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					Final Report on the Evaluation Components of
      the Co-occurring Training Project
                        (6/30/06)
                           by
             William J. Payne, M.A., LADC
                Mark F. Stasson, Ph.D
              Metropolitan State University.
                                         Introduction
   Co-occurring mental health and substance abuse disorders constitute one of the most
pressing problems facing the nation’s mental health and substance abuse delivery systems
today. The estimated 7-10 million people in this country who experience the combination of
at least one mental health and substance abuse disorder present a significant challenge. These
individuals can cycle repeatedly through the mental health and substance abuse treatment
systems. They are in our courts and criminal justice systems, some are homeless and many
receive no services at all (SAMHSA, 2002).
   Many clients in Minnesota’s chemical dependency treatment programs have been found to
have mental illnesses in addition to their problems with alcohol and/or other drugs. While
treatment approaches for addictions in the absence of mental disorders can claim some
success, the presence of psychiatric symptoms has been associated with poor treatment
response and has limited overall rates of success. This presence of clients with mental health
problems in our chemical dependency treatment programs is significant. Lack of
understanding and adequate skills to address the issues of co-occurrence has contributed to
less than desirable outcomes for theses clients (Payne, 2004, p. 4-5).
   It was as a result of this need to improve services and outcomes for clients with co-
occurring disorders in the chemical dependency treatment system which led the Chemical
Health Division (CHD) of the Minnesota Department of Human Services (DHS) to contract
with Metropolitan State University (Metro State) to establish a series of training sessions on
the co-occurrence of mental health problems within our chemical dependency treatment
programs. These sessions were referred to as the “Co-occurring Training Project.”


                          Overall Description of this Training Project
   This Co-occurring Training project provided 60, 2-day (12 hours) training sessions for
alcohol and drug counselors and other staff, who worked in Rule 31 programs in Minnesota.
The training curriculum was designed to provide a basic understanding of the major mental
disorders and how they interact with chemical dependency problems. In addition, specific
counseling methods and techniques to meet the needs of clients with co-occurring substance
abuse and mental disorders was discussed, in order to help counselors improve service
outcomes for these clients (Payne, 2004, p. 5).



                                                                                                 2
   The overall goal of this training project was to improve service outcomes for clients who
have co-occurring chemical dependency and mental disorders in Rule 31 licensed programs.
Specific curriculum and training objectives were:
        To increase counselors’ knowledge of the basic characteristics of the main mental
         disorders, which they are likely to encounter among clients. (Note: curriculum
         focus was on current clients in chemical dependency counseling/treatment, not
         those who are considered to be seriously and persistently mentally ill.)

        To build an awareness of the co-occurrence between those common mental
         disorders and substance abuse.

        To become more familiar with effective treatment methods, such as; assessment,
         counseling approaches, and medications used to address clients with co-occurring
         disorders.

        To become more familiar with community resources for clients with these co-
         occurring disorders (Payne, 2004, p. 6)

   The hope and the promise of education is to help to find more effective solutions to
problems, this coupled with the mission to help to bridge the gap between research and
practice, made this training project so important. These training sessions were a tremendous
opportunity to improve treatment services and outcomes for our many clients who suffer from
mental health and chemical dependency problems (Payne, 2004, p. 4)


                                The Contents of this Report
   This report presents the results of the evaluation components from the Co-occurring
Training Project. The evaluation data was collected during the 60, 2-day (12 hours) training
sessions delivered over a 12 month period from October, 2004 to September, 2005. With data
form nearly 1400 respondents, the results from these evaluation components present a
comprehensive evaluation of this training project.
   This Co-occurring Training Project was directed by the Chemical Health Division of the
MN Department of Human Services and delivered by Metropolitan State University in
collaboration with the Division of Continuing Education and Training at Minneapolis
Community and Technical College.
   Participants in these training sessions were clinical staff members from Rule 31 (Chemical
Dependency Treatment) Programs in MN. Rule 31 requires, ”Treatment directors,
supervisors, nurses, and counselors to obtain 12 hours of training in co-occurring mental

                                                                                               3
problems and chemical dependency…” (MS 9539.6460, Personnel Policies and Procedure
Subp. 2 Staff Development, paragraph E). So, training respondents (subjects) were mandated
by DHS under this Rule 31 training requirement, to attend this training.
   CHD required the evaluation of the training sessions to be part of the delivery of the
training. They were interested in evaluation and data collection related to the make-up of our
chemical dependency workforce, as well as, the clinical knowledge and experience with co-
occurring disorders and evaluation of the training curriculum. As a result, five evaluation
components were developed. They are described as follows:
   1. Pre/Post Tests: the Pretest was designed to first measure an initial base-line of
   information regarding workforce knowledge of co-occurring disorders. Then, to measure
   any increase in knowledge as a result of the training the Posttest was administered.
   Findings from the Pre/Post test results are included in this report.

   2. Training Evaluation: the purpose of this evaluation component was to determine the
   respondents’ experience and satisfaction with the training sessions, the course content and
   the trainer. Findings from the training evaluations are included in this report.

   3. There was also an evaluation in which the trainer, for each session, filled out
   regarding the trainers experience and satisfaction with delivery and respondent response to
   the training session. A summary of these evaluations are included in this report.

   4. Outcome Evaluation: an outcome or follow-up evaluation of the training was
   conducted 6 months after the last of the 60 training sessions were delivered. This was
   administered in March, 2006. This evaluation helped to determine the impact of the
   training sessions had on the knowledge, skills, attitudes, program changes and
   improvements in client outcomes. A summary of this outcome evaluation is included in
   this report.

   5. Workforce Survey: workforce development is a very important issue for the substance
   abuse field. Since it appeared no one had an up to date picture of our chemical
   dependency counseling workforce in Minnesota, CHD was very interested in supporting
   this survey. A separate report on the “Results of the Workforce Survey” was completed in
   April, 2006 and is available from the CHD or the authors of the report (See Payne &
   Stasson, 2006).

         Information Provided to Training Participants regarding these Evaluation
                                         Components
   The training manual (Payne, 2004) provided to participants contained an evaluation
section which informed them about the evaluation components of the Co-occurring Training
Project, how this information was to be used, and their rights. Highlights from this section of
the training manual (p. 91-92) are included below.
                                                                                              4
   Pre/Post Tests: “These tests are designed to first measure an initial base-line of
    information regarding workforce knowledge of co-occurring disorders (Pretest).
    Then, to measure any increase in knowledge, as a result of participation in the training
    sessions (Posttest). The pretest will be given in the beginning of the training and the
    posttest at the end. There will be no attempt to report individual participant scores.
    We are only interested in overall workforce knowledge.”

