Drug Treatment Matrix cell D4: Organisational functioning; Psychosocial therapies
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Drug Treatment Matrix cell D4

Organisational functioning; Psychosocial therapies

One of 25 cells in the Drug Treatment Matrix Matrix cell logo

Key studies on how treatment organisations affect the implementation and effectiveness of psychosocial therapies for drug dependence. See if you agree that “organizational climate underlies the entire process of innovation adoption”, appreciate the obstructive effect of high staff turnover and how to reduce it, ask yourself, “Is my service even ready for change?” – and explore whether change driven by money is just as good for patients as that motivated by a desire to improve their lives.


S Seminal studiesK Key studiesR ReviewsG Guidancemore Search for more studies

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K Organisational health associated with engagement in treatment (2009). In England clients best engaged in treatment and developed rapport with their counsellors when services fostered communication, participation and trust among counselling staff, and had a clear mission but were open to new ideas. For discussion click and scroll down to highlighted heading.

K Workplace ethos sets context for adopting new counselling methods (2012). Workplace climate including strength of mission, staff cohesion, communications, professional autonomy, lack of stress, and receptiveness to change “underlies the entire process” of ‘bottom up’ innovation initiated by counsellors. For discussion click and scroll down to highlighted heading.

K Healthy organisation related to substance use and patient–counsellor relationships (2011; free source at the time of writing). At US substance use counselling centres, rather than resources, training or equipment, the relational features of the organisation including staff feeling able to influence, trust and cooperate with each other were related to a centre’s drug/alcohol use outcomes. Services also differed in the strength of the therapeutic relationships patients reported with counsellors. Implications were that “assuming causality … better outcomes could be achieved by both improving … organizational functioning [and] the alliance of counsellors with their patients”. For related discussion click and scroll down to highlighted heading.

K Organisational context is key to implementing new ways of working (2012; free source at the time of writing). Compelling account of what it takes in the real world (when implementation staff have to grapple with counsellors and organisations over which they have no control) to introduce a new treatment approach. Key lesson is that each organisation is different; being there, learning about that unique context, and taking it into account, are needed to give implementation a chance. For discussion click and scroll down to highlighted heading.

K Autonomy and justice retain counselling staff (2008). Organisations which do not offer autonomy to substance use counsellors, foster a sense of being treated fairly, or promote mutual worker support, risk generating the high staff turnover which impedes workforce development. For discussion click and scroll down to highlighted heading.

R Involve whole organisation in implementing psychosocial treatment (2011). Successful implementation is most likely when the entire agency is the target of the implementation effort rather than individual therapists. For related discussion click and scroll down to highlighted heading.

R When residential care matters (2002). Informal review from Drug and Alcohol Findings concludes that more severely dependent and problematic substance using clients differentially benefit from residential care. Where studies have found no added benefit this may have been because the service’s caseload was limited in severity, or because the study set severity limits so that all the participants could safely be allocated to residential or non-residential care.

G English drug services define their own quality standards (2016). From bodies representing the addictions treatment sector in England, standards developed after consultation and piloting with services. Designed to guide services in assessing how they support people into and through recovery and the quality of vital aspects of their organisations. Includes standards for non-residential and residential rehabilitation services and an implementation guide for the non-residential standards.

G Implementing change ([US] Substance Abuse and Mental Health Services Administration, 2009). How to assess an organisation’s capacity to identify priorities, implement changes, evaluate progress, and sustain effective programmes, and how to implement innovations. For discussions click here and here and scroll down to highlighted headings.

G Simple ways to improve an organisation’s performance. Helpful web site from the University of Wisconsin in the USA providing research findings, promising practices, and toolkits, all geared to encouraging and supporting administrative and therapeutic improvements in addiction and mental health care services.

G Theory into practice strategies ([Australian] National Centre for Education and Training on Addiction, 2005). From one of the world’s major workforce development agencies for the addictions field. Chapter on managing organisational change includes the organisational factors which impede or promote change and how to manage them. For discussion click and scroll down to highlighted heading.

more Search for all relevant Effectiveness Bank analyses or for sub-topics go to the subject search page and hot topics on why some treatment services are more effective and on individualising treatment.

Matrix Bite Open Matrix Bite guide to this cell Open Matrix Bite guide and commentary. Original bites funded by Society for the Study of Addiction web site. Opens new window