Watch: ATTC Network's 30th Anniversary Celebration

Since 1993, the vision of the ATTC Network has been to unify science, education and service to transform lives through evidence-based and promising treatment and recovery practices in a recovery-oriented system of care.

The ATTC Network is an international, multidisciplinary resource for professionals in the addictions treatment and recovery services field.

Established in 1993 by the Substance Abuse and Mental Health Services Administration (SAMHSA), the ATTC Network is comprised of 10 U.S.-based Centers, two national focus Area Centers, and a Network Coordinating Office. Together the Network serves the 50 U.S. states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Islands of Guam, American Samoa, Palau, the Marshall Islands, Micronesia, and the Mariana Islands. 

On June 6, we celebrated our 30th anniversary with a special presentation, highlighted by remarks from SAMHSA Assistant Secretary, Dr. Miriam Delphin-Rittmon, and Dr. Yngvild Olsen, director for the Center for Substance Abuse Treatment (CSAT).

We invite you to watch the celebration here. 

 

ATTC 30th Anniversary Celebration from ATTC Network on Vimeo.

We've also pulled out a few special highlights from the celebration, including this special video featuring photos and memories from our three-decade history. 

ATTC - 30 Years of Memories from ATTC Network on Vimeo.

We'd also be remiss if we didn't share with you these special messages of thanks and encouragement from around our network. An organization is only as good as its people, and our team is filled with amazing, passionate folks who are committed to making a positive difference in the fields of addiction science, treatment and recovery. Thanks team for all that you do for us! 

ATTC - 30th Anniversary Messages from ATTC Network on Vimeo.

Help us keep the 30th Anniversary celebration rolling, all year long, by visiting our Pearls of Wisdom landing page on the ATTC Network website, with more videos, a timeline, and links to all our special content. 

ATTC's Pearls of Wisdom: Flipping the Classroom to Improve Intensive Technical Assistance Efforts

By Bryan Hartzler, PhD, director, Northwest ATTC, director/research associate professor, Addictions, Drug & Alcohol Institute (ADAI), University of Washington School of Medicine

A convergence of technological advances and pandemic influences has resulted in an influx of asynchronous learning resources, or products the health workforce access individually and experience at their own pace. Examples include online training programs, webinar recordings, podcast series, and clinical demonstration videos—all included in the on-demand resource library availed by Northwest ATTC.

Today’s busy workforce members prefer, if not expect, such learning resources to be accessible when, where, and how is most convenient to further their continuing professional education.

As the depicted activities indicate, asynchronous learning resources serve many functions. These include: promoting awareness of useful treatment and recovery practices; increasing didactic or applied knowledge about a given practice; fostering insights about its personal/organizational compatibility; and informing adoption decisions. Within SAMHSA’s tiered rubric for technical assistance (TA), these are most consistent in intent with basic or targeted TA. In contrast, intensive TA efforts facilitate systems-level changes at health organizations to support coordinated implementation of a new practice—only in very rare circumstances would asynchronous learning resources suffice.

The synchronous learning activities depicted below are common features of intensive TA efforts. Among the functions served are: exploring organizational fit and readiness for a new practice; customizing it to local needs and resources; fostering requisite clinical skills amongst staff for its delivery to clients; preparing local systems for coordinated implementation; offering feedback and trouble-shooting during implementation; and creating a sustainment plan. The field of implementation science continues to scientifically test the utility of specific strategies intended to serve such functions. 

The pragmatic approach of the Northwest ATTC, as described elsewhere^1,2, is guided by the phased EPIS framework³ and flexibly bundles and sequence such strategies in intensive TA efforts with community partners.

How may asynchronous learning resources augment intensive TA? If paired with or integrated into synchronous learning activities, they enable one to ‘flip the classroom’⁴—an educational philosophy that communal learning is less effective via passive instruction methods (i.e, didactic lecture, persuasion) than active ones involving higher-order, applied tasks (i.e, case formulations, skills-training with behavioral rehearsal). A blended learning approach is the result, of which the following Northwest ATTC-involved examples included use of:

• A recorded webinar describing the Healing of the Canoe, a substance use and mental health intervention for tribal youth that draws on strengths of community identity. Asynchronous webinar viewing by a targeted group of tribal community members provided conceptual orientation that informed their subsequent participation in a multiday training workshop and longitudinal implementation support activities whereby the intervention was tailored to and later implemented by particular tribal communities.
• Episodes of the Talking to Change podcast series, selected for weekly asynchronous review by pre-service MSW students enrolled in a 10-week Motivational Interviewing (MI) course. Acquainted with this weekly background on applying MI to unique clinical challenges and populations, instructor-led classroom activities each week then focused on corresponding skills-training involving peer coaching and performance-based feedback.
• Contingency Management for Healthcare Settings, an online training with modules for four common personnel strata in health settings (i.e., leadership, supervisory, direct-care, administrative support). Initial asynchronous module completion enabled building of foundational knowledge of CM principles, exposure to clinical demonstrations of several empirically-supported CM paradigms, and tailored material aimed at preparing each personnel group for future CM implementation. At addiction treatment settings, this preceded expert-led synchronous activities recognized as core ingredients of successful CM implementation—namely, engagement of setting leaders in a collaborative design process to customize CM programming, assembly of a local implementation team to prepare setting systems, a coaching-to-criterion process for clinical staff to document readiness to deliver CM programming, organizational consultation and trouble-shooting during initial implementation, and eventual participation in a Community of Practice.¹

