Session: Increasing Access and Providing Social Services in Substance Abuse Treatment: Conceptual, Methodological and Empirical Issues (Research that Promotes Sustainability and (re)Builds Strengths (January 15 - 18, 2009))

Services research increasingly indicates that treatment outcomes improve when substance abuse treatment includes access to health and social services. These findings result from studies of comprehensive service approaches designed to address the numerous problems that co-occur with substance abuse. The argument for comprehensive substance abuse services is based on the premise that substance abuse treatment is more effective when health, mental health, parenting, vocational, housing and legal services are provided in conjunction with substance abuse services. Further, although data are not consistent, a number of studies indicate that specific types of comprehensive service strategies contribute to improved outcomes. Among service strategies studied are: 1) outcome-targeted services, services specifically related to the outcome of interest, i.e., substance abuse counseling services targeted to the outcome of post-treatment substance use; 2) access services, services designed to link clients to substance abuse services; and 3) matched services, services received by clients that focus on areas of client-identified needs. For example, it is well-documented that both individual and group counseling focused on substance use are effective in reducing post-treatment substance use. It also has been shown that linkage services in the forms of transportation, child care and intensive outreach can increase the number of services received and improve outcome. Increasingly, the value of matching services to specific client-identified needs has been demonstrated. Although the value of comprehensive services is well-documented in the literature, the development of effective models will require attention to the conceptualization and measurement of specific service strategies, as well as attention to their impact across diverse service populations.

This symposium will bring together analyses of comprehensive services models across two large-scale data sets of substance abuse treatment programs: 1) the National Treatment Improvement Evaluation Study (NTIES), a large, prospective study of substance abuse treatment programs, and 2) the Illinois Alcohol and Other Drug Abuse (AODA) Waiver study. Both are studies that included measures of the provision of specific health and social services across diverse subpopulations of clients. Both also are studies concerned with the development of more effective treatment models. Each symposium participant will incorporate the following three questions into their presentations:

1. What is the underlying conceptualization and measurement of comprehensive services used in their analysis?

2. To what extent does the analysis inform understanding of types of services: outcome-targeted services, access services and matched services?

3. What are the implications of the research for the development of effective substance abuse treatment?