Welcome to the New National Hispanic and Latino Addiction Technology Transfer Center

Pierluigi Mancini, Phd, MAC
Director, National Hispanic and Latino ATTC
National Hispanic and Latino ATTC

Welcome to the New National Hispanic and Latino Addiction Technology Transfer Center, (National Hispanic and Latino ATTC) the latest member of the Addiction Technology Transfer Center network (ATTC). The National Latino Behavioral Health Association (NLBHA), the grant recipient, was established to fill a need for a unified national voice for Latino populations in the behavioral health arena and to bring attention to the great disparities that exist in areas of access, utilization, practice-based research and adequately trained personnel. (www.nlbha.org)

The Latino population in the United States combines very diverse populations. The major groups are Mexican Americans (who constitute 63.0% of Latinos), mainland Puerto Ricans (9.2%), and Cubans (3.5%). The Census Bureau's code list of subgroups other than the major groups contains over 30 Hispanic or Latino subgroups, including Brazil, South America’s largest country.

There are also individuals who were born in the United States of America who identify themselves as Hispanic or Latino.

The various Latino groups concentrate in different regions of the U.S. and they constitute a large proportion of the foreign-born population, slightly more than half (53.1%) of the total foreign-born population is composed of immigrants from Latin American and Caribbean nations.

Latino groups also differ in nativity status. About one-third (36%) of Hispanics of Mexican origin are foreign-born, as compared with more than half of Cubans and Dominicans (59% and 57%, respectively). Among Puerto Ricans living in the United States, one-third (31%) were born on the island. In addition, there is substantial heterogeneity across Latino groups in terms of immigration history and patterns.

The National Hispanic and Latino ATTC will be addressing the diverse needs that this heterogeneous community faces when it comes to seeking and finding addiction treatment, prevention and recovery services. Besides country of origin we will be addressing issues of acculturation, limited English proficiency, health literacy, or the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.

We plan to train the behavioral health workforce that will be serving Hispanic/Latino communities and developing and/or adapting the evidence-based practices and services that these professionals will be using in order to bring meaningful change to the lives of these individuals.

We will serve individuals and organizations who provide behavioral health services to Hispanic/Latino populations throughout the United States. The center will provide training and technical assistance to a wide range of public, nonprofit and private organizations in culturally and linguistically appropriate practices and programs effective in serving Latino populations including evidenced based, community defined evidence, and other best or emerging practices.

Finally, we will make sure that the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards) are recognized. Training and hiring protocols will be implemented to support the culture and language of all subpopulations (English, Spanish or Portuguese), with a focus on the diverse Hispanic/Latino populations.

For additional information, please don’t hesitate to contact Project Director, Pierluigi Mancini PhD, MAC, at pierluigi@nlbha.org or at 678-883-6118

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REFERENCES
Acosta, YD., De la Cruz, GP. Brief ACSBR/10-15. US Dep. Commer., Econ. Stat. Adm., US Census Bur; 2011. The foreign born from Latin America and the Caribbean: 2010. http://www.census.gov/prod/2011pubs/acsbr10-15.pdf

Ennis, SR., Rios-Vargas, M., Albert, NG. Brief C2010BR-04. US Census Bur; 2011. The Hispanic population 2010. http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf

Brown, A., Patten, E. Hispanics of Puerto Rican origin in the United States, 2011. Pew Res Cent, Hisp Trends. 2013 Jun 19. http://www.pewhispanic.org/2013/06/19/hispanics-of-puerto-rican-origin-in-the-united-states-2011/



Great Lakes ATTC: Process Improvement Focus Helps Organizations Implement Evidence-Based Practices


Todd Molfenter, Ph.D.
Director, Great Lakes ATTC

The mission of the ATTC Network includes “accelerating the adoption and implementation of evidence-based and promising addiction treatment and recovery-oriented practices and services.”

At the Great Lakes ATTC, we’re applying our background in implementation science and process improvement to help accelerate the adoption and implementation of EPBs in our region and beyond.

