Steve Martino, PhD
Professor of PsychiatryCards
Appointments
Additional Titles
Chief of Psychology, VA CT Healthcare System
Contact Info
Psychiatry
VA Connecticut Healthcare System, 950 Campbell Avenue (116B)
West Haven, CT 06516
United States
Appointments
Additional Titles
Chief of Psychology, VA CT Healthcare System
Contact Info
Psychiatry
VA Connecticut Healthcare System, 950 Campbell Avenue (116B)
West Haven, CT 06516
United States
Appointments
Additional Titles
Chief of Psychology, VA CT Healthcare System
Contact Info
Psychiatry
VA Connecticut Healthcare System, 950 Campbell Avenue (116B)
West Haven, CT 06516
United States
About
Titles
Professor of Psychiatry
Chief of Psychology, VA CT Healthcare System
Biography
Dr. Martino specializes in the treatment of addictive disorders and of patients diagnosed with co-occurring psychiatric problems, with specific interests in motivational interviewing, group work, and brief interventions in medical settings. He has extensive experience conducting randomized controlled hybrid effectiveness-implementation multisite trials, feasibility and acceptability psychotherapy development studies, and mixed qualitative-quantitative formative evaluations. At VA Connecticut, he serves as the Chief of the Psychology Services, Director of the Implementation, Dissemination, and Education Core of the VA HSR&D Center of Innovation (COIN) Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, and Co-Project Director of the Interpersonal Violence Center for Innovation and Research, Innovation and Implementation Core. His current research focuses on strategies for implementing treatments and brief interventions in community treatment programs and VA and non-VA medical settings.
Appointments
Psychiatry
ProfessorPrimary
Other Departments & Organizations
- Adult Psychiatry
- Division of Addictions
- Division of Mental Health Services
- Division of Substance Abuse
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center
- Psychiatry
- Psychology Section
- Psychotherapy Development Center
- Yale Ventures
- Yale-Drug use, Addiction, and HIV prevention Research Scholars (DAHRS)
- Yale-UPR Integrated HIV Basic and Clinical Sciences Initiative
Education & Training
- Post Doctoral
- Yale University School of Medicine (1991)
- PhD
- Depaul University (1990)
Research
Overview
The driving force behind my research and related scholarly activities has been my dedication to promoting the use of evidence-based psychosocial treatments in clinical settings. In the early 1990s, I began to apply motivational interviewing (MI) in the treatment of patients with severe mental illness and addictions. I engaged in a series of studies to develop this adaptation and empirically examined its treatment effects in a randomized clinical trial. At the time, few investigators had published about how to specifically apply MI to this dual diagnosis population and to test how well it worked. To my surprise, I found that MI was differentially effective with psychotically ill patients who abused cocaine, but not with those who abused marijuana. My work highlighted the complexities of enhancing motivation in patients with severe co-occurring mental illness and addiction. From these efforts to tailor MI, I became more interested in studying how to effectively train clinicians in evidence-based practices. I was impressed by the disciplined methods used to teach clinicians behavioral treatments in clinical trials (use of manuals, recording sessions, integrity rating, supervisory feedback and coaching, ongoing close monitoring of performance) and, ironically, how uncommon this careful training approach was employed in real world educational and practice settings. This simple observation led me to shift my research toward dissemination and implementation science, and I became increasingly involved in the NIDA Clinical Trials Network. Specifically, I assisted in the conduct of several national multi-site effectiveness trials involving MI. I had primary responsibility for serving as the local, and then national trainer, and developing an integrity rating scale and system to be used for supervision and independent observer treatment validation in the trials. I took the lead in psychometrically validating the scale and developing a NIDA-SAMHSA national dissemination product called Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency – a manual that details methods for supervising MI in community treatment programs. Subsequently, I became the national trainer-of-trainers for MIA: STEP and played a key role in its dissemination nationally and internationally, and the studied its in improving clinicians' MI adherence and competence and clients' clinical outcomes. In addition, I have published studies that have examined the effectiveness and cost effectiveness of a train-the-trainer and specialist vs. generalist approach for implementing motivational interviewing in community and medical settings. I also have piloted an innovative stepwise approach in which clinicians only receive more intensive treatment training if they fail to meet a criterion performance threshold. The study showed the promise of more adaptive training program designs and suggested that future training trials screen participants to exclude those who already have the targeted skills and little room for improvement. Currently, in two large national multisite hybrid trials I am examining the effectiveness of hub-and-spoke and implementation facilitation approaches to support the use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for motivating Veterans with chronic pain and risky substance use to engage in VA multimodal nonpharmacological pain care. This work includes substantial formative evaluation to understand implementation barriers and facilitators, adapt interventions, and adjust implementation strategies as the work unfolds.
Medical Subject Headings (MeSH)
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Charla Nich
Samuel Ball, PhD
Carlos Grilo, PhD
Dwain Fehon, PsyD
Gail D'Onofrio, MD, MS
Galina A. Portnoy, PhD
Motivational Interviewing
Psychotherapy
Implementation Science
Publications
2024
M41 Do People With Substance Misuse (SM) Use Distinct Pain Treatment Modalities?
