What is Project MERITS?

Project MERITS stands for Managing Effective Relationships in Treatment Services and includes 3 different projects: MERITS I, II, and III.

MERITS I

Project MERITS I was a 5-year grant funded by the National Institute on Drug Abuse (NIDA). The project examined the factors related to turnover among counselors and clinical supervisors working in substance abuse treatment centers throughout the United States. The grant was approved in September 2006 and data collection started in late March of 2007. Members of the research team traveled to each substance abuse treatment center until 2010 to administer surveys to substance abuse counselors and clinical supervisors.

The Principal Investigator on the grant, Dr. Lillian Eby, has been studying workplace issues for over a decade and became interested in clinical supervision after talking with Dr. Paul Roman about the work his group was doing on health services delivery. With Paul’s encouragement and support, Lillian took the plunge and devoted 2 years to develop the idea behind Project MERITS. Her specific interest and expertise in organizational mentoring relationships was a perfect fit with the need to better understand how the clinical supervisory relationship relates to work attitudes, burnout, and ultimately turnover. This longitudinal study provided an in-depth look at these issues and generated recommendations for enhancing the quality of working conditions for employees and improving human resource management systems in substance abuse treatment centers.

The research design for Project MERITS involved four years of data collection. In years 1, 2 and 3 we surveyed counselors and clinical supervisors in the field. In years 2, 3, and 4 we collected archival turnover data. Most of the treatment centers participating in the grant were part of NIDA’s Clinical Trials Network (CTN). A total of 26 geographically dispersed treatment centers participated in this research project. Over the course of the study, over 2,745 counselors and 947 clinical supervisors participated in MERITS I and completed at least one survey!

MERITS II

Project MERITS II was a 4-year grant funded by the National Institute on Drug Abuse (NIDA).  Specifically, this project studied the effects of the OASAS Tobacco-Free regulation by collecting data from a convenience sample of treatment provider programs in New York State.  Three rounds of survey data collections were carried out annually starting in 2008.

Both full-time and part-time counselors and clinical supervisors were eligible to participate by completing a paper and pencil survey on-site. The findings of the study provided insights into how the Tobacco-Free regulation affected employee attitudes, stress reactions and behaviors. It also identified how the organizational implementation of the Tobacco-Free regulation influenced these same outcomes. The results proved useful not only to treatment providers in New York State, but also yielded evidence-based prescriptive recommendations for other states considering the adoption of a similar Tobacco-Free regulation. While smoking bans are popular in many organizational settings (www.smokefreeworld.com/usa.shtml), New York was the first state to implement a 100% Tobacco-Free regulation in substance abuse treatment facilities. However, the field of substance abuse treatment has struggled for years with the seeming contradiction of treating dependence on drugs while allowing the use of tobacco in treatment facilities. With New York State as a test case, it is expected that other states will likely follow suit and need guidance on how to most effectively implement Tobacco-Free regulation in their states.

MERITS III

Project MERITS III was a 5-year grant funded by the National Institute on Drug Abuse (NIDA) starting in 2010. It expanded upon MERITS II, which studied the availability of Evidence-Based Treatments (EBTs) for smoking in substance abuse treatment centers in the state of New York. Data collection, data analyses and dissemination of findings is completed. With MERITS III, we collected data from a nationally representative sample of providers to pursue two aims: First, we longitudinally examined the availability of EBTs for smoking among those seeking treatment for co-occurring substance abuse disorders, including low-income patients. By examining what predicts changes in service availability over time in treatment programs, we were able to identify the organizational and policy factors that predict the availability, implementation, and sustainability (or discontinuation) of EBTs for smoking. Second, we were longitudinally investigating the conditions under which counselor awareness of available EBTs for smoking in their treatment programs translates into clinical behaviors that support smoking cessation. Three waves of data were collected by conducting phone interviews with Program Administrators and Clinical Directors and by administering web-based surveys to Counselors.

With this study, we gained a better understanding of the adoption, implementation, and sustainability of evidence-based smoking cessation services and how these services are implemented by counselors. Furthermore, the findings from this study helped treatment centers in program planning and provided information about alternative treatment options, thus allowing for specific and empirically-based recommendations for implementing new services while limiting negative outcomes. Participating centers additionally benefited from this study as they gained an enhanced understanding of how employee’s perceptions and attitudes toward their work and their employer could influence counseling related behaviors.


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