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Bartholomew, N. G., Chatham, L. R., & Simpson, D. D. (1994, revised). Time Out! For Me: An assertiveness/sexuality workshop specially designed for women. Fort Worth: Texas Christian University, Institute of Behavioral Research.  See description in the Manuals section.

Bartholomew, N. G., Rowan-Szal, G. A., Chatham, L. R., & Simpson, D. D. (1994). Effectiveness of a specialized intervention for women in a methadone program. Journal of Psychoactive Drugs, 26(3), 249-255.

Abstract: Over the past 20 years, specialized programming for chemically dependent women has been recommended for improving psychosocial functioning and retention in treatment. This study examined the impact of a structured, six-week assertiveness and sexuality workshop for women at three community-based methadone maintenance programs. Results indicated that women who participated frequently in the women's groups (four to six sessions) showed greater increases in self-esteem and knowledge compared to women who participated infrequently (one to three sessions). In addition, level of participation was positively associated with length of stay in the treatment program after completing the workshop. [Keywords: Intervention; methadone maintenance; retention; self-esteem; treatment; women]

Bartholomew, N. G., & Simpson, D. D. (1994). Approaches to HIV/AIDS education in drug treatment. Fort Worth: Texas Christian University, Institute of Behavioral Research.  See description in the Manuals section.

Boatler, J. F., Knight, K., & Simpson, D. D. (1994). Assessment of an AIDS intervention program during drug abuse treatment. Journal of Substance Abuse Treatment, 11(4), 367-372.

Abstract: Since 1985, many drug abuse treatment centers and health care providers have implemented special education programs for individuals who inject drugs. They focus primarily on increasing awareness of the threat of the human immunodeficiency virus (HIV) being spread through drug injection equipment and by sexual activities. As part of the Drug Abuse Treatment for AIDS-Risk Reduction (DATAR) project, the AIDS/HIV Risk Reduction Module was designed to meet these special intervention needs. This study examined program impact on 110 methadone treatment clients. Results indicated that for those in treatment less than 4 months, the AIDS intervention program enhanced specialized knowledge about AIDS, aided in the reduction of AIDS-risky behaviors, and enhanced attitudes toward achieving and maintaining abstinence from drug use. Thus, AIDS education and intervention programs appear to be effective and should be emphasized in the early phase of drug abuse treatment.
[Keywords: AIDS intervention; AIDS education; substance abuse; AIDS risk; drug treatment]

Chatham, L. R., & Simpson, D. D. (1994).  Delivering and evaluating outpatient treatment:  Finding a practical balance.  In B. W. Fletcher, J. A. Inciardi, & A. M. Horton (Eds.), Drug abuse treatment:  The implementation of innovative approaches (pp. 181-193).  Westport, CT:  Greenwood Press.

Dansereau, D. F., Dees, S. M., & Simpson, D. D. (1994). Cognitive modularity: Implications for counseling and the representation of personal issues. Journal of Counseling Psychology, 41(4), 513-523.

Abstract: Recent modular views of cognition are described and related to counseling approaches. A framework for client-counselor interactions that are based on these views is developed and used to examine ways of expressing and representing counseling issues. The resulting analysis suggests that, for certain counseling activities, spatial-graphic representations are likely to be useful adjuncts to natural language. Previous work with specialized spatial-graphic approaches (e.g., genograms, behavior loop maps) is reviewed, and a general representational technique, node-link mapping, is introduced.

Dees, S. M., Dansereau, D. F., & Simpson, D. D. (1994). A visual representation system for drug abuse counselors. Journal of Substance Abuse Treatment, 11(6), 517-523.

Abstract: Node-link mapping is a technique that consists of drawing spatial-verbal displays to

visually represent interrelationships between ideas, feelings, facts, and experiences. These multi-relational maps are drawn during ongoing counseling sessions to represent a variety of personal and nonpersonal topics. This article provides an overview of this technique, including rationale, related and supporting research, and an example of its use during counseling. In addition, this article describes the potential impacts of mapping and comments on practical considerations related to the effective use of this tool in drug abuse counseling. [Keywords: Node-link maps; graphic representations; mapping; visual representations; cognitive strategy]

Joe, G. W., Dansereau, D. F., & Simpson, D. D.   (1994). Node-link mapping for counseling cocaine users in methadone treatment. Journal of Substance Abuse, 6, 393-406.

Abstract: Treatment engagement problems associated cocaine-using opioid addicts were addressed using a cognitively enhanced counseling strategy. Analysis of client urines, participation, and counselor ratings of clients over a 6-month period during treatment indicated that the use of node-link mapping–a multipurpose visual representation strategy for communication–produced better results for both low and high cocaine-using opioid addicts in methadone maintenance than those treated without this enhancement.

Joe, G. W., Simpson, D. D., & Sells, S. B. (1994). Treatment process and relapse to opioid use during methadone maintenance. American Journal of Drug and Alcohol Abuse, 20(2), 173-197.

