Readiness and barriers to adopt evidence-based practices for substance abuse treatment in Mexico

Abstract

Introduction. Evidence shows a lag in adoption of evidence-based practices (EBPs) for substance abuse treatment and supports the need for studying the factors involved in this worldwide problem.

Objective. This study aimed to assess the readiness and barriers to adopt EBPs for substance abuse in a sample of outpatient treatment centers of a newly created Mexican Clinical Trials Network.

Method. An online survey was administered to directors (n = 8) and clinicians (n = 40) from seven outpatient treatment centers in Mexico. Questions were obtained from two surveys that had been implemented in the US to assess the same objectives.

Results. Respondents reported being more ready to adopt Cognitive Behavioral Therapy (CBT, 83.3%) and Motivational Enhancement Therapy (MET, 79.1%), compared to 12 step facilitation (58.3%), couples therapy (56.2%), Brief Strategic Family Therapy (BSFT, 66.6%), and motivational incentives (60.4%). Directors had lower mean resistance to EBPs (11.8 vs. 17.4; p = 0.01) than clinicians. The biggest barriers identified by directors to EBP adoption were not having enough clinical staff, being unable to afford well-trained staff, not enough psychiatric and medical support.

Discussion and conclusion. CBT and MET emerged as the most frequently used evidence based practices in the sites that are part of the Mexican Clinical Trials Network. Staff positive attitudes towards EBPs are critical for adoption.