The ATTC-NE Science to Service Laboratory
The SSL seeks to actively enhance the perceived attributes of evidence-based treatment approaches by working collaboratively with organizations to increase the perceived advantages, compatibility, observability, and trialability of new practices, while reducing issues of complexity.
The comprehensive technology transfer model has several key components.
The first is getting organizational commitment for the process. Adopting new treatment practices is often impeded by the belief that making organizational changes “just happens,” that it doesn't require much thought or preparation. Indeed, many practitioners believe that if an intervention is good enough, it will “sell itself.” Little thought is given to the context and culture into which the new intervention must fit, and implementation is usually seen as the counselor's responsibility because the counselor is the one delivering the intervention. The reality is that successful implementation of a new practice depends greatly upon organizational change that requires significant agency involvement.
In order to support the adoption process, a number of up-front commitments are required from the agency: an initial pledge to ensure the availability of the fiscal and human resources necessary to complete the adoption process; the identification of internal agency “champions for change” and other interested personnel for participation on the implementation team; and assurances that the organization will develop and maintain the use of a work plan as outlined in The Change Book.
Another key component of the technology transfer model is using a developmental model for change. Most practitioners in the substance abuse treatment field are familiar with the Transtheoretical Model of Change. Dwayne Simpson, PhD, developed a model for organizational change that parallels the transtheoretical model. Simpson's model is tailored toward administrators and practitioners. Like the Transtheoretical Model, Simpson's model is divided into stages of action: exposure, adoption, implementation, and practice (roughly equivalent to the stages of change for individuals in the Transtheoretical Model). Similarly, Simpson's model emphasizes that change is a process that takes time and effort. A progressive model such as Simpson's helps break the work of implementation into an orderly, manageable progression.
Using external consultants to assist in the organizational change process is important. In our model we call these helpers “technology transfer specialists,” and they are trained to deal with various issues that can arise during the adoption process and they are knowledgeable about the particular intervention being implemented. The specialists work with agency implementation teams (at the agency and in larger, multi-agency work groups) to help them learn about implementation dynamics and the particulars of adopting the specific intervention. A specialist doesn't solve problems for the implementation team, but serves as a catalyst to help the team solve problems collaboratively.
This model is designed to foster a productive connection between the scientist and the practitioner. Both the technology transfer specialists and the agency implementation teams receive training in the selected clinical intervention directly from a researcher or expert in the intervention/practice. These trainings are designed to allow plenty of opportunity not only for the flow of knowledge, but also for skill development and discussion of adoption and implementation strategies with the researcher/expert.
Finally, development of multi-agency work groups – sometimes called ‘learning collaboratives’ – is important. Working in groups rather than individually fosters interaction that supports change. In the SSL, we ask multiple agencies to come together to work with the technology transfer specialists (a cost-effective approach to using consultants). Team members problem-solved together, shared ideas about internal changes, and collaborated to identify what client profiles work best with the intervention. Participating in multi-agency work groups appears to be an important aspect of promoting successful organizational change.
Since 2003, the ATTC-NE has worked with 54 community-based treatment agencies throughout New England using the Science to Service Laboratory. Ninety-six percent of agencies that have completed all SSL components have successfully adopted and implemented contingency management. Through surveys that provided feedback on satisfaction with the quality, organization, and utility of the Science to Service Laboratory as an organizational change model, agencies and their staff members rated these components favorably.
For more information see:
Squires, D.D., Gumbley, S.J., & Storti, S.A.. Training substance abuse treatment organizations to adopt evidence-based practices: The Addiction Technology Transfer Center of New England Science to Service Laboratory. Journal of Substance Abuse Treatment, 34, 293-301.
Gumbley, S.J., Squires, D.D., & Storti, S.A. (2007). Adopting new practices: An agency model that works. Addiction Professional, 5. 29-33.
