1. Chapter 17 Subset of Overview by Type of Treatment GAIN Coordinating Center (11/21/2012). Normal, IL: Chestnut Health Systems. November 2012. Available from www.gaincc.org/slideswww.gaincc.org/slides Created for: Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) under contract number 270-2012-00001

2. 2 SAMHSA/CSAT Full GAIN Outcome Data Set Sample: The 2011 SAMHSA/CSAT data set includes data on 29,782 clients from 230 local evaluations, recruited between 1997-2011 who were due for at least one follow-up and available in the last quarterly data set of 2011. Levels of Care: Outpatient, Intensive Outpatient, Short-term & Moderate/Long-term Residential, Corrections-Based Treatment and Post-Treatment Continuing Care Instrument:Global Appraisal of Individual Needs (GAIN) (see www.gaincc.org/gaini) Versions 3 (CYT & ATM) and 5.1 through 5.6 www.gaincc.org/gaini Follow-up:89% with one or more follow-ups at 3, 6, 9 & 12 months post intake, and 66% with two or more Funding: SAMHSA/CSAT contracts 270-07-0191 and 270- 2012-00001 and 230 individual grants (see Detailed Acknowledgement)

3. 3 Type of Treatment Local Tx Manual: Specific Manualized Treatment 6.6% (n=1,895) MET/CBT: Motivational Enhancement Therapy/Cognitive- Behavioral Therapy 36.5% (n=10,543) Other: Non-Manualized Treatment 17.8% (n=5,140) Other EBTx: Evidence Based Treatment 10.9% (n=3,158) A-CRA/ACC: Adolescent Community Reinforcement Approach/ Assertive Continuing Care 28.2% (n=8,144) SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,880)

4. 4 Risk and Protective Factors by Type of Treatment  The following slides present information on demographics, and risk and protective factors by different age groups for clients at intake, including:  Demographics  Substance use  Risk behaviors  Victimization  Mental health disorders  Physical health problems  Crime and violence  Sources of stress and strengths  Costs  Summary indices (problem prevalence, quality of life, general satisfaction)  Non-client characteristics (program, level of care, and type of treatment)

5. 5 Age by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,880)

6. 6 Gender by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,869)

7. 7 Race by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,866)

8. 8 8 Risk of Homelessness by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,745)

9. 9 Past Year Substance Severity by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,510)

10. 10 Primary Substance by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,815)

11. 11 Number of Substance Problems by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,815)

12. 12 Tobacco Diagnosis by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,490)

13. 13 HIV Risk Scale* by Type of Treatment * Available at intake only. SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,847)

14. 14 HIV Risk Change Index* by Type of Treatment *Can be used to measure change. SAMHSA 2011 GAIN Summary Analytic Data Set (n=25,973)

15. 15 Number of Sex Partners* by Type of Treatment *In the past 90 days SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,867)

16. 16 Severity of Victimization by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,607)

17. 17 Mental Health Disorders by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,789)

18. 18 Homicidal/Suicidal Thoughts by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,577)

19. 19 Health Problems by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,583)

20. 20 Health Care Utilization Cost* by Type of Treatment *Using 2011 Dollars SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,604)

21. 21 Crime & Violence by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,809)

22. 22 Type of Crime by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,492) * Violent crime includes assault, rape, murder, and arson. ** Other crime includes vandalism, possession of stolen goods, forgery, and theft.

23. 23 Cost of Crime* by Type of Treatment *Using 2011 Dollars SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,516)

24. 24 Intensity of Justice Involvement by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,726)

25. 25 Count of Major Clinical Problems* at Intake by Type of Treatment *Based on count of self reporting criteria to suggest alcohol, cannabis, or other drug disorder, depression, anxiety, trauma, suicide, ADHD, CD, victimization, violence/ illegal activity SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,880)

26. 26 Sources of Stress Index by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,590)

27. 27 Treatment Readiness by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,464)

28. 28 Self-Help Activities by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=8,342)

29. 29 Strength Self-Efficacy Index by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,641)

30. 30 General Social Support Index by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,715)

31. 31 Spiritual Social Support by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,468)

32. 32 Environmental Strengths Index by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,730)

33. 33 Quarterly Cost to Society* by Type of Treatment *Using 2011 Dollars SAMHSA 2011 GAIN Summary Analytic Data Set (n=25,861)

34. 34 Problem Prevalence Index by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,712)

35. 35 Quality of Life by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=21,688)

36. 36 General Satisfaction by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,279)

37. 37 Program by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,880)

38. 38 Level of Care by Type of Treatment SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,849)

39. 39 Outcomes  The following slides present information on the outcomes of substance abuse treatment by type of treatment, including:  Abstinence  Recovery  GPRA outcomes (vocationally engaged, housed, no justice system involvement, social consequences, abstinence, and social connectedness) and  NOMS outcomes (treatment initiation, engagement and continuing care; no problems with: health, mental health, family, illegal activity; abstinent, vocationally engaged and housed).  Data on follow up rates, months to last follow up, and number of follow ups per client are provided in the Methods Appendix.Methods Appendix

40. 40 Percent Change in 6 Month Abstinence by Type of Treatment SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=19,584)

41. 41 Relative Percent Change in 6 Month Abstinence by Type of Treatment SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=19,584)

42. 42 Past Month AOD Abstinence by Type of Treatment *Interpolated SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

43. 43 Recovery* by Type of Treatment *Recovery defined as no past month use, abuse, or dependence symptoms while living in the community. SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups **Interpolated

44. 44 Change in GPRA Outcomes by Type Of Treatment (Intake to Last Wave*) MET/ CBT ACRA/ ACC Other EBTx Local Tx Manual Other *Last wave is the last follow-up SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

45. 45 NOMS Outcome: Number of Treatment Received Outcomes Met* by Type of Treatment *Based on a count of initiation within 14 days, evidence based practice, engagement for at least 6 weeks, and any continuing care. SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=23,814)

46. 46 SAMHSA Outcome: Treatment Cost Bands by Type of Treatment SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=17,050)

47. 47 Change in Selected NOMS Outcomes by Type of Treatment (Intake to Last Wave) MET/ CBT Other EBTx ACRA/ ACC Other Local Tx Manual *Past monthSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

48. 48 NOMS Outcomes: Count of Positive Outcomes (Last FU–Intake) by Type of Treatment SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=24,700)