Self EfficacyNCT07262372
Supervision in Substance Use Disorder Treatment Programs
A study testing FOCUS supervision strategy in people with Self Efficacy and Burnout, Professional, run by University of Arkansas at 1 site in United States.
Trial summary
Substance use disorders such as opioid addiction affect millions of adults in the United States each year, but the delivery of high-quality, effective addiction services is disrupted by organizational issues such as counselor burnout and turnover. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Self Efficacy, Burnout, Professional, Substance Use Disorders
- What is being tested?
- FOCUS supervision strategy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 43 participants
- Where
- 1 siteUnited States
- Study dates
- 21 Jul 2025to 30 Jun 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Serves as a supervisor (i.e., oversee work of counselors) or counselor (i.e., directly work with clients) at a substance use treatment facility/program
- Program/facility provides residential services
Who cannot join
- Supervisors contracted (not employed) by the facility
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Jure Baloh, PhD, 501-526-6604, jbaloh@uams.edu
About this study
Official title: Supervision Strategy for Substance Use Disorder Treatment Programs: A Pilot Study
Substance use disorders such as opioid addiction affect millions of adults in the United States each year, but the delivery of high-quality, effective addiction services is disrupted by organizational issues such as counselor burnout and turnover. Clinical supervisors are essential for supporting counselors in specialty addiction treatment programs, but few supervisors receive supervision-focused training. This project seeks to develop and pilot an evidence-based supervision strategy that has a high potential to enhance supervision and result in improved counselors' well-being and performance and, in turn, to improve client outcomes.
Read the detailed description
Substance use disorders (SUDs) such as addiction to opioids, methamphetamines and alcohol are a significant burden in the US, affecting almost 50 million individuals annually. Community specialty SUD treatment programs ("SUD programs") are a key type of SUD providers and while effective treatments for SUD exist, significant issues in the organization and delivery of SUD programs (e.g., burnout, turnover) undermine the delivery of high-quality services. Clinical supervisors are centrally positioned to support SUD counselors (frontline clinical providers) and ensure high service quality. For clinical supervisors to effectively support counselors, they need evidence-based supervision strategies. Currently, supervisors in community SUD programs receive very little training, support, and direction for supervision, and thus their supervision practices are highly variable, raising concern about the effectiveness of clinical supervision as currently provided in these programs. Evidence-based supervision strategies can help fill the gap, and evidence from child welfare settings shows they improve leadership, climate, and client outcomes. Based on our preliminary formative work with SUD providers in Arkansas, a reinforcement-based supervision strategy developed for counselors was deemed acceptable and feasible in SUD programs, and had high perceived potential to improve supervision quality, counselor well-being and performance, and client outcomes. Participants thought the structure and content of the strategy were a good fit for SUD settings. However, for a supervision strategy to be supportive of the work they do, it needs to be developed to reflect the language, case examples, and organizational factors relevant to the SUD settings. The goals of our study are to iteratively develop and refine a supervision strategy for SUD settings, and to pilot it in residential treatment programs using quality improvement and implementation science tools and approaches. Aim 1 involves leveraging previous experience developing supervision strategies and partnering with SUD providers to develop and refine the supervision strategy for SUD. Using the Evidence-Based Quality Improvement (EBQI) process, we will engage SUD partners in a series of collaborative meetings to review and discuss the supervision strategy and related study materials, and to make key decisions. The output of this work will be a refined and optimized SUD supervision strategy. Aim 2 involves conducting two pilot cycles with supervisors and counselors in a sample of SUD residential treatment programs to assess the feasibility and acceptability of the supervision strategy, examine its impact on key organizational, counselor, and client outcomes, and to document barriers and facilitators for its implementation and sustained use in routine practice. This study will provide key information to inform planning and design of a future fully powered study to assess the effectiveness of the new supervision strategy in a large sample of SUD programs.
