Date of Award

Spring 2011

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Counseling Psychology

First Advisor

Campbell, Todd C.

Second Advisor

Young, Terry

Third Advisor

Edwards, Lisa

Abstract

While over 4 million people in the United States aged 12 and over are engaged in treatment for substance use disorders each year, much remains unknown about how clients can be optimally referred to available treatment services, settings, providers, and interventions. Historically, clients received treatment in uniform, high intensity settings. Research over recent decades, however, has shown increased cost effectiveness and sustained, if not improved, clinical outcomes associated with efforts to individualize care. This study utilized the Delphi research methodology to examine community experts' (N = 9) perspectives on the real world implementation of client-treatment matching principles within a major metropolitan area in the Midwest.

Expert panel members underwent an iterative process of qualitative and quantitative surveys to build consensus and highlight areas of dis-sensus related to: 1) current matching practices in the region of interest, 2) matching practices in an optimal treatment system, 3) barriers to treatment system improvement, 4) consequences of existing systemic shortcomings, and 5) solutions for identified problems in client-treatment matching. Results are compared with both available information about treatment systems in the community of interest and published literature about client-treatment matching to yield recommendations for enhancing the efficiency and effectiveness of substance use disorder treatment through client-treatment matching. Recommendations suggest specific strategies for improving treatment by: enhancing clients' capacity to make informed treatment choices, expanding the scope of available services and interventions to which clients can be matched, improving screening and comprehensive assessment, and better motivating providers to utilize client treatment-matching strategies.

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