Using organizational assessment as a tool for program change.

Organizational functioning within substance abuse treatment organizations is important to the transfer of research innovations into practice. Programs should be performing well for new interventions to be implemented successfully. This study examined the characteristics of treatment programs that participated in an assessment and training workshop designed to improve organizational functioning. The workshop was attended by directors and clinical supervisors from 53 community-based treatment units in a single state in the Southwest. Logistic regression analysis was used to examine attributes related to program-level decisions to engage in a structured process for making organizational changes. Findings showed that programs with higher needs and pressures, more limited institutional resources, and poorer ratings on staff attributes and organizational climate were the most likely to engage in a change strategy. Furthermore, organizations with greater staff consensus (i.e., smaller standard deviations) on ratings of organizational climate were also more likely to engage in change.

Sexual abuse history and treatment outcomes among women undergoing methadone treatment.

Women entering drug abuse treatment programs who report a history of sexual abuse are also likely to report poorer psychosocial functioning, more drug-related problems, and more family-of-origin problems. This study investigates outcome differences at follow-up between women with and those without sexual abuse histories who were treated at an outpatient methadone treatment program. Follow-up interviews were conducted with 98 women, 40% of whom reported prior sexual abuse. Those with a history of sexual abuse who reported problems at intake with psychosocial functioning and family support continued to report such problems at follow-up as compared with the women without a history of sexual abuse. However, no difference was found at follow-up between women with and those without sexual abuse histories in terms of drug use, employment, criminality, or HIV-risky behaviors. The findings suggest that sexual abuse history alone cannot predict treatment outcomes for women in methadone treatment. The implications of these findings are discussed in terms of treatment process and services.