Effectiveness of high versus low structure individual counseling for substance abuse

Outcomes during treatment were compared for inner-city drug-dependent individuals randomly assigned to high-structure, behaviorally-oriented (HSB) or to low-structure, facilitative (LSF) individual counseling. No group differences were found for symptom reduction, patient and counselor ratings of benefit, retention, or drug free urines. However, the more depressed and "helpless" clients showed significantly better control of substance use in HSB counseling, while the less depressed and helpless patients realized better control in LSF treatment. These results suggest that outcomes might be improved by matching patients to high- and low-structure counseling based on their pretreatment levels of depression and learned helplessness.