Improving the Organization, Management, and Outcomes of Substance Abuse Treatment Programs

Objective: This study presents an organizing framework for empirical analyses of substance abuse treatment program effectiveness, based on relevant theories of organization and public management and the body of substance abuse treatment studies, and is applied in analyses of treatment program data. Method: We use descriptive analyses of data from the National Treatment Improvement Evaluation Study that were collected from 519 substance abuse treatment service delivery units and 6593 patients to identify instruments of policy and management that might either frustrate or facilitate the implementation of “best practices” in substance abuse treatment. Results: The analyses show statistically significant and substantively interesting relationships among measures of organizational structure and mission, financial management (e.g., revenues per patient and revenue sources), human resources management (e.g., staffing levels, the use of case managers, etc.), and measures of service technology (e.g., the provision of supportive services, counseling intensity, etc.). Conclusion: Researchers should strive to measure and account for the significant interactions among structural, management, and service technology variables in substance abuse treatment programs and the impact of these variables, mediated through patient characteristics and pre-treatment histories, on treatment outcomes.