Integrative modeling of client engagement and outcomes during the first 6 months of methadone treatment

Integrative models containing client and treatment components were tested i n a sample of 396 daily opioid users from three methadone maintenance treat ment sites. Measures included client motivation at intake as well as repeat ed assessments of therapeutic engagement (relationships between clients and their counselors, session attendance, and results of urine testing) during the first 6 months of treatment. There was a positive effect of pretreatme nt motivation on greater engagement and a reciprocal positive relationship between components of engagement and their effects on lowering drug use thr oughout treatment. Further analyses addressed differential effects of group versus individual counseling and showed that group session attendance was associated with higher rates of drug-negative urines. (C) 1999 Elsevier Sci ence Ltd.