Sarah Hargand


August 2009

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


The adoption and implementation of evidence based practices for the treatment of drug and alcohol abuse have received little research. While outcome studies are important, the organizational factors that are associated with adoption and fidelity remain unknown. The purpose of this study is to determine which organizational factors are associated with the adoption and fidelity of implementation of cognitive behavioral therapy in substance abuse treatment centers. Data from a sample of 268 centers and their counselors was used to create two outcomes; adoption and fidelity of CBT. In this study, the adoption of cognitive behavioral therapy was associated with an increase in the amount of training new counselors receive, the use of medications, centers where the counselors rated CBT as more acceptable as a treatment for substance abuse. Fidelity of implementation in CBT was also associated two elements of training; the use of TIPS and TAPS and staff familiarity with CBT.




School of Medicine



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