Address correspondence to Danica Kalling Knight, Ph. D., Institute of Behavioral Research, Texas Christian University, TCU Box 298740, Fort Worth, TX 76129. Kirk M. Broome, Ph.D., D. Dwayne Simpson, Ph.D., and Patrick M. Flynn, Ph.D., are with the Institute of Behavioral Research, Texas Christian University, Fort Worth, TX.
Program Structure and Counselor–Client Contact in Outpatient Substance Abuse Treatment
Article first published online: 10 SEP 2007
© Health Research and Educational Trust
Health Services Research
Volume 43, Issue 2, pages 616–634, April 2008
How to Cite
Knight, D. K., Broome, K. M., Simpson, D. D. and Flynn, P. M. (2008), Program Structure and Counselor–Client Contact in Outpatient Substance Abuse Treatment. Health Services Research, 43: 616–634. doi: 10.1111/j.1475-6773.2007.00778.x
- Issue published online: 10 SEP 2007
- Article first published online: 10 SEP 2007
- Program structure;
- organizational functioning;
- outpatient substance abuse treatment;
- counselor–client contact;
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.