Alcohol and drug abuse among the workforce of this country, produces dramatic costs in terms of lost productivity and health care expenses. There is now substantial evidence suggesting that Employee Assistance Programs (EAP's) can be effective for the workers. However, since the continuation of these employee assistance programs depends in large part on the cost- effectiveness of their services to the companies that sponsor them, they must be able to shown sustained improvement at reasonable costs. While there has been no clear demonstration of significantly better outcomes from any single type of substance abuse treatment program, or treatment setting in the patient population as a whole, it is equally clear that substantial variability exists in the treatment needs of these patients. Our previous research indicates that each of these treatment setting could be differentially effective with certain subgroups of the patient population, and that the overall efficacy and efficiency of the treatment system could be improved by """"""""matching"""""""" patients with particular treatments needs, to setting and/or programs having specific strengths in those problem areas. Therefore, in the present study the objective will be to develop an effective, relatively inexpensive and generalizable matching procedure for an EAP treatment network in the Philadelphia area. Since this EAP network is quite representative of many other EAP networks in other parts of the country; and since the evaluation methods to be employed are quire suitable for an ongoing clinical/commercial treatment network, we expect that the proposed design can be used widely within the substance abuse treatment community (particularly in EAP settings) to improve the efficacy and reduce the costs of treatment. The goals of the present proposal are: 1. The development and implementation of a practical, generalizable, non-invasive patient-treatment matching procedure that is suitable for a variety of employee assistance programs and other treatment networks. 2. An analysis of the efficacy of this matching procedure in an existing, representative EAP treatment network. In this regard, we hypothesize: A) A general increase in the effectiveness of the EAP through specific improvement of the patient-treatment assignment procedures. B) A general reduction in the cost of treatment through reductions in drop-out recidivism, and additional treatment.
