Addiction studies: exploring students' attitudes toward research in a graduate program.
Abstract: An exploratory study was conducted to compare addiction studies and community counseling students' attitudes toward research. A survey of 66 addiction studies and 17 community counseling students in graduate programs was used to explore interest and self-efficacy in research and the research training environment. A pre/post test design was used to measure differences in an addiction etiology anal epidemiology course containing 14 participants. Differences between recovering and non-recovering students were also explored. Independent t-test analyses were conducted to detect significant differences between addiction studies and community counseling students (p<. 05), as well as significant differences in those students enrolled in the pilot course (p<. 05). No differences were noted among reported recovery status. Implications for graduate program development in addiction studies are discussed.
Subject: Epidemiology (Public opinion)
Students (Surveys)
Students (Public opinion)
Substance abuse (Care and treatment)
Substance abuse (Public opinion)
Authors: James, Raven
Simons, Lori
Pub Date: 08/01/2011
Publication: Name: Journal of Alcohol & Drug Education Publisher: American Alcohol & Drug Information Foundation Audience: Academic; Professional Format: Magazine/Journal Subject: Health; Psychology and mental health; Social sciences Copyright: COPYRIGHT 2011 American Alcohol & Drug Information Foundation ISSN: 0090-1482
Issue: Date: August, 2011 Source Volume: 55 Source Issue: 2
Topic: Event Code: 290 Public affairs
Product: Product Code: 8000143 Alcohol & Drug Abuse Programs NAICS Code: 62142 Outpatient Mental Health and Substance Abuse Centers SIC Code: 8093 Specialty outpatient clinics, not elsewhere classified
Accession Number: 268478442
Full Text: The scientist-practitioner (S-P) model or "Boulder model" of training has served as the backbone of counseling psychology doctoral programs in the United States for nearly six decades. Ideally, science-practitioners should be able to apply psychological knowledge to their therapeutic work with clients (Jones, & Mehr, 2007). Research and practice should be synthesized into an integrated way of working which will be expressed in practice by employing a scientific approach (Spengler et al., 1995; Jones, & Mehr, 2007). Gelso and Lent (2000), offered the following synopsis: "Ultimately, ... our science and practice will be enhanced by helping our students learn how scholarly work can be done in the context of practice and practice settings" (p. 135). Over the years, leaders in the field have echoed this call by asserting that further integration of science and practice is needed to strengthen counseling psychology (e.g., Heppner, et al., 1992; Heppner, Casas, Carter, & Stone, 2000; Kahn & Gelso, 1997).

Despite the proliferation of research on the S-P model in counseling psychology programs, a lack of investigation in addiction counselor training programs prevails. Part of this may be explained by the sheer numbers of psychology counseling programs as compared to addiction preparatory programs, as well as the underlying structure of addiction counseling. Many addiction counselors are recovering themselves, and historically, the pattern of training and treatment approaches were based on the disease model and 12-step ideology. As such, addiction counselors have been reticent to utilize evidence-based practices and treatments in a formal manner, citing their belief in outdated, empirically flawed methodology. A gap has been noted between what has been shown to be promising in the addiction literature and what is traditionally practiced by clinicians (Hodgson, 1994; Miller, Brown, et al., 1995; Miller & Carroll, 2006; Miller & Hester, 1986).

Although research over the past 30 years has helped advance knowledge of substance use disorders and their treatment efficacy, treatment professionals may find it difficult to keep up with such a broad body of literature that encompasses a diverse array of populations, theoretical approaches, study methods, and findings (Kahler, 1995). Previous research indicates that more than of half of addiction counselors are recovering alcoholics/addicts (Koch & Bianco, 2001). The typical addiction counselor is a recovering alcoholic/addict that gains experience through involvement in twelve-step programs and on-the-job training (Koch & Bianco, 2001; Sheehan, 2003). However, recent changes in formal education requirements for certification has prompted paraprofessionals and professionals to enter addiction studies programs (Taleff, 2003), yet many of them are recovering and continue to practice experiential therapy techniques (Walker-Smith et al., 2004). The treatment field is progressively moving from a culture of "recovering" counselors, to ones who are trained in more of a traditional academic and clinical manner. With this shift in culture of training addiction counselors, was the introduction of and conflict with older, more traditional recovering counselor beliefs regarding research-based treatments. Part of this may also be explained by the way in which information in the scientific literature is presented sub-optimally to current clinicians. If they are not trained on how to understand scientific research, understanding how it relates to their clinical practice will be dismissed. For these reasons, it is important to evaluate the recovery status of addiction counselors and students.