Abstract: A general framework for studying drug abuse treatment process factors is presented, and components are then used to predict relapse to opioid use during treatment in methadone maintenance. Major domains of the treatment process research framework include client variables at entry, program characteristics, treatment events, and client outcomes. The analyses rely on the use of proportional hazards models to identify significant outcome predictors in a sample of 590 methadone maintenance clients from 21 clinics in the Research Triangle Institute/Treatment Outcome Prospective Study (RTI/TOPS) data system who remained in treatment at least 3 months. The analyses were performed on the total sample and separately on clients from three groups of clinics classified on the basis of the distribution of client relapse rates and tenure in treatment. Relapse rates were related to dosage level, client monitoring with urinalyses, and methadone take-home privileges in some clinics, and hence, these time-varying treatment events were important factors in treatment outcomes. Even at entry to treatment, some measures were found to be related to how the client later performed during treatment. Finally, it was also found that the particular area of professional specialty of the staff making client diagnosis at intake and preparing treatment plans was associated with client outcomes.

Knight, D. K., Dansereau, D. F., Joe, G. W., & Simpson, D. D. (1994). The role of node-link mapping in individual and group counseling. American Journal of Drug and Alcohol Abuse, 20(4), 517-527.

Abstract: The value of using a visual representation strategy, called node-link mapping, was evaluated in individual and group drug abuse counseling settings. Methadone maintenance clients were randomly assigned to counselors trained to use mapping techniques (n = 57), and those who used standard counseling (n = 51). Clients in the mapping counseling group had more favorable perceptions of their own therapeutic engagement and progress as indicated by ratings of cognitive-behavioral and motivational attributes than did those in standard counseling. Overall, individual sessions were viewed by clients as being more valuable than group counseling, but the use of mapping increased the helpfulness attributed to group counseling to near the same level as individual counseling. [Keywords: Cognitive-based intervention; problem representation; individual and group counseling; methadone maintenance; node-link mapping]

Knight, K., Simpson, D. D., & Dansereau, D. F. (1994). Knowledge mapping: A psychoeducational tool in drug abuse relapse prevention training. Journal of Offender Rehabilitation, 20(3/4), 187-205.

Abstract: This study examined the effectiveness of relapse prevention training (RPT), a part of an outpatient-drug education program for a group of 83 drug addicted probationers, with special attention to the use of "knowledge maps" as supplemental instructional materials. In general, it was found that program participation by probationers improved during the use of RPT, as indicated by higher completion rates compared to a social skills curriculum used the previous year. In addition, persons who successfully completed RPT sessions had lower rates of drug use after RPT (based on urinalysis results) and higher test scores on lesson materials. Finally, the randomly-assigned group of probationers who were trained using maps scored significantly higher on knowledge tests administered after each lesson, showing that the maps aided in enhancing immediate processing and recall of the information presented in the lesson. The results therefore suggest that manual-driven lessons dealing with relapse prevention issues can be used effectively with probationers. Since it appears to enrich group presentations by increasing participation in discussion as well as by improving understanding and application of information, "knowledge mapping" is also recommended as a technique for enhancing instructional materials.

Rowan-Szal, G., Joe, G. W., Chatham, L. R., & Simpson, D. D. (1994). Simple reinforcement system for methadone clients in a community-based treatment program. Journal of Substance Abuse Treatment, 11(3), 217-223.

Abstract: Clients in a community-based methadone treatment program earned stars for attending counseling sessions as scheduled and for providing clean urines. These stars were later redeemed for contingent rewards (food or gas coupons or bus tokens) according to one of three randomly assigned reward schedules, including high reward (four stars per prize), low reward (eight stars per prize), or delayed reward (those who had to wait 3 months to earn a prize). Clients in the high reward condition showed a pattern of increasing the number of stars earned for group sessions and clean urines across the 3-month intervention. All clients, independent of reward condition, attended significantly more group counseling sessions during the months that contingent reinforcers were available than in the months prior to, and after, the intervention. Finally, urinalysis data indicated that, in the postintervention period, high-reward clients had fewer dirty urines than did low-reward or delayed-reward clients. This study suggests that a simple system of recognizing client progress with stars and modest prizes for performing specific behaviors can be an effective tool in increasing clinic attendance rates and reducing positive urines. [Keywords: Contingency management; methadone; reinforcement; behavior modification]

Simpson, D. D., Camacho, L. M., Vogtsberger, K. N., Williams, M. L., Stephens, R. C., Jones, A., & Watson, D. D. (1994). Reducing AIDS risks through community outreach interventions for drug injectors. Psychology of Addictive Behaviors, 8(2), 86-101.

Abstract: Community outreach and AIDS intervention services were provided to 1,080 out-of-treatment injecting drug users (IDUs) in 5 cities. Using random assignments to experimental conditions representing alternative intervention strategies, drug use and sex risks were measured at intake as well as 1 and 6 months later. Interventions resulted in significant behavioral risk reductions from intake to follow-up, but outcomes were unrelated to the completion of an interview on behavioral risk assessment at intake and to the intervention procedure IDUs received. Risk reduction measures 6 months after intake were unrelated to the receipt of a follow-up at Month l. Intervention procedures and components of these community-based AIDS prevention programs need to be reconsidered.

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