Implementing EPBs can be challenging for organizations of any size. Emerging research from implementation science tells us that successful EPB implementation needs:
  1. more than training alone,
  2. coaching and feedback; and
  3. standardized improvement model.
See related article, Water into Sand: OUD Pharmacotherapy and Implementation Science: Why Training on Evidence-Based Practices is Never Enough

The NIATx Model

A fundamental tool in the Great Lakes ATTC’s effort to accelerate EPB implementation is the NIATx model, developed in 2003 as a demonstration project supported by the Robert Wood Johnson Foundation and SAMHSA. A seminal article written by McCarty et al. in 2007 described the impact of the NIATx model on access and retention in addiction treatment settings. Since then, more than 50 peer-reviewed articles have documented the use of the NIATx model in adopting evidence-based practices in addiction treatment, mental health, HIV treatment, child welfare, criminal justice, and other human services settings.

The NIATx Change Leader Academy

To teach the NIATx model, we offer the NIATx Change Leader Academy (CLA): a one-day, face-to-face workshop followed by three months of peer networking and support from a NIATx coach. The CLA teaches organizations how to use the NIATx model of process improvement to lead change projects that focus on improving systems or implementing EBPs.

Based on customer feedback (and applying NIATx Principle #1: Understand and Involve the Customer), we continue to refine this training session to make it focused, team-based, and interactive. Participants leave the skill-building workshop with tools they can use to start a change project as soon as they get back to the office.

Available in our region and beyond

During our first year as the Great Lakes ATTC, we conducted NIATx CLAs in each state in our region. These events were a great way to build relationships with our stakeholders and to introduce more behavioral health providers to the NIATx model.

Organizations in our region are using the NIATx approach for a wide range of change projects, including implementation of medication-assisted treatment for opioid use disorder and Screening, Brief Intervention, and Referral to Treatment. NIATx tools are helping to build Recovery-Oriented Systems of Care in Ohio, Indiana, Illinois, and soon, we hope, in other states in our region. Organizations can use the NIATx approach to implement other EPBs, such as those listed in SAMHSA’s Evidence-Based Practices Resource Center.



Photo: NIATx Change Leader Academy, MARRCH, April 3, 2019

The NIATx model also provides a framework for making changes to administrative processes. In Minnesota, a recent NIATx CLA marked the launch of a strategic initiative by the Minnesota Associations of Resources for Recovery and Chemical Health (MARRCH): a statewide Change Leader Learning Community that will help Minnesota providers adapt to policy changes coming to the state.

Read the related news story: NIATx Change Leader Academy Launches Minnesota Learning Collaborative

We offer the NIATx CLA regularly in the states throughout our region; check the Great Lakes ATTC calendar for info on upcoming offerings. And if you are interested in hosting a NIATx CLA in our region, give us a call!

Why Understanding and Involving the Customer Matters in Behavioral Health

Mat Roosa, LCSW-R
NIATx Coach





Treatment organizations continue to face the challenge of improving access to and retention in treatment. NIATx (originally known as The Network for the Improvement of Addiction Treatment) was developed specifically to help treatment providers make simple, powerful changes that can improve service delivery.

NIATx is based on five principles. The first principle, Understand and Involve the Customer, is number one for a reason. According to the research that was foundational to NIATx, this principle has more impact on the success rates of change implementation than all of the other four principles combined!

Listening to the voice of the customer
Everyone has heard the old business adage, “the customer is always right.” Many of us struggle with this concept. While a shoe store might take back a pair of shoes with half the sole worn off, do we really think that the customer is “right” to ask for the refund? Principle #1 helps us to understand just how right the customer always is.

There is no more important vision and voice than that of the customer. The customer is the only one who can tell us what they feel and what they want. The customer is always right about their perceptions of their experience, and that perception is the most important concern when we are trying to engage and help them. The best product or service will not be successful unless it is embraced by the customer.

