1. Introduction Results and Conclusions On counselor background variables, no differences were found between the MH and SA COSPD specialists on race/ethnicity, total years of counseling experience, or amount of COPSD training in the past year. The provider groups did display differences in the areas of experience and education. Although the two groups were essentially equivalent in years of general counseling experience, MH providers reported significantly more years of providing COPSD counseling services compared to SA specialists. The SA providers had a significantly higher proportion of individuals with graduate degrees relative to the MH providers. In the area of professional credentials, the two groups had approximately equal percentages of licensed chemical dependency counselors, other professional counselors, and paraprofessionals; however, the SA providers had a greater number of clinical interns providing services. Analyses of the CODECAT results indicated that the MH counselors rated themselves as having lower competencies in knowledge and skills on two of the nine best practice principles: Principle 6: Disease and Recovery Model with Parallel Phases of Recovery and Stages of Change/Stages of Treatment, and Principle 7: Individualization of Treatment. These two principles emphasize the concepts of phases of recovery, stages of change, phases of treatment, and treatment matching. Comparisons of COPSD client demographics by service setting revealed that clients in MH centers were more likely to be male, non-Hispanic, older, and not in the labor force. In the area of psychiatric diagnoses, MH clients were more often diagnosed with bipolar disorder and schizophrenia, whereas as clients in SA centers had the highest rates of depressive disorders (X 2 = 77.31, p <.0001). Analyses of substance abuse treatment history indicated that the MH group had a higher incidence of previous non- detox treatment and had attended AA meetings more frequently in the 30 days prior to admission. Substance use patterns also differed between the groups. Clients in SA centers had greater rates of cocaine as the primary substance of abuse, had used their primary substance more days in the past month, and were more likely to engage in daily substance use. MH clients were more likely to use marijuana and engage in polysubstance use relative to SA clients. A number of treatment characteristics were also found to be significantly different between clients in MH and SA centers. MH clients were predominantly treated in outpatient settings and had longer length of stay in treatment. SA clients had higher rates of residential placement and more often completed treatment relative to MH clients. At discharge, clients in SA centers were more likely to be abstinent, to have attended AA in the past 30 days, and to have close people supporting their recovery. Clients in MH centers were more often in living situations with exposure to alcohol or drugs at discharge. Findings of this study suggest significant differences between MH and SA settings in Texas in both the client population base and counselor perceptions of competency. The results of the COSPD specialist counselor survey indicate that with the exception of the greater percentage of graduate degrees in the SA providers, the counselors are generally similar in their training backgrounds, years of counseling experience, and professional certifications. Despite the MH group’s greater length of experience providing COPSD services, the MH providers rated themselves lower in knowledge and skill competencies in the areas of stages of change, recovery models, and treatment matching concepts and may benefit from enhanced training in these areas. Analyses of COPSD client characteristics also suggest differences in psychiatric diagnoses, substance use severity, and treatment environment between the MH and SA settings. Identification of these types of distinctions in client base may inform development of training in evidence-based practices tailored to each setting’s characteristics. Acknowledgements Presented at the Addiction Health Sciences Research Conference, Santa Monica, California, October 25, 2005 Psychiatric Diagnoses CODECAT Scale Scores Demographics Treatment History and Substance Use Numerous studies have documented the high incidence of co-occurring psychiatric and substance use disorders (COPSD) in clients presenting for either substance abuse or mental health treatment. Knowledge of this substantial prevalence has resulted in the development of a variety of treatment interventions designed to address both psychiatric and substance use issues. Adaptation of both the substance abuse and mental health treatment systems is an inherent and crucial element in the evolution of specialized COPSD services. Few studies have examined features of these two service systems within the context of COPSD treatment. The current study compares counselor, client, and substance abuse treatment characteristics of state-funded programs in Texas providing treatment for COPSD in either a mental health (MH) or substance abuse (SA) treatment setting. Identification of unique features of these systems in the treatment of COSPD may assist in targeting distinct training needs in MH versus SA programs. Demographics and Training The authors acknowledge the Texas Department of State Health Services (TDSHS), Mental Health and Substance Abuse Treatment Division for their assistance in providing data for this study. The findings and conclusions of this in this presentation are the opinions of the authors and do not necessarily reflect the official position of TDSHS. Counselor Characteristics Sample and Method The counselor sample consisted of 96 COPSD specialists providing services in state- funded mental health and substance abuse treatment centers in Texas (MH: n = 42; SA: n = 54). Counselors completed a background survey and the Co-Occurring Disorders Educational Competency Assessment Tool (CODECAT; Minkoff, 1998). The CODECAT is an assessment tool that measures self-perceived clinical competencies associated with nine best practice principles developed by the SAMHSA Managed Care Initiative Panel on Co-Occurring Disorders. The CODECAT was administered on-line for an 8-day period. Participation in the survey was voluntary and anonymous, and resulted in a response rate of 67% of the statewide COPSD personnel. The survey results were compared between COPSD specialists working in mental health versus substance abuse treatment centers. The client sample consisted of 4,981 COPSD clients who were served in these programs during the same fiscal year that the survey was conducted (MH: n = 2,038; SA: n = 2,943). Clients were contrasted by service setting using data from BHIPS, the mandatory data collection and outcomes monitoring system for state-funded substance abuse treatment programs in Texas. Clients were compared on demographic, admission, treatment, and discharge characteristics to assess for potential differences between mental health and substance abuse treatment settings. Continuous variables were analyzed using between-groups t-tests and Chi-square analyses were used to examine categorical variables. Discharge Characteristics COPSD Client Characteristics Treatment Environment Treatment of Co-Occurring Psychiatric and Substance Use Disorders in Mental Health Versus Substance Abuse Service Systems Laurel Mangrum & Richard Spence University of Texas at Austin, Addiction Research Institute