   Workforce Survey: “Workforce development is a very important issue for the
    substance abuse field. Since no one appears to have an up to date picture of our
    chemical dependency counseling workforce in Minnesota, the purpose of this survey
    is to collect a data base of information about it. This survey includes items related to
    demographics, knowledge, skills, and attitudes about the profession. The survey will
    be assigned at the end of the 1st day of training and is due at the beginning of the 2nd
    day.”

   Evaluation of the Training: “The purpose of this is to evaluate the participants’
    experience and satisfaction with the training sessions, regarding the course content,
    and trainer. There is also a brief training needs assessment as part of this evaluation.
    Trainers will also complete an evaluation of each training session they deliver. The
    evaluation will be completed at the end of the 2nd day of training.”

   Outcome or Follow-up Evaluation: “There will also be a follow-up or outcome
    evaluation conducted after the initial set of 50 training sessions is completed in July,
    2005. This evaluation will be conducted in 2006 and will help to determine the impact
    of these training sessions on knowledge, skills, attitudes, program changes, and
    improvements in client outcomes, as a result of these training sessions.”

Confidentiality: “Please, do not put your name on any of the tests, survey or evaluation.
We are only interested in aggregate data from these evaluation and data collection
instruments. We are NOT trying to determine individual scores on test, nor attempt to
connect individual names to test scores, evaluation, or survey instruments.”

What will we do with this information? “We will provide a summary of the
aggregate/group data collected to DHS. Individual scores will not be reported. There is
also the probability that aggregate/group data collected with be used for reports or articles
and available to others who maybe interested in it.”

Participants Rights (Payne, 2004, p. 93): “In order to make you aware of and protect
your rights we also want you to know the following:
   1.       That your participation in completing the evaluations and workforce survey is
            voluntary.
   2.       That you have the right to not answer any questions asked in the evaluations or
            workforce survey or to return these instruments blank without filling them out.
   3.       In order to assure confidentiality of the information you do provide, please do
            NOT put your name on any of these materials.
   4.       We will not make any attempt to determine individual scores on evaluation
            tests or anyone’s identity on evaluation or survey instruments.

                                                                                               5
       5.      We will use the data you provide in aggregate form in reports to DHS, journal
               articles, and make it available to other parties interested in using it for
               workforce development purposes.”

   The evaluation components of this Co-occurring Training Project were submitted for
review to the Metropolitan State University Human Subject Review Committee. The
committee determined only the Workforce Survey needed full human subject’s protection
review. This review was successfully completed and approval to conduct the Workforce
Survey was granted.


               Summary of Highlights from each of the Evaluation Components
   a. Pre/Post Tests: the results from these tests indicated an increase in mean participant
scores from the Pre to the Post test which was statistically significant but only slightly
meaningful. What was perhaps more interesting and meaningful was the distribution of
scores on each of these tests. See Part 1: Report on the Pre/Post Test, below.
   b. Training Evaluation by Participants: Overall the results from the Participant
Evaluations were gratifying. The respondents indicated their experience in the training was
very positive. Respondents were most strongly satisfied with the trainer for the session they
attended. There was also a Training Needs Assessment included in this evaluation. See Part
2: Report on the Training Evaluation by Participants, below.
   c. Training Evaluation by the Trainer: Overall, the trainers who delivered the content
for the training sessions were highly satisfied with the training sessions they delivered and the
participants response to the training. See Part 3: Report on the Training Evaluation by the
Trainers, below.
   d. Outcome Evaluation: We were very pleased with the results from the outcome
evaluation of this project. Not only was the return rate of this evaluation much higher than
expected at 33%, but the demographics of responses had a good distribution and were very
consistent with the data from the Workforce Survey (Payne & Stasson, 2006). The evaluation
itself revealed an increase in clinical skills and improvement in knowledge as a result of this
training. The outcome evaluation confirmed that the main curriculum and training objectives
for the project (see page 3 of this report) were met. See Part 4 Report on Outcome Evaluation
of the Training Project, below.



                                                                                                  6
                             Part 1: Report on the Pre/Post Tests
   The Pretest was designed to first measure an initial base-line of information regarding
participant knowledge of co-occurring disorders. Then, in order to measure any increase in
knowledge, as a result of the training, the Posttest was administered. The results of the
Pre/Post Test are discussed in this part of the report.
   Both the Pre test and Post test contained identical 40-item multiple choice questions. The
test instrument was designed by Bill Payne (Co-occurring Training Project Coordinator and
Assistant Professor, Human Services Department, College of Professional Studies) and Mark
Stasson (Project Consultant and Professor, Psychology Department, College of Professional
Studies). The questions used in the Pre/Post tests were selected from semester exams from
the “Dual Disorders” course (HSCD 309) at Metropolitan State University.
   The procedure used to administer the Pre/Post Tests to respondents was for the trainer to:
        Handout the Pre test to participants at the beginning of the two-day training
         session,
        Read: a prepared script which described the purpose of this evaluation component
         (Training Manual p. 91), a statement to assure that respondents were aware of their
         rights and protections (i.e. confidentiality),
        Participants were allowed 15 minutes to complete the Pre test, which was collected
         by the trainer at the end of the testing period.
        At the end of the second training day, the trainer administered the Post test.

   In order to comply with institutional human rights review standards the following chain of
custody for the tests was adhered to:
    The collected tests were then forwarded (hand delivered or mailed) by the trainer to
     the support staff person for the Co-occurring Training Project.
    The support person counted the tests to determine if there were any missing from the
     training session. This information was tabulated into a “Training Log.”
    The support person then delivered the tests to Institutional Research, who scanned and
     scored them and then returned the tests to the support person for secure storage.
    Institutional Research then produced a summary report of the aggregate test results
     data using SPSS (Statistical Package for the Social Services) which was collected
     from the tests.
    Each month, as the training sessions were being delivered and data collected, an
     evaluation meeting was held to monitor the data collection, processing, and outputs to
     assure quality control.




                                                                                                7
      The results from the Pretest were:
                   N = 1354
                   Average pretest score: 25.89/40 (65% correct)
                   Range: 0 to 35 correct
                   Standard deviation: 4.64

      The results from the Posttest were:
                   N = 1359
                   Average posttest score: 28.11/40 (70% correct)
                   Range: 0 to 38 correct
                   Standard deviation: 4.46

      The diagram below indicates the difference mean difference between the pretest and then
the post test.


