title: Enhanced outpatient treatment for co-occurring disorders: main outcomes.
abstract: This study, which was conducted in an outpatient substance abuse treatment program, randomly assigned clients with mental health symptoms to either a control group, which received basic program services, or an experimental group, which was configured as a modified therapeutic community (TC) track, with the addition of modified TC features and three specific elements-psychoeducational seminar, trauma-informed addictions treatment, and case management. The experimental group had significantly better outcomes as compared with the control group on measures of psychiatric severity and on the key measure of housing stability; no difference was observed for substance use, crime, and employment. The findings must be qualified because (a) only 3 of 34 representative measures (<10%) showed significant differential treatment effects and (b) analysis revealed partial implementation of the enhancements. The study provides modest support for the effectiveness, on specific outcomes, of outpatient substance abuse treatment programs that add modified TC features and targeted interventions to strengthen their capacity to treat co-occurring disorders.
authors.affiliation: Center for the Integration of Research and Practice, National Development and Research Institutes, New York, NY 10010, USA. sacks@ndri.org
authors.forename: Stanley
authors.initials: S
authors.lastname: Sacks
authors.forename: Karen
authors.initials: K
authors.lastname: McKendrick
authors.forename: Joann Y
authors.initials: JY
authors.lastname: Sacks
authors.forename: Steven
authors.initials: S
authors.lastname: Banks
authors.forename: Michael
authors.initials: M
authors.lastname: Harle
mesh_terms: D000041:Absenteeism; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015897:Comorbidity; D003710:Demography; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome