Organizational Variables in Drug Treatment Efficacy

描述：(申请人提供) 这项研究促进了对组织变量作用的理解 在成功实施住宅药物滥用治疗方案方面。 了解组织特征对组织的重要性 这些方案的成功明显体现在：(A)DATOS研究发现 住宅药物滥用治疗方案之间结果的差异性， (B)迅速扩大住房方案，为新的人口服务，以及 (C)这些项目的第三方资助者要求的变化。一把钥匙 组织变量是临床主任之间的内部协议， 专业专科工作人员、初级治疗人员和客户，关于 治疗目标和治疗成功所需的要素。根据 表述、协议由两个变量组成，一致性(抄送：定义为 组织中不同组之间的协议级别，例如 管理员、员工和客户)和共识(Cs：定义为 这些集团内部的协议)。这些变量加在一起决定了 在执行治疗议定书方面的协调努力。这两个变量 不同的是，不同的群体之间不可能没有高水平的和谐 小组内部的高水平共识，但高水平的共识可以 没有相应的高水平的和谐存在。当CC较高时 在所有组织团体中，遵守规定的治疗 礼仪很高。这项研究调查了一个模型，在该模型中：i)组织 背景变量(例如，组织规模、工作人员与客户的比率) 影响沟通、参与决策和建设性 冲突；二、沟通、参与决策和建设性 冲突影响CC和Cs；以及iii)CC和Cs各自影响治疗成功， 以员工和客户满意度衡量，客户参与度 治疗和保留。目标包括1)确定 CC和Cs；2)确定CC和Cs的组织关联；3) 确定CC和Cs与治疗成功的关系；4) 确定客户、员工和项目之间的关系 关于居民治疗项目成功的特点。

DESCRIPTION: (provided by applicant) This study advances the understanding of the role of organizational variables in the successful delivery of residential substance abuse treatment protocols. The importance of understanding the organizational features essential to the success of these programs is evident in: (a) the DATOS study finding of great variability in outcomes among residential substance abuse treatment programs, (b) the rapid expansion of residential programs to serve new populations, and (c) changes demanded by third-party funders of these programs. A key organizational variable is internal agreement among clinical director, professional specialty staff, primary treatment staff and clients, about the treatment goals and elements needed for treatment success. According to the formulation, agreement consists of two variables, concordance (Cc: defined as the level of agreement between different groups in an organization, such as administrators, staff, and clients) and consensus (Cs: defined as the level of agreement within these groups). Together, these variables determine the extent of coordinated effort in implementing the treatment protocol. The two variables differ in that high levels of concordance between groups cannot occur without high levels of consensus within the groups, but high levels of consensus can exist without correspondingly high levels of concordance. When Cc is high across all organizational groups, adherence to the prescribed treatment protocol is high. The study investigates a model in which: i) organizational contextual variables (e.g., size of the organization, staff-to-client ratios) affect communication, participation in decision-making and constructive conflict; ii communication, participation in decision-making, and constructive conflict affect Cc and Cs; and iii) Cc and Cs each affect treatment success, measured in terms of staff and client satisfaction, client engagement in treatment, and retention. Aims include 1) determining the relationship between Cc and Cs; 2) identification of the organizational correlates of Cc and Cs; 3) determination the relationship of Cc and Cs with treatment success; and 4) determination of the relationship between client, staff, and program characteristics on the success of residential treatment programs.