           30




           29




           28
  95% CI




           27




           26




           25




           24




                                  pretest                            posttest




                                                                                                8
      Comments: There was an aggregate average improvement of 2.22 points or an 8.6%
increase in respondent scores between the pre and the post test. On a 40 item test these results
were statistically significant but only slightly meaningful, with a 95% confidence interval.
      What appears more significant was the distribution of scores on each of these tests. For
example, the range of scores for the pretest was from 0 to 35 correct. See histogram below:



                                                pretest



              250




              200
  Frequency




              150




              100




               50


                                                                               Mean = 25.8929
                                                                               Std. Dev. = 4.63573
                                                                               N = 1,335
                0
                    0.00   10.00        20.00           30.00          40.00
                                        pretest




                                                                                                     9
The range of scores for the posttest was from 0 to 38 correct. See histogram below:




                                             posttest



              300




              250




              200
  Frequency




              150




              100




               50

                                                                       Mean = 28.1148
                                                                       Std. Dev. = 4.45462
                                                                       N = 1,342
                0
                    0.00   10.00     20.00          30.00      40.00
                                    posttest



        Comment: These test results suggests some respondents may have had learning or
cognitive problems in completing this 40 question multiple choice test based upon the content
of the training. There was also at least one anecdotal report from one of the trainers who
indicated one of the participants did not know how to complete a multiple choice test.
Another trainer observed a participant who could not read the test because he asked that the
questions be read to him.




                                                                                               10
                   Part 2: Report on the Training Evaluation by Participants

    The purpose of this evaluation component was to determine the respondents’ experience
and satisfaction with the training sessions, the course content and the trainer. Findings from
the training evaluations are discussed in this part of the report.
    The Participant Evaluation was a 26 item form which gathered this information from
respondents regarding their experience in the 2-day training sessions. It was designed by the
Project Coordinator/PI and based upon the evalution tool used for continuing professional
education at Minneapolis Community and Technical College. The 26 evaluation questions
were grouped in the following areas:
        a.        How respondents rated the training overall?
        b.        How respondents rated the content of the training?
        c.        How respondents rated the instructor?
        d.        How respondents rated the logistical arrangements related to the training?
    There were also two open-ended questions which asked the respondents what was most
helpful (#24) and then least helpful (#25) from the training. Finally, there was a training
needs assessment question which asked respondents about future training interests.
    The procedure used to administer the Participant Evaluation to respondents was for the
trainer to:
         Handout the Participant Evaluation to participants at the end of the two-day
          training session,
         The introduction to the Participant Evaluation on the form was as follows:

              “Thank you for taking the time to complete this form. It will help us to evaluate this training
              session and assess future training needs. Responses to most questions are provided by filling in
              circles with pen or pencil or any non-reflective ink.”

         Participants were allowed up to 15 minutes to complete the Participant Evaluation,
          which was collected by the trainer as the participants turned in the Post Test and
          picked up their certificate of attendance for attending this training.

    In order to comply with institutional human rights review standards the following chain of
custody for the tests was adhered to:
         The collected Participant Evaluations were then forwarded (hand delivered or
          mailed) by the trainer to the support staff person for the Co-occurring Training
          Project.
         The support person counted the Participant Evaluations to determine if there were
          any missing from the training session. This information was tabulated into a
          “Training Log.”
                                                                                                                 11
         The support person then delivered the Participant Evaluations to Institutional
          Research, who scanned them and then returned the Evaluations to the support
          person for secure storage.
         Institutional Research then produced a summary report of the aggregate Participant
          Evaluation results using SPSS (Statistical Package for the Social Services) which
          was collected from the evaluations.
         Each month, as the training sessions were being delivered and data collected, an
          evaluation meeting was held to monitor the data collection, processing, and
          outputs to assure quality control.

     Overall the results from the Participant Evaluations were gratifying. The 1327
respondents who completed the evaluation indicated their experience in the training was very
positive. Respondents were most strongly satisfied with items which evaluated the trainer for
the session they attended, (see items #12-17). These items were all rated very highly by at
least 90% of participants. Respondents were least satisfied with three items (#2, 7, & 9), i.e.
how much they learned, the case example exercises, and skills development. Although, even
these items, were favorably endorsed by at least 75% of all participants. There was moderate
dissatisfaction with two items (#18, 19). These had to do with the ease of registration and
finding the location for the training session. Although, it should again be noted these items
were rated positively rated by over 80% of the participants. The following is a reporting of
the details from this evaluation.


A.      How satisfied or dissatisfied were you with each of the following aspects of this
        training session?
        1.      The overall quality of the training? Nearly 90% of the respondents (87.9%)
        indicated they were either very satisfied or satisfied with the training.


                                47%
       50%
                     41%
       40%
                                                                           Very Satis.
       30%                                                                 Satisfied
                                                                           Neutral
       20%
                                                                           Dissatisfied
                                           8%
       10%                                                                 Very Dissat.
                                                      3%        1%
        0%
                 Satisfaction with the overall quality of the training




                                                                                                12
 2.     How much you Learned? Nearly 80% of the respondents (79.5%) indicated
 they were either very satisfied or satisfied with the training.


60%                     53%
50%
                                                                    Very Satis.
40%
                                                                    Satisfied
             27%
30%                                                                 Neutral
20%                               14%                               Dissatisfied
10%                                          5%                     Very Dissatis.
                                                        2%
0%
             Satisfaction with how much was learned?




 3.     The quality of the training materials? Nearly 90% of the respondents
 (89.0%) indicated they were either very satisfied or satisfied with the training.



50%                      46%
              43%

40%
                                                                      Very Satis.
30%                                                                   Satisfied
                                                                      Neutral
20%
                                                                      Dissatisfied
                                    9%
10%                                                                   Very Dissat.
                                              2%         1%
0%
            Satisfaction with quality of training materials?




 4.     The quality of the instruction? Nearly 90% of the respondents (87.5%)
 indicated they were either very satisfied or satisfied with the training.


60%           51%
50%
                        36%                                         Very Satisfied
40%
                                                                    Satisfied
30%                                                                 Neutral
20%                                                                 Dissatisfied
                                   9%
10%                                                                 Very Dissat.
                                             2%         1%
0%
                    Satisfaction with instruction?




                                                                                     13
B.    How strongly do you agree or disagree with each of the following statements
      about the course content?
      5.      The training was well organized. Over 90% of the respondents (91.8%)
      indicated they either agreed or strongly agreed with this statement.


     50%         47%
                          45%

     40%
                                                                   Stongly Agree
     30%                                                           Agree
                                                                   Neutral
     20%
                                                                   Disagree
     10%                           6%                              Stongly Disagree
                                            2%       0%
     0%
                     Training was well organized?




