This document summarizes an advisory board meeting for the National Frontier and Rural Addiction Technology Transfer Center (NFAR ATTC). The goals of the meeting are to introduce the NFAR ATTC, build relationships with advisory board members, solicit feedback on proposed deliverables, and utilize the members' expertise. Key collaborators are identified, including treatment provider associations and telehealth experts. Year 1 key events are outlined, such as developing telehealth competencies and curricula, presenting at conferences, and sponsoring trainings. The intended audiences are identified as addiction counselors and treatment staff. Contact information is provided to download the presentation and learn more about promoting telehealth technologies.

1. Welcome

2. National Frontier and Rural ATTC
Advisory Board Meeting
Nancy A. Roget, MS
Principal Investigator/Project Director
2.28.13

3. Serve as the national subject expert
and key resource to PROMOTE the
awareness and implementation of
telehealth technologies

4. Original Advisory Board Members

5. Last Round of Funding Board Members

6. NFAR ATTC BOARD MEMBERS

7. Goals of Advisory Board Meeting
• Formally Introduce NFAR ATTC
• Build Relationships with Advisory Board
Members
• Solicit Feedback and Guidance on Proposed
Deliverables
• Utilize Advisory Board Members Expertise
to Enhance Proposed Products

8. Unofficial Goals

12. Which Technology Enhances Your
Work and Expands the Possibilities

16. University of Nevada, Reno

17. CASAT
5.3 million dollar
annual budget
20 grants & contracts

19. Center for the Application of
Substance Abuse Technologies (CASAT)
Orvis Building
University of Nevada, Reno

22. NFAR Staff

24. History of History
the ATTC of the
Network ATTCs
Thanks to Dr. Anne Helene Skinstad

25. ATTC History:
We’ve been around for a while
1993
CSAT funds first 11
“Addiction Training Centers” (ATCs)
Coverage: 19 US States and Puerto Rico
Program expanded to cover 4 additional states in 1995

26. 1995 Addiction Training Centers become ATTCs
– SAMHSA decided not to support students over the ATTC
budget (About $ 200,000 removed from individual ATTC
centers’ budgets)
– Criminal Justice Supplement added to several of center’s
budgets
– Virginia Commonwealth University’s responsibility
expanded to include Maryland and North Carolina
– Northwest Frontier’s responsibility expanded to include
Hawaii
– Iowa ATC received a subcontract through Governor State
University, became the ATC of Iowa
• Developed a 60 SH MA program in Substance Abuse and Mental
Health Counseling (CACREP Approved in 2001)

27. ATTC History
1996
CSAT re-names the program from ATCs to
“Addiction Technology Transfer Centers”
(ATTCs) to better reflect the scope of work

28. ATTC Network from 1998 - 2001

29. ATTC History
1998
CSAT establishes the ATTC Network, with
the creation of the ATTC National
Office
 13 Regional Centers and a National Office
covering 39 states, the District of Columbia,
Puerto Rico and the US Virgin Islands
1998
The ATTC Curriculum Committee writes
the Addiction Counseling
Competencies, which CSAT publishes as
TAP 21

30. ATTC History
2000
The ATTC Network published The
Change Book: A Blueprint for
Technology Transfer
2001
NIDA and SAMHSA enter into an
interagency agreement to form the
NIDA/SAMHSA Blending Initiative

32. ATTC Network from 2002 -2007

33. BUPRENORPHINE TREATMENT:
ATTC History
A TRAINING FOR
MULTIDISCIPLINARY
ADDICTION PROFESSIONALS
Module I - Introduction
2005
First NIDA/SAMHSA “Blending Product”
released, Buprenorphine Treatment: A
Training for Multidisciplinary Professionals.
2006
With significant involvement from the ATTCs,
SAMHSA publishes an updated version of TAP
21: The Addiction Counseling Competencies.

35. ATTC History
2011: ATTC Network Technology Transfer Workgroup
publishes “Research to practice in addiction treatment: key
terms and a field-driven model of technology transfer,” in the
Journal of Substance Abuse Treatment.
2011: SAMHSA & State Department create the
first international ATTC, the Vietnam HIV
ATTC.
2012: ATTC Network completes national
workforce study, “Vital Signs: Taking the
Pulse of the Addiction Treatment
Profession.”

36. ATTC Network from 2012 - 2017

38. Four National Focus Areas
• National American Indian & Alaska Native ATTC
email: americanindianalaskanative@attcnetwork.org
• National Frontier & Rural ATTC
email: frontierrural@attcnetwork.org
• National Hispanic & Latino ATTC
email: hispanic@attcnetwork.org
• National Screening, Brief Intervention & Referral to
Treatment ATTC
email: sbirt@attcnetwork.org

39. National
American Indian & Alaska Native National
ATTC SBIRT
ATTC
National
Frontier & Rural
ATTC National
Hispanic & Latino
ATTC

40. Almost 20 Years…..

42. Serve as the national subject
expert
and
key resource to
PROMOTE the awareness and
implementation of telehealth
technologies

43. Definitions
Telehealth ‘refers to the use of
telecommunications and information
technologies to provide access to health
information and services across a
geographical distance.’
Telemedicine ‘use of medical
information exchanged from one site to
another via electronic communications to
improve patients’ health status’

44. Definitions
• Synchronous communications
telephone counseling
• Asynchronous Communications
email or web-based programs
• Some web-based programs include
both type of communications

45. 1879

46. Telemedicine/Telehealth
• Annually, 10 million patients
receive telemedicine services.
• In 2011, the Veteran
Administration alone provided
6,700 patients with telemental
health services.

