Kola Leads Initiatives to Integrate Substance Abuse and Mental Health Services for Co-Occurring Disorders

—by Paul M. Kubek

Cleveland, OH—Lenore Kola has a reputation as an agent of change. For 45 years, she has led national efforts in local communities to enhance services and quality of life for people who struggle with addictions and mental illness. She has acquired and administered more than $7 million in grants from federal, state, and county agencies and charitable foundations to educate and train countless numbers of social work students and licensed professionals about clinical innovations.

Ask her what she thinks about her accomplishments, and she circles back to the words agent of change, deflects the compliment with a hearty chuckle and rolling eyes. She says, "Oh, please. I don't know about that." She provides her own interpretation. "Listen. I was just doing my job."

Lenore A. Kola, PhD, is associate professor of social work at the Jack, Joseph and Morton Mandel School of Applied Social Sciences and former dean of the School of Graduate Studies at Case Western Reserve University. After 39 years on the job, she is retiring. She will continue to serve as co-director of the Center for Evidence-Based Practices, which is a partnership between the Mandel School and the Department of Psychiatry at the Case Western Reserve University School of Medicine. She will also continue as consultant and advisor to a gambling addiction initiative at the University that was recently funded by the Woodruff Foundation of Cleveland.

Consulting & training

For a moment, let's go back to the beginning—to the early career experiences that set the stage for Kola's work at the Mandel School. She earned a Doctorate of Clinical Psychology at Boston University in 1970 then worked as a regional coordinator for the Division of Alcoholism in the Massachusetts Department of Public Health on an initiative partially supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). She provided technical assistance (program consultation, clinical consultation, and training) for the implementation of addiction services at state psychiatric hospitals, general hospitals, and community-based service agencies in and around Boston.

"I learned that federal initiatives provide important financial incentives," she says, "but the money does not guarantee change in the community. The people who run state systems and county systems and local agencies must be willing to make and sustain improvements. And clinicians must be able to understand the benefits and be motivated to make the necessary changes in daily practice."

Classroom & community

When Kola arrived at the Mandel School in 1975, the study of substance abuse was not yet in the School's repertoire. She developed courses for a curriculum specialization in the study of alcohol and other drugs of abuse (AODA) and chaired that program for 30 years.
During her career, she also developed and implemented over 10 different training and fellowship programs for master's students, Mandel School faculty, and professionals in the community. These programs have helped advance the knowledge, skills, credentialing, and professional development of social workers and chemical dependency counselors alike. Among the funders of these initiatives have been the National Institute of Drug Abuse (NIDA); the National Institute on Alcohol Abuse and Alcoholism (NIAAA); the Substance Abuse and Mental Health Services Administration (SAMHSA); the Ohio Department of Mental Health and Addiction Services (OhioMHAS); the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County; and the Woodruff Foundation of Cleveland.

Kola has also been the author or co-author of many training manuals, modules, and curricula. She has also published journal articles and book chapters on the topics of alcohol and other drugs and the elderly and, more recently, on integrated treatment for co-occurring mental illness and substance use disorders (also called dual disorders); supported employment; evidence-based practices; and implementation science and technology transfer—the translation of research into practice.

Integrated behavioral healthcare

There are moments in some people's lives when past experiences coalesce and emerge to produce an important outcome. For Kola, that was 1999, when she was invited to serve on a leadership team which brought a block grant from SAMHSA to Ohio to support a statewide implementation of Integrated Dual Disorder Treatment (IDDT), the evidence-based practice for people with co-occurring severe mental illness and substance use disorders. She helped draft the plan to create the Center for Evidence-Based Practices and its Ohio Substance Abuse and Mental Illness Coordinating Center of Excellence (SAMI CCOE) initiative. The framework for the plan was inspired by her experiences in Boston and Cleveland.

"The issues are a bit different today, but the processes of change are pretty much the same," Kola says. "Systems change, organizational change, and clinical change are interconnected. You have to address all three with consultation and training. You have to help people find their own motivation to change and give them the support to do it."

Kola has co-directed the Center with Robert J. Ronis, MD, MPH, chairman of the Department of Psychiatry at the Case Western Reserve University School of Medicine since its inception in 1999. The Center provides technical assistance to service systems and organizations to help implement and integrate behavioral healthcare innovations that improve outcomes for people with mental illness, addiction, and co-occurring disorders.
The Center has been using its methods with success in a variety of communities throughout Ohio, including urban centers in Toledo, Cleveland, Youngstown, Columbus, Cincinnati, and Dayton, as well as numerous rural communities in between. The Center provides technical assistance to all six of Ohio's regional psychiatric hospitals and over 60 community-based mental health organizations in Ohio. The Center has also received requests for help from policymakers and service organizations in 23 other states and four other countries.

Readiness to change

Ask Kola to share some advice with social workers who are interested in doing innovative work, and she doesn't hesitate to respond.

"Change is often slow," she says. "Changing organizations and systems of care can take a lot of time because people get wedded to the way things are. If you want to influence change, you better be in it for the long haul." 

Additional highlights from Dr. Kola's career include the following:

  • Project director of an NIAAA-funded Alcoholism Training Program in the Mandel School's master's program (1975-1982).
  • Project director for an NIAAA-Alcoholism Research Training Program in the Mandel School's doctoral program (1976-1982).
  • Project director for the NIAAA/NCAE-funded National Occupational Program Training Program (1981-1982).
  • Project director for the Faculty Development Program from the NIAAA/NIDA/CSAP (1990-95).
  • Project director of a fellowship program for the study of dual disorders for Mandel School master's students, funded by the Ohio Department of Mental Health and the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County (2000-2009).
  • Member of the National Association of Social Workers (NASW) Task Force that developed teaching modules in substance abuse (1992-1994).
  • Founding chair of the NASW section on alcohol, tobacco and other drugs (ATOD) and founding editor of the award winning NASW ATOD newsletter, Issues of Substance (1995-1996).
  • Recognized by the Graduate Student Senate of the School of Graduate Studies, Case Western Reserve with the creation of the The Lenore A. Kola Graduate Student Community Service Award, which is awarded annually (2006).
  • Recognized by Case Western Reserve's Flora Stone Mather Alumnae Association Spotlight Series for Women's Scholarship Award for Excellence in Research and Scholarship (2007).
  • Recognized by the Council of Social Work Education's Role and Status of Women in Social Work Education Mentoring Program for her mentoring of a junior faculty member (2010).