So, what steps can we take to engage and involve the customer better?
I recall being at a meeting during which a veteran administrator was asked how recipients of services would feel about a major change. As he waxed on about a number of variables, I could see a supervisor of peer services, a woman with a great deal of lived experience as a service recipient, growing more and more frustrated. When he took a breath, she simply said, “Why don’t you just ask them?”

Why don’t we spend more time “just asking them”? The asking of customers requires that we treat them as partners at the table of service development and service improvement. While most would say they are willing to ask, fewer are willing to invest the time and ready to relinquish the control that is required for genuine asking. The walk-through, the Empathy Map and the Nominal Group Technique are three tools that will help teams to build a culture that values customer input.

The walk-through
One essential NIATx tool is the walk-throughThis role play exercise in which staff walk through the client experience is typically conducted at the beginning of the change project and helps teams see treatment barriers and process problems that are often hiding in plain sight. Walk-through exercises have uncovered issues such as an incorrect phone number listed as the agency contact information, poor directions to the treatment location, confusing signage at the facility, unwelcoming waiting areas, and lengthy intake sessions that require excessive or duplicative paperwork.

Here are a few tips for ensuring a successful walk-through:

1. Inform your staff: The team should be prepared for the experience. You want to see the process at its best, and then consider how it can be improved.

2. Stay in your role: complete the process in an authentic fashion.

3. Note the details of the process, and your emotional experiences

4. With each step of the process ask two questions: Is this necessary? If yes, Is it the best that it can be?

The Empathy Map
What do your customers say, think, feel, and do? What are their goals? Draw a large version of the Empathy Map grid, and ask your team members to write single ideas on sticky notes to be placed in the five sections of the grid. This tool will cultivate empathy for your customers’ experiences. It can serve as a way to gather all of the wisdom that customers have shared with administrative and treatment staff over time, and can help to identify key themes that will lead toward improvements. These questions are also an excellent structure for asking customers for feedback through interviews or focus groups.

The Nominal Group Technique
Using the Nominal Group Technique (NGT), another essential NIATx tool, is an excellent way to brainstorm with a team that includes customers, The structure of the process is designed to create inclusive participation among the team members. The four steps of the NGT process are intended to ask a powerful question and encourage listening to all of the answers offered. It can empower customers, and teach staff members about the value of the customer voice.

Four steps of the NGT



The walk-through, Empathy Map, and the NGT: three critical tools for understanding and involving the customer, and understanding just how right the customer is.



About our guest blogger:
Mat Roosa was a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant in the areas of quality improvement, organizational development and planning, evidence-based practice implementation, and also serves as a local government planner in behavioral health in New York State. His experience includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human service agency administration.

You can reach Mat at: matroosa@gmail.com

ECHO-CMU for ATTC 25th Anniversary: SEA-HATTC’s expansion of new learning strategies


Behavioral health is a major problem while ongoing health workforce shortage is global issue. SEA-HATTC signed MOU with Missouri Telehealth Network, University of Missouri for utilization of ECHO® model and software to conduct virtual clinics via multi-point videoconferencing also extend behavioral healthcare knowledge and tele-consultation to primary care and community hospitals in the upper northern Thailand.

To promote the expansion of new learning strategies, SEA-HATTC mapped out an implementation of behavioral health ECHO® (Extension for Community Healthcare Outcomes) model as a guided practice strategy for transforming medical education and increasing workforce capacity to teach best-practice specialty care.Having been endorsed as a highly innovative strategy that produces improvements in the quality and efficiency of integrated care, ECHO is a low-cost yet high-impact intervention linking expert inter-disciplinary teams of practitioners through tele-education.

A regular monthly 60-minute tele medical education on ‘behavioral health’ under ECHO-CMU Project has been launched for doctors, nurses, psychologists and nutritionists.The goal is to manage and control of chronic disease through behavioral health interventions. ECHO-CMU has 4 sites in Chiang Mai, Chiang Rai, Lamphun and Lampang Provinces all are the provincial hospitals located in the upper northern region of Thailand. Hub is located at SEA-HATTC Office, Department of FamilyMedicine at Chiang Mai University. Spokes are residents of Family Medicine in in-service training program.

