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Bartholomew, N. G., Hiller, M. L., Knight, K., Nucatola, D. C., & Simpson, D. D. (2000). Effectiveness of communication and relationship skills training for men in substance abuse treatment. Journal of Substance Abuse Treatment, 18(3), 217-225.

Abstract: Although the importance of gender-sensitive programming for women has been acknowledged, few studies have examined outcomes from male-centered interventions in substance abuse treatment programs. Data were collected from 122 male clients in a court-mandated residential treatment program who participated in a study of a psychoeducational group intervention for men. The intervention (Time Out! For Men) addressed communication skills, sexuality, gender socialization, and intimacy. Participation in the training resulted in significant increases in knowledge and social conformity, along with reductions in attitudes that may be associated with rigid socialization and gender-role conflict. The results provide support for the utility of male-targeted programming in substance abuse treatment settings. [Keywords: Substance abuse treatment; men's issues; court-mandated treatment; psychoeducational groups; gender roles]

Bennett, J. B., Lehman, W. E. K., & Reynolds, S. (2000).  Team awareness for workplace substance abuse prevention:  The empirical and conceptual development of a training program.  Prevention Science, 1(3), 157-172.

Abstract: This paper describes the empirical and theoretical development of a workplace training program to help reduce/prevent employee alcohol and drug abuse and enhance aspects of the work group environment that support ongoing prevention.  The paper (1) examines the changing social context of the workplace (e.g., teamwork, privacy issues) as relevant for prevention, (2) reviews studies that assess risks and protective factors in employee substance abuse (work environment, group processes, and employee attitudes), (3) provides a conceptual model that focuses on work group processes (enabling, neutralization of deviance) as the locus of prevention efforts, (4) describes an enhanced team-oriented training that was derived from previous research and the conceptual model, and (5) describes potential applications of the program.  It is suggested that the research and conceptual model may help prevention scientists to assess the organizational context of any workplace prevention strategy.  The need for this team-oriented approach may be greater among employees who experience psychosocial risks such as workplace drinking climates, social alienation, and policies that emphasize deterrence (drug testing) over educative prevention.  Limitations of the model are also discussed.  [Keywords:  Substance abuse; workplace; training; theory]

Blankenship, J., & Dansereau, D. F. (2000). The effect of animated node-link displays on information recall. The Journal of Experimental Education, 68(4), 293-308.

Abstract: The attentional effects of animation on the processing of information from node-link maps and text were explored. The authors randomly assigned college students to receive a static node-link map presentation (n = 40), an animated nodelink map presentation (n = 37), a static text presentation (n = 29), or an animated text presentation (n = 27). The participants were asked to recall the information 48 hr later. The participants recalled more main-idea information from animated node-link maps than from static maps or animated text. There were no differences with regard to presentation or display format on the recall of microstructural information.

Czuchry, M., & Dansereau, D. F. (2000). Drug abuse treatment in criminal justice settings: Enhancing community engagement and helpfulness. American Journal of Drug and Alcohol Abuse, 26(4), 537-552.

Abstract:  This study examined the impact of a treatment readiness program on probationers receiving drug abuse treatment in a modified therapeutic community (TC). The program we developed was designed to increase motivation and improve skills needed for treatment progress. Probationers (N = 500) were assigned randomly to receive either the treatment readiness training or the standard approach used at the facility. Probationers responded to newly developed and established measures of community characteristics. Probationers receiving the readiness training rated their communities as more engaged and helpful than did those receiving the standard program. As predicted, probationers who had higher levels of treatment experience prior to entry into the current program (and who may have thus perceived treatment as having more limitations) gave more reserved estimates of community engagement. The current study suggests that the readiness training is having its intended impact on probationers. In addition, the study supports the usefulness of a newly developed measure in evaluating treatment effectiveness.

Griffith, J. D., Rowan-Szal, G. A., Roark, R. R., & Simpson, D. D.  (2000).  Contingency management in outpatient methadone treatment:  A meta-analysis.  Drug and Alcohol Dependence, 58, 55-66.

Abstract:  A meta-analysis was conducted on contingency management interventions in outpatient methadone treatment settings.  The outcome measure of interest was drug use during treatment, as detected through urinalysis.  The results confirm that contingency management is effective in reducing supplemental drug use for these patients.  The analysis of behavioral interventions yielded an overall effect size (r) of 0.25 based on 30 studies.  Significant moderators of outcomes included type of reinforcement provided, time to reinforcement delivery, the drug targeted for behavioral change, number of urine specimens collected per week, and type of subject assignment.  These factors represent important considerations for reducing drug use during treatment.  [Keywords:  Contingency management; treatment efficacy; methadone maintenance; meta-analysis]

Hiller, M. L., Broome, K. M., Knight, K., & Simpson, D. D. (2000).  Measuring self-efficacy among drug-involved probationers.  Psychological Reports, 86, 529-538.