Beyond the appeal and convenience that asynchronous learning resources hold, they offer cost- effective and inclusive means of reaching workforce members who may otherwise be missed by our collective ATTC network efforts. With increasing demands for equitable workforce access to professional education and shrinking budgets available for its provision, there is much to be gained by expanding the situations and circumstances in which intensive TA efforts of the ATTC network embody a blended learning approach. Perhaps the aforementioned trio of examples may stimulate further innovative ideas for such expansion. Such innovation may just reflect the ATTC network’s best and brightest opportunities to accelerate the adoption and implementation of useful treatment and recovery practices among the addiction workforce.

References

¹ Hartzler, B., Gray, K., Marx, M., Kirk-Lewis, K., Payne-Smith, K., & McIlveen, J.W. (in press). Implementing contingency management to address stimulant use. Journal of Substance Use & Addiction Treatment.

² Hartzler, B. (in press). It’s time to broaden dissemination of cognitive-behavioral therapy for substance use disorders: Charting pathways to ascend the remaining mountainside. Clinical Psychology: Science and Practice.

³ Aarons, G. A., Hurlburt, M., & McCue Horwitz, S. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services, 38(1), 4–23.

⁴ Bergmann, J., & Sams, A. (2012). Flip your classroom: Reach every student in every class every day. Washington, DC: International Society for Technology in Education.

NIATx in New Places: Bringing the NIATx Change Leader Academy to HealtheKnowledge

By Maureen Fitzgerald, communications manager, Great Lakes ATTC, MHTTC, and PTTC, and Scott Gatzke, director of dissemination, Great Lakes ATTC, MHTTC, and PTTC

NIATx began as a demonstration project in which 39 substance use treatment organizations tested process improvement tools borrowed from industry and manufacturing to improve treatment access and retention.

The success of the NIATx approach surpassed expectations. Grantees reported impressive improvements in show rates, continuation, and even the financial bottom line of their organizations. NIATx director Dave Gustafson and his team realized they needed a plan to disseminate the model and meet the growing demand for NIATx training. A key part of the dissemination plan was to host an annual national conference.

Scott Gatzke, senior NIATx trainer and director of dissemination, joined the NIATx team in 2006 to make that plan a reality. “The Summit was also an event to celebrate the success of NIATx change teams and share best practices,” he adds.

“What set the NIATx model apart and what really motivated change teams who attended the event was the impact of making small changes that quickly yielded great results,” says Scott. “The annual Summit tapped into that energy with built-in peer networking. We also made a point to select speakers from outside the field to inspire new ideas and creative thinking.”

Each year of the Summit (2007–2013), Scott used the NIATx approach to improve the planning and execution of the event. “We analyzed attendee feedback for improvement suggestions, designed PDSA cycles for the processes needing improvement, and tested them through walk-throughs focusing on the customer experience.”

Disseminating the NIATx model
NIATX Change Leader Academy: Rapid Cycle Change for Teams

Scott was also one of the team members who helped develop and refine the NIATx Change Leader Academy (CLA). “The CLA was created to meet the growing demand for NIATx training and make the approach available to any organization looking for as easy-to-use model for making improvements,” says Scott. “Since launching in 2006, the CLA has trained hundreds of change leaders in practically every state in the country.”

The CLA also demonstrates how NIATx has expanded to reach new groups outside the original audience of substance use treatment providers. “CLAs in recent years have helped change teams in diverse areas such as culturally and linguistically appropriate services, workforce development, and suicide prevention programs in schools.”

As NIATx has expanded to new areas, the CLA has also adapted in response to customer needs. “We shortened the original two-day in-person training to one day to reduce travel time,” says Scott. “When COVID-19 hit, we developed a virtual CLA, and our newest version is now available on-demand as an online course through HealtheKnowledge: NIATx Change Leader Academy: Rapid-Cycle Change for Teams.”

Todd Molfenter, Director of the Great Lakes ATTC, MHTTC, and PTTC, created content for the course.

“We’re excited to offer training on the NIATx model in a self-paced online learning environment,” adds Scott. “The course lays out the core elements of the NIATx model using the case example of a probation department trying to improve treatment show rates for juveniles coming out of detention—reinforcing the concept that while NIATx was designed originally for substance use treatment field, the approach can work in any setting.”