      6.      The instructional materials enhanced my learning experience. Well over
      80% of the respondents (85.3%) indicated they either agreed or strongly agreed with
      this statement.

     50%                   45%
                  40%
     40%
                                                                      Strongly Agree
     30%                                                              Agree
                                                                      Neutral
     20%
                                     11%                              Disagree
     10%                                                              Strongly Disagree
                                              3%       1%
      0%
           Instructional materials enhanced learning experience?




                                                                                            14
 7.       The case examples/exercises enhanced my learning experience. Over 75% of
 the respondents (77.6%) indicated they either agreed or strongly agreed with this
 statement.


50%                      44%

40%             33%                                                  Strongly agree
30%                                                                  Agree
                                   16%                               Neutral
20%
                                                                     Disagree
10%                                         4%                       Strongly disagree
                                                      2%
 0%
        Case examples/exercises enhanced learning experience?




 8.      The training increased my knowledge or understanding of this topic. Over
 80% of the respondents (80.9%) indicated they either agreed or strongly agreed with
 this statement.


50%                       45%

40%             36%
                                                                      Strongly agree
30%                                                                   Agree
                                                                      Neutral
20%
                                   12%                                Disagree
10%                                          5%                       Strongly disagree
                                                       2%
0%
      Training increased my knowledge/understanding of this topic?




                                                                                          15
 9.     The training enhanced my skills. Over 75% of the respondents (76.3%)
 indicated they either agreed or strongly agreed with this statement.


60%                  57%

50%
                                                            Strongly agree
40%
           30%                                              Agree
30%
                                                            Neutral
                              17%
20%                                                         Disagree
10%                                     5%                  Strongly disagree
                                                  2%
0%
               Training enhanced my skills?




 10.    This training was relevant to my job. Nearly 90% of the respondents (89.8%)
 indicated they either agreed or strongly agreed with this statement.


50%                     46%
             43%
40%
                                                                 Strongly agree
30%                                                              Agree
                                                                 Neutral
20%
                                                                 Disagree
                                  8%
10%                                                              Strongly disagree
                                             2%        1%
 0%
                  Training was relevant to my job?




 11.    This training will benefit my clients. Over 80% of the respondents (84.5%)
 indicated they either agreed or strongly agreed with this statement.


50%                   45%
            39%
40%
                                                             Strongly agree
30%                                                          Agree
                                                             Neutral
20%
                               12%                           Disagree
10%                                                          Strongly disagree
                                        2%        2%
 0%
              Training will benefit my clients?




                                                                                     16
C.    How strongly do you agree or disagree with each of the following statements
      about the instructor? It was gratifying to see the participants rated their trainer
      higher than any other area of this training experience. This seemed to support the
      standards set by the project coordinator/PI for trainer selection, the training of these
      trainers and the on-going support provided for them by the coordinators of this project.

      12.    The trainer was knowledgeable about the subject matter. Nearly 95% of the
      respondents (94.2%) indicated they either agreed or strongly agreed with this
      statement.


     70%           62%
     60%
     50%                                                                 Strongly Agree
     40%                     33%                                         Agree
     30%                                                                 Neutral

     20%                                                                 Disagree

                                       4%                                Strongly disagree
     10%                                         2%       1%
      0%
             Trainer was knowledgeable about the subject matter?




      13.    The trainer was well prepared for the sessions. Over 90% of the respondents
      (93.8%) indicated they either agreed or strongly agreed with this statement.


     70%           61%
     60%
     50%                                                              Strongly agree
     40%                   33%                                        Agree
     30%                                                              Neutral

     20%                                                              Disagree
                                     4%                               Strongly disagree
     10%                                      1%        0%
     0%
                Trainer was well prepared for the sessions?




                                                                                                 17
 14.    The trainer responded effectively to participant questions. Over 90% of the
 respondents (93.7%) indicated they either agreed or strongly agreed with this
 statement.


70%           65%
60%
50%                                                          Strongly agree
40%                                                          Agree
                      29%
30%                                                          Neutral

20%                                                          Disagree
                                4%                           Strongly disagree
10%                                      1%        1%
0%
          Trainer responded effectively to questions?




 15.    The trainer was receptive to participant interaction. This was the highest
 rated item in the participant evaluation. An astounding 96.3% indicated they either
 agreed or strongly agreed with this statement. This was the highest rated item in the
 Participant evaluation. Thus indicating the importance of discussion among
 participants regarding their experience with and knowledge of co-occurring disorders.


              69%
70%
60%
50%                                                            Strongly agree
40%                                                            Agree
                       28%                                     Neutral
30%
20%                                                            Disagree
                                                               Strongly disagree
10%                              2%        1%        1%
 0%
         Trainer was receptive to participant interaction?




                                                                                         18
 16.    The trainer presented information in an organized manner. Over 90% of the
 respondents (93.5%) indicated they either agreed or strongly agreed with this
 statement.


70%           61%
60%
50%                                                                Strongly agree
40%                    33%                                         Agree
30%                                                                Neutral

20%                                                                Disagree
                                 5%                                Strongly disagree
10%                                        1%       0%
 0%
       Trainer presented information in an organized manner?




 17.    The trainer managed time effectively. Over 90% of the respondents (92.7%)
 indicated they either agreed or strongly agreed with this statement.


70%           61%
60%
50%                                                            Strongly agree
40%                   32%                                      Agree
30%                                                            Neutral

20%                                                            Disagree
                               5%                              Strongly disagree
10%                                     1%         1%
0%
               Trainer managed time effectively?




                                                                                       19
D.     This last section of the Participant Evaluation asked respondents whether they
agreed or disagreed with each of the following statements related to logistical
arrangements.
       18.    Registration for this training was easy. Over 85% of the respondents (86.8%)
       indicated they either agreed or strongly agreed with this statement.

                    47%
      50%
                               39%
      40%
                                                                              Strongly agree
      30%                                                                     Agree
                                                                              Neutral
      20%
                                                                              Disagree
                                           7%
      10%                                            4%                       Strongly disagree
                                                                 2%
       0%
                     Registration for this training was easy?




       19.    Finding the location for the training was easy. Over 80% of the respondents
       (84.0%) indicated they either agreed or strongly agreed with this statement.

      50%          43%
                            41%
      40%
                                                                       Strongly agree
      30%                                                              Agree
                                                                       Neutral
      20%
                                                                       Disagree
                                       8%
      10%                                       6%                     Strongly disagree
                                                            2%
       0%
                Finding the location of the training was easy?




       20.    The training facility was comfortable. Just over 90% of the respondents
       (90.3%) indicated they either agreed or strongly agreed with this statement.

