In substance abuse treatment, although monitoring and feedback approaches have been recommended and many lines of evidence support their potential value, none has been formally evaluated in standard treatment. The specific aims of this project are to conduct a three-staged study to develop and evaluate a monitoring instrument and associated intervention, as follows: Stage 1 - Develop and determine the reliability, validity, and sensitivity to change of a brief Multidimensional Monitoring Instrument (MMI) for clients in outpatient substance abuse treatment; Stage 2 - Develop a Monitoring and Feedback Intervention (MFI) and treatment manual and training materials that use the MMI, as well as competence and adherence measures; and conduct a feasibility study in an outpatient substance abuse treatment program to refine the intervention, manual, materials and measures; Stage 3 - Conduct a randomized clinical trial to determine the preliminary efficacy of the MFI compared to treatment as usual (TAU) for clients in outpatient substance abuse treatment. In this pilot study, it is hypothesized that the MFI will positively impact the treatment process and during treatment outcomes. Specifically, as measured during the 3-month post admission period, compared to TAU clients, MFI clients will: H1. Have longer lengths of stay in the index treatment program; H2. Be more likely to complete treatment and/or remain in treatment; H3. Have more drug-free urines during treatment; H4. Report more treatment that is not directly focused on substance abuse; and H5. Report a stronger therapeutic alliance with their primary counselor. Secondary analyses will be conducted to examine multidimensional outcomes at 3-months post admission. The intervention (MFI) is conceptualized as an approach that counselors can easily incorporate into their usual practice with minimal training. As has been recommended for the field, the MFI has the potential to be portable, practical and sustainable. If successful, a larger multisite study would be proposed. Future work could establish benchmarks and data could be fed back to supervisory personnel as well as to the treating clinician, and quality improvement efforts could be initiated and evaluated. Finally, the monitoring instrument (MMI) could aid evaluators and researchers in evaluating the course of clients' change during treatment and their discharge status across treatment organizations or experimental conditions. [unreadable] [unreadable] [unreadable]
NIH ExPorter
NIH ExPorter