- Being tested
- FOCUS supervision strategy
- Keywords
- supervision, substance use disorder treatment facility, organizational context, counselor burnout, counselor self-efficacy
- Medical subject headings
- Burnout, Professional, Substance-Related Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
FOCUS supervision strategyOther
The FOCUS supervision strategy provides a strenghts-based model for supervision. It is built around three core components: (1) Five pillars for effective supervision interactions, (2) practical skills that operationalize these principles, and (3) a set of experiential activities that provide foundational learnings for staff to practice the skills around real-life situations (from which future client-specific interventions can be built). In this study, FOCUS is being tailored for SUD treatment settings.
| Study group | Role | What they receive |
|---|---|---|
| Supervision arm | Experimental | Supervisors will be trained and coached in a new supervision strategy (FOCUS) Receives: Other: FOCUS supervision strategy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Counselor self-efficacy
Self-reported survey response at the counselor level (Efficacy subscale on TCU ORC; 1-5 Likert scale, higher scores are better; Lehman WEK, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22(4):197-209. doi: 10.1016/S0740-5472(02)00233-7.)
Measured: Every 6 months for 2 years
Secondary outcomes (12)
Supervisor fidelity to FOCUS
Expert rated fidelity to FOCUS at the supervisor level (measure to be developed as part of the study)
Measured: Monthly, 2 years
FOCUS acceptability
Supervisor perceptions of acceptability (satisfaction, appeal) of FOCUS and related materials (Acceptability of Intervention Measure [AIM], 1-5 Likert scale, higher scores are better; Weiner BJ, Lewis CC, Stanick C, et al. Psychometric assessment of three newly developed implementation outcome measures. Implementation Science. 2017;12:1-12. doi: 10.1186/s13012-017-0635-3.)
Measured: Every 6 months, for 2 years
FOCUS feasibility
Supervisor perceptions of feasibility (ease of use, "do-ability") of FOCUS and related materials (Feasibility of Intervention Measure [FIM], 1-5 Likert scale, higher scores are better; Weiner BJ, Lewis CC, Stanick C, et al. Psychometric assessment of three newly developed implementation outcome measures. Implementation Science. 2017;12:1-12. doi: 10.1186/s13012-017-0635-3.)
Measured: Every 6 months, for 2 years
Leadership - implementation leadership
Counselor perceptions of supervisors' support for ESTs (Implementation Leadership Scale [ILS], 1-5 Likert scale, higher scores are better; Aarons GA, Ehrhart MG, Torres EM, Finn NK, Roesch SC. Validation of the implementation leadership scale (ILS) in substance use disorder treatment organizations. J Subst Abuse Treat. 2016;68:31-35. doi: 10.1016/j.jsat.2016.05.004.)
Measured: Every 6 months, for 2 years
Leadership - clinical supervision
Counselor perceptions of supervisor instrumental assistance (Clinical Supervision, 1-5 Likert scale, higher scores are better; Knudsen HK, Ducharme LJ, Roman PM. Clinical supervision, emotional exhaustion, and turnover intention: A study of substance abuse treatment counselors in the clinical trials network of the national institute on drug abuse. J Subst Abuse Treat. 2008;35(4):387-395. doi: 10.1016/j.jsat.2008.02.003.)
Measured: Every 6 months, for 2 years
Organizational Social Context - implementation climate
Supervisor and counselor shared perceptions of organizational expectations of, and support and reward for EST use (Implementation Climate Scale [ICS], 1-5 Likert scale, higher scores are better; Ehrhart MG, Torres EM, Hwang J, Sklar M, Aarons GA. Validation of the implementation climate scale (ICS) in substance use disorder treatment organizations. Substance abuse treatment, prevention, and policy. 2019;14(1):1-10. doi: 10.1186/s13011-019-0222-5.)
Measured: Every 6 months, for 2 years
Organizational Social Context - organizational climate
Supervisor and counselor shared perceptions of organizational environment (Mission, Cohesion, and Stress subscales from TCU ORC; and Effort subscale from the Patterson Organizational Climate Measure; 1-5 Likert scale, higher scores are better; responses will be aggregated across subscales for primary analyses; Lehman WEK, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22(4):197-209. and Patterson MG, West MA, Shackleton VJ, et al. Validating the organizational climate measure: Links to managerial practices, productivity and innovation. J Organ Behav. 2005;26(4):379-408. doi: 10.1002/job.312.)
Measured: Every 6 months, for 2 years
Counselor functioning - burnout
Counselor perceptions of being overextended and depleted of emotional and physical resources (Emotional Exhaustion on Maslach Burnout Inventory; 1-5 Likert scale, lower scores are better; Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2(2):99-113. doi: 10.1002/job.4030020205.)
