How Can Treatment and Clients Inform

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How Can Treatment and Clients Inform and
Influence Research on Substance Use
Disorders? Rudolf H. Moos Center for Health
Care Evaluation Veterans Affairs Health Care
System and Stanford University Palo Alto,
California
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Principles What We Have Learned from Treatment
and Clients
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Principle 1
Treated or untreated, an addiction is not
an island unto itself
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Principle II
Common dynamics underlie the process of problem
resolution in formal treatment, informal care,
and natural recovery
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Principle III
Treatment settings and counselors who establish a
therapeutic alliance, are goal-oriented, and are
moderately structured, tend to promote positive
outcomes
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Principle IV
Treatment programs with quite diverse ideologies
are effective in reducing substance use and
improving psychosocial outcomes
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Unresolved PuzzlesQuestions Raised by Treatment
and Clients
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Puzzle 1
How can we best conceptualize and examine service
episodes and treatment careers?
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Puzzle II
What is the role of the health care work
environment in treatment process and outcome, and
in shaping clinicians morale and openness to
innovation?
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Puzzle III
How can we better understand the connections
between the theory, process and outcome of
treatment
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Puzzle IV
How can we identify effective patient-treatment
matching strategies?
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Puzzle V
How can we integrate formal substance abuse
treatment and clients participation in self-help
groups?
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Evidence-Based Practices and Paradigm
Transformation