THERAPEUTIC COMMUNITIES--CLIENT TREATMENT MATCHING

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APPLICANT'S ABSTRACT: The overall objective of the proposed project is to enhance retention in three different TC-oriented treatment settings by improving the match between client and setting. The proposed research will experimentally evaluate the impact of an explicit protocol for guiding matching/referral decisions to three TC - oriented treatment modalities: long-term residential (at least 12 months); short-term residential (3-9 months); and non-residential treatment ( 9-12 months). There are three specific aims: (l) To assess and evaluate the efficacy of current practices and criteria in matching clients to 3 different TC oriented treatment settings; (2) To test the efficacy of an explicit protocol, the Client Matching Protocol, (the CMP) for guiding for matching decisions; and (3) To assess client reasons for dropout or completion to further validate the CMP and to identify client perceived factors which may improve matching decisions. Six multimodal TC agencies will participate in all phases of the study. Under Aim 1 interviews with personnel will identify the current criteria for referral to the various treatment settings; the effect of these referral criteria on retention is determined on 600 consecutive admissions to the three settings. Under Aim 2 the CMP is field tested on another cohort of 600 admissions to further refine the criteria. Then a second study will directly test the efficacy of the refined CMP on two consecutive admission cohorts of 600 each in a two condition design; when counselors are uninformed ("blind") and then informed of the CMP information. Under Aim 3, the validity of the matching protocol will be assessed in face to face and telephone interviews with over 700 dropouts and completes who provide their reasons for separation and their perceptions of treatment suitability. Finally, six comparison multimodal TC agencies participate in the activities in the initial year only, during which they continuously provide file data as to admissions, referrals and retention rates in each of their three settings. Comparison between these two groups will provide a test of the general impact of the project program referral and client retention rates.