Objectives of this research are to investigate the relative contributions of treatment, client and counselor factors in determining the outcomes of polysubstance abuse clients exposed to brief individual counseling in a publicly supported, center-city, drug-free treatment program. Specifically, our objectives are to: (1) compare the effects of a high- structure, behaviorally-oriented with a low-structure, facilitative individual counseling style; (2) Contrast the treatment benefits received for clients whose coping styles are matched to treatments with those whose styles are mismatched; (3) investigate differences in counselor effectiveness as these might combine or interact with treatment and/or client factors; and (4) examine the relationships among several measures of client coping style and compare their predictive validities within this polysubstance abuse - population. Post-hoc analyses will focus on clients' perceptions of their counselors and of benefits received, on factors predictive of client retention, and on the role of counselors' coping styles in affecting client benefit. This five-year study involves the random assignment of 160 polysubstance abuse clients to ten graduate student counselors, each of whom will be trained to conduct both treatment styles in serial but counterbalanced order, while pretreatment, in-treatment, post-treatment and follow-up measures are obtained. Our research design attempts to address several priority issues in the substance abuse field, including the differential effectiveness of particular counseling approaches, the development and use of manual-driven therapies, the identification of optimal client-treatment matches, and the separation of """"""""counselor effects"""""""" from true treatment effects in outcome studies. Our eventual goal is to contribute toward better retention and outcome for polysubstance abuse clients in individual, drug-free outpatient counseling.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA008527-01A1
Application #
2121041
Study Section
Special Emphasis Panel (SRCD (26))
Project Start
1994-09-30
Project End
1999-08-31
Budget Start
1994-09-30
Budget End
1995-08-31
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Thomas Jefferson University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
061197161
City
Philadelphia
State
PA
Country
United States
Zip Code
19107
Patkar, Ashwin A; Thornton, Charles C; Mannelli, Paolo et al. (2004) Comparison of pretreatment characteristics and treatment outcomes for alcohol-, cocaine-, and multisubstance-dependent patients. J Addict Dis 23:93-109
Thornton, Charles C; Patkar, Ashwin A; Murray, Heather W et al. (2003) High- and low-structure treatments for substance dependence: role of learned helplessness. Am J Drug Alcohol Abuse 29:567-84
Thornton, Charles; Gottheil, Edward; Patkar, Ashwin et al. (2003) Coping styles and response to high versus low-structure individual counseling for substance abuse. Am J Addict 12:29-42
Gottheil, Edward; Thornton, Charles; Weinstein, Stephen (2002) Effectiveness of high versus low structure individual counseling for substance abuse. Am J Addict 11:279-90
Thornton, C C; Gottheil, E; Weinstein, S P et al. (1998) Patient-treatment matching in substance abuse. Drug addiction severity. J Subst Abuse Treat 15:505-11
Gottheil, E; Thornton, C C; Weinstein, S P (1997) Treatment structure, client coping methods, and response to brief individual counseling: preliminary findings in a substance dependent sample. J Addict Dis 16:51-65