Measured: Every 6 months, for 2 years
Counselor performance
Supervisor ratings of counselor performance (based on annual performance evaluations in use at the facilities)
Measured: Every 6 months, for 2 years
Organizational performance/outcomes - turnover
Objective measures of employee turnover rate (at program level)
Measured: Every 6 months, for 2 years
Organizational performance/outcomes - client treatment completion
Objective measures of client treatment completion rate (at program level)
Measured: Every 6 months, for 2 years
Organizational performance/outcomes - client satisfaction
Client-reported satisfaction levels (at program level; as routinely collected by programs)
Measured: Every 6 months, for 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Dec 2025
- Study start21 Jul 2025
- Primary completion31 May 2027 (estimated)
- Study completion30 Jun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Self EfficacyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- One arm pilot/feasibility study
- Masking
- None (open label)
- Enrolment
- 43 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Arkansas
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA), Chestnut Health Systems
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07262372
- Sponsor's protocol ID
- 297361
- Other IDs
- R34DA060419
- Status last verified
- Dec 2025
- First submitted
- 12 Nov 2025
- Last updated
- 11 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Individual data will include observational data on supervisor fidelity (expert ratings); survey data on leadership, organizational social context, and counselor functioning (self-reported by counselors and/or supervisors); and interview data with leadership, supervisors, and counselors based on semi-structured interview guides informed by the study conceptual model and implementation science framework.
Study at a glance
From the registry record, last updated by the sponsor on 11 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Supervision Strategy for Substance Use Disorder Treatment Programs: A Pilot Study
- ClinicalTrials.gov ID
- NCT07262372
- Acronym / sponsor ID
- 297361
- Keywords
- supervision, substance use disorder treatment facility, organizational context, counselor burnout, counselor self-efficacy
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 43 participants (estimated)
- Lead sponsor
- University of ArkansasUniversity, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA), Chestnut Health Systems
- Study start
- 21 Jul 2025 (actual)
- Primary completion
- 31 May 2027 (estimated)
- Study completion
- 30 Jun 2027 (estimated)
- First posted
- 3 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Substance use disorders such as opioid addiction affect millions of adults in the United States each year, but the delivery of high-quality, effective addiction services is disrupted by organizational issues such as counselor burnout and turnover. Clinical supervisors are essential for supporting counselors in specialty addiction treatment programs, but few supervisors receive supervision-focused training. This project seeks to develop and pilot an evidence-based supervision strategy that has a high potential to enhance supervision and result in improved counselors' well-being and performance and, in turn, to improve client outcomes.
Detailed description
Substance use disorders (SUDs) such as addiction to opioids, methamphetamines and alcohol are a significant burden in the US, affecting almost 50 million individuals annually. Community specialty SUD treatment programs ("SUD programs") are a key type of SUD providers and while effective treatments for SUD exist, significant issues in the organization and delivery of SUD programs (e.g., burnout, turnover) undermine the delivery of high-quality services. Clinical supervisors are centrally positioned to support SUD counselors (frontline clinical providers) and ensure high service quality. For clinical supervisors to effectively support counselors, they need evidence-based supervision strategies. Currently, supervisors in community SUD programs receive very little training, support, and direction for supervision, and thus their supervision practices are highly variable, raising concern about the effectiveness of clinical supervision as currently provided in these programs. Evidence-based supervision strategies can help fill the gap, and evidence from child welfare settings shows they improve leadership, climate, and client outcomes. Based on our preliminary formative work with SUD providers in Arkansas, a reinforcement-based supervision strategy developed for counselors was deemed acceptable and feasible in SUD programs, and had high perceived potential to improve supervision quality, counselor well-being and performance, and client outcomes. Participants thought the structure and content of the strategy were a good fit for SUD settings. However, for a supervision strategy to be supportive of the work they do, it needs to be developed to reflect the language, case examples, and organizational factors relevant to the SUD settings. The goals of our study are to iteratively develop and refine a supervision strategy for SUD settings, and to pilot it in residential treatment programs using quality improvement and implementation science tools and approaches. Aim 1 involves leveraging previous experience developing supervision strategies and partnering with SUD providers to develop and refine the supervision strategy for SUD. Using the Evidence-Based Quality Improvement (EBQI) process, we will engage SUD partners in a series of collaborative meetings to review and discuss the supervision strategy and related study materials, and to make key decisions. The output of this work will be a refined and optimized SUD supervision strategy. Aim 2 involves conducting two pilot cycles with supervisors and counselors in a sample of SUD residential treatment programs to assess the feasibility and acceptability of the supervision strategy, examine its impact on key organizational, counselor, and client outcomes, and to document barriers and facilitators for its implementation and sustained use in routine practice. This study will provide key information to inform planning and design of a future fully powered study to assess the effectiveness of the new supervision strategy in a large sample of SUD programs.
