The proposed study has two overall goals. First, we will examine the extent to which treatment practices in the nation's outpatient drug treatment system are meeting known or desired standards of care. Information will be gathered on several important aspects of treatment including: client assessment practices, extent to which clients receive various services (e.g., mental health counseling), length of treatment, and efforts to follow-up clients post discharge. With this information we can assess how well the units are meeting known or desired standards of care. For example, to what extent are units providing methadone doses that meet recommended levels (D'Aunno & Vaughn, 1992)? The second goal is to examine how well key organizational factors (e.g., unit ownership, funding, staffing, location) can account for variation in treatment practices and services. To achieve these goals, we will continue the National Drug Abuse Treatment System Survey in 1994. With the addition of the 1994 survey, we will have panel data for a representative national sample of outpatient drug-free and methadone units for 1988, 1990 and 1994. Though the 1994 survey will retain much of the content of our previous surveys, it will focus especially on treatment practices, and organizational factors that can affect them, in two key areas: 1. The needs of special populations. Within the broader population of drug abuse clients, we will focus on clients at high risk for HIV infection, women (especially pregnant women and those with children), and ethnic minority groups. 2. Client's needs for primary health care. We will examine variation in the availability of, and linkages to, primary health care. We will focus on the number and type of available services as well as the form of linkage to primary care whether through referral, contract, or in- house provision. 3. Finally, we will examine the extent to which key organizational factors and factors in the environment of treatment units can account for variation in treatment practices. These factors include ownership, funding sources and mechanisms location (both geographic location and location in a parent organization), treatment goals/philosophy, and staff characteristics.
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