Abstract:  Summary.  Self-efficacy has been shown to be related to outcomes from interventions for alcohol and tobacco abuse but relatively little attention has been focused on it in evaluations of treatment for illicit drug abuse. Almost no research has examined offenders involved with drugs. The current study, therefore, adapted the Alcohol Abstinence Self-efficacy Scale of DiClemente, Carbonari, Montgomery, and Hughes and administered it to 250 probationers mandated to 6 months of residential treatment. With some modifications, confirmatory factory models replicated four previously reported dimensions, e.g., Negative Affect, Social/Positive, Physical and Other Concerns, Cravings and Urges. Findings also indicated high construct validity for the Alcohol Abstinence Self-efficacy Scale as adapted here. Studies are needed to examine the use of self-efficacy as a prospective measure of treatment progress and to explore its association with outcomes from corrections-based treatment.

Hiller, M. L., Simpson, D. D., Broome, K. M., & Joe, G. W. (2000). Legal status at intake and posttreatment incarceration: 12-Month follow-up of methadone maintenance treatment. Journal of Maintenance in the Addictions, 1(4), 27-43.

Abstract:  Although court referral to methadone maintenance treatment is rare, individuals with an official legal status (i.e., parole, probation, or awaiting trial) commonly enter this setting. Relatively few studies, however, have assessed the impact of this factor on client outcomes. A sample of 710 clients admitted to methadone maintenance was followed up 12 months after treatment discharge. Clients with and without a legal status at treatment intake were compared on the basis of pretreatment characteristics, during-treatment behavior, and posttreatment incarceration. Clients with a legal status had more extensive arrest histories and greater educational and employment deficits. However, the legal status group did not differ from the no legal status group in terms of during-treatment counseling session attendance, illicit drug use, or criminal behavior. At the 12-month follow-up, 26% of the sample were incarcerated, and those who had a pretreatment legal status were over five times more likely to be incarcerated. Thus, clients under criminal justice supervision at treatment admission did not differ from other clients in during-treatment performance, but their preexisting legal status placed them at higher risk for incarceration both during and 12 months after treatment. [Keywords: Legal status; incarceration; outcome; methadone maintenance treatment]

Knight, K., Hiller, M. L., Broome, K. M., & Simpson, D. D. (2000).  Legal pressure, treatment readiness, and engagement in long-term residential programs.  Journal of Offender Rehabilitation, 31(1/2), 101-115.

Abstract:  Clients are less likely to drop out of residential drug treatment programs prematurely when they are either internally motivated (i.e., having a high level of treatment readiness) or externally pressured by the legal system to enter, participate, and remain in treatment.  However, little is known about the combined impact these factors have on treatment engagement and retention.  This study focused on a national sample of 2,194 clients admitted to 18 long-term residential facilities.  Although there was no significant interaction effect, findings indicated that clients with higher levels of treatment readiness at intake stayed in treatment at least 90 days, regardless of legal pressure.  Likewise, those under legal pressure (defined by legal status and supervisory pressures) remained in treatment longer, regardless of treatment readiness.  However, motivational readiness for treatment accounted for the greatest improvements in retention and, unlike legal pressure, was related to indicators of therapeutic engagement.  [Keywords:  Legal pressure; treatment motivation; treatment retention]

Melnick, G., De Leon, G., Hiller, M. L., & Knight, K. (2000).  Therapeutic communities: Diversity in treatment elements.  Substance Use & Misuse, 35(12-14), 1819-1847.

Abstract:  This study addresses the need to describe the diversity of therapeutic community (TC) programs. The Survey of Essential Elements Questionnaire (SEEQ) was used to develop a typology of TC programs based on 19 programs that identified themselves as traditional or modified TCs in the Drug Abuse Treatment Outcome Studies (DATOS). These traditional and modified TCs differed in adherence to the elements of TC treatment, on operational characteristics, and in client mix. Differences in treatment philosophy and approach included the emphasis on self-reliance, and the use of work as a therapeutic agent for traditional TCs. There were also trends for traditional TC programs to utilize community-as-method, provide educational and vocational training, and include family members as part of therapy. Modified programs showed a greater tendency to rely on counselors. Implications of the findings for program quality, health care policy, and research are discussed. [Keywords: Therapeutic community; substance user treatment; milieu therapy; questionnaire]

Rowan-Szal, G. A., Chatham, L. R., Joe, G. W., & Simpson, D. D. (2000).  Services provided during methadone treatment:  A gender comparison.  Journal of Substance Abuse Treatment, 19, 7-14.

