1. Recovery Support Services and Client Outcomes: Results of Two Interim Evaluations in Texas College on Problems of Drug College on Problems of Drug Dependence Conference June 15, 2008

2. The author has no known conflicts of interest or financial relationships associated with the topic of this presentation. The author has no known conflicts of interest or financial relationships associated with the topic of this presentation.

3. Recovery Oriented Systems of Care Projects in Texas Access to Recovery (ATR) Co-Occurring State Incentive Grant (COSIG)

4. Texas ATR Project

5.  Targets individuals who are involved in the criminal justice system through drug courts, probation, or child protective services  Provides independent assessment to determine service needs and client choice among an array of service providers, including faith-based and community organizations

6. Texas ATR Voucher System  Clinical Assessment  Care Coordination  Addiction Treatment  Individual Recovery Coaching  Spiritual Support Group  Relapse Prevention Group  Life Skills Group  Recovery Support Group  Transitional Housing  GED Assistance  Employment Coaching  Marital and Family Counseling

7. ATR Interim Evaluation  Study examines outcomes of 825 individuals who received ATR services during the period of June 2005 and September 2006  Assessment providers rated 38% of the sample as successfully completing the ATR program  Successful completers of the ATR program (n = 311) were compared to non-completers (n = 514) on recovery support service characteristics

8. Recovery Support Service Utilization

9. Categories of Recovery Support Services Direct Recovery Support  Individual Recovery Coaching  Recovery Support Group  Relapse Prevention Group  Spiritual Support Group  Life Skills Group  Family and Marital Counseling Social Support  Employment Coaching  Transportation  Transitional Housing  GED Assistance  Childcare

10. Categories of Recovery Support Services Received * *

11. Texas COSIG Project

12. Texas COSIG Project Key Components  Training of addiction counselors on co- occurring disorders and the use of diagnostic and assessment instruments to improve identification of comorbidity and monitor client progress  A voucher system that provides recovery support services to enhance the treatment process ($1800 per client)

13. COSIG Voucher Service Categories  Child Care  Housing Support  Transportation  Food Assistance  Education Support  Employment Assistance  Clothing  Medical Care  Prescriptions  Peer Mentoring

14. COSIG Interim Evaluation  Data were obtained for 424 COSIG clients who entered and were discharged from addiction treatment during the period of February 2005 through October 2006  76% of the sample completed treatment  Treatment completers (n=323) and non- completers (n=101) were compared on recovery support service characteristics

15. Recovery Support Services Received During Treatment

16. Recovery Support Service Combinations

17. Conclusions  The types of recovery support services received may have a differential effect on client outcomes  Direct recovery support services may be essential components in an individual’s service array  Provision of social supports alone may be less effective in enhancing client outcomes

18. Future Research Needs  Successful completion of the ATR program or treatment is only one method of defining outcomes; other studies are needed using a wider array of outcome measures  More studies are needed to explore the effect of various service combinations on client outcomes  Longitudinal studies are needed to examine the lasting effects of recovery support services on sustaining the process of recovery

19. Acknowledgements Texas Department of State Health Services Karen Eells, MSSW, LMSW ATR Project Director Kwame Bruce, Psy.D. COSIG Project Director Lesli San Jose Decision Support Research Specialist Substance Abuse and Mental Health Services Administration