Study design
- Primary purpose
- Health services research
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- One arm pilot/feasibility study
| Arm | Type | Receives |
|---|---|---|
| Supervision arm | Experimental | Other: FOCUS supervision strategySupervisors will be trained and coached in a new supervision strategy (FOCUS) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Serves as a supervisor (i.e., oversee work of counselors) or counselor (i.e., directly work with clients) at a substance use treatment facility/program
- Program/facility provides residential services
Key exclusion criteria (1 listed)
- Supervisors contracted (not employed) by the facility
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| FOCUS supervision strategyThe FOCUS supervision strategy provides a strenghts-based model for supervision. It is built around three core components: (1) Five pillars for effective supervision interactions, (2) practical skills that operationalize these principles, and (3) a set of experiential activities that provide foundational learnings for staff to practice the skills around real-life situations (from which future client-specific interventions can be built). In this study, FOCUS is being tailored for SUD treatment settings. | Other | Supervision arm |
Primary outcome
Counselor self-efficacy
Time frame: Every 6 months for 2 years
Self-reported survey response at the counselor level (Efficacy subscale on TCU ORC; 1-5 Likert scale, higher scores are better; Lehman WEK, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22(4):197-209. doi: 10.1016/S0740-5472(02)00233-7.)
12 secondary outcomes
Supervisor fidelity to FOCUS
Time frame: Monthly, 2 years
FOCUS acceptability
Time frame: Every 6 months, for 2 years
FOCUS feasibility
Time frame: Every 6 months, for 2 years
Leadership - implementation leadership
Time frame: Every 6 months, for 2 years
Leadership - clinical supervision
Time frame: Every 6 months, for 2 years
Organizational Social Context - implementation climate
Time frame: Every 6 months, for 2 years
Organizational Social Context - organizational climate
Time frame: Every 6 months, for 2 years
Counselor functioning - burnout
Time frame: Every 6 months, for 2 years
Counselor performance
Time frame: Every 6 months, for 2 years
Organizational performance/outcomes - turnover
Time frame: Every 6 months, for 2 years
Organizational performance/outcomes - client treatment completion
Time frame: Every 6 months, for 2 years
Organizational performance/outcomes - client satisfaction
Time frame: Every 6 months, for 2 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Dec 2025.
- Individual participant dataSharing planned: Yes. Individual data will include observational data on supervisor fidelity (expert ratings); survey data on leadership, organizational social context, and counselor functioning (self-reported by counselors and/or supervisors); and interview data with leadership, supervisors, and counselors based on semi-structured interview guides informed by the study conceptual model and implementation science framework.
Related trials for Self Efficacy
Not yet recruiting
A Hybrid Effectiveness-Implementation and Cost-Utility Evaluation of a Support Programme for Informal Carers of People With Dementia in Primary Care (EsCuidar2)
Quality of Life
Active, not recruiting
The Effect of Planned Group Interaction on Ostomy Adaptation, Quality of Life, and Stoma Care Self-Efficacy Levels in Individuals With an Ostomy
Ostomy - Ileostomy or Colostomy
Not yet recruitingPhase 1/2
Reducing Firearm Suicide Among Veterans: Evaluating the Effectiveness of Peer-Delivered Lethal Means Counseling
Suicide, Secure Firearm Storage
Recruiting
Efficacy of Triple-daily 15mA tACS on Adolescent NSSI
Non-suicidal Self-injury (NSSI)
Recruiting
IMB-Guided Health Education Intervention for Medication Adherence and Blood Pressure Control in Non-adherent Hypertensive Patients
Hypertension
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing FOCUS supervision strategy in people with Self Efficacy and Burnout, Professional, run by University of Arkansas at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 11 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jure Baloh, PhD (501 526 6604, jbaloh@uams.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Counselor self-efficacy (time frame: Every 6 months for 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2025.