The primary objective of this proposal is to explore the potential of the community mental health system to deliver drug abuse treatment on an outpatient basis. This overall objective will be met by conducting a national comparative study of drug-free outpatient treatment services currently delivered both in the community mental health system and community based programs supported by the National Institute for Drug Abuse. Programs will be surveyed to identify the prevailing patterns of client utilization, the dominant treatment technologies used, the organizational and community contexts in which the programs are delivered, and finally, measures of program impact or outcome where available. Programs will be matched for community characteristics and surveyed by telephone in an initial screening telephone survey and subsequently in intensive telephone interviews. Following the telephone surveys, sub-samples will be examined in more detail through mail questionnaire methods, and finally, an intensive field study of a small number of model programs will be conducted using site visits and interviews. The expected benefits of this national comparative study include 1) information that will assist policy makers in assessing the capacity of the community mental health system to identify populations in need of drug-free outpatient services and to deliver responsive services to these clients; 2) to provide a clearer understanding of the relationships between client characteristics, the organizational and community contexts in which drug abuse treatment services are delivered, the typical treatment strategies used by programs in the community context, and the relative effectiveness of these strategies; and finally 3) to identify model programs for outpatient drug-free treatment and to describe them in sufficient detail to make replication and dissemination of these programs possible in the future.
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