Comparison of Clients Assigned to In-patient and Out-patient Treatment for Alcoholism and Drug Addiction

Skinner, Harvey A.

doi:10.1192/bjp.138.4.312

Cited by 18 publications

(4 citation statements)

References 17 publications

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“…Characteristics that emerged as important for the aftercare arm may relate more to the relapse process since aftercare clients were generally abstinent at the beginning of the Project MATCH treatments, whereas in the outpatient arm predictor variables may be more related to the process of moving toward and stabilizing abstinence which was the initial task of the outpatient treatments. These effects for both aftercare and outpatient subjects are consistent with prior research (Skinner, 1981;Timko et al, 1993). Of clinical relevance is the fact that both motiva-tion and social support for drinking are modifiable characteristics and suggest the need for treatment strategies that target them (DiClemente et al, 1992;Longabaugh et al, 1995).…”

Section: Process Data and Analysis Of Session Videotapes Will Enable supporting

confidence: 83%

Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.

1997

J. Stud. Alcohol

1,659

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To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of client attributes. Method: Two parallel but independent randomized clinical trials were conducted, one with alcohol dependent clients receiving outpatient therapy (N = 952; 72% male) and one with clients receiving aftercare therapy following inpatient or day hospital treatment (N= 774; 80% male). Clients were randomly assigned to one of three 12-week, manual-guided, individually delivered treatments: Cognitive Behavioral Coping Skills Therapy, Motivational Enhancement Therapy or Twelve-Step Facilitation Therapy. Clients were then monitored over a 1-year posttreatment period. Individual differences in response to treatment were modeled as a latent growth process and evaluated for 10 primary matching variables and 16 contrasts specified a priori. The primary outcome measures were percent days abstinent and drinks per drinking day during the 1-year posttreatment period. Results: Clients attended on average two-thirds of treatment sessions offered, indicating that substantial amounts of treatment were delivered, and research follow-up rates exceeded 90% of living subjects interviewed at the 1-year posttreatment assessment. Significant and sustained improvements in drinking outcomes were achieved from base-line to 1-year posttreatment by the clients assigned to each of these well-defined and individually delivered psychosocial treatments. There was little difference in outcomes by type of treatment. Only one attribute, psychiatric severity, demonstrated a significant attribute by treatment interaction: In the outpatient study, clients low in psychiatric severity had more abstinent days after 12-step facilitation treatment than after cognitive behavioral therapy. Neither treatment was clearly superior for clients with higher levels of psychiatric severity. Two other attributes showed time-dependent matching effects: motivation among outpatients and meaning-seeking among aftercare clients. Client attributes of motivational readiness, network support for drinking, alcohol involvement, gender, psychiatric severity and sociopathy were prognostic of drinking outcomes over time. Conclusions: The findings suggest that psychiatric severity should be considered when assigning clients to outpatient therapies. The lack of other robust matching effects suggests that, aside from psychiatric severity, providers need not take these client characteristics into account when triaging clients to one or the other of these three individually delivered treatment approaches, despite their different treatment philosophies. (J. Stud. Alcohol 58: 7-29, 1997) FTER AN EXTENSIVE review of alcoholism outcome research, the Institute of Medicine (1990) concluded that it may no longer be appropriate to ask whether alcoholism treatment works or which treatment works best. Reflecting current views in the field, the report instead suggested that the more important question is, "Which kinds of individuals, with what kinds of alcohol pr...

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Section: Process Data and Analysis Of Session Videotapes Will Enable supporting

confidence: 83%

Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.

1997

J. Stud. Alcohol

1,659

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“…Items for the ADS were culled from a longer parent instrument, the Alcohol Use Inventory (Horn et al 1977), which the Wisconsin DOC used in the developmental phase of the battery. Research using the Alcohol Use Inventory (Berglund et al 1988;Skinner 1981;Horn 1985, 1987) and experience with that instrument strongly support the ADS as the primary discriminator among clinical populations (inpatient vs. outpatient; first admission vs. readmission). It was determined that the ADS could be substituted without loss of significant information (Lettieri et al 1985).…”

Section: Alcohol Dependence Scalementioning

confidence: 99%

Drug abuse treatment in prisons and jails

Leukefeld¹,

Tims²

1993

Journal of Substance Abuse Treatment

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Acknowledging the fact that the criminal justice system is currently awash with drug abusers and that prison drug abuse treatment has had a varied history in the United States, this article explores possible directions for the future of drug abuse treatment in prisons and jails. The current status of drug abuse treatment is reviewed, and selected treatment approaches are high-lighted. In addition, evaluation issues are presented, and special issues are reviewed including case management, community follow-up, and methodological considerations. Finally, recommendations are suggested for treatment, research, evaluation, demonstrations, management information, community linkage, training, and technical assistance.

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“…The general alcoholism scale taps the severity of alcohol misuse, whereas the primary and secondary scales yield more specific information for differential diagnoses. Encouraging data have been reported to date on measurement properties of the AUI [58,59,60].…”

Section: Dimensions Within a Populationmentioning

confidence: 99%

Statistical Approaches to the Classification of Alcohol and Drug Addiction

Skinner

1982

British Journal of Addiction

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This article critically reviews the literature from statistical attempts to derive empirical classifications of alcohol and drug abuse. Consideration is given to the search for discrete subtypes using cluster analysis, as well as to attempts to identify major dimensions along which individuals are ordered using factor analysis. Several important conclusions are drawn. First, this research is at an early stage of development and refinements are needed in methodology before it is likely to have broad impact. Next, only limited content areas have been examined to date. For instance, the clustering research on alcoholism has curiously avoided a direct focus on akohoi use patterns, but instead has predominantly studied personality variables. Moreover, the empirical research has not been well integrated with either theory or clinical practice. Although statistical methods have not been instrumental for the identification of new syndromes, these techniques do provide a powerful technology for refining provisional syndromes as well as for making diagnoses more objective and reliable.

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Comparison of Clients Assigned to In-patient and Out-patient Treatment for Alcoholism and Drug Addiction

Cited by 18 publications

References 17 publications

Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.

Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.

Drug abuse treatment in prisons and jails

Statistical Approaches to the Classification of Alcohol and Drug Addiction

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