                  50%
     50%
                            41%
     40%
                                                                      Strongly agree
     30%                                                              Agree
                                                                      Neutral
     20%
                                                                      Disagree
     10%                              6%                              Strongly disagree
                                                3%
                                                            1%
      0%
                   The training facility was comfortable?



                                                                                                  20
 21.    The food was good. Over 80% of the respondents (83.5%) indicated they
 either agreed or strongly agreed with this statement. Since lunch was provided at no
 cost to the participants and was provided by a variety of vendors, we were pleased that
 participant satisfaction with the food was as positive as the evaluation indicates.


50%          43%
                      40%
40%
                                                                 Strongly agree
30%                                                              Agree
                                                                 Neutral
20%
                                  12%                            Disagree
10%                                       4%                     Strongly disagree
                                                   1%
0%
                      The food was good?




 22.    The fees for the training were reasonable. Nearly 90% of the respondents
 (89.5%) indicated they either agreed or strongly agreed with this statement. Since the
 fee for the training was free, we wonder why 100% of respondents did not agree or
 strongly agree with this statement. Perhaps a few thought there should have been a
 charge to attend the training.



80%            71%
70%
60%
                                                                   Strongly agree
50%
40%                                                                Agree
30%                                                                Neutral
                            18%
20%                                     10%                        Disagree
10%                                               0%
 0%
            The fees for the training were reasonable?




                                                                                        21
       23.     I would recommend this training to a colleague. Nearly 85% of the
       respondents (84.6%) indicated they either agreed or strongly agreed with this
       statement.


     60%            52%
     50%
                                                                   Strongly agree
     40%                    33%
                                                                   Agree
     30%
                                                                   Neutral
     20%                                                           Disagree
                                     10%
     10%                                      3%                   Strongly disagree
                                                       2%
      0%
              I would recommend this training to a colleague?




E.     Most or Least Helpful? As stated above, there were two open-ended questions
included in the participant evaluation in which participants could hand-write any comments
they wished to make. These comments were transcribed and provided to the specific trainer
of each training session, for feedback to the trainer.
       24.     What about the training was most helpful to you? In response to this
opportunity to express their opinions, participants did so. There were numerous written
comments made in every training session. A representative sample included: positive
comments about the instructor (“knowledgeable,” “pleasant,” “well- prepared,”), the training
manual and support materials, case examples/studies, and the discussion or interaction with
the other participants and the instructor.
       25.     What about the training was least helpful to you? There were also numerous
comments made in every training session to this question, although much less so that the
hundreds of responses to question #24 above. A representative sample included: “the
information was too basic”…”I would have liked more advanced training”…”I would like to
learn more.” Some participants didn’t like being tested, i.e. “I didn’t like the evaluations.”
Other responses to this question could be referred to as “creature comforts,” i.e. “the room
was cold,” “the chairs were uncomfortable,” “I didn’t like the food.”


F.     Training Needs Assessment:
       50 possible topics were listed in this needs assessment. Respondents were asked;
“from the list below, please select up to 7 areas in which you would like to receive training.”
                                                                                              22
1327 total respondents made the selections shown below. The number of responses and
percent identifying each potential training topic are listed below in alphabetical order. There
were four training topics selected by at least 20% of the sample, these are shown in bold.)

       N       %       Training Need/Item                        .
       112      8%     Administration management skills
       241     18%     Adolescent counseling skills
       197     15%     Assessment tools & skills
       204     15%     Best-practices
       112      8%     Client retention skills
       122      9%     Clinical supervisions
        81      6%     Confidentiality & HIPAA
       399     30%     Cognitive-behavioral counseling skills
       111      8%     Computer (technology) training
       240     18%     Co-occurring substance abuse & Mental health (advanced)
       104      8%     Counseling the African-American client
        56      4%     Counseling the Asian-American client
        57      4%     Counseling the Latino client
       135     10%     Counseling the Native-American client
       112      8%     Counseling the Gay, Lesbian, Bi-sexual, Transgender client
       244     18%     Counseling the criminal offender
       130     10%     Cross-Cultural counseling skills
       191     14%     Crisis intervention skills
       113      9%     Detoxification
       122      9%     Documentation skills
       160     12%     Domestic violence
       122      9%     Drug testing methods
        89      7%     Empathy skills
       154     12%     Ethics
       336     25%     Evidenced-based practices
       277     21%     Family systems counseling skills
        70      5%     High risk sexual behaviors
        97      7%     Gender specific counseling skills
        68      5%     Gerontology counseling skills
       180     14%     Group counseling skills
       205     15%     Harm reduction counseling skills
        48      4%     HIV/STD’s/Communicable diseases
       120      9%     Individual counseling skills
        78      6%     Learning, cognitive, physical & Other disabilities
        83      6%     Licensure exam preparation
       138     10%     Marriage & family therapy
       237     18%     Medications used to treat addictions
        60      5%     Methadone maintenance
       311     23%     Motivational counseling skills
        83      6%     Models/theories of addiction
       152     11%     Neurobiology of addiction
        90      7%     Outcomes evaluations
        85      6%     Professional & ethical responsibilities
        96      7%     Progress note writing
       117      9%     Screening tools
       175     13%     Stages of change
       157     12%     Suicide
       141     11%     Trauma
       212     16%     Treatment planning
        31      2%     Other (specify)
                                                                                              23
                 Part 3: Report on Training Evaluation by the Trainers
    There was also an evaluation which the trainer, for each of the 60 training sessions, filled
out regarding their experience and satisfaction with their delivery of and participant response
to the training session. The purpose of this evaluation was to provide the trainers with a
formal means to provide communication to the Project Coordinator/PI regarding their
experience in delivering the training. A summary of these evaluations are discussed in this
part of the report.
    The tool designed for this trainer evaluation of the training was a simple one page
instrument which included two main components, i.e. trainer satisfaction with the training and
participant response to the training.
    The procedure used to administer the Trainer Evaluations was for the trainer to:
         Complete the Trainer Evaluation at the end of the two-day training session,
         The completed Trainer Evaluation was then forwarded (hand delivered or mailed)
          by the trainer to the support staff person for the Co-occurring Training Project.
         The support person then delivered the Trainer Evaluation to the training project
          coordinator (PI).
         The Project Coordinator (PI) who reviewed the evaluation and tabulated the
          results.
         Each month, as the training sessions were being delivered and data collected, an
          evaluation meeting was held to monitor the data collection, processing, and
          outputs to assure quality control.