To date, there is a lack of investigation on the S-P model and attitudes toward research for students in addiction counselor training programs. This study explored attitudes toward research of graduate students enrolled in addiction studies and in community counseling programs at a mid-western University and identified factors that influenced their attitudes. The following research questions were asked: (a) Are there significant differences in students' interest in learning about research from the beginning to the end of the semester, (b) Are there differences in students' interest in learning about research between graduate students enrolled in an addiction studies program and students enrolled in a community counseling program, and (c) Are there differences in students' interest in learning about research between recovering and non-recovering students?

METHOD

Participants

Participants were 83 current graduate students (ages 22-64 years, M= 37; 70 females, 13 males) from an Addiction Studies and Community Counseling Program at a public, suburban midwestern University. The number of students reflected those who responded voluntarily to class surveys. Access to two community counseling and four addiction studies classes was granted by instructors, yielding a response rate of 17 community counseling and 66 addiction studies students. Reported ethnicity was 66%: African American, 2%; Latino, 26%; White, 1%; multiracial, 2%; refused to self-report; and 1% other. Students reported working in a variety of settings, 27% in drug and alcohol agencies, 10% in mental health settings, 2% in community agencies, 5% in hospital settings, 10% in educational institutions, and 12% in human service settings. Fourteen students (17%) reported not working and fifteen (18%) of the working students were not employed in their self-ascribed fields. Reported recovery status consisted of 17% recovering students and 83% non-recovering students.

Instrumentation

Several instruments were used to gather data and assess the identified variables, including a demographic survey designed by the authors, as well as the following scales:

Interest in Research Questionnaire (IRQ), developed by Bishop and Bieschke (1994), is a 5-point Likert scales that assessed various research activities on 16 items. Items were presented as statements, and respondents endorsed their levels of agreement with each statement by circling a score on a 5-point Likert scale ranging from 1, "strongly disagree," to 5, "strongly agree." Items were added together to produce a full scale score ranging from 16 to 80. Internal consistency for the IRQ ranges from .89 to .90.

Past Attitudes toward Research (PATR), developed by Royalty, Geslo, Mallinckrodt and Garrett (1986), is a 4-item measure that assesses students' interest in conducting research and the value which they place upon research-related activities. Items were presented as statements, and respondents endorsed their levels of agreement with each statement by circling a score on a five point Likert scale ranging from 1, "disagree," to 5, "agree." Responses were summed across the four items to form a measure of past research interest that ranged from 4 to 20. Higher scores on this measure indicate greater research interest. Alpha coefficients range from .87 to .90, and retest coefficients range from .93 to .98.

Research Self-Efficacy (RSE), developed by Kahn and Scott (1997), is used to assess research self-efficacy. Twelve items measured 4 domains of research self-efficacy including: research design skills, quantitative and computer skills, practical research skills, and writing skills. Items were presented as statements, and respondents endorsed their levels of agreement with each statement by circling a score on a nine-point rating scale ranging from 0, "no confidence," to 9, "total confidence." Total scores range from 0 to 108, with higher scores reflecting greater research self-efficacy. Internal consistency for the total score was .90.

Research Outcome Expectations Questionnaire (ROEQ), developed by Bieschke and Bishop (1994), is a 5-point Likert scale that measures beliefs about research involvement on 8 items. Items were presented as statements. Respondents endorsed their levels of agreement by circling a score on a five-point Likert scale ranging from 1, "strongly disagree," to 5, "strongly agree." Items were added together to produce a full scale score ranging from 8 to 40. Internal consistency for the ROEQ ranges from .89 to .90.

Research Training Environment Scale (RTES), developed by Gelso, Mallinckrodt, and Royalty (1991), is a 45-item inventory designed to assess effective research training environments. The instrument includes 9 subscales, each examining a different component of the training environment such as involving students m research early and faculty modeling of appropriate scientific behavior. Items were presented as statements, and respondents endorsed their agreements with each statement by circling a score on a five-point Likert scale ranging from 1, "disagree," to 5, "agree." We used 42 items from this scale, omitted items that were designed specifically for doctoral students, and then added all of the items together to produce a full score. A full scale score was used in this study. Test-retest reliability coefficient for the total scale was .92.

