Recovery Support Services and Client Outcomes: Results of Two Interim Evaluations in Texas

1
Recovery Support Services and Client
OutcomesResults of Two Interim Evaluations in
Texas

• College on Problems of Drug
• Dependence Conference
• June 15, 2008

2

• The author has no known conflicts of interest or
  financial relationships associated with the topic
  of this presentation.

3
Recovery Oriented Systems of Care Projects in
Texas

• Access to Recovery (ATR)
• Co-Occurring State Incentive Grant (COSIG)

4
Texas ATR Project
5
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

6
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

7
ATR Interim Evaluation

• Study examines outcomes of 825 individuals who
  received ATR services during the period of June
  2005 and September 2006
• Assessment providers rated 38 of the sample as
  successfully completing the ATR program
• Successful completers of the ATR program (n
  311) were compared to non-completers (n
  514) on recovery support service characteristics

8
Recovery Support Service Utilization
9
Categories of Recovery Support Services

• Social Support
• Employment Coaching
• Transportation
• Transitional Housing
• GED Assistance
• Childcare

• Direct Recovery Support
• Individual Recovery Coaching
• Recovery Support Group
• Relapse Prevention Group
• Spiritual Support Group
• Life Skills Group
• Family and Marital Counseling

10
Categories of Recovery Support Services Received


11
Texas COSIG Project
12
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)

13
COSIG Voucher Service Categories

• Child Care
• Housing Support
• Transportation
• Food Assistance
• Education Support

• Employment Assistance
• Clothing
• Medical Care
• Prescriptions
• Peer Mentoring

14
COSIG Interim Evaluation

• 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 (n323) and non-completers
  (n101) were compared on recovery support service
  characteristics

15
Recovery Support Services Received During
Treatment
16
Recovery Support Service Combinations
17
Conclusions

• The types of recovery support services received
  may have a differential effect on client outcomes
• Direct recovery support services may be essential
  components in an individuals service array
• Provision of social supports alone may be less
  effective in enhancing client outcomes

18
Future Research Needs

• 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

19
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