Organizational Variables in Drug Treatment Efficacy

描述：（申请人提供） 本研究推进了对组织变量作用的理解 成功实施了住院药物滥用治疗方案。 理解组织特征对组织的重要性， 这些方案的成功是显而易见的：（a）DATOS研究发现， 住院药物滥用治疗方案之间结果的变异性， (b)快速扩展住宅项目，为新人口提供服务， (c)这些项目的第三方资助者所要求的变化。一个关键 组织变量为临床主任内部一致性， 专业的专科人员，基层治疗人员和客户，关于 治疗目标和治疗成功所需的要素。根据 公式，一致性由两个变量组成，一致性（Cc：定义为 一个组织中不同群体之间的一致程度，例如 管理员、员工和客户）和共识（Cs：定义为 在这些团体中）。这些变量共同决定了 在执行治疗方案时协调一致的努力。两个变量 不同之处在于，如果没有高水平的一致性， 集团内部的高度共识，但高度共识可以 没有相应的高度一致性。当Cc高时 在所有组织团体中，坚持规定的治疗 协议很高。该研究探讨了一种模式，其中：i）组织 上下文变量（例如，组织的规模、工作人员与客户的比例） 影响交流、参与决策和建设性的 冲突;二沟通，参与决策，建设性 冲突影响Cc和Cs;以及iii）Cc和Cs各自影响治疗成功， 从工作人员和客户满意度、客户参与度 治疗和保留。目标包括：（1）确定 Cc和Cs; 2）识别Cc和Cs的组织相关性; 3） 确定Cc和Cs与治疗成功的关系;以及4） 确定客户、员工和项目之间的关系 居住治疗方案成功的特点。

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.