Transcript TCU Trt Model Overview

Drug Abuse Treatment
Outcome Studies
(Funded by NIDA)
National Treatment
Engagement Findings
from DATOS
Charts Prepared & Released for Public Use by
Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC),
Douglas Anglin (UCLA), & Bennett Fletcher (NIDA)
Slide 1 of 13
Drug Abuse Treatment Outcome Studies
Third National Evaluation of Treatment Effectiveness
Funded by the
National
Institute on
Drug Abuse
1991-93
11 Cities
96 Programs
~10,000 Patients
All treatment types
Follow-up: 1 & 5 Yrs
Over 60 Studies Published –
Psychology of Addictive Behaviors (Dec 97)
Drug and Alcohol Dependence (Dec 99)
Archives of General Psychiatry (June 99)
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Conceptual Model for
Evaluating Program Effects
Patient Attributes
(History)
Program Attributes
(Resources)
Program
Services
and
Retention
Treatment Outcomes
LTR
Programs?
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Long-Term Residential (LTR)Treatment
Changes from Before to After Treatment
100
Pre
Post
88
77
80
66
60
41
40
40
22
20
24
19
17
16
13
6
0
Cocaine
(Weekly)*
Heroin
(Weekly)*
Heavy
Alcohol*
Illegal
Activity*
No FT
Work*
Suicidal
Ideation*
*p<.001
% of DATOS Sample (N=676)
Slide 4 of 13
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Comparison of Year 1 Outcomes
by Length of Stay in LTR
100
< 90 Days
90+ Days
80
60
40
55
54
53
28
19
20
24
15
9
0
Cocaine
(Any Use)*
UA+
(Any Drug)*
Alcohol
(Daily Use)*
Any Jail*
*p<.001
% of Sample
Slide 5 of 13
N=342; Simpson, Joe, & Brown, 1997 (PAB)
Predictors of Retention in LTR
(based on posttreatment interviews)
Relationship w/ counselor
During Treatment
2.2
6.0
90+
Days
Aftercare
(12-steps)
Attending education classes
Similar findings in other modalities!
Satisfaction w/ program
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Simpson, Joe, & Brown, 1997 (PAB)
Motivation & Retention in LTR
Client Predictors
Motivation
Older
Stages
Problem Recognition
Desire for Help
Treatment Readiness
Never married
Alcohol problem
Employed
90+
Days
Legally involved
Fewer arrests
Intake
Slide 7 of 13
Joe, Simpson, & Broome, 1998 (Addiction)
Motivation & Retention in LTR
Treatment
Readiness
(at Intake)
Each based on
5-item composites
Commitment
Confidence
Similar
findings in
ODF & OMT
Rapport
Therapeutic Involvement
in Months 1 & 3
Slide 8 of 13
Joe, Simpson, & Broome, 1998 (Addiction)
Process Model for Time in LTR Treatment
(Structural equation modeling)
Frequency
& Focus
Previous Trt
Session
Attributes
Depression
Cocaine Prob
(Trt Readiness)
Pretreatment
(90+ days)
Therapeutic
Involvement
Motivation
Hostility
Retention
-
Client Ratings of
• Rapport
• Confidence
• Commitment
Months 1-2
Slide 9 of 13
Joe, Simpson, & Broome, 1999 (Drug & Alcohol Dependence)
Treatment Process Model:
Client & Program Predictors
Hierarchical Linear Modeling (HLM)
Session
Attendance
(Mos 1-3)
Trt Confidence (Mo 3)
Client Ratings
Rapport
w/ Counselor
Trt Commitment (Mo 3)
(Mo 1)
Program factors
Treatment
Readiness
Client
factors
2/3
1/3
• Referred services
• Missed sessions
• Diversity of needs
LTR ODF OMT
Slide 10 of 13
Joe, Simpson, & Broome, 1999 (Drug & Alcohol Dependence)
Home Page
About DATOS
Background
Highlights
Special Topics
Publications
Web Posters
What’s New
CONTENT
News and Features
Latest DATOS studies have
been published in Drug and
Alcohol Dependence
Treatment process (engagement and participation),
retention, and outcomes are the focus of this series of
studies, and our first cost-benefit analysis addresses
cocaine treatment. The latest DATOS publications and "in
press" are listed on the Publications page.
Cocaine Treatment Outcome
Study is Released
(in June 1999 issue of Archives of General Psychiatry)
Findings emphasize the need for "adequate treatment stays,"
especially when problem severity is moderate-to-high. At
least 90 days in intensive residential (TC) programs was
indicated for high-severity cases. More information is
provided in a new section of Highlights page, "Outcomes for
Treatment of Cocaine Dependence.”
www.datos.org
Selected
Studies
1-Year
Outcomes
Treatment
Services
& Process
Cocaine
Treatment
Selected
Web Posters
Adolescent
Studies
Cost Benefits of
MM Treatment
Readiness
for Treatment
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TCU Treatment Process Model
Induction
Enhanced
Counseling
Family &
Friends
Motiv
Early
Engagement
Early
Recovery
Patient
Attributes
at Intake
Therapeutic
Relationship
Behavioral
Compliance
Counselor
Attributes
& Skills
Personal Health Services
Supportive
Networks
Sufficient
Retention
Program
Participation
Psychological
Improvement
Program
Characteristics
Drug Use
Crime
Social Adj
Posttreatment
Behavioral
Strategies
Social Skills
Training
Social Support Services
Slide 12 of 13
Simpson, 2001 (Addiction)
IBR HOME PAGE
WHAT’S NEW
ABOUT IBR
STAFF
PROJECTS
NEWSLETTERS
PUBLICATIONS
WEB POSTERS
MANUALS
FORMS
OTHER LINKS
Features:
Animated slide
presentations
TCU Treatment Process Model
now available for downloading
Counseling Manuals now have
sample chapters to download
SITE GUIDES:
Search
Contents
Site map
DATOS
TCU Treatment Assessment
Forms are re-organized for
easier downloading by users
www.ibr.tcu.edu
IBR Research
Summaries
highlight special
topics
Research
Current
issue of
Summary
Research
Roundup
Research
Roundup
Publication lists
Data
10 Collection
most popular
TCU
forms for
Instruments
downloading
Slide 13 of 13