? The Texas Process and Practice Improvement (PPI) study will examine utilization of science-based practices and improved proximal client outcomes as influenced by organizational feedback on practices and outcomes, and by an organizational change process intervention. ? Specific Aims: ? 1. Measure the effects of strategic graphic outcome and management feedback as it may influence utilization of science-based practices and improved during-treatment outcomes' ? 2. Determine whether there is an additional benefit of adding a change process enhancement protocol. ? Two organizational interventions will be implemented: 1) graphic feedback on program trends on a few key during-treatment proximal-outcome measures, and 2) an organizational change process protocol offered through a structured workshop, followed by individualized team consultation and support. The conceptual framework integrates concepts from complexity science as well as the literature on innovation diffusion and technology transfer. The Texas Christian University (TCU) treatment process model (Simpson et al) is also utilized in the design. The study will involve block grant funded treatment programs throughout the state, as well as programs with special emphasis on science-to-service initiatives of CSAT. Data will be obtained from the States' web-based clinical reporting system as well as through supplemental instruments measuring during-treatment treatment processes, organizational functioning, and utilization of science-based practices. In addition to other analyses, cost comparisons will be conducted to determine whether the added costs of intervention #2 are justified in terms of improved proximal client outcomes. ? ?