title: Matching to sufficient treatment: some characteristics of undertreated (mismatched) clients.
abstract: A previous study by the investigative team using Drug Abuse Outcome Study data supported the validity of a sufficient treatment matching paradigm, which defines successful placement as the least treatment intensity required to address the severity of a disorder. The least favorable outcomes were obtained in the under-treated clients who received insufficient treatment intensity. The purpose of the current study was to further clarify characteristics of the undertreated clients. Four groups, those matched and mismatched to long-term residential (LTR) and drug-free outpatient (ODF) treatment, were compared on several baseline variables. Results indicated that the severity levels of drug use, social and psychological problems, and motivation for those mismatched to ODF (undertreated) were significantly lower than the clients matched to LTR but generally higher than the clients matched to ODF and those mismatched to LTR (overtreated). These findings underscore the importance of identifying clients at risk for under-treatment and facilitating their entry into treatments of sufficient intensity. More generally, they highlight the need to develop a range of treatment options of sufficient intensity to meet severity differences among clients.
authors.affiliation: Center for Therapeutic Community Research, National Development and Research Institutes, Inc, New York, NY 10010, USA. deleon@ndri.org
authors.forename: George
authors.initials: G
authors.lastname: De Leon
authors.forename: Gerald
authors.initials: G
authors.lastname: Melnick
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009042:Motivation; D010045:Outpatients / Q000706:statistics & numerical data; D012114:Residential Treatment / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012919:Social Behavior; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome