COUNSELOR NOTE: IMPLEMENTATION OF MET IN SUD TREATMENT SERVICES IN THE VETERANS HEALTH ADMINISTRATION

In 2011, the Veterans Health Administration (VHA) implemented a national initiative to provide evidence-based MET counseling to veterans with SUDs. VHA developed a competency-based training program (Drapkin et al., 2016) that consisted of an initial 3.5-day training on MI plus assessment feedback, followed by 6 months of consultation with experienced MI training consultants (TCs). TCs provided ongoing supervision and coaching based on direct observation of counseling sessions using audio recordings. Training materials were adapted to address the speciic needs of veterans. The VHA model of implementation was based on research in the training and supervision of clinical staff in MI to enhance implementation and fidelity.

Implementation of this competency-based model of training and supervision was enhanced by encouraging training participants to actively engage with the VHA MET community by becoming TCs and “MET champions,” who provided information and consultation on how local VHA facilities could best disseminate and implement MET into their SUD treatment approach. TCs participate in monthly national conference calls with other TCs covering advanced MET topics. This model combines the use of outside trainers with in-house workforce development of new trainers and MET champions to create learning communities that sustain the use of MET in VHA facilities.