Design and Procedure

A cross-sectional sample utilizing surveys was used to examine differences in attitudes toward research between 83 graduate students enrolled in addictions studies and in community counseling courses during the fall of 2009. Students were informed that the survey was part of an evaluation about student attitudes toward research, and that their participation in this study was voluntary. Students were offered a chance to enter a random drawing for one 50 dollar VISA gift card as an incentive to participate in the study. Anonymous tags (based on their class designation) were assigned to consent forms in order to identify the winner of the drawing. Students who completed surveys in the pilot course were entered twice into the drawing. A graduate assistant administered and collected surveys throughout the term from several courses in each program.

A pre- and post-test design was used in a graduate etiology and epidemiology course in addiction studies to measure differences between student attitudes toward research before and after participation in the course. The course was designed to incorporate previously identified variables in influencing student attitudes toward research in the curriculum to measure differences in student attitudes before and after taking the class. It was hypothesized that there would be an increase in student interest in research on some of the identified variables.

RESULTS

Pre- and Post-Test Differences in Students' Attitudes in the Etiology and Epidemiology Course: A paired t test was conducted to measure differences in the Interest in Research (IRQ), Past Attitudes Toward Research Interest (PATR), Research Self-Efficacy (RSE), and the Research Training Environment (RTES) scale scores from the beginning to the end of the semester for graduate students (n=14) enrolled in an etiology and epidemiology substance abuse course. As shown in Table 1, students made higher ratings of the research training environment of the graduate program as fostering their understanding of statistics and the application of research to clinical service over time.

Differences between Addictions Studies and Community Counseling Students Attitudes toward Research: An independent t test was conducted to measure differences in the Interest in Research Questionnaire (IRQ), Past Attitudes Toward Research (PATR), Research Self-Efficacy (RSE), and the Research Training Environment (RTES) scale scores between addiction studies and community counseling students. As indicated in Table 2, addiction studies students had higher past interest scores but lower RTES compared to community counseling students. Addiction studies students had lower ratings of faculty modeling scientific behavior, program incentives for conducting student research, the use of relevant statistics, identifying methodological flaws in research, and the application of research clinical service than community counseling students.

Differences of Research Attitudes between Recovering and Non-Recovering Students: An independent t test was conducted to measure differences in Interest in Research (IRQ), Past Research Interest (PATR), Self-Efficacy in Research, and the Research Training Environment (RTES) scale scores between recovering and non-recovering graduate students. There were no significant differences in scores between recovering and non-recovering students, which may be attributed to few students (17%) having identified themselves as in recovery from alcohol and/or drug abuse.

DISCUSSION

A growing body of research has examined substance abuse counselor attitudes toward using empirically supported treatments (Fals-Stewart, Logsdon and Birchler, 2004; Godley, et al., 2001; Gotham, 2004; Najavits, 2004; Simons, Jacobucci, and Houston, 2005, 2006). Empirically supported treatments are based on research principles, and resistance of substance abuse providers to utilize them reflects lack of familiarity and comfort with research-based interventions. Researchers and practitioners agree that there is a gap between promising interventions identified in outcome studies and techniques that are commonly practiced by addiction counselors (Read et al., 2003). Understanding the variables which impact addiction students' lack of interest in research, will enable addiction preparation programs to strengthen offerings to address this critical need. In turn, this will help students to bridge the gap between research and practice.

Students in the addiction studies program had lower ratings of the research training environment compared to those in the community counseling program. In fact, students in addiction studies had lower ratings of faculty modeling of research and positive incentives for taking part in scholarship. These students also had lower scores for understanding the science in social research, the use of relevant statistics, different types of methodology and research limitations, and the application of research to clinical services compared to students in community counseling. These findings may be explained by the different graduate curricula and are congruent with previous research that compared undergraduate students in a behavioral health to those in a psychology program (Simons, Jacobucci, and Houston, 2005, 2006).

Differences between course offerings of addiction studies and the community counseling program vary. The addiction studies program operates on open enrollment whereas community counseling admits students twice per year and has a cohort group. Group cohesiveness can impact how students interact with one another on research or group projects. Curricular differences may account for differences between groups. The addiction studies Master's program is currently 32 hours of coursework, whereas the community counseling program requires 54 hours. Community counseling also includes 3 practicum hours, giving students more exposure to and supervision of implementing empirically-supported treatments as well as requiring courses in theory and practice, research methodology and measurements and evaluation. These courses provide more exposure and development in research-based practice and are more supportive of the scientist-practitioner model. If students in addiction studies are to be prepared to understand the science-practitioner model then they should be exposed to statistics and research courses as well as research-based practices that are part of the community counseling curricula.

