Treatment structure, client coping methods, and response to brief individual counseling: preliminary findings in a...

In this paper we report preliminary treatment outcome findings for the first 16 substance abuse patients who volunteered and qualified for a 12-week research-treatment program. Eight patients were exposed to a high-structure, behaviorally-oriented (HSB) individual counseling style, while the remaining eight were exposed to a low-structure, facilitative (LSF) style. 'Counselor effects' were controlled by having each of four counselors conduct both styles (two patients each) in serial but counterbalanced order; under these conditions treatment outcomes did not differ for patients randomly assigned to the different counselors. Outcomes also did not differ for the HSB and LSF clients with regard to retention, drug and alcohol use during treatment or for reported symptom reduction during the program as measured by the Addiction Severity Index. Though the LSF clients reported receiving more treatment benefits than did the HSB patients in their post-session ratings, this was not confirmed in the counselors' post-treatment ratings or in the other treatment response measures. Finally, with a few exceptions, patients scoring higher versus lower on four measures of coping, including conceptual and developmental levels of functioning, field independence and social independence, did not differ in their treatment outcomes.