Program structure and counselor-client contact in outpatient substance abuse treatment

Health Serv Res. 2008 Apr;43(2):616-34. doi: 10.1111/j.1475-6773.2007.00778.x.

Abstract

Objectives: To examine organizational structural attributes associated with counselor-client contact.

Data sources: 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.

Study design: 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.

Data collection: 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.

Primary findings: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Accreditation / standards
  • Case Management / organization & administration
  • Counseling / organization & administration*
  • Episode of Care
  • Health Services Research
  • Humans
  • Private Sector
  • Professional-Patient Relations*
  • Public Sector
  • Residence Characteristics
  • Substance-Related Disorders / rehabilitation*
  • Time Factors
  • United States
  • Workload