Predictors of Change in the Provision of Services Within Outpatient Substance Abuse Treatment Programs

Abstract

The current study examines patterns and predictors of change over a 2-year period in whether outpatient core and wraparound services are offered onsite or by referral. A sample of 69 outpatient non-methadone programs from four US regions provided organizational information across a 2-year period. Services provided within outpatient substance abuse programs were relatively stable over time, particularly with regard to core therapeutic services. The use of referral networks to provide a broader array of wraparound services increased, with programs adding services that reflect recent national initiatives toward program improvement, namely pharmacotherapy, medical diagnosis and treatment, and psychiatric services. Organizational factors such as parent affiliation, counselor caseload, staff size, budget change, and proportion of dually-diagnosed clients were related to change in core and wraparound services. Dynamic organizational factors, such as staff size and budgets can serve as barriers to and/or facilitate change in service provision over time and have managerial and policy implications.

The impact of organizational stress and burnout on client engagement

“…All programs provided individual and group counseling sessions on-site, and most also provided a variety of wraparound services (see Knight, Edwards, & Flynn, 2010). On average, within the 89 programs, 4.9 staff (SD = 3.9, total of 445 across programs) and 52.63 clients (SD = 63.11, total of 5013 across programs) responded.…”

Sustainment of Smoking Cessation Programs in Substance Use Disorder Treatment Organizations

“…Less is known about sustainment of smoking cessation programs in the natural environment. Studies of other SUD services have shown that organizations do change their service offerings over time (Ducharme, Knudsen, & Roman, 2006;Knight, Edwards, & Flynn, 2010;Knudsen, Roman, & Ducharme, 2005;. Indeed, prior research from this sample of SUD treatment programs found considerable discontinuation of NRT over time.…”

The Relationship Between Client Characteristics and Wraparound Services in Substance Use Disorder Treatment Centers

“…Despite extensive research linking the provision of wraparound services to positive client outcomes (Knight et al, 2010;Marsh et al, 2011;McLellan et al, 1998), many clients do not receive treatment in settings that provide the services required to meet their needs. Our fi ndings are crucial for individuals and organizations that are providing SUD care in treatment centers across the United States.…”

“…Research over the past 20 years has demonstrated that providing wraparound services enhances treatment retention and improves treatment outcomes (Knight et al, 2010;Marsh et al, 2000Marsh et al, , 2004Marsh et al, , 2011McLellan et al, 1998). Despite these fi ndings, client-level data suggest that many client needs are unmet (Apantaku-Olajide et al, 2012;Machlan et al, 2005;Pringle et al, 2006).…”