To date, there are 75 health professionals (excluding Hub team) participating. Sessions under behavioral health theme included ‘care for patients with EMCO stroke’; ‘multidisciplinary approach for self-management support’; ‘approach and management for delated development at child’; ‘MI and counseling’; ‘health behaviors and behavior change’; ‘caring past stroke patients’;‘depression’; ‘deconditioning’; ‘nutrition for patient with NCD’; ‘dealing with alcohol and smoking in chronic disease patient’; ‘ updating guideline for NCD’; ‘diet for DM’; ‘exercise for elderly with chronic disease’, and etc., as the model shown below.



The clinics are supported by basic, widely available teleconferencing technology. During teleECHO clinics, primary care clinicians from multiple sites present patient cases to the specialist teams and to each other, discuss new developments relating to their patients, and determine treatment. Specialists from Faculty of Medicine, Chiang Mai University and Mahidol University serve as mentors and colleagues, sharing their medical knowledge and expertise with primary care clinicians. Essentially, ECHO® creates ongoing learning communities where primary care clinicians receive support and develop the skills they need to treat a particular condition. As a result, they can provide comprehensive, best-practice care to patients with complex health conditions, right where they live.

Besides the behavioral health theme of the pilot ECHO-CMU, the upcoming theme will be provided on ‘Caregiver of NCDs Geriatric Patient’ targeted to primary care practitioners, co-health workers, village leaders and health volunteers.

Given the limited project budget and the vast geographic spread of the target countries, SEA-HATTC introduced ECHO model to the regional advisory board members as an effective multi-point videoconferencing platform in extending HIV/addiction technology transfer and tele-consultation to health and social workers in Tier 1 countries including Cambodia, Lao PDR, Myanmar plus India and Indonesia for workforce development within the Southeast Asia region.

Workplace Learning: Helping Practitioners Work Wiser

Nancy Roget, Joyce Hartje & Terra Hamblin 
CASAT, University of Nevada Reno 


After 25 years of conducting training workshops, translating research into bite-size pieces for curricula or stand-alone products, and creating opportunities for performance feedback to enhance skill development, the Addiction Technology Transfer Centers (ATTCs) are ‘upping their game’ to offer novel training/technical assistance (TA) options that include multiple learning components in new delivery formats focused on changing practices. 1, 2, 3 Leading these efforts in 2017-2018, the Pacific Southwest ATTC, which includes three partnering institutions: University of California at Los Angeles (UCLA); University of Nevada Reno (UNR); and Arizona State University (ASU), recently began implementing new training models for workforce development. Specifically, the Pacific Southwest ATTC based its new model on two of the principles derived from the work of Flexner4 and others 5:

  1. Learning is competency-based and embedded in the workplace
  2. All workers learn; all learners work
Typically, training for behavioral health professionals and recovery support specialists has been conducted offsite with staff traveling to the learning event (e.g., workshop or conference) rather than embedded within the workplace. While many behavioral health practitioners liked being out of the office to receive training, administrators frequently complained about loss of revenue (billable hours), which is a valid concern especially with many more complex EBPs requiring three- and four-day training events. Unfortunately, administrators used this rationale in some instances to decrease the amount of training practitioners could attend. However, limiting or eliminating training paid for by organizations in order to reduce costs and increase revenue is not a viable answer since training/TA can enhance the quality of service delivery and improve client-level outcomes. Workplace-embedded training is feasible and, like all ATTC-sponsored training, competency-based.

In 2018, the Pacific Southwest ATTC piloted several sequenced learning events delivered online during regular work hours over an extended period of time (4 to 8 weeks). Initial feedback showed that participants liked the format, although some still struggled with the technology. The Pacific Southwest ATTC is currently revising its sequenced workplace learning events to match lessons learned from the business and healthcare fields regarding increased team building and providing a context for the new skills.