Rosen M, Gilstad-Hayden K, Sellinger J, Lazar C, Martino S. M41 Do People With Substance Misuse (SM) Use Distinct Pain Treatment Modalities? Drug And Alcohol Dependence 2024, 260: 110321. DOI: 10.1016/j.drugalcdep.2023.110321.Peer-Reviewed Original ResearchGroup-Based Metacognitive Reflection and Insight Therapy (MERITg) and Its Relationship to Recovery-Oriented Beliefs in Serious Mental Illness
Musket C, Bullock J, Fiszdon J, Stacy M, Martino S, James A, Lysaker P, Martin A. Group-Based Metacognitive Reflection and Insight Therapy (MERITg) and Its Relationship to Recovery-Oriented Beliefs in Serious Mental Illness. Behavioral Sciences 2024, 14: 520. PMID: 39062343, PMCID: PMC11273885, DOI: 10.3390/bs14070520.Peer-Reviewed Original ResearchAltmetricConceptsSerious mental illnessMental illnessMaryland Assessment of RecoveryRecovery-oriented interventionsInsight TherapyThirty-one participantsAssessment of recoveryGroup participantsShort formEvidence-basedInpatient groupTreatment settingsMetacognitive reflectionTreatment programsParticipantsIllnessTherapeutic interactionSMIThirty-oneBeliefsAdjunctive treatmentInterventionGroupMarylandTherapySensitivity, specificity, and discordance with self-report of nail sample testing for alcohol and cannabis
Morie K, Gilstad-Hayden K, Martino S, Lazar C, Rosen M. Sensitivity, specificity, and discordance with self-report of nail sample testing for alcohol and cannabis. Drug And Alcohol Dependence 2024, 261: 111358. PMID: 38943713, DOI: 10.1016/j.drugalcdep.2024.111358.Peer-Reviewed Original ResearchAltmetricConceptsDelta 9-THCAlcohol-related problemsRisky alcohol useSelf-reportAlcohol useEthyl glucuronideAUDIT-CAlcohol use patternsSelf-reported alcoholInaccurate self-reportsSubstance use patternsFactors associated with discordanceSubstance-related harmsMarijuana problemsNail clippingsCannabis metabolitesNon-Hispanic ethnicityStandard cut-offsMarijuana useClinical trialsCannabisAlcohol metabolitesWhite raceTelephone questionnaireHighest specificityDo veterans with risky substance use (RSU) use distinct pain treatment modalities?
Meshberg‐Cohen S, Gilstad‐Hayden K, Martino S, Lazar C, Sellinger J, Rosen M. Do veterans with risky substance use (RSU) use distinct pain treatment modalities? American Journal On Addictions 2024 PMID: 38849976, DOI: 10.1111/ajad.13620.Peer-Reviewed Original ResearchAltmetricConceptsRisky substance usePain treatment modalitiesTreatment modalitiesPain treatmentPrescribed opioidsPain treatment utilizationSubstance Involvement TestNonopioid pain treatmentPain treatment outcomesSubstance useOver-the-counter medicationsNumerical rating scalePrimary careMusculoskeletal conditionsAssociated with numberPain serviceNonopioid treatmentsPrescription medicationsOpioid medicationsChronic painOpioid prescriptionsOver-the-counterVeteransDisability claimsOpioidDefining the therapeutic relationship in the context of alcohol use, other drug use, and behavior change: Principles and practices
Magill M, Martino S, Wampold B. Defining the therapeutic relationship in the context of alcohol use, other drug use, and behavior change: Principles and practices. Journal Of Substance Use And Addiction Treatment 2024, 163: 209398. PMID: 38754554, PMCID: PMC11180559, DOI: 10.1016/j.josat.2024.209398.Peer-Reviewed Original ResearchConceptsTherapeutic relationshipBehavioral changesTherapist interpersonal skillsClient behavior changeBehavior change processEvidence-based alcoholBehaviour change mechanismsTherapy relationshipTherapy manualContent analysisQualitative content analysisContext of behavioral changeAlcohol usePeer-reviewed articlesClinical supervisorsInterpersonal considerationsDrug usePractice guidelinesInterpersonal skillsModerate agreementCore processesChange mechanismAlcoholLiterature reviewChange processEfficacy of Integrating the Management of Pain and Addiction via Collaborative Treatment (IMPACT) in Individuals With Chronic Pain and Opioid Use Disorder: Protocol for a Randomized Clinical Trial of a Digital Cognitive Behavioral Treatment
MacLean R, Ankawi B, Driscoll M, Gordon M, Frankforter T, Nich C, Szollosy S, Loya J, Brito L, Ribeiro M, Edmond S, Becker W, Martino S, Sofuoglu M, Heapy A. Efficacy of Integrating the Management of Pain and Addiction via Collaborative Treatment (IMPACT) in Individuals With Chronic Pain and Opioid Use Disorder: Protocol for a Randomized Clinical Trial of a Digital Cognitive Behavioral Treatment. JMIR Research Protocols 2024, 13: e54342. PMID: 38506917, PMCID: PMC10993119, DOI: 10.2196/54342.Peer-Reviewed Original ResearchCitationsAltmetric