    Trainer Satisfaction with the Training. This section of the evaluation included issues
related to how satisfied the trainer was with the individual training session they delivered.
Each trainer rated seven statements on a 5 point scale (5 = very satisfied to 1 = very
dissatisfied). The seven statements were:
        1.      Overall satisfaction with your delivery of the training?
        2.      Satisfaction with your lectures?
        3.      Satisfaction with your interaction with participants and response to their
                questions?
        4.      Satisfaction with case examples and discussion?
        5.      Satisfaction with your time management or pacing of the training?
        6.      Satisfaction with the training facilities?
        7.      Overall satisfaction with the participant response to the training?

    Comment: The trainers were very satisfied with the training they delivered and the
response of the participants. Overall, the trainers gave these seven questions a rating of 4.28
or a satisfaction rating of 85.7%. The mean scores related to each of these seven items are
depicted in the chart below.
                                                                                                24
                                                 Trainer Satisfaction

        4.6                          4.5                                 4.5            Delivery Overall
                    4.4
        4.4                                                        4.3                  With Lectures
                           4.2                             4.2                          Participant Interaction
        4.2
                                                 4                                      Case Examples
          4
                                                                                        Time Mgt
        3.8                                                                             Facilities
        3.6                                                                             Overall Response




   Participant Response to the Training : this section of the evaluation included questions
in which the trainer evaluated the participants and their response to the training. These five
questions were also rated on 5 point scale (5 = very much/ highest degree to 1 = not at
all/lowest degree). The five questions were:
       8.      To what extent were participants interested in the training?
       9.      To what extent were participants interested in and responsive to your lectures?
       10.     To what extent were participants actively engaged in the training?
       11.     To what extent did the participants interact with each other?
       12.     To what extent were the participants interested in the subject matter?

   Comment: Overall, the trainers gave these five questions a rating of 4.3 or an 86%,
which indicated a very high rating and they were very pleased with how participants
responded to the training sessions. The mean scores related to each of these five items are
depicted in the chart below.

                                 Pacticipant Response to the Training
                                                     4.5
        4.5
        4.4                                                                    Interested in the Training?
                     4.3       4.3         4.3                                 Responded to Lectures?
        4.3
                                                                 4.2           Engaged?
        4.2
                                                                               Interacted?
        4.1                                                                    Interested in Subject Matter?
         4




                                                                                                               25
            Part 4: Report on Outcome Evaluation of the Training Project
       An outcome evaluation of the training was conducted six months after the last of the
   60 training sessions were delivered. This evaluation was administered in March, 2006.
   The outcome evaluation helped to determine the impact of the training sessions on
   clinician knowledge, skills, and attitudes; and improvements in client outcomes. The
   results of the outcome evaluation are discussed in this part of the report.
       The outcome evaluation instrument was designed by the Project Coordinator/PI and
   the training project’s evaluation team. This evaluation included the following main
   components:
       A.      Demographic data: Seven items were included. Six of which (#1-6) were
   selected to match demographic questions taken from the “Workforce Survey” and one
   additional item (#7) to measure the geographic distribution of the respondents to the
   outcome evalution.
       B.      Changes in clinical skills: This section of the evaluation contained eight
   items in which the respondents were forced to choose either “Yes” or “No” in answer to
   the item. It attempted to measure any improvements in clinical skills or behaviors among
   training participants as a result of attending the training sessions.
       C.      Changes in knowledge or attitudes: This section of the evaluation contained
   nine items which respondents were asked to rate whether they agreed or disagreed with a
   statement along a 5 choice scale. This section attempted to measure any improvements in
   clinical knowledge, attitudes, and overall assessment of the training sessions.


   The Outcome Evaluation and the procedure in which it was to be administered were
submitted for review to the Metropolitan State University Human Subjects Review Board
(HSRB). The HSRB determined this evaluation posed a “Minimal Risk” to respondents. The
following consent and written description was also approved by HSRB and provided in
written form to all respondents.
       “In order to make you aware of and protect your rights we also want you to know the following:

       1.      Your participation in completing this outcome evaluation survey is voluntary.
       2.      You have the right to not answer any questions asked in this outcome evaluation or to
               return it blank without filling it out.
       3.      In order to assure confidentiality of the information you do provide, please do NOT put
               your name on any of these materials.
               a.        Survey Tracker, the software used to collect and store the information you
                         provide, is protected against hackers.

                                                                                                   26
               b.        Your answers via this software are made anonymously, i.e. without you name
               or e-mail address attached.
       4.      We will not make any attempt to determine individual responses on this evaluation or
               anyone’s identity on this evaluation.
       5.      We will use the information you provide in aggregate form in reports to DHS, journal
               articles, and make it available to other parties interested in using it for evaluation
               purposes.

   If you have questions or concerns regarding your rights by participating in research, please
   contact:
    Metropolitan State University Human Subject Review Committee
        hsrb@lists.metrostate.edu or write HSRB, Provost Office, Metropolitan State University, 700
        East Seventh Street, St. Paul, MN 55106. 651-793-1921

   If you have questions about this research project, please contact:
    William J. Payne, Principle Investigator for the Co-occurring Training Project, Metropolitan
        State University, 700 East Seventh Street. St. Paul, MN 55106.
        651-793-1352.”


   The procedure used to conduct this Outcome Evaluation was to e-mail it to the training
participants who provided their e-mail addresses as part of the registration process for these
training sessions. The project evaluation team made a decision to conduct the Outcome
Evaluation by e-mail for two reasons; we had 816 usable e-mails from training participants
(nearly 2/3 (64 %) is this of training participants); and the findings from the “Workforce
Survey” (Payne & Stasson, 2006) indicated respondents “have access to a computer” (p. 42),
and use it “several times per day” (p. 43). As a result, the project evaluation team decided to
conduct this evaluation by e-mail rather than by mailing it.
   Our response goal for the Outcome Evaluation was to have at least 125 returns (at least
100 clinicians and at least 25 program directors) from the over 1300 training participants.
This would give us a projected response rate of about 10%. In actuality, we were very
pleased to have a response rate of 33% (i.e. 270 responses from 816 e-mail requests), over
three times our initial goal!
   We were also very pleased with the following overall results of the Outcome Evaluation.
       a.      The response to the outcome evaluation seemed to have a good demographic
distribution which was consistent with the findings from the Workforce Survey (Payne &
Stasson, 2006). See items 1-7 below for details.
       b.      There was an increase in Clinical Skills as a result of this training. See items
“a-h” in this section below for details.




                                                                                                    27
       c.      There was also an increase in Knowledge or an improvement in Attitudes
related to clients with co-occurring disorders, as a result of this training, also reported by
respondents. See items “a-i” in this section below for details.


