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Abstract
The aim of this study was to compare the progress of clients attending two substance misuse treatment agencies. A wide range of problems were recorded at 1, 3-6, and 12 month intervals; these included measures of substance misuse and dependence together with social problems and physical and mental health problems. Differences in outcome between the two agencies were entirely attributable to the number and severity of a range of problems rather than simply to severity of dependence or differences between the agencies themselves. This raised questions of how treatment outcomes are understood and explained, and the usefulness of therapeutic models per se.