Clinicians' impact on the quality of substance use disorder treatment

Clinicians' impact on substance use disorder treatment has been much less s tudied than therapy and patient variables. Yet, in this selective review of literature, a growing body of empirical work on clinicians' impact highlig hts several key issues that have relevance both to clinical practice and fu ture research. These issues include clinicians' effect on treatment retenti on and outcome, professional characteristics, recovery status, adherence to protocols, countertransference, alliance, personality, beliefs about treat ment, and professional practice issues. Specific recommendations are offere d to help improve the quality of care clinicians provide. In particular, it is suggested that greater accountability for clinicians' performance be ba lanced with increased support for their very difficult role. Methodological issues in studying clinicians are also addressed.