Patient assessment and treatment planning are critical elements in contemporary addiction treatment. This technology-transfer project seeks to study and enhance these processes in standard community treatment programs - thereby improving patient retention and outcomes. There are two parts to the technology transfer: a computer-assisted ASI assessment to improve the identification and prioritization of patients' problems; and the Computer-Assisted System for Patient Assessment and Referrals (CASPAR) which provides a comprehensive listing of all free or low-cost health and social services (e.g. legal counsel, housing and job training) available in the community. This project builds upon an earlier, 2-year NIDA-funded randomized trial of this computer-assisted patient assessment and care planning process. That study showed that counselors readily learned to use these aides and that they produced significantly better treatment care plans and provided significantly better services-to-needs matching to their patients. This proposal replicates and extends that study to test the contribution of the CASPAR system over the computer-assisted ASI assessment alone in achieving improved care planning, better patient retention, increased services received over a longer time period, and better 6-month outcomes. In Phase I, 12 randomly selected, abstinence-oriented outpatient substance abuse treatment programs, and 40 counselors will be trained in the ASI assessment software. Research Staff will recruit five patients from each counselor's caseload (total of 200 subjects) and independent research technicians will check the quality and 'match' of the treatment plans; perform TSR interviews measuring the nature and amounts of services received at 2, 4, 8 and 12 weeks; and complete six-month ASI follow-ups, including urine and Breathalyzer testing. In Phase II, the programs will be randomly assigned to receive either a 3-hour ASI """"""""booster"""""""" training (SA Group - 5 programs, 20 counselors), or a 3-hour training in the Resource Guide software and problem-services matching (EA Group - 5 programs, 20 counselors). Research staff will again recruit five patients per counselor (200 per group) and they will be followed as in Phase I. If successful, this low-cost, user-friendly technology enhancement could be an important addition to the meager clinical tools currently available to drug counselors.
