Behavioral Science

Robert Walker, M.S.W., L.C.S.W.

(University of Kentucky, 1979)
333 Waller Avenue, Suite 400
Lexington, Kentucky 40504
Phone: (859) 257-6623
Email: Robert.Walker@uky.edu

Research Description

Robert Walker’s research focuses on treatment outcomes of substance abuse treatment among clinical populations as well as partner violence victimization. His research has included a wide range of problems associated with substance abuse including traumatic brain injury, depression, and the ethics of consent processes. He is principal investigator of a statewide treatment outcome study that examines intake level data collected by clinicians in publicly funded treatment programs and follow-up data collected on former clients 12 months after treatment. The follow-up interviews are conducted by UK CDAR. These data now represent ten years of follow-up findings that include a description of avoided costs associated with treatment. He also is principal investigator of two projects that examine treatment outcomes among pregnant women with substance use disorders. These studies involve matching project-specific data collected by clinicians in public treatment programs to large state datasets on birth outcomes and service utilization.

2011 Accomplishments

During 2011, Robert Walker spent the majority of time on research pertaining to substance abuse and dependence. He had four publications in 2011 with one as first author. As last year, he completed three outcome and evaluation reports for the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities. Four other brief reports were also developed and disseminated to the practice community on substance abuse related findings in Kentucky that are relevant to practice.  Robert Walker was re-appointed in 2011 by the governor to the Traumatic Brain Injury Trust Fund Board.  A CSAT-funded residential program for pregnant and postpartum women has completed its third and final year with Robert Walker as evaluator and grant author. Baseline clinical data were collected on 135 women over the life of the project. One hundred six women were eligible for follow-up interviews 6 months after discharge and the follow-up rate was 91%.  We analyzed birth event data on 91 births among women during the program period. Only one birth gave evidence of drug exposure to the newborn and that was for a mother who only stayed for a few days and left treatment AMA. The birth event dataset from Vital Statistics were used to match these mothers to their birth events with correct personal IDs. The data suggest birth events for the substance using mothers are the same as for the general population and somewhat better than for a similar clinical population seen in an outpatient case management program funded by the state. Robert Walker conducted journal reviews for four journals in 2010. He serves as a prisoner advocate reviewer for the UK Medical IRB and, as a general member, reviewed over 50 studies this year. Robert Walker has been working closely with the IRB on developing an electronic system for protocol submission, review and committee action.  As last year, Robert Walker has worked with Recovery Kentucky Task Force and its leadership to continue development of a plan for Medicaid coverage of substance abuse treatment for adolescents, pregnant women and parents in the child protective service system. Given massive changes in the state’s Medicaid program, the decision was taken to submit a 1915 State Plan Amendment to CMS so that these services could be included in the Medicaid service array. The array of services and cost assessment for this waiver were developed by Robert Walker.  Robert Walker served as a behavioral health consultant to the Kentucky Department of Public Advocacy on six death penalty cases during 2011. Consultancy relates to developing theories of the case for both guilt/innocence and mitigation phases of these capital trials. Robert Walker has worked with the DPA to revise the structure of case reviews to develop more comprehensive defense planning and use of expert witnesses.  Robert Walker and his staff developed a web-based data collection instrument for the KIDS NOW Plus program – a state funded case management program for pregnant women with substance abuse problems. In addition, major changes were put in place in three other web-based projects (KTOS, RKTOS, and IMPACT) during 2011.  Much of the writing this year has been applied to a book examining willed intentions and partner violence using neuroscience, philosophy, law, and psychology literatures. This began in June 2010 and is likely to take another year, thus interrupting journal article submissions.  Total external funds for this year were about $1.1 million. Robert Walker also provided 13 training events for clinical provider groups and organizations with four of those sessions being national in focus. The training has mostly focused on neuroscience and addiction and related behavioral health disorders including pregnancy and substance abuse.