Abstract: Greater improvement in posttreatment outcomes has been shown in programs that tailor frequency and type of services to unique client needs. Using a sample of 635 clients (199 females and 436 males) admitted to three community-based methadone treatment programs, this study examined gender differences in services needed and provided during the first 3 months of treatment. Results revealed that compared to males, women entered treatment with more psychological symptoms and AIDS/HIV-risky behaviors; they also presented with less criminal activity, less alcohol use, and higher motivation. Counselors addressed psychological and crisis issues more frequently with women, and counseling strategies were more often directed toward developing problem-solving and communication skills. Counselors also made more medical referrals and reported having better rapport with females. Attention to employment issues and HIV/AIDS sexual-risk behaviors did not differ by gender, even though women had more needs in these areas. [Keywords: Gender; services; opiate addiction; methadone]

Rowan-Szal, G. A., Chatham, L. R., & Simpson, D. D. (2000).  Importance of identifying cocaine and alcohol dependent methadone clients.  The American Journal on Addictions, 9(1), 38-50.

Abstract:  Clients in outpatient methadone treatment (OMT) who abuse cocaine or alcohol are difficult to engage and retain in treatment. The impact a triple addiction to these drugs has on treatment was the focus of this study (N = 127). Admission characteristics, treatment response, and retention were compared among clients dependent on opiates only (O), opiates and alcohol (OA), opiates and cocaine (OC), or all three drugs (OAC). Findings indicate these groups differ in admission needs assessment, session attendance, issues discussed during treatment, and development of counselor rapport, with the OAC group being significantly more difficult to engage and retain in treatment.

Rowan-Szal, G. A., Joe, G. W., & Simpson, D. D. (2000).  Treatment retention of crack and cocaine users in a national sample of long term residential clients.  Addiction Research, 8(1), 51-64.

Abstract:  Clients entering treatment with cocaine problems are difficult to engage and retain in treatment. Crack users, a subset of cocaine users, are especially difficult to treat. This study investigated whether type of cocaine used (crack or non-crack) was related to retention in treatment. The sample consisted of 900 clients in 13 long-term residential (LTR) programs participating in the national Drug Abuse Treatment Outcome Studies (DATOS). Clients met the DSM-III-R criteria for cocaine dependence and were at least weekly users of cocaine (including crack). Hierarchical logistic model regression analysis was used to test the relationship between type of cocaine preference and retention. Crack users had lower retention rates than non-crack cocaine users, even after adjusting for covariates. Higher retention was also related to being older, a high school graduate, unmarried, not depressed, alcohol dependent, more motivated for treatment, and having fewer arrests. New strategies to improve retention for crack users through increased client motivation are discussed. [Keywords: Crack; cocaine; DATOS; treatment retention]

Sia, T. L., Dansereau, D. F., & Czuchry, M. (2000).  Treatment readiness training and probationers' evaluation of substance abuse treatment in a criminal justice setting.  Journal of Substance Abuse Treatment, 19, 459-467.

Abstract:  Clients who are legally coerced into substance abuse treatment often have low intrinsic motivation to participate, are less ready for treatment, and are consequently more problematic to treat and less satisfied with their treatment than are voluntary clients.  A set of readiness training activities, designed to promote early involvement in treatment, was implemented in a 4-month residential criminal justice program.  Five hundred probationers were randomly assigned to receive either the readiness training we developed or the approach typically used at the facility.  Based on their response to an intake interview, probationers were categorized as having low, medium, or high readiness for treatment.  Probationers in the readiness training group rated their counselors, groups, and community meetings higher than did probationers in the standard group.  In addition, probationers in the readiness training group rated themselves as "working the program" to a greater extent than did probationers in the standard group.  Probationers with higher initial levels of readiness for treatment rated their counselors, sessions, and security staff higher than did probationers with lower levels.  The results suggest that the readiness training activities may help probationers become more involved in treatment and that this may lead to greater satisfaction with counselors and sessions.  [Keywords:  Substance abuse; treatment evaluation; treatment readiness training; satisfaction with counselors; satisfaction with treatment]

Simpson, D. D., Joe, G. W., Greener, J. M., & Rowan-Szal, G. A. (2000).  Modeling year 1 outcomes with treatment process and post-treatment social influences.  Substance Use & Misuse, 35(12-14), 1911-1930.

Abstract:  Follow-up studies of drug user treatment generally find significant improvements in client functioning, but information about the therapeutic components associated with client behavioral changes over time is limited. An integrative model developed previously to predict treatment retention was expanded and applied to post-treatment outcomes. This study is based on 321 daily opioid users treated in three methadone treatment clinics. Effects of pretreatment motivation, treatment process measures representing therapeutic relationship, counseling session attendance, and length of treatment are examined in relation to measures of family relations, peer deviancy, return to treatment, drug use, and criminality in the year after treatment. Models were tested in two stages. The first was built on a during-treatment process model for predicting time in treatment to include post-treatment outcomes. The second model was expanded further to include the effects of intervening social support variables as predictors of post-treatment drug and criminality outcomes. The results supported both models and emphasize the importance of considering social influences and related community contextual factors that affect recovery dynamics. [Keywords: Treatment process model; follow-up outcomes; motivation for treatment; therapeutic relationships; treatment engagement]
 

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