Objectives of this research are to investigate the relative contributions of treatment, client and counselor factors in determining the outcomes of polysubstance abuse clients exposed to brief individual counseling in a publicly supported, center-city, drug-free treatment program. Specifically, our objectives are to: (1) compare the effects of a high- structure, behaviorally-oriented with a low-structure, facilitative individual counseling style; (2) Contrast the treatment benefits received for clients whose coping styles are matched to treatments with those whose styles are mismatched; (3) investigate differences in counselor effectiveness as these might combine or interact with treatment and/or client factors; and (4) examine the relationships among several measures of client coping style and compare their predictive validities within this polysubstance abuse - population. Post-hoc analyses will focus on clients' perceptions of their counselors and of benefits received, on factors predictive of client retention, and on the role of counselors' coping styles in affecting client benefit. This five-year study involves the random assignment of 160 polysubstance abuse clients to ten graduate student counselors, each of whom will be trained to conduct both treatment styles in serial but counterbalanced order, while pretreatment, in-treatment, post-treatment and follow-up measures are obtained. Our research design attempts to address several priority issues in the substance abuse field, including the differential effectiveness of particular counseling approaches, the development and use of manual-driven therapies, the identification of optimal client-treatment matches, and the separation of """"""""counselor effects"""""""" from true treatment effects in outcome studies. Our eventual goal is to contribute toward better retention and outcome for polysubstance abuse clients in individual, drug-free outpatient counseling.
