Research That Matters (January 17 - 20, 2008)

Background and Purpose: The value of matching substance abuse treatment services to specific client needs is increasingly documented in comprehensive approaches to treatment. Comprehensive approaches to substance abuse treatment address the reality that clients in the specialty substance abuse treatment system enter treatment with substance abuse problems that co-occur with health, mental health and social problems. Although efforts to “match” specific health, mental health and social services to client-identified needs in these areas is seen as a service approach that can result in more effective treatment, little is known about the extent to which matching may be differentially effective across racial/ethnic groups. Methods: The study uses National Treatment Improvement Evaluation Study (NTIES) data, a prospective study of U.S. substance abuse treatment programs serving vulnerable and underserved groups. Multi-level data were collected on treatment organizational, service and client characteristics. Organizational data were collected from program administrators at two points during a 12-month period. Client and service data were obtained from client interviews obtained at treatment intake, treatment exit and 12 months after treatment exit. The analytic sample consists of 3,142 clients (1812 Blacks, 486 Latino and 844 White clients. Descriptive statistics were used to assess the “need-service gap”, i.e., the percentage of clients reporting they had received services at the end of treatment that they had reported needing at intake in 6 different services areas: physical health, mental health, family service, vocational service, housing, financial service for Black, Latino and White clients. Hierarchical linear modeling also was used to assess the impact of matched services on service outcomes of substance use and client satisfaction for each group. Results: Results indicate that of those reporting need in a particular area, a limited percentage received matched services, especially among the Hispanic group. Further, receipt of matched services had a positive impact on both reductions in substance abuse and client satisfaction. When race and ethnic subgroups were analyzed separately, receipt of matched services was significantly related to the outcome variables only for the Black and White groups. Conclusions and implications: This study increases knowledge of effective strategies for delivering ancillary health and social services to racial/ethnic subgroups in specialty substance abuse treatment programs. The study points to the value of assessing client-identified needs and then providing services to meet those needs. It also documents that needs differ across racial/ethnic groups reinforcing the value of culturally competent services tailored to specific client needs.