Another significant contributor to this new method of delivering training/TA in the workplace is the work of Aaron and colleagues. 6, 7 These researchers found that administrators possessed significant influence (positive or negative) regarding the adoption of EBPs by their organizational staff. One concrete way administrators showed organizational support of workplace learning was by allowing employees to count the learning sessions as part of their work day schedule.

The Pacific Southwest ATTC is committed to making workplace learning a reality in the region by designing learning events that: are delivered online using easy and inexpensive or free learning platforms; include instruction/support on how to use the online learning platforms; are conducted during work hours; include team building exercises/assignments; use workplace-specific real life scenarios in case studies; include near-peer performance feedback; and ensure there is administrator support. Making workplace learning a routine practice for delivering competency-based training similar to other Fortune 500 businesses is the goal, culminating in the creation of innovative delivery of training events that increase access, decrease costs, and help practitioners and recovery support specialists work wiser.

References

  1. Edmunds, J.M. et al. (2013). Dissemination & implementation of evidence-based practices: Training & consultation as implementation strategies. Clinical Psychology: Science and Practice, 20, 152–165.
  2. Powell, B.J. et al. (2014). A systematic review of strategies for implementing empirically supported mental health interventions. Research on Social Work Practice, 24, 192–212.
  3. Herschell, A. D. et al. (2010). The role of therapist training in the implementation of psychosocial treatments: A review & critique with recommendations. Clinical Psychology Review, 30, 448–466.
  4. Flexner, A. (1910). Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. Bulletin No. 4. Boston, MA: Ubdyke.
  5. Miller, B.M. et al. (2010). Beyond Flexner: A new model for continuous learning in the health professions. Academic Medicine, 85(2), 266-272.
  6. Aarons, G.A. et al. (2014). The Implementation Leadership Scale (ILS): Development of a brief measure of unit level implementation leadership. Implementation Science, 9(1), 45.
  7. Aarons, G.A. et al. (2016). The roles of system & organizational leadership in system-wide evidence-based intervention sustaniment: A mixed-method study. Administration and Policy in Mental Health, 43, 991-1008.

Trainer Development Efforts to Build a Competent Behavioral Health Treatment and Recovery Workforce in the Pacific Jurisdictions



Beth A. Rutkowski, MPH

In the 2012-17 funding cycle, the Pacific Southwest Addiction Technology Transfer Center (Pacific Southwest ATTC) region was expanded to encompass HHS Region 9. Formerly serving only California and Arizona, the Pacific Southwest ATTC now also serves Nevada, Hawaii, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Republic of the Marshall Islands, and Republic of Palau.

One strategy employed to service the unique and varied needs of the Pacific Jurisdictions was to join forces with the SAMHSA-funded Pacific Jurisdictions Workforce Development Initiative. This initiative began in 2011 to develop local expert trainers, grooming to provide the on-the-ground training and technical assistance to local behavioral health providers.

Topics were determined by each jurisdiction to address local needs (e.g., Matrix Model treatment, SBIRT, adolescent treatment, culturally responsive treatment and prevention). During the first year of the project, participants visited host sites in the mainland United States to gain experience from organizations providing services in their chosen focus area.

In March 2013, the Pacific Southwest ATTC, in partnership with the Pacific Behavioral Health Collaborating Council (PBHCC), conducted a conference attended by 27 individuals from the six Pacific Jurisdictions, along with representatives from the SAMHSA’s CSAT, CSAP, CMHS, and the Regional Administrator, HHS Region 9 (Dr. Jon Perez).

Participants engaged in meetings that focused on developing participants' skills in training and technical assistance. Each participant provided training on their focus area to peers and invited guests, and received individual coaching to improve skills. Participants heard from Drs. Thomas Freese (UCLA ISAP) and Steve Gallon (Oregon Health & Science University) on effective training and technical assistance strategies. Participants were also invited to UCLA ISAP to hear from ISAP's principal investigators about domestic and international research activities. The four-day conference ended with a recognition ceremony.

