Measuring client progress in treatment is crucial to understanding the elements of effective drug abuse treatment. To improve treatment effectiveness it is necessary to implement research-based treatment interventions in actual program settings and evaluate their benefits for practice. This application will improve therapeutic community (TC) treatment by implementing and evaluating a protocol that integrates research based instruments measuring client progress in treatment into established clinical practices in three residential and eight outpatient TC settings. This Protocol for Improving Clinical Practice (PICP), whose feasibility for use has been established in field tests at four TCs in community and prison settings, has three components: a) Staff braining in a curriculum of theoretically-based practitioner-validated goals of TC treatment; b) Monthly repeated staff/client evaluation of progress toward these goals using three unique, new psychometrically tested instruments developed by the investigator and validated as part of a five-year K21 (scientist development) award. These instruments are utilized with a system for recording/tracking client progress; and c) Integrating this progress information into established program routine enabling practitioners to identify and address treatment issues relevant to individual clients. The project is comprised of an ongoing formative evaluation to assess and improve the operation of this empirically tested protocol, a summative comparison of three treatment conditions in a quasi-experimental design, and a retrospective comparison, documenting protocol benefits to program staff, clients, and the agency. The three conditions are: 1) A baseline control group that receives treatment as usual; 2) A group that receives staff training only; and 3) A group that receives staff training plus the full protocol. The dose working collaborative effort between the research team at NDRI, a nationally-known, premiere research institution, and Daytop Village, one of the largest and best-known TCs in America, will document the mutual benefits that result from merging research with clinical practice. Implementing the PICP in practice will improve treatment and provide a foundation for the continued scientific investigation of the relationship between progress in treatment and treatment outcome.
