Five principal strategies of family intervention have been identified in the drug and alcohol treatment literature. A small number of studies have concluded that various of these family intervention strategies (FIS) are effective in engaging and retaining resistant people in drug and alcohol treatment. But, these studies comprised very few agencies and a small sample of counselors. They may have reflected how effective FIS can be, but did not quantify the actual prevalence of use and efficacy of FIS in the field. Quantifying the use and efficacy of FIS will yield clinical and service system data necessary for optimal use of FIS. This knowledge can enhance effective decision-making regarding resource allocation, staff and policy development, as well as clinical determinations by counselors. This study will be the first to examine FIS in the field. Three research questions need to be answered. First, what is the prevalence of use of FIS? A survey to all certified drug and alcohol treatment agency directors in Washington, Oregon and Idaho will be used to build a database of availability of this service. The survey will also inquire of counselors at non-state certified agencies who provide family intervention services in each geographic area and estimates of how often FIS is conducted, A second survey to all identified intervention counselors, whether affiliated with certified or non-certified agencies will inquire of their experience and education, which of five strategies of intervention identified in the literature each employs, an estimate of the frequency of use, and again inquire of intervention counselors at noncertified agencies. From this family intervention counselor database, a random sample of intervention counselors will be contracted with to track the process and outcome of FIS cases for up to 4 months. Monthly stipends will be paid to the counselors for submitting data, either on paper or via the Internet, from interventions conducted. Safeguards will be employed to prevent and guard against Hawthorne effects. With data collected from the field, question one can be further validated and two questions of efficacy can be answered. First, """"""""What is the efficacy of intervention in the field as measured by rates of engagement into drug and alcohol treatment and treatment retention as measured with 60 day treatment follow-up?"""""""" And second, """"""""What counselor, agency, intervention recipient (including HIV), and family variables predict successful engagement and retention in treatment for each of five family intervention strategies?""""""""
