Health Services Research

23 Pages 5845 Words

psychiatric symptomatology may determine in part the need for higher-intensity treatment (Project MATCH Research Group 1993; Rounsaville, Dolinsky, Babor, et al. 1987). Based on these studies, we replicated research that had examined outcome by psychiatric status (McLellan, Luborsky, Woody, et al. 1983).Changes in alcohol and drug treatment policy have primarily emphasized a decrease in treatment intensity, and many of the changes have been justified by findings from randomized clinical trials (Fuller 1990; Institute of Medicine 1990; Gerstein and Harwood 1990). However, it is difficult to recruit for randomized trials that assign subjects to services requiring different levels of commitment, given the wide range in addiction severity and motivation among patients and the conviction of many practitioners and clients that more intensive treatment is superior. Trials unable to recruit a large representative group may not produce results generalizable to the population needing treatment. For instance, demographic characteristics, addiction severi...