAFT), have demonstrated good efficacy but not all programs utilize these methods or have clinicians trained in them.

In conclusion, the success of treatment programs rests, in part, on the preparedness of its clinical team. In order to address the service delivery side of the equation, appropriate clinical training in addiction treatment is crucial especially since evidence-based models and intervention strategies are all part of a good training and a strong contributor to successful treatment.

Written by Dr. Errol Rodriguez
Assistant Dean and Program Director of the Master’s programs in Psychology and Mental Health Counseling in the Derner Institute of Advanced Psychological Studies.