       Demographic Data:
   1. What is your gender? Nearly 60% of the 270 respondents were female (59.6%) and
39.6% were male. This response is nearly consistent with the findings from the Workforce
Survey (Payne & Stasson, 2006) with 65% of respondents who were female (p. 10).




            40%

                                                   Female
                                      60%          Male




   2. How old were you on your last birthday? The age indicated by 262 valid
       respondents were distributed at follows:
              20-29: 8%
              30-39 : 13%
              40-49: 29%
              50-59: 34%
              60+: 16%
Comment: This age distribution quite similar to workforce survey (see Payne & Stasson,
2006, p. 11)

                              Age of Respondents

     40%                                    34%
                                    29%                                  20-29
     30%
                                                                         30-39
     20%                                            16%                  40-49
                            13%
                    8%                                                   50-59
     10%
                                                                         Over 60
      0%




                                                                                                 28
   3. To which racial/ethnic group(s) do you belong? Of the 270 respondents there were:
White/Caucasian 87.8%; Asian American 1.1%; Black/African American 3.7%;
Latino/Hispanic 0.7%; American Indian 4.4%; Other 2.2%. This response rate was also
consistent with the findings from the Workforce Survey (Payne & Stasson, 2006, p. 12)
   4. What is the highest level of education that you have completed? The responses to
this question were distributed as follows: High School Diploma 0.7%; Some College/No
degree 4.8%; CD Counseling Certificate/No degree 11.9%; Associate’s Degree (2 years)
15.6%; Bachelor’s Degree (4 years)33.7%; Master’s or Doctoral Degree 28.2%. This
distribution of educational levels was fairly consistent with the finding from the Workforce
Survey (Payne & Stasson, 2006, p. 14)
   5. What is your current position? The responses to this question were as follows:
Counselor 47.0%; Supervisor 13.0%; Director 11.1%; Nurse 8.5%; Other 19.3% (Techs or
Aides?). These results also were fairly reflective of the findings from the Workforce Survey
(Payne & Stasson, 2006, p. 21).
   6. In total, how many years have you been in the chemical dependency field? The
distribution of the number of years in the field is as follows:
            0 - 4 years: 21%
            5 - 9 years: 19%
            10-14 years: 17%
            15-19 years: 20%
            20-24 years: 10%
            25+ years: 13%

                                      Years Employed in CD Field

       25%            21%
                                19%               20%                                 <4
       20%                                17%
                                                                                      5 to 9
                                                                   13%
       15%                                                                            10 to 14
                                                          10%
       10%                                                                            15 to 19
                                                                                      20 to 24
        5%
                                                                                      >25
        0%




Comment: Compared to Workforce Survey (Payne & Stasson, 2006, p. 27), this Outcome
Evaluation sample seems a little less experienced in field.




                                                                                                 29
   7. In which region of the state do you work? This question was not asked in the
Workforce Survey (Payne & Stasson, 2006). We added it to the Outcome Evaluation to
determine if we were getting an adequate geographical distribution of responses from across
the state of Minnesota. Responses were: Northwest 4.8%; Northeast 8.9%; Central 19.6%;
Twin Cities Metropolitan Area 45.6%; Southwest 8.9%; Southeast 10.4%.



                          Which Region of the State do you Work In?

     50.0%                                   45.6%
                                                                              Northwest
     40.0%                                                                    Northeast
     30.0%                                                                    Central
                                     19.6%
     20.0%                                                                    Twin Cities
                             8.9%                    8.9%   10.4%
                                                                              Southwest
     10.0%         4.8%
                                                                              Southeast
      0.0%



Comment: it appears that respondents to the Outcome Evaluation were overrepresented in
the Twin Cities area.




                                                                                            30
       Changes in Clinical Skills:
   In this section of the Outcome Evaluation, the respondents were asked to simply answer
“Yes” or “No” to eight questions related to improvement in clinical skills. We were pleased
to find an increase in Clinical Skills as a result of this training. The table below indicates the
frequency and percent of respondents who said they used the clinical skills which were
learned in the training. For example of the eights clinical skills which were the focus of the
training 63.2% of respondents indicated they used 4 or more of these skills. An astounding
20% of respondents indicated they used all 8 of these skills, with less than 5% (4.8) of
respondents who did not use any.

                     Number of training uses che cke d

                                                               Cumulative
                      Frequency     Percent    Valid Percent    Percent
  Valid     .00              11          4.1             4.8           4.8
            1.00             12          4.4             5.3         10.1
            2.00             13          4.8             5.7         15.8
            3.00             25          9.3           11.0          26.8
            4.00             23          8.5           10.1          36.8
            5.00             37         13.7           16.2          53.1
            6.00             29         10.7           12.7          65.8
            7.00             32         11.9           14.0          79.8
            8.00             46         17.0           20.2         100.0
            Total           228         84.4          100.0
  Missing   System           42         15.6
  Total                     270       100.0




                                                                                                 31
         The chart below proves a summary of these eight clinical skill items in which respondents
indicated the percent of increase in these clinical skills as a result of this training. As shown,
there was an increase of over 50% in the use of clinical skills contained in the training. With
the largest increases in skills related to assessment hints, counseling techniques and use of the
training manual or other materials. See the section after the chart for more specific details on
these and the other measures.



               80




               60
  % in (1,1)




               40




               20




                0
                      Used         Used       Used       Used         Used         Have      Used manual Sought
                    screening   assessment counseling   referral   educational   consulted     or other  additional
                      tools        hints   techniques   source      materials      more        training   training
                                                                                              materials




                                                                                                                      32
    The following are specific details of the responses from these eight questions (items a-h)
related to clinical skills or behavior changes, as a result of the training.
        a.      I have used at least one of the screening tools introduced in the training?
        There was a moderated increase in the use of screening tools demonstrated and used in
        the training. With Yes, 52.2%; No, 38.1%.


        b.      I have used some of the assessment hints that were suggested in the
        training? The second biggest increase was in using assessment hints suggested in the
        training with nearly 70% (68.9%) of respondents indicating “Yes” they did and 23.7%
        indicating “No” they did not.


        c.      I have used some of the counseling techniques with were introduced in the
        training? The third biggest increase was in using counseling techniques suggested in
        the training with just over 2/3 (66.3%) of respondents indicating “Yes” they did and
        24.4% indicating “No” they did not.


        d.      I used some of the referral resources that were introduced in the training?
        One of the lowest increases in skills or behavior change was related to using new
        referral resources to help address the needs of client with co-occurring disorders.
        Under 50% (48.9%) of respondents indicating “Yes” they did and 41.6% indicating
        “No” they did not.


        e.      I have used some of the information or materials from the training to help
        educate clients about their disorder/condition? 62.2% of respondents indicating
        “Yes” they did and 29.3% indicating “No” they did not.


        f.      I have consulted more often with other mental health professionals?
        Another one of the lowest increases in skills or behavior change was related to
        whether or not the training increased the use of consulting with other mental health
        professionals to help address the needs of client with co-occurring disorders. Under
        50% (47.0%) of respondents indicating “Yes” they did and 43.0% indicating “No”
        they did not.