The HealtheKnowledge course consists of four 15–30-minute interactive modules that give learners the tools to sketch out a change project. "They'll also learn how to apply the tools separately from a change project."

The course will also be the first component of an expanded online offering that NIATx coach Mat Roosa is now developing. “The working title for this course is NIATx CLA 4.0,” says Scott. “It will combine the core HealtheKnowledge course with a series of short videos, quizzes, and a step-by-step change project worksheet.”

Scott Gatzke is a senior trainer/coach of the NIATx process improvement model and director of dissemination for the Great Lakes ATTC, MHTTC, and PTTC. Scott is also the collaborative learning manager for the Behavioral Health Excellence-Technical Assistance Center. Scott has more than 15 years of experience coordinating state-wide and national conferences, trainings, and learning collaboratives for behavioral health and social service professionals and educators.

ATTC's Pearls of Wisdom: Training & Trainer Evolution – COVID’s Lasting Impact

 By Paul Warren, LMSW, Research Project Director at the New York State Psychiatric Institute

The COVID-19 pandemic forced and expedited the use of technology to provide services, training, and technical assistance (TA) on an unprecedented scale across the globe, in all professions. From our present vantage point, trainers and TA Providers may wonder “Will SUD workforce training and TA ever go back to the way it was before COVID?”

I predict, “No”. End of story. Next question. All kidding aside, I believe the answer is still “There is no going back.”

As challenging as these adjustments in training and TA delivery have been, and despite the attrition of experienced trainers, the intentional and skilled use of technology has extended our reach, increased availability and, dare I be so bold as to suggest, more effectively prepared and supported the SUD workforce through training and TA interventions.

Let us now transition from broad forces to granular experience and application.

As with in-person training, on-line training platforms like Zoom and others succeed or fail based on a Trainers’ ability to engage participants in the learning environment. A robust grounding in Adult Learning principles is essential in contexts and in building and maintaining engagement on-line requires significant adjustments on the part of the trainer.

Pearl One - the “training” begins before the “training” starts – also applicable to on-line TA provision. For in-person training, I often arrive an hour or at the very least 30 minutes prior to its start. Yes, to set up and manage logistics, and more importantly to build engagement. I’ve sincerely grown to enjoy on-line training because I’ve adjusted to achieve comparable levels of participation and engagement. I enter the virtual classroom/meeting space prior to the start time, I greet people as they enter, use their names, invite them to unmute and ask them questions about their real and virtual backgrounds. I express my sincere curiosity and extend a genuine welcome.

 

All of this “engagement” intentionally occurs prior to launching into logistics or any training content. Of course, the time is greatly condensed. Prior to opening the on-line classroom, I send waiting-room messages, affirming their early presence and extending welcome. Practically speaking, the classroom opens five-minutes prior to the official start, and I also use the first five-minutes to continue to build engagement and set a tone for the Learning Community Conversation.

Pearl Two – Consider facilitating Learning Community Conversations (LCC). “What’s in a name?” you may ask. I believe a lot! Especially if, in your role as Trainer/Facilitator, you truly respect the experience and needs of Adult Learners.

As I’m building engagement and setting the tone in the five minutes before and after the official start time, I’m planting the Learning Community Conversation seeds. I’ve seen these seeds consistently flower during many training sessions. Adult Learners have a lot to offer, they want to talk, and they want to be heard. Establishing ground rules is essential to making sure that the LCC remains safe, inclusive, and forward moving. The “Language Matters” slide is an excellent visual anchor for the LCC. A related tip focuses on the intentional use of reflections and summaries by Trainers/Facilitators. As during the provision of direct client services, Adult Learners also want/need to be heard. Trainers can continue to build engagement by taking the extra moment invested in reflecting or summarizing what a participant risks to offer during the LCC.

Pearl Three - In real estate, it’s “Location, Location, Location”, in on-line training it’s “Duration, Duration, Duration”. Zoom time and in-person time are not the same. “Zoom Fatigue” is real. I’ve experimented with duration within the bounds of deliverables needs. Ideally, when possible, I don’t conduct on-line training or TA sessions that go beyond three hours. Clearly this is an individual call based on many variables. What I can anecdotally share is that I’ve found great benefit in putting several days between Part One (first three-hours) and Part Two (second three-hours).

Many years ago, in another life I learned a very valuable lesson that I’ve applied in this context, “less is more”. I find it highly applicable when considering duration and amount of content to include in an on-line training. Ultimately it comes down to intentional utilization of the duration, methods and approaches that will best illuminate the content and provide Adult Learners with opportunities to explore, adopt and implement.

It's likely that training and TA provision will never return to the way it was before COVID. Trainers and Technical Assistance providers have an opportunity to responsively devise ways to engage, establish synergistic Learning Community Conversations and to compose educational interventions that maximize the means of the moment. These intentional adjustments and the openness to flex holds great promise for a strong Substance Use Disorder workforce.