Program structure and counselor-client contact in outpatient substance abuse treatment.
OBJECTIVE
To examine organizational structural attributes associated with counselor-client contact.


METHODS
Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs.


METHODS
The study uses a naturalistic design to investigate organizational structure measures-ownership, accreditation, and supplemental services-as predictors of time in counseling and case management, and caseload size, controlling for geographic differences.


METHODS
Directors at 116 outpatient drug-free treatment programs located in four regions across the U.S. (Great Lakes, Gulf Coast, Northwest, and Southeast) voluntarily completed a survey about program structure.


RESULTS
Clients received more counseling hours in programs that were "intensive," publicly owned, accredited, and had a lower proportion of recently hired counselors. More case management hours were offered in "intensive," private-for-profit or publicly owned (versus private-nonprofit) programs, serving a lower proportion of dual-diagnosis clients, and providing more on-site supplemental services. Smaller caseloads were found in programs that were accredited and had a smaller average client census and a lower proportion of criminal justice referred clients.


CONCLUSIONS
Organizational attributes are related to counselor-client contact and may have implications for staff turnover and service quality.
Knight
Danica K
DK
Institute of Behavioral Research, Texas Christian University, TCU Box 298740, Fort Worth, TX 76129, USA.
Broome
Kirk M
KM
Simpson
D Dwayne
DD
Flynn
Patrick M
PM
D000068:Accreditation / Q000592:standards; D019090:Case Management / Q000458:organization & administration; D003376:Counseling / Q000458:organization & administration*; D017050:Episode of Care; D006302:Health Services Research; D006801:Humans; D017149:Private Sector; D011369:Professional-Patient Relations; D017150:Public Sector; D012111:Residence Characteristics; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013997:Time Factors; D014481:United States; D016526:Workload