A field application of the ASAM placement criteria in a 12-step model of treatment for chemical dependency

Procedures followed in the development of a standardized method of rating patient behavior relevant to engaging in a 12 step model of recovery are presented in the context of deriving an empirical cross-walk for the ASAM PPC. This instrument permits addictions counselors to rate the severity of operationally defined behaviors on each of the six criteria dimensions identified in the adaptation of the PPC by the WV Division on Alcoholism and Drug Abuse for use in the 14 member community mental health centers funded by the state. Substance dependent adults (N = 78), who self-selected either residential or partial day treatment at EastRidge's Addictions Treatment Center were evaluated with this procedure over a nine month period. Intercorrelations of ratings on six criteria dimensions at intake ranged from .053 to .576 and after an average length of stay of 18 days, behavioral severity on all dimensions was significantly reduced (p < .0001) on the discharge evaluation with this tool. An empirically based, treatment matching matrix, was constructed from confidence intervals calculated obtained from intake data to form norm referenced ranges for four levels of care (which equate to PPC-2 Levels: III.5, II.5, II.2, I). The utility of this methodology in facilitating the application of the WVPC and PPC-2, and the potential of the DRS as a multiple baseline measure in treatment outcome research is discussed.