Supervision in Substance Use Disorder Treatment Programs

Purpose

Substance use disorders such as opioid addiction affect millions of adults in the United States each year, but the delivery of high-quality, effective addiction services is disrupted by organizational issues such as counselor burnout and turnover. Clinical supervisors are essential for supporting counselors in specialty addiction treatment programs, but few supervisors receive supervision-focused training. This project seeks to develop and pilot an evidence-based supervision strategy that has a high potential to enhance supervision and result in improved counselors' well-being and performance and, in turn, to improve client outcomes.

Conditions

  • Self Efficacy
  • Burnout, Professional
  • Substance Use Disorders
  • Supervision

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Serves as a supervisor (i.e., oversee work of counselors) or counselor (i.e., directly work with clients) at a substance use treatment facility/program - Program/facility provides residential services

Exclusion Criteria

  • Supervisors contracted (not employed) by the facility

Study Design

Phase
N/A
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Intervention Model Description
One arm pilot/feasibility study
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Supervision arm 		Supervisors will be trained and coached in a new supervision strategy (FOCUS)
  • Other: FOCUS supervision strategy
    The FOCUS supervision strategy provides a strenghts-based model for supervision. It is built around three core components: (1) Five pillars for effective supervision interactions, (2) practical skills that operationalize these principles, and (3) a set of experiential activities that provide foundational learnings for staff to practice the skills around real-life situations (from which future client-specific interventions can be built). In this study, FOCUS is being tailored for SUD treatment settings.

Recruiting Locations

University of Arkansas for Medical Sciences
Little Rock 4119403, Arkansas 4099753 72205
Contact:
Jure Baloh, PhD
501-526-6604
jbaloh@uams.edu

More Details

Status
Recruiting
Sponsor
University of Arkansas

Study Contact

Jure Baloh, PhD
501 526 6604
jbaloh@uams.edu

Detailed Description

Substance use disorders (SUDs) such as addiction to opioids, methamphetamines and alcohol are a significant burden in the US, affecting almost 50 million individuals annually. Community specialty SUD treatment programs ("SUD programs") are a key type of SUD providers and while effective treatments for SUD exist, significant issues in the organization and delivery of SUD programs (e.g., burnout, turnover) undermine the delivery of high-quality services. Clinical supervisors are centrally positioned to support SUD counselors (frontline clinical providers) and ensure high service quality. For clinical supervisors to effectively support counselors, they need evidence-based supervision strategies. Currently, supervisors in community SUD programs receive very little training, support, and direction for supervision, and thus their supervision practices are highly variable, raising concern about the effectiveness of clinical supervision as currently provided in these programs. Evidence-based supervision strategies can help fill the gap, and evidence from child welfare settings shows they improve leadership, climate, and client outcomes. Based on our preliminary formative work with SUD providers in Arkansas, a reinforcement-based supervision strategy developed for counselors was deemed acceptable and feasible in SUD programs, and had high perceived potential to improve supervision quality, counselor well-being and performance, and client outcomes. Participants thought the structure and content of the strategy were a good fit for SUD settings. However, for a supervision strategy to be supportive of the work they do, it needs to be developed to reflect the language, case examples, and organizational factors relevant to the SUD settings. The goals of our study are to iteratively develop and refine a supervision strategy for SUD settings, and to pilot it in residential treatment programs using quality improvement and implementation science tools and approaches. Aim 1 involves leveraging previous experience developing supervision strategies and partnering with SUD providers to develop and refine the supervision strategy for SUD. Using the Evidence-Based Quality Improvement (EBQI) process, we will engage SUD partners in a series of collaborative meetings to review and discuss the supervision strategy and related study materials, and to make key decisions. The output of this work will be a refined and optimized SUD supervision strategy. Aim 2 involves conducting two pilot cycles with supervisors and counselors in a sample of SUD residential treatment programs to assess the feasibility and acceptability of the supervision strategy, examine its impact on key organizational, counselor, and client outcomes, and to document barriers and facilitators for its implementation and sustained use in routine practice. This study will provide key information to inform planning and design of a future fully powered study to assess the effectiveness of the new supervision strategy in a large sample of SUD programs.