Methodological and clinical challenges in evaluating treatment outcome of substance-related disorders and comorbidity

Objective: To review the steps required to develop an outcome evaluation pa ckage and to report on the 12-month outcome of an integrated day program. Method: Based on the identification of salient outcome predictors, standard ized instruments were selected. A cohort of 78 patients was assessed at the time of admission to the program, at discharge, and 3, 6, and 12 months af terward. Results: Improvements were sustained over I year in all areas including tre atment needs, quality of life, readiness to change. Conclusions: The gap between the "cultures" of treatment anti research must be narrowed Following evidence of a program's general effectiveness throug h outcome monitoring, a randomized control design is optimal for specific i nterventions. The optimal length of follow-up depends on the perceived conf ounds.