Strategies for Improving Methadone Treatment Process and Outcomes

Major findings are summarized for a program of research focused on therapeutic enhancements to methadone treatment. Cognitive, behavioral, and psychoeducational strategies for improving client engagement and counseling services are described. Evaluations focused on during-treatment performance and follow-up outcomes collected 1 year after discharge, with an emphasis on the impact of services delivered as well as client and counselor perceptions of one another. Interrelations were examined between treatment process components: therapeutic relationship between clients and counselors, service intensity and type, behavioral compliance of clients during treatment, and length of stay. Results showed enhanced counseling and length of time spent in treatment were related to treatment outcomes.

[1]  D. Simpson,et al.  Gender, cocaine and during-treatment HIV risk reduction among injection opioid users in methadone maintenance. , 1996, Drug and alcohol dependence.

[2]  F. Tims,et al.  Innovative Approaches in the Treatment of Drug Abuse: Program Models and Strategies , 1993 .

[3]  J. Hoffman,et al.  The phases-of-treatment model for methadone maintenance: implementation and evaluation. , 1994, Journal of psychoactive drugs.

[4]  D. Simpson,et al.  Heavy drinking in a population of methadone-maintained clients. , 1995, Journal of studies on alcohol.

[5]  R. Coombs,et al.  Drug Abuse Treatment: A National Study of Effectiveness , 1992 .

[6]  Donald F. Dansereau,et al.  Node-link mapping: A visual representation strategy for enhancing drug abuse counseling. , 1993 .

[7]  D. Dansereau,et al.  Effectiveness of node-link mapping enhanced counseling for opiate addicts: a 12-month posttreatment follow-up. , 1997, The Journal of nervous and mental disease.

[8]  Melvin L. Holcom,et al.  TCU Psychosocial Functioning and Motivation Scales : Manual on Psychometric Properties , 1997 .

[9]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[10]  D. Dansereau,et al.  Node-link mapping and the evaluation of drug abuse counseling sessions. , 1995 .

[11]  G. Leon.  The therapeutic community: status and evolution. , 1985, The International journal of the addictions.

[12]  D. Dansereau,et al.  Mapping-enhanced drug abuse counseling: urinalysis results in the first year of methadone treatment. , 1997, Journal of substance abuse treatment.

[13]  D. Dansereau,et al.  Ethnicity and the effects of mapping-enhanced drug abuse counseling. , 1996, Addictive behaviors.

[14]  M. Hiller,et al.  Effectiveness of a specialized women's intervention in a residential treatment program. , 1996, Substance use & misuse.

[15]  D. Simpson,et al.  A simple reinforcement system for methadone clients in a community-based treatment program. , 1994, Journal of substance abuse treatment.

[16]  D. Dansereau,et al.  Node-link mapping for counseling cocaine users in methadone treatment. , 1994, Journal of substance abuse.

[17]  D. Simpson.  The relation of time spent in drug abuse treatment to posttreatment outcome. , 1979, The American journal of psychiatry.

[18]  D. Dansereau,et al.  Cognitive modularity: Implications for counseling and the representation of personal issues. , 1994 .

[19]  Alan Ross,et al.  The Effectiveness of Methadone Maintenance Treatment , 1991, Springer New York.

[20]  D. Simpson,et al.  HIV risks, gender, and cocaine use among opiate users. , 1995, Drug and alcohol dependence.

[21]  D. Simpson,et al.  Client engagement and change during drug abuse treatment. , 1995, Journal of substance abuse.

[22]  Y. Hser,et al.  Treatment of Drug Abuse , 1990, Crime and Justice.

[23]  D. Simpson,et al.  Heavy drinking, alcohol-dependent vs. nondependent methadone-maintenance clients: a follow-up study. , 1997, Addictive behaviors.

[24]  D. Simpson,et al.  Assessment of an AIDS intervention program during drug abuse treatment. , 1994, Journal of substance abuse treatment.

[25]  D. Dansereau,et al.  The use of node-link mapping in drug abuse counseling: the role of attentional factors. , 1995, Journal of psychoactive drugs.

[26]  G. de Leon.  Therapeutic communities for addictions: a theoretical framework. , 1995, The International journal of the addictions.

[27]  G. de Leon,et al.  Circumstances, motivation, readiness, and suitability (the CMRS scales): predicting retention in therapeutic community treatment. , 1994, The American journal of drug and alcohol abuse.

[28]  D. Simpson,et al.  Straight ahead: transition skills for recovery. , 1993 .

[29]  D. Knight,et al.  Influences of family and friends on client progress during drug abuse treatment. , 1996, Journal of substance abuse.

[30]  D. Dansereau,et al.  The role of node-link mapping in individual and group counseling. , 1994, The American journal of drug and alcohol abuse.

[31]  J. Platt.  Heroin Addiction: Theory, Research, and Treatment , 1976 .

[32]  D. Dansereau,et al.  Attentional difficulties and the effectiveness of a visual representation strategy for counseling drug-addicted clients. , 1995, The International journal of the addictions.

[33]  D. Simpson,et al.  Psychological Problems and Client Engagement in Methadone Treatment , 1995, The Journal of nervous and mental disease.

[34]  D. Dansereau,et al.  A visual representation system for drug abuse counselors. , 1994, Journal of substance abuse treatment.

[35]  D D Simpson,et al.  Relapse and recovery among opioid addicts 12 years after treatment. , 1986, NIDA research monograph.

[36]  F. Tims,et al.  Drug Abuse Treatment Evaluation: Strategies, Progress, and Prospects: NlDA Research Monograph 51 A RAUS Review Report: (497002006-001) , 1988 .

[37]  D. Simpson.  National treatment system evaluation based on the Drug Abuse Reporting Program (DARP) followup research. , 1984, NIDA research monograph.

[38]  S. B. Sells,et al.  Effectiveness of treatment for drug abuse: An overview of the DARP research program. , 1982 .

[39]  D. Dansereau,et al.  The role of node-link maps in enhancing counseling efficiency. , 1997, Journal of addictive diseases.

[40]  D. Simpson.  Drug treatment evaluation research in the United States. , 1993 .

[41]  D. Simpson,et al.  Psychological dysfunction and HIV/AIDS risk behavior. , 1996, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[42]  D. Simpson,et al.  Motivation as a predictor of early dropout from drug abuse treatment. , 1993 .

[43]  D. Simpson,et al.  Maintenance of HIV risk reduction among injection opioid users: a 12 month posttreatment follow-up. , 1997, Drug and alcohol dependence.

[44]  M. Hiller,et al.  Increasing Early Engagement in Methadone Treatment , 1997 .

[45]  S B Sells,et al.  Treatment process and relapse to opioid use during methadone maintenance. , 1994, The American journal of drug and alcohol abuse.

[46]  D. Simpson.  Treatment for drug abuse. Follow-up outcomes and length of time spent. , 1981, Archives of general psychiatry.

[47]  G. de Leon,et al.  Program-based evaluation research in therapeutic communities. , 1984, NIDA research monograph.

[48]  Donald F. Dansereau,et al.  Cognitive Modularity: Implications for Counseling and the Representation of Personal Issues. , 1994 .

[49]  R. Hubbard,et al.  Treatment predictors of tenure in methadone maintenance. , 1991, Journal of substance abuse.

[50]  T. Vaughn,et al.  Variations in methadone treatment practices. Results from a national study. , 1992, JAMA.

[51]  D D Simpson,et al.  Effectiveness of a specialized intervention for women in a methadone program. , 1994, Journal of psychoactive drugs.