Access to local training and technical assistance experts is essential for the Pacific Jurisdictions. These island nations span an area of ocean larger than the continental United States. Their total land mass (669 islands and atolls spread across 5 million square miles of ocean) is smaller than the five states of New England. The total population of the Pacific Jurisdictions is approximately 451,000, and 19 languages are spoken. The island populations self-identify predominantly as native to their island, although segments of the populations are Filipino (5%-26%), Chinese (2%–5%), "other" Pacific Island background (2%–8%), and 2%–6% Whites or “other.”

Since 2013, the Pacific Southwest ATTC has visited Hawai’i and five of the six Jurisdictions on more than 15 occasions. The days are long, but the relationships developed and impact made is most satisfying. Recently, with supplemental funding from the PBHCC, Drs. Thomas Freese and Chris Rocchio and Mr. Alex Ngiraingas, an expert trainer from Palau, traveled to Pohnpei, FSM, to conduct a weeklong Alcohol and Drug Certification (ADC) Academy, to prepare providers to challenge the IC&RC certification exam. Because of this intensive weeklong training experience, eight people achieved regional certification, and one person achieved international certification. This increase in certified counselors represents a huge improvement in building a larger, more competent behavioral health workforce in the Pacific.

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Northwest ATTC & Tri-County Behavioral Health Providers Association Motivational Interviewing Teaching & Coaching Collaborative


March 27, 2019

Meg Brunner, MLIS

Motivational interviewing (MI) is the number one training request the Northwest ATTC receives from our region. Providers are embracing this evidence-based practice and, at the same time, are also struggling to access training and on-going coaching to promote staff proficiency.

The challenge leaders report is: how do we build internal staff capacity to support this evidence-based practice and fully implement it in our organizations?


In response to this need, the Northwest ATTC, in collaboration with the Tri-County Behavioral Health Providers Association in Oregon, is providing a year-long Motivational Interviewing Teaching and Coaching Learning Collaborative. Eighteen clinical supervisors from fifteen behavioral health organizations are participating in this intensive technical assistance project aimed at developing their MI teaching and coaching skills. The goal of the project, which is funded by Washington and Multnomah County, is to increase internal staff capacity for teaching and coaching staff in MI.

Participant selection included nomination by each organizations’ CEO and submission of a written application and sample MI audio-session. The project kick-off included a 1.5-day training on teaching and coaching MI and securing organizational buy-in and support.

At monthly learning collaborative meetings, participants receive a 90-minute module focused on a specific MI skill such as reflective listening, developing discrepancy, or eliciting change talk, along with all the necessary handouts and materials for them to subsequently present the skill module to a select group of staff at their organization between learning sessions. Staff members are encouraged to practice each MI skill between sessions and report back on their experiences.

Participants report deepening their own MI skills through this process as well as seeing significant MI skills development in staff members.

The value of this project is evidenced in these comments from participants:

The training series has helped me advocate for integration of the practice and spirit of MI varying levels of our office. Beyond that, it’s been really amazing to comb through my own understanding of the practice and better support clinicians that I supervise to help people change by being able to teach the principles more effectively and confidently. – Participant from Morrison Kids

This training brings MI to the fore as a process oriented, respectful form of therapy, and highlights the cooperation between provider and client that makes for a great treatment bond. –Participant from Cascadia Behavioral Healthcare

The Northwest ATTC plans to replicate this project in the future across Region 10 and is excited to be able to support this training and technical assistance need in our region!

For more information, or to find out how you can be a part of one of our MI technical assistance projects, visit our NWATTC Motivational Interviewing website.