2023
Weight change in a national cohort of U.S. Military Veterans engaged in medication treatment for opioid use disorder
Carr M, Wolkowicz N, Cave S, Martino S, Masheb R, Midboe A. Weight change in a national cohort of U.S. Military Veterans engaged in medication treatment for opioid use disorder. Journal Of Psychiatric Research 2023, 168: 204-212. PMID: 37918033, DOI: 10.1016/j.jpsychires.2023.10.012.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsOpioid use disorderMethadone treatmentBuprenorphine treatmentUse disordersMedication treatmentWeight changeVeterans Health Administration (VHA) administrative dataWeight gainSignificant weight gainCourse of treatmentU.S. military veteransTreatment episodesNational cohortObservation periodMilitary veteransLinear mixed modelsVeteransTreatmentBMIDisordersAdministrative dataCohortFiscal year 2017Fiscal year 2019Mixed modelsScreening for Intimate Partner Violence Experience and Use in the Veterans Health Administration
Portnoy G, Relyea M, Presseau C, Orazietti S, Bruce L, Brandt C, Martino S. Screening for Intimate Partner Violence Experience and Use in the Veterans Health Administration. JAMA Network Open 2023, 6: e2337685. PMID: 37831451, PMCID: PMC10576210, DOI: 10.1001/jamanetworkopen.2023.37685.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsVeterans Health AdministrationCross-sectional studyStress disorder diagnosisPosttraumatic stress disorder (PTSD) diagnosisMental health servicesIPV useIntimate partner violenceHealth AdministrationVeterans Health Administration medical centersHealth servicesMental health care visitsClinical diagnosisMajor public health problemDisorder diagnosisElectronic medical record dataHealth care visitsIPV experiencesMedical record dataPublic health problemMental health cliniciansMental health careQuality improvement initiativesHealth care settingsOutcomes of interestPast-year prevalenceMusculoskeletal Pain During Pregnancy Among Veterans: Associations With Health and Health Care Utilization
Kroll-Desrosiers A, Wallace K, Higgins D, Martino S, Mattocks K. Musculoskeletal Pain During Pregnancy Among Veterans: Associations With Health and Health Care Utilization. Women's Health Issues 2023, 34: 90-97. PMID: 37580185, DOI: 10.1016/j.whi.2023.07.004.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsVA mental health careAdjusted odds ratioMental health careMSK painMusculoskeletal painVeterans Health Administration electronic health record dataIntegrative health approachesHealth care utilizationElectronic health record dataHealth careConfidence intervalsMajor depressive disorderHealth care engagementHealth record dataMental health conditionsPost-traumatic stress disorderPregnant veteransOpioid prescriptionsCesarean sectionPain groupSecondary outcomesPrimary outcomeCare utilizationEntire cohortCare engagementUnderstanding Veterans' intimate partner violence use and patterns of healthcare utilization
Relyea M, Presseau C, Runels T, Humbert M, Martino S, Brandt C, Haskell S, Portnoy G. Understanding Veterans' intimate partner violence use and patterns of healthcare utilization. Health Services Research 2023, 58: 1198-1208. PMID: 37452496, PMCID: PMC10622301, DOI: 10.1111/1475-6773.14201.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsVeterans Health AdministrationHealthcare utilizationIPV useChronic painMedical treatmentSevere chronic painNon-VA providersChronic sleep problemsNon-VA servicesPost-traumatic stress disorderChi-square testRisk factorsOperation New Dawn veteransProvider trainingSleep problemsVA healthcareNew Dawn veteransOperation Enduring FreedomDATA SOURCESWomen veteransOutpatient healthcareHealth AdministrationOperation Iraqi FreedomClinical settingStudy setting
Clinical Trials
Current Trials
Engaging Veterans Seeking Service-Connection Payments in Pain Treatment (PragmaticSBIRT)
HIC ID2000022664RoleSub InvestigatorPrimary Completion Date09/30/2023Recruiting ParticipantsGenderBothAge18 years - 100 years
Links & Media
News
- July 01, 2024
Sellinger, Pietrzak Honored by VA Connecticut Healthcare System
- November 17, 2023
Yale Psychiatry Researchers Awarded Grant to Establish PRISM Initiative
- October 13, 2023
Screening for Intimate Partner Violence Experience and Use in the Veterans Health Administration
- July 24, 2023Source: Health Services Research
Understanding Veterans' Intimate Partner Violence Use and Patterns of Healthcare Utilization
Get In Touch
Contacts
Psychiatry
VA Connecticut Healthcare System, 950 Campbell Avenue (116B)
West Haven, CT 06516
United States