Rural communities, like urban communities, experience problems associated with drug abuse and drug dependence (Edwards, 1992). However, existing treatment interventions are not tailored for rural settings (Leukefeld, Clayton and Meyers, 1992). The overall aim of this three year project is to modify an existing social skills behavioral therapy for rural populations (Monti et al. 1989), refine the therapy, develop a manual, train and supervise therapists, and pilot test the structured behavioral outpatient rural therapy to treat rural drug abusers and drug dependents as Stage I Research for NIDA's Behavioral Therapies Development Program. Year one and part of the second year will involve rural treatment program therapists, university clinical staff, recovering patients, and the project team in modifying the existing behavioral therapy for use with rural drug abusers/dependents. A focus group will be convened by project staff to develop an initial draft manual. In year two instrumentation will be finalized after preliminary testing. The draft manual will also be finalized for the pilot test. Therapists will be selected competitively for the pilot test. Manual training will be given to therapists selected to be involved in the comparative pilot test. In year three therapy will be delivered by manual trained therapists in three rural Eastern Kentucky sites. At least one day of on-site therapist supervision will be given monthly and supervision sessions will be provided weekly during the comparative pilot test in year three.
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