This project will continue work begun in 1989 for enhancing treatment of hard-core injection drug users. Our previous findings show cognitive- based enhancements to counseling (using node-link mapping) can be effective for improving communications and therapeutic alliance between client and counselor as well as reducing client relapse to drug use (and HIV risks) during treatment. Contingency management using inexpensive positive rewards were found to produce encouraging increases in session attendance and abstinence rates among clients, and manual-driven interventions developed for specialized program needs (e.g., HIV/AIDS, women's issues, transition to aftercare) helped improve group counseling, client learning, and treatment retention rates. Our previous research raised new issues that are addressed in this application. First, studies for improving counseling procedures with examine (1) the effectiveness of abbreviated mapping strategies for addressing specific crisis issues, which account for a large portion of early treatment individual counseling sessions, (2) specialized training for client- initiated mapping to improve personal skills in problem definition and decision making, and (3) the differential effectiveness of individual only versus group plus individual counseling in early and late treatment stages. The second series examine strategies for improving client engagement and focus during early treatment. They will include studies on (1) guided cognitive protocols to increase client self-examination and induction into treatment roles, combined with contingency management to improve their session attendance rates, and (2) feasibility and impact of requiring more frequent treatment counseling contacts. Third, our earlier work on psychoeducation and life-skills training for specialized problems and counseling needs will be extended to develop and test manual-driven modules for (1) sexual trauma resolution for women, (2) parenting skills training, and (3) communication and sexual health issues for men. Finally, treatment process and outcome studies are planned that investigate individual differences related to treatment engagement and mapping success, the role of gender and cultural issues, cognitive deficits among drug addicts, and the relationships of outcomes during and after treatment with program services and counselor alliance. No-fee methadone treatment services during the first year in treatment will be supported in order to recruit an estimated 700 opioid addicts (over the next 5 years) needed to conduct early induction and engagement studies in this project; long-term clients already stabilized in the program will also participate in other studies focusing on later treatment stages. The treatment sample will be approximately 55% Mexican American and 30% female.
| Simpson, D Dwayne; Joe, George W; Dansereau, Donald F et al. (2011) Addiction treatment outcomes, process and change: Texas Institute of Behavioral Research at Texas Christian University. Addiction 106:1733-40 |
| Joe, George W; Simpson, D Dwayne; Rowan-Szal, Grace A (2009) Interaction of counseling rapport and topics discussed in sessions with methadone treatment clients. Subst Use Misuse 44:3-17 |
| Simpson, D Dwayne; Dansereau, Donald F (2007) Assessing organizational functioning as a step toward innovation. Sci Pract Perspect 3:20-8 |
| Czuchry, Michael; Dansereau, Donald F (2003) A model of the effects of node-link mapping on drug abuse counseling. Addict Behav 28:537-49 |
| Simpson, D D; Joe, G W; Rowan-Szal, G A et al. (1997) Drug abuse treatment process components that improve retention. J Subst Abuse Treat 14:565-72 |
