In 2012, Olmstead, Abraham, Martino, and Martin published a groundbreaking article, Counselor Training in Several Evidence-based Psychosocial Addiction Treatments in Private US Substance Abuse Treatment Centers. They posited that few addiction counselors enter the field prepared to implement psychosocial evidence-based practices (EBPs), which puts treatment centers in the position of providing the needed training.  The investigators examined the extent to which treatment centers provided formal training in four EBPs—cognitive behavioral therapy (CBT), motivational interviewing (MI), contingency management (CM), and brief strategic family therapy (BSFT)—by conducting face-to-face interviews with 340 directors of a nationally representative sample of privately funded US substance abuse treatment centers. The table below summarizes the EBPs that the counselors in the treatment centers use and whether formal training is provided.  Only 4% of the treatment centers have counselors that implement all four EBPs.  Investigators did not assess counselors’ fidelity to the model although they pointed out that few centers utilized supervisor review of audiotapes of counselors’ performance.

Click on table below to enlarge

6.6.13 ncpic table

These results indicate that training gaps remain where EBPs are concerned.  This finding led researchers to conclude that clinicians continue to need formal training that is supported by supervision, coaching, feedback, fidelity monitoring, and booster sessions to reinforce the proper implementation of the EBPs.


Olmstead TA, Abraham AJ, Martino S, Roman PM.  Counselor training in several evidence-based psychosocial addiction treatments in private US substance abuse treatment centers.  Drug and Alcohol Dependence, 2012;120(1-3):149-54.