A NATURALISTIC COMPARISON OF OUTCOMES AT SOCIAL AND CLINICAL MODEL SUBSTANCE ABUSE TREATMENT PROGRAMS

Since the 1970s, much of the public treatment system in California has been based on a social model orientation to recovery for alcoholics, but there has been minimal research on program outcomes. This article reports on follow-up interviews conducted with a representative sample of 722 people who had entered treatment about a year earlier in public and private programs, including publicly-funded social model detoxification and residential programs, and clinical model programs in hospitals and HMO clinics. Social model clients came to treatment with more severe legal and employment problems, whereas those seeking treatment at clinical programs reported more severe family problems. At follow-up, clients at both types of programs reported attending a similar number of Alcoholics Anonymous (AA) meetings, but social model clients reported going to more Narcotics Anonymous (NA) meetings and being involved in more AA activities. Social model clients were less likely than clinical model clients to report problems with alcohol or drugs at follow-up, but the odds of reporting other problems (e.g., medical, psychological, legal, family/social) were similar. The program effect for better alcohol outcomes at the social model programs was partially *This research was supported by the National Institute for Alcohol Abuse & Alcoholism (NIAAA grants R01 AA09750-04 and P50 AA05595) and the Center for Substance Abuse Treatment (CSAT)/National Evaluation Data Technical Assistance Center (NEDTAC contract 270-94-0001).