Relating counselor attributes to client engagement in England.

Client functioning and treatment engagement were examined in relation to staff attributes and organizational climate across a diverse sample of drug treatment and outreach programs in England. Self-rating assessments were obtained from 1,539 clients and 439 counselors representing 44 programs, and results were interpreted using comparable data from studies of treatment programs in the United States. Client scores on treatment participation and counseling rapport in England were directly related to their higher levels of motivation and psychosocial functioning, as well as to staff ratings of professional attributes and program atmosphere. By linking records from English clients with their counselors in each program, findings also indicate these relationships are rooted in the personal interactions between clients and their counselor. Standardized assessments of treatment structure, process, and performance used across therapeutic settings and national boundaries show there is generalizability in the pattern of clinical dynamics, including the relationships between organizational functioning and quality of services.

Node-link mapping in individual counseling: treatment impact on clients with ADHD-related behaviors.

Three types of individual drug abuse counseling were investigated in a private methadone clinic in order to replicate and extend previous work on node-link mapping techniques (two dimensional graphic approaches for visualizing problems and solutions). Standard counseling, enhanced counseling with free-form maps (f-maps), and enhanced counseling with both f-maps and guide-maps (g-maps) were compared at six and 12 months of treatment. Also assessed were differential effects of these counseling conditions on clients with low and high levels of behaviors related to attention deficit hyperactivity disorder (ADHD; low-problem versus high-problem clients). Dependent variables included the number of scheduled sessions attended per month, counselor ratings of session characteristics (e.g., powerful, valuable), client psychological status ratings (i.e., self-esteem, depression, and anxiety) and treatment retention (i.e., the number of months clients remained in treatment). Findings replicate and extend prior work indicating the positive impact of using node-link maps in individual drug abuse counseling. Particular benefits were found for clients with high levels of ADHD-related problems.