Improving Substance Use Prevention and Treatment: International Efforts

March 20, 2019


Kim Johnson
Executive Director
ICUDDR 



Did you know that there is an international effort to improve the quality of substance use prevention and treatment through workforce and infrastructure development? The Department of State Bureau of International Narcotics and Law Enforcement Affairs (INL) supports a series of efforts in developing countries to do work much like the ATTC does in the United States. They are helping developing countries create infrastructure for certification and licensure, develop education and training systems for workforce development, and link people who work in the field all over the world through engagement in education and social networks that cross national boundaries.

Global Center for Credentialing and Certification 


First, there is the Global Center for Credentialing and Certification (formerly ICCE) that provides testing and credentialing services for individuals and countries that want to establish standards of care. The treatment certifications have reciprocity with NAADAC. You can find more information about them at: NAADAC.ORG/Colombo-plan and at the ISSUP page, The Global Centre for Credentialing and Certification. People with a NAADAC credential can have deemed status and receive the comparable ICAP credential. Find out more at the ISSUP page, Credentialing and Certification Examination

International Society of Substance Use Professionals (ISSUP)


Second, there is the International Society of Substance Use Professionals (ISSUP) that is designed to be a place to link to other people who work in any aspect of substance use prevention, treatment, recovery, research all over the world. ISSUP will soon be linking the ATTC HealtheKnowledge portal  of online training and education to a global audience. ISSUP membership is free and it links you to other people who are trying to solve the same problems that you are in countries in Asia, Africa, Latin America, the Middle East and Europe. The goal is to support evidence-based practice in addressing substance use issues and mutual problem solving by international peers.

International Consortium of Universities for Drug Demand Reduction (ICUDDR) 


Finally, there is the project that I am now heading up: The International Consortium of Universities for Drug Demand Reduction (ICUDDR). ICUDDR brings together universities to develop and improve upon their degree programs or courses in what is internationally called drug demand reduction. We have 160 member universities from countries in every part of the world. Many of them are using and adapting curricula created by international researchers and educators including ATTC leadership. The curricula are called the Universal Prevention Curriculum and the Universal Treatment Curriculum (UPC and UTC).

In my work as executive director of ICUDDR I have traveled to Thailand to host a meeting of 13 universities from 11 Asian countries; Brazil to meet with universities developing prevention education programs, Kenya to meet with 40 universities from all over Africa to organize a continental effort to develop education programs, and to the Philippines to talk to universities there about how to adapt curricula to be more culturally appropriate. If you want to see where I am next, follow me on Twitter: @icuddr

Cusco, Peru

Interested in joining a global workforce?


If becoming part of a global workforce to address substance use and addiction excites you, please check out the websites in this blog post, become a member of ISSUP or ICUDDR and perhaps attend one of our conferences. ISSUP will hold a conference in Vienna July 1-5 and they are still accepting abstracts! ICUDDR will host its annual meeting in Cusco, Peru July 21-23. It will be high season for visiting Machu Picchu, so if you want to come to the ICUDDR meeting, register soon.  I would love to see more of you engaged in this very exciting global effort.


About our Guest Blogger

Kimberly A. Johnson, is the executive director of the International Consortium of Universities for Drug Demand Reduction and an associate research professor at the University of South Florida. Prior to her move to Florida, she served for two years as the Director of the Center for Substance Abuse Treatment, a U.S. federal government agency.

Dr. Johnson has worked as an associate scientist at the University of Wisconsin, Madison where her projects included studies on mobile apps for behavior change, quality improvement in care development and acting as the co-director of the national coordinating office of the Addiction Technology Transfer Centers and as co-deputy director of NIATx. She received funding from multiple NIH centers, AHRQ, SAMHSA and several foundations. She has also served as the state of Maine single state authority for substance abuse, and as the executive director of a substance abuse treatment agency. In her early career, Dr. Johnson was a child and family therapist and managed treatment and prevention programs.

