Do Program Differences Matter in the Treatment of Alcoholism? A Contextual Analysis of Treatment Programs

Shawn M. Flower, University of Maryland at College Park

ABSTRACT
In the substance abuse literature, there are contradictory findings regarding the relationship between the length of stay int reatment and successful outcomes. Some studies find that the longer an individual participates in treatment, the higher likelihood of better outcomes, while other studies find no differences for varying lengths of time in treatment. In addition, the literature also debates whether the type of treatment modalities (e.g., outpatient versus inpatient) results in differential treatment outcomes. The purpose of this study is to conduct a contextual analysis of treatment programs to ascertain if differing program components have a differential effect on outcomes by using data from the National Treatment Improvement Education Study (NTIES). Conducting the analysis with Hierarchical Linear Modeling (HLM) and controlling for individual differences such as gender, age, race, addiction severity and how clients were referred to treatment, this study examines differences between the treatment programs on outcomes. Program differences compared include dropout rates, the frequency of individual counseling, and emphasis placed on stresing environmental change, enhanced self-image and attendance at 12 step meetings. Outcome measures are based on a 12-month follow-up interview and include relapse, attendance at 12 step meetings, and crime measures including shoplifting, burglary, robbery and assault.

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Updated 05/20/2006