47. Telehealth Research
• 141 Randomized Control Trials
–148 telemedicine interventions with
nearly 37,000 patients
–108 of the trials were favorable toward
telemedicine intervention
–38 trials showed no statistical
differences

48. Telehealth is not about technology itself
but is a bridge to relationship with the patient
in order to provide care. (Shore, 2012)

49. Telehealth as it Relates to Treatment
and Recovery for SUDs

50. 4

51. Video Conferencing

55. Brief Review of Research

56. TES is an interactive, web-based
program theoretically grounded in the
evidence-based Community
Reinforcement Approach (CRA) to
behavior therapy
Theoretical Approach: Community
Reinforcement Approach (CRA) behavior
therapy; contingency management (CM)
Target Substance: Poly-substance use

57. Mōtiv8 is a web based contingency
management program for smoking
cessation using a home monitoring
system
Subjects log onto a website and use video recording
software to record and submit videos of breath carbon
monoxide (CO) samples. The Mōtiv8 application uses a
web-based interface for collecting data, automating
immediate voucher (incentive) delivery, and some versions
of the application include a group support forum.

58. MES is a computer-based brief
intervention with the goal of facilitating
self-change, treatment engagement,
and/or motivation to change via a single
intervention session.
Theoretical Approach:
Motivational intervention
Target Substance: Multiple substances,
poly-substance use

59. cMET/CBT/CM is a computer-
delivered intervention for cannabis
use disorders, incorporating features
of three evidence-based treatments:
cognitive behavioral therapy (CBT),
motivational enhancement therapy
(MET), and contingency management
(CM). Nine sessions presented over
12 weeks offer computer-assisted
instruction

60. MyStudentBody is an interactive, web-
based brief intervention for alcohol use
in college student populations
Theoretical Approach: Screening and
Brief intervention
Target Substance: Alcohol

61. McClure, Acquanta, Harding, & Stitzer
In Press
• Surveyed 8 urban clinics in Baltimore
(266 patients)
• Client’s Access to:
–Mobile Phone- 91%
– Text Messaging- 79%
– Internet/Email/Computer 39-45%

62. Training Substance Abuse Clinicians in
Motivational Interviewing Using Live
Supervision via Teleconferencing
Teleconferencing supervision (TCS)
was developed to provide remote, live
supervision for training MI
TCS shows promise for promoting new
counseling behaviors following
participation in workshop training.
(Smith, et al., 2012 Journal of Consulting and Clinical Psychology;80(3):450-464)

63. NASADAD Survey
• In 2009, Addiction Treatment Providers
in 16 states reported offering
treatment services using telehealth
(16 states out of the 37 states that responded to the survey)
• 25 states reported providing mental
health treatment services using
telehealth

65. Summary of
Goals

66. Create addiction treatment
telehealth competencies and develop
policy recommendations for national
license portability to encourage the
addiction treatment and recovery
workforce to ADOPT the use of telehealth
services

68. Use state-of-the-art culturally-relevant
training and technical assistance activities
to help the frontier/rural addiction
treatment and recovery workforce
IMPLEMENT telehealth services

69. We need to embrace
RECOVERY

70. White, 2011
Recovery is contagious. Get close to it.
Stay close to it. Catch it. Keep catching it. Pass it on

71. PREPARE pre-service addiction
treatment and allied health students on
using telehealth technologies by
developing and disseminating academic
curricula for infusion into existing courses

73. Key Collaborators
• NASADAD
• SAAS-Treatment Provider Associations
• HRSA Regional/National Telehealth Centers
• Telehealth Experts
• Regional Addiction Educators Groups
• Project Echo at UNR
• Telehealth Experts
• NAADAC
• IC&RC

74. Year 1 Key Events

75. Year 1 Key Events
• Build compendium through Literature Searches
• Develop Graphics/Marketing Themes
• Conduct Telehealth Needs Assessments
• Develop Curricula
• Present at National Conferences
• Present at Regional Summer Institutes
• Sponsor two TOTs
• Conduct State Presentations 2 x each ATTC Region
• Sponsor Early Adopters Summit

76. Drive target
population to
our website
76

78. 2 UpcomngTrainings
Brief Introductory Training
Administrators Training

79. Utilize Video

80. It’s the Relationship with Stakeholders
and Customers that is MOST Important
Groundswell: Bernoff & Li, 2009

81. Year 2-5
• Film and Disseminate Two Telehealth Workshops
• Develop Clinical Supervisor Curriculum
• Annotate Bibliographies
• Create Marketing Videos
• Host Webinars of Curricula
• Build Addiction Educators Curriculum and Sponsor
Training
• Sponsor Telehealth Competencies Workgroup and
Develop a Product
• Create and Implement Peer Recovery Curriculum
• Develop Addiction Treatment Curricula

83. Who is Our Audience?

84. Addiction Treatment Counselors

85. The majority of the Substance Abuse
Treatment Workforce is …
Clinical Direct Care
Directors Staff
Gender Female (59%) Female (67%)
Ethnicity White (86%) White (64%)
50+ (60%)
Age 35+ (64%)
[Avg. 52]
Employment Full time (95%) Full time (77%)

89. Serve as the national subject
expert
and
key resource to
PROMOTE the awareness and
implementation of telehealth
technologies

90. Download this PowerPoint Presentation
from our website
www.attcnetwork.org/frontierrural