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Counseling Staff’s Views of Patient-Centered Methadone Treatment: Changing Program Rules and Staff Roles

  • Shannon Gwin Mitchell
  • Laura B. Monico
  • Elizabeth Lertch
  • Sharon M. Kelly
  • Jan Gryczynski
  • Jerome H. Jaffe
  • Kevin E. O’Grady
  • Robert P. Schwartz
Article

Abstract

Conflicts with methadone program counseling staff and violations of program rules can contribute to patients leaving treatment prematurely. This qualitative study was conducted as part of a larger trial of patient-centered methadone treatment (PCM). In-depth, semi-structured interviews at baseline and 12-month follow-up were conducted with five counselors and three clinical supervisors from the programs participating in the PCM parent study. Data were analyzed using Atlas.ti. Counselors reported that, in some cases, PCM allowed them to focus on building a therapeutic alliance with patients because they were not addressing program rule issues. Some reported using more pro-active, innovative strategies for engaging PCM patients and that counseling sessions tended to include a broader range of individually tailored topics, compared to topics normally addressed in typical treatment sessions. Adjusting to the new counselor role was challenging for some counselors and required a shift in tactics to encourage patients’ participation in counseling services. Clinical trial registration: Clinicaltrials.gov NCT 01442493

Notes

Funding

The study was supported through National Institute on Drug Abuse (NIDA) Grant No. 2R01DA15842 (PI Schwartz).

Compliance with Ethical Standards

Conflict of Interest

Dr. Schwartz in the past provided a one-time consultation to Reckitt-Benckiser, one of the manufacturers of buprenorphine, on behalf of Friends Research Institute. Dr. O’Grady in the past received reimbursement for his time from Reckitt–Benckiser. No financial disclosures were reported by the other authors.

Disclaimer

NIDA or the National Institutes of Health had no role in the design and conduct of the study; data acquisition, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

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Copyright information

© National Council for Behavioral Health 2018

Authors and Affiliations

  • Shannon Gwin Mitchell
    • 1
  • Laura B. Monico
    • 1
  • Elizabeth Lertch
    • 1
  • Sharon M. Kelly
    • 1
  • Jan Gryczynski
    • 1
  • Jerome H. Jaffe
    • 1
    • 2
  • Kevin E. O’Grady
    • 3
  • Robert P. Schwartz
    • 1
    • 2
  1. 1.Friends Research Institute, Inc.BaltimoreUSA
  2. 2.Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreUSA
  3. 3.Department of PsychologyUniversity of MarylandCollege ParkUSA

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