Montreal Cross-Training Program: The contribution of positional clarification activities to help bridge fragmented prevention and treatment services for co-occurring disorders

Health Soc Care Community. 2020 May;28(3):1090-1098. doi: 10.1111/hsc.12942. Epub 2019 Dec 29.


Co-occurring disorders in mental health and addiction present a high prevalence, but services available to prevent and treat them are often fragmented. Cross-training activities have been used to help minimise breaks in service continuity. This study assesses to what extent positional clarification (a specific type of cross-training activity) can help bridge fragmented services for co-occurring disorders by providing information and promoting interactions to help professionals better orient and treat their clientele. A total of 2,107 participations were recorded for 11 positional clarification events taking place within the Montreal Cross-Training Program for mental health and substance use disorders between 2010 and 2016. The Kirkpatrick four-level training evaluation model was used to evaluate these activities. Evaluation questionnaires (n = 1,650) and interviews with a convenience sample of 32 participants were analysed using descriptive statistics and thematic analysis. More than three-quarters of participants reported that the activity met their expectations and was relevant to their practice. Respondents also reported receiving useful information to better orient their clientele, discovering new resources, learning about the functioning of other resources, identifying members of other networks who could orient them when needed, and learning more about the theme of the activity and the different mechanisms for collaboration among the related services. Among those who participated in more than one positional clarification event, roughly three-quarters reported that they were able to call upon new resources at least once as a result of their participation, and were able to establish referrals towards resources that were unknown or less familiar to them prior to their participation. Results suggest that the programme meets its service integration objectives and that positional clarification events can lead to changes that can help facilitate the integration of fragmented services by improving participants' knowledge of specific themes and available resources to better orient and treat their clientele.

Keywords: Co-occurring disorders; addiction; cross-training; mental health; positional clarification; programme evaluation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Community Mental Health Services / organization & administration*
  • Comorbidity
  • Female
  • Humans
  • Inservice Training / organization & administration*
  • Interprofessional Education / organization & administration*
  • Male
  • Mental Disorders / rehabilitation*
  • Patient Care Team

Grant support