A comparison of three methods of measuring the type and quantity of services provided during substance abuse treatment.

This study examined three data collection methods of quantifying and categorizing treatment services provided in a publicly funded methadone program. All three approaches were research technician implemented: (1) bi-weekly patient interview with the Treatment Services Review (TSR); (2) weekly counselor interview by the Counselor Services Interview (CSI); and (3) data abstraction from clinical patient records (REC). Fifty patients were followed over 28 days using each method to assess the services received/provided within the program. Five service domains were assessed: medical, employment, alcohol/drug, family, and psychiatric. Correlations were calculated among the three methods of data collection across each of the five service domains. Overall, low to moderate correlations were found with the highest rates of agreement detected between the TSR and the REC in the employment domain (0.48) and the REC and CSI in the family domain (0.48). Post hoc focus groups with the counselors and patients found that: (1) counseling sessions rarely focused on specific problem domains; (2) counselors and patients disagreed about the quality of treatment services; and (3) counselors 'rounded-up' time spent counseling. These findings suggest that measuring treatment service delivery varies markedly based on who provides the information (e.g. patient or treatment staff) and what procedures are used for data collection (e.g. chart abstraction or self-report).