A comparative evaluation of substance abuse treatment - III. Examining mechanisms underlying patient-treatment matching hypotheses for 12-Step and cognitive-behavioral treatments for substance abuse

This study examined several hypotheses for matching patients to 12-Step and cognitive-behavioral (CB) treatments in a multisite evaluation of VA inpat ient substance abuse programs. A total of 804 male patients in five 12-Step programs, and 1069 male patients in five CB programs completed an intake, discharge, end 1-year follow-up questionnaire, The findings did not support the notion that certain patient characteristics would differentially predi ct better outcomes after 12-Step and CB treatment. This conclusion held whe n the pure est 12-Step and CB programs were used, and when patients who rec eived the full dose of treatment (i.e., treatment completers) were examined separately. Process analyses of the hypothesized mechanisms underlying the patient-treatment matching effects did not yield the expected links among patient characteristics, proximal outcomes, and 1-year outcomes. Our conclu sion is that there is no advantage to matching men with substance abuse pro blems to 12-Step or CB treatments based on the patient attributes measured here.