It is important to note that understanding reasons why students lack research interest is important. This information can be utilized to target course offerings and strengthen program designs. It appears that we need more addiction scientists. Developing research tracks in addiction studies programs could help cultivate interest in students becoming more research-oriented. Part of the importance of this study can also assist faculty in designing course curriculums to help students develop how to apply science to practice and to use critical thinking skills.

Changes over time in programs can be measured once a research track is developed and implemented, providing markers in strengthening the scientist-practitioner model. Investigations on counseling students suggest that students who lack interest in research produce low levels of scholarship (Bishop & Bieschke, 1998; Kahn, 2001). As reflected in this study, student involvement in basic research activities who acquired confidence in research design skills was associated with higher rating of the research training environment of their graduate program. These students made improvements in their knowledge of research design, writing skills, use of relevant statistics, and the application of research to clinical services. Students' acquired confidence in research design skills is consistent with previous findings of Bishop and Bieschke (1998) and Kahn (2001), who found that students' confidence was associated with positive outcome expectations, increased research interests and scholarship productivity.

The majority of the faculty members in this addiction program were not actively engaged in research. This may account for the lower student ratings of research as a social science. Gelso (2006) suggests that mentoring students is an essential part of graduate training that influences and reinforces their favorable views of science and practice. Gelso (2006) also proposes that research seminars, participation on research teams, and faculty mentoring enhance students' interest and involvement in scholarship. It may be advantageous early if we are able to adequately prepare addiction studies students to use empirically supported techniques.

LIMITATIONS

The current study adds to the literature on addiction studies students' attitudes toward research, although the results should be viewed in light of a few key limitations. First, the sample size is small and may only be generalizable to public universities in the mid-western United States. Second, data were collected using self-report methods which may have been a problem on the question regarding recovery status.

Of the eight full-time faculties, five hold doctoral degrees, with only two currently involved in research. Faculty characteristics could account for differences in findings related to the research environment. In order to accurately control for these differences, changes in program structure with regard to student research opportunities are needed.

Lastly, there were unequal sample sizes between the groups. A Bonferoni correction was not conducted on the unequal sample sizes because the number of participants in both groups was small, therefore, the findings may be a result of homogeneity effects associated with the participants in both groups. More research is needed with equal sample sizes to accurately reflect differences between addictions studies and community counseling students.

IMPLICATIONS FOR FUTURE RESEARCH

Clinicians in the substance abuse field are reticent to using evidence-based practices, which are research-based. Understanding these treatments and the underlying theories can help clinicians make better informed choices regarding treatment for their clients. Being trained in research as part of a counseling and certification program may help future addictions counselors better understand and incorporate research-based principles into their respective work with clients. The results from this study will inform grant preparation for funding to develop faculty, staff and student interest and capacity to conduct research in an addiction studies program.

Fostering the development of faculty involvement with research can be used to model teaching methods which involve students to develop individual and group projects, both clinical and educational. Having opportunities to engage in research can motivate students to become trained in the scientist-practitioner model. Introducing research courses can expose students to methods that are increasingly being used in the field (Taleff, 2003). If these suggestions were to be implemented, addiction students might become more knowledgeable, skilled, and efficient. These students could also contribute to diffusion of evidence-based practices as they become employed as professionals in the addiction field.

Variables that could be put into the program include a research methods course as well as research seminar, which would require students to design a research proposal and implement a research project. Faculty could also include students in personal research projects, allowing them opportunities to assist in data collection, literature reviews, intervention development and other relevant activities. Students could also be encouraged to engage in secondary data analyses, critique manuscripts and write for publication as part of the process. Faculty could also mentor students to help guide them through their development as researchers, offer seminars and opportunities to present their research with each other and their mentors at professional venues.

Identifying the factors that impede students from wanting to learn about and utilize relevant research can help training programs focus on courses and training approaches that will assist students in being able to make the connections between research and practice. In addition, students involved in basic research activities and who acquire confidence in research design skills are more likely to have favorable views of the scientist-practitioner model. Making changes in addictions counselor training programs can better prepare future clinicians to be more accepting of and willing to use research in practice. Future research is needed to implement recommendations from these findings and systematically study student outcomes.