Research Funding

Principal Investigator, Kentucky Substance Abuse Treatment Outcome Study, 2003 to present. Kentucky Department of Mental Health, Developmental Disabilities, and Addiction Services.
Principal Investigator, Adolescent Substance Abuse Treatment Outcome Study, 2005 to present. Kentucky Department of Mental Health, Developmental Disabilities, and Addiction Services.
Principal Investigator, Independence House Project for Pregnant and Postpartum Women. October 2008 – September 2011. This CSAT-funded residential substance abuse treatment project is for long term residential treatment for pregnant and postpartum women in Appalachian Kentucky. Kentucky Department of Mental Health, Developmental Disabilities, and Addiction Services.
Principal Investigator, Kids Now Project. July 2005 – Present. This is a state-funded program using case management oriented early interventions for pregnant women at risk for substance abuse. The evaluation study examines clinical outcomes using pre-post data on women served. Kentucky Department of Mental Health, Developmental Disabilities, and Addiction Services.
Principal Investigator, Families in Safe Homes Network. November 2007 – October 2012. This Kentucky River Community Care project is funded by the Administration for Child and Family services (ACF) in the Department for Health and Human Services. This project collects data on parents with substance use disorders whose children have been reported to protective services for child neglect or abuse. Kentucky River Community Care contract.
Principal Investigator, Opiate Replacement Treatment Program data system and outcomes project. January 2005 to present. This state-funded project uses baseline and follow-up measures as well as dose change measures, urinalysis results, and take-home exception request processing. Annual award – is part of the KTOS system and SDI initiative.

Representative Publications

Walker, R. (2009). Retention in treatment - Indicator or illusion: An essay Journal of Substance Use and Misuse, 44, 18-27.

Walker, R. (October, 2009). Translating neurodevelopment to practice: How to go from fMRI to a home visit. Journal of Loss and Trauma.

Walker, R., Cole, J., & Logan, TK. (2008). Identifying client-level indicators of recovery among DUI, criminal justice, and non-criminal justice treatment referrals. Special issue - Substance Use and Misuse,43, 1785-1801.

Walker, R. & Logan, TK (2008). Substance Abuse and Dependence. In H. E. A. Tinsley & S. H. Lease (Eds.). Encyclopedia of Counseling, Volume 2: Personal Counseling and Mental Health Problems (pp. 893-899). Thousand Oaks, CA: Sage.

Walker, R., Cole, J.E., Logan, TK. (2007). Screening substance abuse treatment clients for traumatic brain injury: Prevalence and characteristics. Journal of Head Trauma Rehabilitation, 22, 360-368.

Walker, R., Logan, T., Clark, J.J., & Leukefeld, C. (2005). Informed consent to undergo treatment for substance abuse: a recommended approach. Journal of Substance Abuse Treatment, 29 (4), 241-251.

Walker, R., & Logan, T. (2004). Treating substance abuse clients with co-occurring intimate partner violence. In K. Knight & D. Farabee (Eds.), Treating addicted offenders: A continuum of effective practices. (pp. 23.1-23.11). Kingston, NJ: Civic Research Institute.

Logan, T.K., Cole, J., Shannon, L., & Walker, R. (2006). Partner Stalking: How Women Respond, Cope, and Survive. Springer Publishers.

Logan, T., Walker, R., Jordan, C.J., & Leukefeld, C. (2006). Women and victimization, contributing factors, interventions, and implications. Washington, DC: American Psychological Association Press.

Walker, R., & Logan, T. (2004). Setting the stage for treating drug court clients: How to initiate treatment. In B. Sims (Ed.), Substance abuse treatment with correctional clients: Practical implications for institutional and community settings. Binghampton, NY: Hayworth Press.

Walker, R., Hiller, M., Staton-Tindall, M., & Leukefeld, C. (2003). Head injury among drug abusers: An indicator of co-occurring problems. Journal of Psychoactive Drugs, 35(3).