1. Introduction Results and Conclusions Results: On demographic and social characteristics, ATR completers were more likely to be male, Hispanic, employed, living independently, and to have higher levels of education. By contrast, ATR non-completers were more often Black and relatively younger. ATR completers were more likely to be referred from drug court and had significantly longer stays in the program (177 vs. 160 days). Analyses of voucher service combinations revealed that ATR non-completers were more likely to receive recovery support services only rather than in combination with treatment or treatment only. Among the specific recovery support services, ATR completers more often received individual recovery coaching, relapse prevention group, recovery support group, spiritual support group, life skills group, and marital/family counseling. ATR non- completers were more likely to receive transportation and employment coaching. Overall, ATR completers received a greater number of voucher service types relative to non- completers (3.4 vs. 2.7). When the voucher services are conceptually categorized into direct recovery support (individual recovery coaching, relapse prevention group, recovery support group, spiritual support group, life skills group, and marital/family counseling) and social support (transitional housing, transportation, employment coaching, and childcare), ATR program completers were more likely to receive direct recovery support services, whereas non- completers more often received social support services. Conclusions: Results suggest that the provision of treatment only or treatment in combination with recovery support services are associated with positive outcomes, whereas provision of recovery support services only appears to be associated with negative program outcomes. Further, recovery support service types that are more directly associated with the process of recovery, such as recovery coaching, recovery support, and relapse prevention group, may be most strongly associated with positive outcomes. Other recovery support service types that provide social support, such as transitional housing, transportation, and employment coaching appear to be associated with negative outcomes, particularly in the absence of treatment. Finally, results also suggest that clients under drug court supervision and individuals who are employed, living independently, and have higher levels of education may respond more positively to the ATR program. These findings suggest that in recovery- oriented systems of care models, the types of service combinations provided may be important considerations in program design and that direct recovery support services may be a critical ingredient in enhancing client outcomes within the continuum of care. Acknowledgements Presented at the Addiction Health Services Research Conference, Boston, October 21, 2008 Mean Number of Days in ATR Program Addiction Treatment and Recovery Support Service Combinations The Access to Recovery Grant encompasses a recovery- oriented systems (ROSC) of care model in the treatment of addiction. The ROSC model employs a person-centered and self-directed approach to sustaining health and wellness in which individuals choose their own path to recovery. ROSCs also provide a broad range of recovery support services that assist individuals in multiple life areas to build on personal strengths and to enhance resilience in the recovery process. The extant literature examining the effect of recovery support services is limited and generally confined to studies of wrap-around service provision in mental health treatment settings. Further, research regarding the effectiveness of specific types of services or service combinations in enhancing engagement in the recovery process is particularly lacking. In Texas, the Access to Recovery (ATR) project provides voucher monies for addiction treatment and/or recovery support services to drug court participants, probationers, and individuals involved with Child Protective Services. Key components of the ATR project include independent assessment to determine individual service needs and the provision of client choice among an array of service providers, including faith-based and community organizations. Recovery support services in the Texas ATR program include individual recovery coaching, relapse prevention group, recovery support group, spiritual support group, life skills group, family/marital counseling, transitional housing, transportation, employment coaching, GED assistance, and childcare. The current study examines client and voucher service characteristics associated with successful completion of the ATR program. The purpose of the current study is to examine the relations among client characteristics, addiction treatment, and recovery support service types associated with program outcomes. The authors acknowledge Lesli San Jose, Decision Support Research Specialist at the Texas Department of State Health Services (TDSHS), Mental Health and Substance Abuse Services Division for her assistance in providing raw data for this study. The author has no financial relationships associated with the topic of this presentation. 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. Sample and Method The sample consisted of 4,564 clients who entered and were terminated from the ATR program during the period of June 2005 and January 2008. Assessment providers rated 32% of the sample as successfully completing the ATR program, resulting in group sizes of 1,470 in the ATR completer group and 3,094 in the ATR non-completer group. ATR program completers and non-completers were compared on client and voucher service characteristics. Demographic and voucher service utilization data were obtained from the Behavioral Health Integrated Provider System, which is the mandatory data collection and outcomes monitoring system for state funded programs in the state of Texas. Continuous variables were analyzed using t-tests and categorical variables were assessed using X 2 tests. Client and Service Characteristics Client and Service Characteristics Associated with Successful Completion of the Texas Access to Recovery Program Laurel Mangrum, PhD a & Karen Eells, MSSW, LMSW b a University of Texas at Austin, Addiction Research Institute b Texas Department of State Health Services ATR Recovery Support Service Categories Demographic and Social Characteristics ATR Recovery Support Services Received ATR Program Completion by Referral Source