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Non-participation in outpatient dual diagnosis services presents a challenge for providers assisting clients in their recovery. To better understand factors that facilitate participation, the purpose of this paper is to examine positive recovery states – hope, meaning, and empowerment – as they relate to motivational interviewing (MI) and service use.

Six dually diagnosed adults completed four baseline assessments, four MI sessions, a post-MI tape-assisted recall interview, and one-month follow-up measures. Simulation modeling analysis of phone survey responses, comparisons of baseline and intervention phase data, and grounded theory analysis of interviews were conducted to determine MI's relationship to the dependent variables.

MI was associated with modest improvement in levels of participation, hope, empowerment, and with greater change in life purpose. Key recovery themes were: positive sense of self, increased self-efficacy, and improved relationships. Feelings of safety and trust were tied to greater self-disclosure while more active emotions were more closely linked to the discussion of recovery progress.

The paper's finding are limited by small sample size and phone survey response sets.

To better help dually diagnosed clients sustain treatment involvement, MI practitioners should pay special attention to recovery accomplishments, values, abilities, and self-esteem, while linking these attributes to service participation where appropriate and creating a safe, valuing atmosphere conducive to self-disclosure.

This is the first paper to measure key recovery constructs within MI process, and to explore the role of positive emotions related to MI, recovery, and service participation.

Evidence‐based practices (EBPs) are increasingly being implemented in real‐world settings. While intervention effectiveness is dependent on fidelity, interventions are often adapted to service settings according to the needs of stakeholders at multiple levels. This study aims to examine the naturalistic implementation of The Incredible Years (IY) parenting programme in a residential substance abuse treatment programme for pregnant and parenting women.

The study took place in a residential substance abuse treatment programme serving pregnant and parenting women and their children. Participants included 120 female clients. The primary IY facilitator was a master's level counselling psychologist. In person observations of IY sessions were completed by a trained bachelor's level anthropologist. Ethnographic field notes were collected and then coded in keeping with a priori themes and to identify emergent themes. The Parent Group Leader Checklist was used to evaluate quality and integrity of the IY basic parent programme.

Quantitative analyses indicate that fidelity varied by type of checklist activity. Specifically, adherence to the IY programme was highest in beginning topic activities, setup, and home activity review, and lowest in role play, vignettes, and wrap‐up activities. Qualitative analyses revealed a number of adaptations in implementation of IY. Adaptations fit into two broad categories: modification of programme delivery and modification of programme content. Within each of these categories modifications included organisation‐driven adaptations, provider‐driven adaptations, and consumer‐driven adaptations.

Changes to evidence‐based practice generally take two forms – adaptations consistent with model intent and theoretical approach and changes that represent drift from core elements of the EBP. The challenge for implementation science is to develop frameworks in which models can be adapted enough to make them viable for the service context (or the service context adapted to fit the model), yet avoid drift and maintain fidelity. Attending to the complexities of adaptation prior to and during implementation in a planned way is likely to help organisations better utilise EBPs to meet their unique needs while maintaining fidelity.

The paper shows that identification of types of intervention adaptations and drift allows for consideration of systematic approaches, frameworks, and processes to increase adherence during EBP implementation in community mental health and substance abuse treatment settings.