The Healing of the Canoe: Community Pulling Together


March 14, 2019

Meg Brunner, MLIS



The Healing of the Canoe began as a collaborative project between the Suquamish Tribe, the Port Gamble S’Klallam Tribe, and the Alcohol & Drug Abuse Institute at the University of Washington, now the home of the Northwest ATTC. 

Suquamish and Port Gamble S’Klallam identified the prevention of youth substance abuse and the need for a sense of cultural belonging and cultural revitalization among youth as primary issues of community concern. 

Port Gamble S'Klallam
In response, the Healing of the Canoe partnership sought to address these issues through the development of a community-based, culturally-grounded prevention and intervention life skills curriculum for tribal youth that builds on the strengths and resources in the community. 

The Culturally Grounded Life Skills for Youth Curriculum, created through this collaboration, is an adaptable curriculum for Native youth focused on substance abuse and suicide prevention. It uses the Canoe Journey as a metaphor, providing youth the skills needed to navigate their journey through life without being pulled off course by alcohol or drugs – with tribal culture, tradition, and values as compass to guide them and anchor to ground them. 

Suquamish
The Northwest ATTC is proud to offer a range of different training and technical assistance options for the Healing of the Canoe, and has worked with several regional tribes already. At a recent summit of American Indian Health Commission Tribal Leaders, Steve Kutz, the chair of AIHC and Cowlitz leader, expressed his thanks to Leonard Forsman, chairman of the Suquamish Tribe, for his role in the development of the Healing of the Canoe project, “a program that so many tribes in Washington and in the country are now implementing in their communities.” 

The NWATTC offers individual or multiple tribe training workshops, in-person/webinar/phone technical assistance, ongoing involvement in learning collaboratives, booster sessions, and consultation for funding opportunities to support implementation and sustainability. If you are interested, please contact the Northwest ATTC at northwest@attcnetwork.org

For more information about Healing of the Canoe, please watch this “digital story” from Nigel Lawrence of the Suquamish Tribe: 


And be sure to check out the NWATTC’s web page about the Healing of the Canoe project! 

Advancing Family-Centered Care for Pregnant and Parenting Women

Pat Stilen, MSW
Co-Director
Sarah Knopf-Amelung, MA-R
Kate Mallula, MPH, LMSW

Mid-America ATTC

March 5, 2019



As former director of a women’s treatment program in Nebraska, Mid-America ATTC Co-Director Pat Stilen saw firsthand the importance of family in mothers’ recovery journeys. She also recognized that family-centered care was the exception rather than the standard of substance use disorder (SUD) care. It was with this perspective that she and her team at Mid-America ATTC led the ATTC Center of Excellence on Behavioral Health for Pregnant and Postpartum Women and Their Families (ATTC CoE-PPW) from October 2015 – September 2017. We collaborated with three other regional centers – Great Lakes, New England, and Southeast ATTCs – to advance family-centered care nationally.

Medication-Assisted Treatment: Promoting Tools for Successful Recovery

February 25, 2019

Pat Stilen, MSW
Co-Director, Mid-America ATTC


Kansas City, home to the Mid-America ATTC at the
University of Missouri Kansas City


A decade ago, few people knew about the array of medications available to support persons in recovery from substance use disorders (SUDs). In the judicial and corrections arenas, if persons coming into jails and prisons were on medication to help mitigate drug cravings, these medications were immediately stopped. Having worked in a field where abstinence was the gold standard for clients, counseling staff from entry-level to supervisors were often suspicious about such medications, and sometimes downright resistant.
...counseling staff from entry level to supervisors were often suspicious about such medications, and sometimes downright resistant. 
Many physicians didn’t get pre-service training in substance use disorders, didn’t see the need to know, and, frankly, didn’t care to work with “those” people. Policymakers were hesitant to add yet another layer of education, treatment and expenses to an already complex and siloed system. In order for the delivery system for SUD medications to be effective, not just the counseling profession, but all four legs of this stool, would need to work together: medical, behavioral health, judicial, and policymakers. There was an urgency to coordinate these groups as the opioid epidemic grew.