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Recovery Support Services and Client Outcomes: What do the Data Tell Us?. Recovery Community Services Program Grantee Meeting December 14, 2007. Recovery Oriented Systems of Care Projects in Texas. Access to Recovery (ATR) Co-Occurring State Incentive Grant (COSIG). Texas ATR Project.

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recovery support services and client outcomes what do the data tell us

Recovery Support Services and Client Outcomes:What do the Data Tell Us?

Recovery Community Services Program Grantee Meeting

December 14, 2007

recovery oriented systems of care projects in texas
Recovery Oriented Systems of Care Projects in Texas

Access to Recovery (ATR)

Co-Occurring State Incentive Grant (COSIG)

texas atr project4
Texas ATR Project
  • Targets individuals who are involved in the criminal justice system through drug courts, probation, or child protective services
  • Provides independent assessment to determine service needs and client choice among an array of service providers, including faith-based and community organizations
texas atr voucher system
Clinical Assessment

Care Coordination

Addiction Treatment

Individual Recovery Coaching

Spiritual Support Group

Relapse Prevention Group

Life Skills Group

Recovery Support Group

Transitional Housing

GED Assistance

Employment Coaching

Marital and Family Counseling

Texas ATR Voucher System
atr study 1
ATR Study 1

Study compares addiction treatment outcomes of ATR clients (n = 1049) with a randomly selected sample of criminal justice clients (n = 1049) receiving state funded treatment services who did not participate in the ATR program

client characteristics
Client Characteristics
  • ATR clients were more likely to be Hispanic and employed, whereas non-ATR clients were more often White, older, and male
  • Non-ATR clients had a greater history of both detox and non-detox addiction treatment
  • Non-ATR clients reported more days of primary substance use during the month prior to admission; however, the groups did not differ in the frequency of use over the past six months
slide12
Percentage of ATR Clients Receiving Recovery Support Services in Combination with Treatment by Completion Status

*

summary of atr study 1 atr vs non atr criminal justice clients
Summary of ATR Study 1:ATR vs. Non-ATR Criminal Justice Clients
  • ATR clients had shorter lengths of stay in treatment
  • ATR clients had more successful outcomes in the areas of treatment completion and past month abstinence and AA/NA attendance at discharge
  • ATR clients who completed treatment were more likely to receive recovery support services in combination with treatment rather than treatment alone
atr study 2
ATR Study 2
  • Study examines outcomes of 825 individuals who received ATR services during the period of June 2005 and September 2006
  • Successful completers of the ATR program (n = 311) were compared to non-completers (n = 514) on client and voucher service characteristics
client characteristics15
Client Characteristics
  • Completers were more likely to be Hispanic, employed, living independently, and to have higher levels of education
  • Drug court participants had higher completion rates (61%) relative to probationers (20%) and individuals involved with child protective services (38%)
categories of recovery support services
Emotional / Affiliational

Individual Recovery Coaching

Recovery Support Group

Relapse Prevention Group

Spiritual Support Group

Life Skills Group

Family and Marital Counseling

Instrumental / Informational

Employment Coaching

Transportation

Transitional Housing

GED Assistance

Childcare

Categories of Recovery Support Services
summary of atr study 2 factors associated with successful atr outcomes
Summary of ATR Study 2:Factors Associated with Successful ATR Outcomes
  • Retention in the ATR program
  • Receiving treatment only or treatment in combination with recovery support services
  • Receiving emotional and affiliational recovery support services that are more directly centered on the process of recovery
  • Drug court supervision
  • Client employment and higher education levels
texas cosig project key components
Texas COSIG Project Key Components
  • Training of addiction counselors on co-occurring disorders and the use of diagnostic and assessment instruments to improve identification of comorbidity and monitor client progress
  • A voucher system that provides recovery support services to enhance the treatment process ($1800 per client)
voucher service categories
Child Care

Housing Support

Transportation

Food Assistance

Education Support

Employment Assistance

Clothing

Medical Care

Prescriptions

Peer Mentoring

Voucher Service Categories
cosig study
COSIG Study
  • Data were obtained for 424 COSIG clients who entered and were discharged from addiction treatment during the period of February 2005 through October 2006
  • 76% of the sample completed treatment
  • Treatment completers (n=323) and non-completers (n=101) were compared on client and service characteristics
client characteristics25
Client Characteristics
  • Treatment completers were more likely to be male and homeless
  • Treatment completers had a greater history of both detox and non-detox addiction treatment
  • Treatment completers reported greater primary substance use during the 30 days prior to admission
summary of cosig study service and client characteristics associated with treatment completion
Summary of COSIG Study:Service and Client Characteristics Associated with Treatment Completion
  • Peer mentoring had the strongest association with treatment completion
  • Instrumental and informational support services, particularly in the absence of peer mentoring, were associated with non-completion
  • Treatment completers were more likely to male and have depression and anxiety diagnoses, whereas non-completers were more often diagnosed with bipolar and posttraumatic stress disorders
what do the data tell us about recovery support services
What Do the Data Tell Us About Recovery Support Services?
  • Recovery support services can play a significant role in the continuum of care
  • Emotional and affiliational support services may be essential components in an individual’s service array
  • Provision of instrumental and informational supports only may be less effective in sustaining the process of recovery
why is evaluation important
Why is Evaluation Important?
  • Provides evidence that your services are making a difference
  • Provides feedback regarding meeting your project’s goals
  • Provides information to guide program planning:
      • Effectiveness of various services and service combinations
      • Identification of potential subgroups of participants who are less responsive to services
      • Informs outreach efforts
what more do we need to know
What More Do We Need to Know?
  • Successful completion of the ATR program or treatment is only one method of defining outcomes; other studies are needed using a wider array of outcome measures
  • More studies are needed to explore the effect of various service combinations on client outcomes
  • Longitudinal studies are needed to examine the lasting effects of recovery support services on sustaining the process of recovery
acknowledgements
Acknowledgements

Texas Department of State Health Services

Karen Eells, MSSW, LMSW

ATR Project Director

Kwame Bruce, Psy.D.

COSIG Project Director

Lesli San Jose

Decision Support Research Specialist

Substance Abuse and Mental Health

Services Administration