Client Matching: A Severity-Treatment Intensity Paradigm

ABSTRACT

Despite considerable effort to develop matching strategies and client placement protocols, research studies fail to yield compelling results regarding the benefits of matching to treatment. The most consistent findings suggest a matching paradigm, which defines a successful placement as the least treatment intensity required addressing the severity of the disorder. The purpose of the present study is to provide further empirical support for the validity of a severity-intensity paradigm utilizing data from the Drug Abuse Treatment Outcome Studies. A “passive match” approach employed the Client Matching Protocol decision algorithm, which recommended clients to long-term residential or outpatient drug-free treatment. One-year outcomes for clients matched to long-term residential treatment were better on all outcome variables compared to those undertreated in outpatient drug-free treatment. Findings supported the validity of the severity-intensity paradigm in that undertreated clients showed less improvement compared to matched and overtreated clients.

KEYWORDS:

• Client matching
• severity
• drug-use severity
• treatment intensity

This study was funded by the National Institute on Drug Abuse, Grant # 5 R01 DA015787.

Notes

∗ p < 0.05 by Chi-Square or Wilcoxon (Mann-Whitney) test.

∗ p < 0.05 by paired t-test or McNemar test. Cell contents are either percentages or means with standard deviations in parentheses. BL = baseline; 1Y = 1-year follow-up.

^aAn odds ratio greater than 1 indicates that the first treatment condition in the comparison is more effective than second treatment condition (e.g., sufficient LTR was always more effective than undertreatment). Standardized mean differences were converted to odds ratios using the reverse of the simple formula described by Chinn. ³²