                                                                                               33
   g.      I have used the manual and/or other materials provided in the training
   session as a reference? It was gratifying for the Project Coordinator/PI and writer of
   the training manual to learn, the greatest increase in skills or behavior was using the
   manual developed for the training as a reference. With nearly 70% (69.3%) of
   respondents indicating “Yes” they did and 23.0% indicating “No” they did not.


   h.      I have sought out additional training, education and/or study in co-
   occurring disorders? 54.1%) of respondents indicating “Yes” they did and 37.4%
   indicating “No” they did not.


   Changes in Knowledge and Attitudes:
   The following set of nine questions (a-i) attempted to determine if there were changes
in knowledge or attitudes among respondents as a result of attending the training.
Respondents were asked to rate whether they agreed or disagreed with a statement along a
5-choice scale. There was also an increase in Knowledge or an improvement in Attitudes
related to clients with co-occurring disorders, as a result of this training, also reported by
respondents.
   a.      The training has increased my knowledge or understanding of this topic.
   Out of all nine statements, respondents most strongly agreed with this statement, with
   nearly 80% in agreement. This was an important finding since one of the objectives
   for the training was to increase participant’s knowledge and understanding of co-
   occurring disorders.


            70%                    61%
            60%
            50%                                                            Strongly agree
            40%                                                            Agree
            30%                                                            Unsure
                           19%
            20%                                    12%                     Disagree
            10%                            5%              2%              Strongly disagree
               0%
                 Training increased my knowledge/understanding of this
                                         topic?




                                                                                               34
 b.        As a result of attending this training, I am better able to recognize clients
 who have mental disorders. With agreement of over 70%, this was another of the
 statements in which respondents strongly endorsed. This suggests respondents are
 now better able to recognize clients with co-occurring disorders.



60%                    56%

50%
                                                                Strongly agree
40%
                                                                Agree
30%
                                                                Unsure
20%            17%
                                          13%                   Disagree
                                10%
10%                                                             Strongly disagree
                                                   2%
0%
      Better able to recognize clients with mental disorders?




 c.        As a result of attending this training, my treatment plans for clients with
 co-occurring disorders have improved. With a rating of over 60% there appears to
 have been moderate changes in treatment plans for clients with co-occurring disorders.

                          50%
50%

40%
                                                                        Strongly agree
30%                                                                     Agree

                                    16%                                 Unsure
20%             15%
                                             11%                        Disagree
10%                                                                     Strongly disagree
                                                        2%
0%
                 Treatment plans have been improved?




                                                                                            35
 d.      As a result of attending this training, I am better able to provide case
 management for clients with co-occurring disorders. With a rating of over 60%
 there appears to have been moderate changes in case management activities for clients
 with co-occurring disorders.



60%
                       51%
50%
                                                                   Strongly agree
40%
                                                                   Agree
30%                                                                Unsure
                                17%
20%          13%                          12%                      Disagree
10%                                                                Strongly disagree
                                                   2%
0%
            Better able to provide case management?




 e.      As a result of attending this training, I can manage a client crisis better.
 With a rating of just 60% there appears to have been less change in respondents work
 with clients in crisis as a result of this training. Perhaps this is an indication of the
 need for more specific training in crisis management and possibly respondent concerns
 with their less than adequate effectiveness with crisis management.


                       50%
50%

40%
                                                                    Stongly agree
30%                                                                 Agree
                                 18%                                Unsure
20%                                       15%
             10%                                                    Disagree
10%                                                                 Srtongly disagree
                                                   2%
 0%
                   I can manage a crisis better?




                                                                                             36
 f.     As a result of attending this training, I feel more competent in dealing
 with clients who have co-occurring mental disorders. With agreement of over
 70%, this was another of the statements in which respondents strongly endorsed. This
 suggests respondents feel more competent in dealing with clients with co-occurring
 disorders.



                     58%
60%
50%
                                                          Strongly agree
40%
                                                          Agree
30%
                                                          Unsure
20%           15%                                         Disagree
                              10%      10%
10%                                           3%          Strongly disagree

0%
                    Feel more competent?




 g.     As a result of this training, I am more willing to serve people with co-
 occurring mental disorders. With a rating of over 60% there appears to have been
 moderate changes in attitudes among respondents regarding their willingness to serve
 clients with co-occurring disorders.



60%
                      51%
50%
                                                            Strongly agree
40%
                                                            Agree
30%                                                         Unsure
20%           13%              15%      13%                 Disagree
10%                                            3%           Strongly disagree

 0%
                     More willing to serve?




                                                                                      37
 h.     This training has improved the quality of services which our
 program/agency provides to clients with co-occurring disorders. With a rating of
 just 60% there appears to have been less change in respondent’s perception regarding
 improvement in the quality of services which their program/agency provides. Due to
 the time it takes to produce systems change, this finding was not surprising.



50%                   47%

40%
                                                                Strongly agree
30%                                                             Agree
                                18%                             Unsure
20%          13%                         12%                    Disagree
10%                                                3%           Strongly disagree

0%
       Improved quality of services in our program/agency?




 i.     This training has improved outcomes for our clients with co-occurring
 disorders. With a rating of just under 50% this item was the least endorsed of the
 Outcome Evaluation. Perhaps this can be explained in part for the 30.4% who
 responded they were “Unsure” about this statement.



50%
                        42%
40%
                                  30%                               Strongly agree
30%                                                                 Agree
                                                                    Unsure
20%
                                            12%                     Disagree
               9%
10%                                                     3%          Strongly disagree

 0%
                 Improved outcomes for our clients?




                                                                                        38
                                      References

Payne, William J. (2004). Mental Health for Chemical Dependency. Metropolitan State
University. St. Paul, MN.

Payne, William J. & Stasson, Mark F. (2006). Report on Workforce Survey. Metropolitan
State University. St. Paul, MN.

SAMHSA (2002). Report to Congress on the Prevention and Treatment of Co-occurring
Substance Abuse Disorders and Mental Disorders. US Department of Health and Human
Services. Washington DC.

6/06




                                                                                        39

				
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