CONCLUSION

Much has been published regarding methods for dissemination and adoption of evidence-based practices in substance abuse treatment, yet most of them focus on models that utilize on-the-job approaches such as on- and off-site trainings, supervision, presentations/seminars, blending conferences and online trainings (Condon, Miner, Balmer & Pintello, 2008; Haug, Shopshire, Tajima, Gruber & Guydish, 2008; Miller, Sorensen, Seizer & Brigham, 2006; Simpson, 2002). While there is great scientific value in evaluating these methods, the newer generation of academically prepared counselors has much to contribute to influencing this movement through systematic training in the S-P model. Faculty programs to develop interest in substance abuse education in professional training programs have yielded not only increased faculty research capacity but student interest in addiction research and confidence in treating addicted patients (Miller & Anderson, 2003). Although there is no consensus as to best approaches in training next generation addiction practitioners in academic programs, incorporating research components into a Master's level addiction degree program is a promising method for diffusion of research to practice.

Correspondence concerning this article should be addressed to: Raven James, Ph.D., Assistant Professor, Addiction Studies, Governors State University, 1 University Place, University Park, IL 60484, Telephone: (708) 235-2160; email: r-james@govst. edu.

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Raven James

Governors State University

Lori Simons

Widener University
TABLE 1

Differences in the Students' Interest in Research from the Beginning
to the End of the semester

                            Pretest         Posttest

Variables                  M       SD      M       SD    df     t

Interest in              49.50   14.50   48.42   23.27   13     .18
Research (IRQ)
Past Attitudes           10.78   23.27   11.64    3.06   13   -7.02
Toward Research
Self-Efficacy in
Research
Design                   33.78   12.58   42.92   12.53   13   -3.28 **
Research Skills          26.17    7.81   25.14    7.92   13    0.44
Quantitative Skills      11.21    6.95   10.50    4.89   13    0.53
Writing Skills           39.07   21.51   49.00   18.81   13   -1.98

Research Training
Environment Scale
Faculty Modeling         13.71    3.22   13.64    4.76   13     .90
Positive Reinforcement   16.50    3.56   16.50    3.56   13     .95
Low Threat in Research    8.78    2.29    9.50    3.22   13     .31
Activities
Relevant Statistics      15.07    4.92   17.50    4.58   13   -3.10 **
Science as a Social      16.57    3.91   12.28    2.99   13    4.34 ***
Experience
Flaws in Research        16.50    3.39   17.64   14.35   13    0.75
Exposure to Multiple
Investigative Styles      6.00    1.56    6.35    2.59   13    0.56
Application to           28.75    8.57   34.66    8.17   11   -3.25 **
Clinical Services

Note. *** p<.000, ** p<.01, * p<.05

TABLE 2.

Differences in the Interest in Research Between Addiction Studies
(n = 66) and Community Counseling (n = 17) students

                                   Students

                         Addiction       Community
                          Studies        Counseling

Variables                M       SD      M       SD    df     t

Interest in            50.26   14.51   43.58   14.41   81    1.69
Research (IRQ)
Past Attitudes         11.33    3.63    9.38    3.85   82    1.98 *
Toward Research

Self-Efficacy in
Research
Design                 38.37   12.95   39.38   15.98   82   -0.27
Research Skills        29.78    9.34   27.55   11.66   82    0.85
Quantitative Skills    13.28    6.72   12.16    7.35   82    0.61
Writing Skills         48.87   19.06   47.72   20.92   82    0.22
Research Training
Environment Scale
Faculty Modeling       13.00    3.02   16.94    2.15   82    5.17 ***
Positive               15.86    3.48   20.22    3.09   82   -4.08 ***
Reinforcement
Low Threat in           8.87    1.96    9.72    2.53   82   -1.52
Research Activities
Relevant Statistics    14.83    3.93   18.16    2.68   82   -3.38 ***
Science as a Social    16.01    3.14   19.11    2.11   82   -3.93 ***
Experience
Flaws in Research      15.92    2.92   17.61    2.32   82   -2.25 *
Exposure to Multiple
Investigative Styles    5.98    1.51    7.38    1.33   82   -3.57 ***
Application to         28.78    6.57   35.27    6.09   81   -3.76 ***
Clinical Services

Note. *** p<.000, * p<.05
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