Drug and Alcohol Dependence 2015;153:109-115. [doi: 10.1016/j.drugalcdep.2015.05.047]
Mary Bond Edmond, PhD (University of Georgia), Lydia Aletraris, PhD (University of Georgia), Maria Paino, PhD (Oakland University), Paul M. Roman, PhD (University of Georgia).
Modern treatment options for substance use disorder are diverse. While studies have analyzed the adoption of individual evidence-based practices in treatment centers, little is known about the specific make-up of treatment strategy profiles in treatment centers throughout the United States. The current study used latent class analysis to profile underlying treatment strategies and to evaluate philosophical and structural supports associated with each profile. Using three aggregated and secondary datasets of national representative samples of substance use disorder treatment centers (N=775), including centers participating in the National Drug Abuse Treatment Clinical Trials Network, treatment strategy profiles were determined using via latent class analysis. Using multinomial logistic regression, organizational characteristics associated with each profile were also examined.
Three distinct treatment strategy profiles were found:
- Centers that primarily relied on Motivational Interviewing and Motivational Enhancement Therapy,
- Centers that utilized psychosocial and alternative therapies, and
- Centers that employed comprehensive treatments including pharmacotherapy.
The multinomial logistic regression revealed that philosophical and structural center characteristics were associated with membership in the comprehensive class. Centers with philosophical orientations conducive to holistic care and pharmacotherapy-acceptance, resource-rich infrastructures, and an entrepreneurial reliance on insured clients were more likely to offer diverse interventions. All associations were significant at the .05 level.
Conclusions: The findings from this study clarify the general strategies of treatment centers and how those strategies are interconnected. Practitioners and clients should be aware of the variation in treatment center practices. Access to diverse treatment is beneficial and centers with limited offerings should consider widening their treatment, especially as the Affordable Care Act begins to increase the emphasis on integrated substance use disorder treatment with general health care practice. Centers offering medication-assisted treatment will be better able to integrate other medical services, and programs that make up the comprehensive class, which are able to offer a wide range of core and wraparound services, will be most competitive. (Article (Peer-Reviewed), PDF, English, 2015)
Keywords: Behavior therapy | Motivational Enhancement Therapy (MET) | Motivational interviewing (MI) | National Treatment Center Study (NTCS) | Pharmacological therapy | Drug and Alcohol Dependence (journal)
Document No: 1150, PMID: 26105707, PMCID: PMC4509823.
Submitted by CTN Dissemination Librarians, 6/18/2015.