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remains a “black box.”

Researchers using the DATOS data, which include some information about the structures, environments and other relevant characteristics of substance abuse treatment programs (in addition to extensive patient-level information), also generate consistent findings about the effectiveness of clinical treatment practices, while at the same time observing variation in their implementation across programs.  Hubbard et al. (1997), for example, used the DATOS one-year follow-up data and found treatment duration to be one of the most significant correlates with positive treatment outcomes across different treatment modalities.  They also concluded, however, that the full potential of treatment is not achieved for all patients, and that “more complex questions of access to, use of, and effectiveness of core comprehensive therapies and services for diverse patient sub-populations with different lengths of exposure to treatment” need to be investigated. (276)

In studying the relationship of counseling and self-help activities to DATOS patient outcomes, Etheridge et al. (1999) similarly pointed out that while treatment duration, treatment retention, counseling, psychological impairment, and regular participation in 12-step self-help groups have been associated with post-treatment outcomes in a multitude of studies, the ability of programs to provide these services effectively varies considerably.  They suggested that the inconsistent relationship between treatment services and outcomes may be explained in part by variation in program administration, or in the extent to which programs are able to target treatment and services to patients’ needs.  In their regression models that predicted service receipt and program outcomes, Etheridge et al. found that the simple “program attended” indicator was one of the most significant explanatory factors.

Broome, Simpson and Joe (1999) add that poor treatment results are commonly assumed

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