It is clear from the articles included in this issue that there are currently several pathways to collaborative interdisciplinary education, practice, and/or research. Furthermore, because the interdisciplinary collaborative addiction education (ICAE) movement is still in the early stages of development, it is not surprising that multiple definitions, terms, models, and pathways are presented in the literature. Developing tools or strategies to determine which among the various models are most effective and lead to the best educational outcomes with particular groups (prelicensure and postlicensure students and/or practicing health care professionals) in various settings with diverse clients is, for the most part, a priority task going forward.
As phases of the Affordable Care Act (ACA) are implemented and primary and community health centers continue to expand, we are beginning to see a shift in health professional employment from inpatient settings where most health professionals have traditionally been employed to community settings. By the end of 2011, a total of 350 new community health centers were established via the support of $250 million. Expansion will continue through 2015 as the ACA will invest $11 billion in community health centers. This will raise the number of people served in these settings from 20 million to about 40 million by 2015 (Rosenbaum, 2011).
These settings employ a variety of health care professionals (e.g., advanced practice nurses, physicians, dentists, social workers, counselors, and pharmacists). The client population in these settings is largely underserved, disenfranchised, and of low income. They commonly present with chronic social and health-related problems. Providing effective quality care for these clients is a constant challenge for health professionals, and team support will be a key factor in maintaining workplace harmony and satisfaction for interprofessional team members (USDHHS, 2010).
Of major interest is the potential for interprofessional collaboration in these aforementioned community settings. It makes sense that interprofessional collaboration would be a predictable outcome of the ICAE initiatives. The promotion of ICAE initiatives is essential for implementing SBIRT (screening, brief intervention, and referral to treatment) in clients with potential or actual alcohol and other drug (AOD) abuse problems. Interprofessional collaboration in addictions has the promise of employing team models to implement SBIRT as appropriate depending on the professional role. Building effective process and outcome measures to determine success in using SBIRT would not only potentially boost staff satisfaction but also improve the quality of patient health.
In 2012, the Substance Abuse and Mental Health Services Administration awarded grants up to a total of $7,575,000 to each of three states via the ACA's Prevention and Public Health Fund for a 5-year period. The mandate is for these three states to use the SBIRT approach with adults in primary and community health settings to intercede in the problem of AOD abuse as early as possible. These awards will continue if the programs implemented by the states can show progress (Substance Abuse and Mental Health Services Administration, 2012).
Overall, then, it makes good sense to prepare teams of health professionals at various stages of their education and/or career with a common AOD curriculum either jointly in agencies with interprofessional health care staff or separately in their own educational environments. If there is a shared body of AOD information, it improves the potential for team members to communicate with each other more effectively and be more consistent when approaching clients with SBIRT at any point of system contact.
It is a pleasure and an honor to introduce our guest editors for this issue: Dr. Shirley A. Murphy and Dr. Marianne T. Marcus, two of our most outstanding leaders and scholars in the field of addictions nursing. These internationally renowned educators and researchers have devoted a significant portion of their careers in promoting ICAE, and we are fortunate to have them leading this special issue of the journal.
Dr. Shirley A. Murphy, RN, PhD, FAAN, Professor Emeritus at the University of Washington, has been involved in addiction research, training, and education since 1985. From 1989 until 2005, she was a project director for NIDA training, first for faculty, then for predoctoral and postdoctoral research trainees. In 1997, she received the National Nurses Society on Addictions Research Award.
Other areas of Dr. Murphy's expertise include human responses to traumatic events. In 1992, she received a 5-year NIH award to conduct an intervention study involving parents whose children died by accident, homicide, or suicide. Her research team recruited 269 mothers and fathers and followed them for the first 5 years of bereavement. In 2004, she received the Research Recognition Award from the Association of Death Education and Counseling.
She has served as an Associate Editor of the Journal of Addictions Nursing for over a decade. She is also a peer reviewer for a number of journals including Journal of Loss & Trauma, Issues in Mental Health Nursing, Journal of Family Psychology, Omega, and Death Studies. Dr. Murphy was inducted into the American Academy of Nursing in 1989. Since 2000, she has been an expert witness in wrongful death cases.
Dr. Marianne T. Marcus, EdD, RN, FAAN, is the John P. McGovern Distinguished Professor in Addiction Nursing; the Director of the Center for Substance Abuse Prevention, Education and Research; and the Assistant Dean of the Chair Department of Nursing Systems at the University of Texas at Houston Health Science Center School of Nursing. Her interest in substance abuse began when she opened a primary care clinic at Cenikor Foundation, a therapeutic community. Through interactions at Cenikor, she became aware that nursing curricula provided little content on alcohol, tobacco, and other drug abuse issues.
Since 1988, Dr. Marcus has enthusiastically sought to remedy that inadequacy. As the director of three successive Centers for Substance Abuse Faculty Development Projects, she provided training opportunities for 14 faculty fellows, developed integrated substance abuse curricula for nursing, and designed and implemented a unique graduate program in addictions nursing. She established community demonstration programs in prevention, a continuing education program for acute care nurses, and a monthly seminar series on substance abuse for area clergy.
Dr. Marcus' research interests include treatment outcomes of therapeutic communities and evaluation of the impact of substance abuse education on professional practice. She completed a faith-based substance abuse and HIV/AIDS prevention program at Windsor Village United Methodist Church and was associate director of a national multidisciplinary faculty development program in substance abuse, Project MAINSTREAM. She was a training coordinator for the Texas SBIRT grant funded by Center for Substance Abuse Treatment. Dr. Marcus recently completed a NIDA R01 behavioral therapies trial to study mindfulness-based meditation as an adjunct to therapeutic community treatment.
Dr. Marcus serves on a number of local, state, national, and international advisory panels on substance abuse practice and education. She was appointed by the governor to serve on the SBIRT Grant Steering Committee and is a member of the Drug Demand Reduction Advisory Committee of the State Health Department. Dr. Marcus served for 4 years on the Executive Committee of the Association of Medical Education and Research in Substance Abuse, two years as Secretary.
Her honors include the John P. McGovern Professorship in Addiction Nursing, John P. McGovern Outstanding Teacher Award, the Columbia University School of Nursing Distinguished Alumni Award, the University of Texas-Houston President's Scholar Award, election to Fellowship of the American Academy of Nursing, Association of Medical Education and Research in Substance Abuse's John P. McGovern Award for Excellence in Medical Education, and the International Nurses Society on Addictions Education Award and President's Award for 2004. She received the Lifetime Achievement Award from the Texas Research Society on Alcoholism in 2006 and was elected to the Teachers College, Columbia University Nursing Alumni Hall of Fame in 2010. In 2012, Dr. Marcus received the Regents Outstanding Teaching Award from the University of Texas System in recognition of her contributions to science education.
REFERENCES