Q&A with Danica Kalling Knight

You joined the Institute of Behavioral Research in 1992. How has it grown in the 22 years you have been there?

Our research now impacts scientific inquiry and directly impacts the lives of individuals in treatment settings all over the world. For example, if you were arrested in Texas, you’d have to complete a drug screen developed by the institute. If you have a drug problem, part of your treatment might include using a graphical approach to counseling developed jointly by TCU Psychology and faculty at the IBR. Your progress while in treatment might be documented by the Client Evaluation of Self and Treatment, an assessment tool developed by the institute.    

Part of IBR’s mission is to provide critical methodological and substantive research training for graduate students. Does being around students lead to different insights about behavior?

Yes, daily. Our students come to IBR with a wide array of educational, work, and life experience. Each has a unique perspective, interests and gifts. We encourage them to ask questions and consider complex problems of substance use and recovery through their own lens. They often provide a perspective that I don’t have. Students play an integral role in the research we do and are encouraged to pursue their own interests within the context of our broader projects.  

How can young people be encouraged to make wise and healthy decisions? 

There are two primary things we can do to encourage youth to make wiser decisions  — strengthen positive and productive relationships and provide opportunities for kids to practice solving everyday problems.  

We tend to assume that most adolescents make more errors in decisions compared to adults — they don’t have the maturation or experience compared to their older counterparts. But recent studies on decision-making indicate that adolescents and adults are almost equal in their ability to solve complex problems. The difference lies in how much they let social factors influence what they do. Adolescents place higher value on what their peers think, say, believe, and place greater importance on this information, whether it’s accurate or not, compared to hard facts. So one of the best ways to encourage youth to make good decisions is through building productive relationships with parents, mentors and friends who will model and encourage acceptable behaviors and who will help the youth recognize when their thinking is “clouded” by social pressures.  
 IBR has developed tools for youth and adults aimed at teaching and practicing better thinking and decision-making skills.

One of your areas of research involves implementing best organizational practices for treatment centers. How can substance abuse centers operate more efficiently?

Many substance abuse providers operate on shoestring budgets, doing their best to stretch every dollar. One of the most costly elements of treatment involves staffing -- hiring and keeping counselors and administrators who work with youth and adults in treatment settings. There is a high degree of turnover among staff. 
Our research has documented that in outpatient settings, nearly a quarter of counselors and supervisory staff leave their position and/or the agency within any given year. Each time a trained staff member leaves, it “costs”’ the agency in terms of productivity due to shifting of responsibilities and having to hire and train new employees. Improving hiring practices, helping new employees become integrated into and invested in the agency and increasing staff retention would prove cost-effective. 

What would improved efficiency in treatment mean for society as a whole?

This is a question we’re thinking about as part of our newest grant from the National Institute on Drug Abuse. JJ-TRIALS (Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System) focuses on improving the continuum of care for youth on probation who exhibit substance use problems. Because there’s a strong link between delinquent behavior and substance use, it’s important to identify youth who need help and get them linked to appropriate services in a timely manner. Early intervention is the most promising deterrent against future addiction and delinquency. If we can do a better job identifying kids with problems and getting them the help they need early on when they first engage in delinquent activities, perhaps we can help them have healthier, more productive lives while reducing the costs to society as a whole.

Can you retain idealism while focused on human problems? 

I think you have to retain some level of idealism when focusing on complex social issues. Otherwise, it would be too easy to get overwhelmed or discouraged and simply give up. I have immense respect for substance use counselors, probation officers, and others who work tirelessly, day in and day out with youth and adults who have severe mental issues and scarce resources. It’s draining, and takes a unique combination of optimism, perseverance, and grit. Many years ago before coming to IBR, I worked with addicted and mentally ill youth and adults in local psychiatric hospitals. At times I would wonder if there was any hope for some of the people I worked with. They seemed to make the same mistakes over and over and had very little motivation to change.  I left the practitioner side of the field in part because I wanted to understand why people didn’t seem to change.
At the institute, we develop tools and resources to help individuals in need, and we help program administrators and counselors change the way they do business so that more people benefit. Some might think it’s idealistic to believe that what IBR does makes a difference. But when you stop to consider the people who are helped with our materials — the number of positive TCU Drug Screens that resulted in treatment, the number of clients who have gained insight into personal problems through Mapping Enhanced Counseling, the number of publications of our findings, the number of hits on our website and downloads of our manuals, and the frequent emails we get from practitioners in the field describing how their clients are responding to our materials — it motivates you to learn, develop and reach more.    

What do you wish more people knew about the reality of addiction?

I wish more people understood the chronic nature of addiction.  Yes, using illicit substances is a choice, but once someone is addicted, meaning that their brain chemistry has changed so that they crave the drug and have physical symptoms when they don’t get it, it becomes increasingly more difficult to “just say no.”
To overcome addiction means addressing the problem from multiple angles —medications to change brain chemistry and allow the person to function normally without cravings; counseling to address the negative thinking and destructive behaviors that they tend to engage in over and over again; changing the environment (cutting ties with friends who use and establishing new supportive relationships) and surrounding the person with a network of people who will keep him or her accountable.  

Q&A with Danica Kalling Knight