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Clinical Assessment and Substance Abuse Treatment

The Target Cities Experience

Richard C. Stephens

Publication Year: 2003

During the 1990s, in response to the multi-faceted phenomenon of substance abuse, the federal government’s Center for Substance Abuse Treatment funded the Target Cities project in nineteen U.S. cities. This volume evaluates how the Target Cities project affected both treatment systems and individuals with drug and alcohol problems. In each city, programs were established to evaluate the impact of these substances on an individual’s mental and physical health, housing, family relationships, and involvement with the criminal justice system. A brief summary of the evolution of national perceptions of drug and alcohol problems is followed by a description of the project, its participants, the process of entering treatment, an organizational analysis of the project’s many components, participant satisfaction and adjustment, and the implications of the research findings for policy makers and treatment personnel.

Published by: State University of New York Press

Series: SUNY series, The New Inequalities

Clinical Assessment and Substance Abuse Treatment

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pp. vii-viii

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pp. ix-x

The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment. The authors wish to acknowledge the leadership and support of the staff at the Substance Abuse and Mental ...

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1. Background and Overview of the Target Cities Demonstration Program

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pp. 1-16

This volume is an effort to describe the experiences and results of a large, federally funded substance abuse research project known as Target Cities, which was designed to address a multitude of challenges inherent in the country’s approach to treating substance abuse. These challenges included poor treatment infrastructure, accessibility ...

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2. Methodological Issues in the Development of the Target Cities Multisite Databases

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pp. 17-34

Unlike small, localized data collection efforts of the past, the Target Cities Program offered researchers an unprecedented opportunity. Through substantial federal funding over a period of 5 years, in 10 major U.S. cities, CSAT was poised to collect demographic, treatment, and outcome data from thousands of participants in substance abuse ...

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3. Participants in the Target Cities Program

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pp. 35-54

An aim of the Target Cities Program was to provide comprehensive assessment of individuals seeking referral to public sector treatment for substance abuse problems. Local Target Cities projects, driven by the common goal of centralizing the admission process, served a wide variety of individuals who sought assessment or treatment ...

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4. Identifying Service Needs among Substance Abuse Treatment Participants

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pp. 55-72

Each Target Cities site created a centralized intake and assessment function in the community. Centralization was designed to provide rapid access to an array of services, both inside and outside of the substance abuse treatment system, to address the many co-occurring needs of the individuals seeking treatment. Such accessibility ...

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5. The Target Cities Participants: From Centralized Intake to Treatment Entry

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pp. 73-86

An individual’s access to substance abuse treatment can be influenced at multiple points in any particular treatment system. To gain entry to treatment, an individual must typically identify a provider, contact that provider for an appointment, attend and complete a pretreatment assessment, obtain a referral and a starting date ...

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6. Effects of Centralized Intake on Participant Satisfaction with Treatment and Ancillary Services

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pp. 87-102

Monitoring participants’ satisfaction with service components is an important aspect of managing any treatment system, but it is of particular importance when implementing systemic changes of the magnitude proposed in the Chicago Target Cities project. As with any demonstration program, prior to implementation, the extent to which ...

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7. Implementation of Selected Target Cities Components: Analysis of Matching, Case Management, and Linkages

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pp. 103-128

The preceding chapters have described aspects of a centralized intake unit in the Target Cities Program and the people who presented themselves for assessment at them. In addition to a CIU, all Target Cities sites also had a management information system (Hile, 1998). Based upon those structural components, each of the Target Cities sites was then required to match participants to treatment ...

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8. Does Centralized Intake Improve Substance Abuse Outcomes? A Multisite Analysis

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pp. 129-148

In recent years several factors have drawn attention to the problems of increasing access to, and improving outcomes of, substance abuse treatment. There is a growing national awareness of the economic costs of substance abuse, an understanding that these costs are borne largely by the public sector, a realization that ...

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9. Outcomes Before and After Implementing Centralized Intake Services

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pp. 149-164

The Chicago Target Cities Project was designed as a system-level change and was implemented primarily with the intent of altering the method by which individuals access publicly funded substance abuse treatment. Although it was not intended to specifically change the treatment services participants received, there were reasons to believe ...

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10. Effectively Assessing and Preparing Inmates for Community Substance Abuse Treatment: The Portland Target Cities Project In-Jail Intervention by Michael W. Finigan, Nancy Barron, and Shannon Carey

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pp. 165-178

A hallmark of the Target Cities Program, with its emphasis on system change, was the importance placed on the development of linkages between the substance abuse treatment system and the legal system. CSAT allowed limited Target Cities funds to support treatment and pretreatment enhancements for individuals in correctional ...

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11. Lessons Learned from the National Target Cities Initiative to Improve Publicly Funded Substance Abuse Treatment Systems

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pp. 179-200

At the start of the Target Cities Program, the nation’s approach to substance abuse treatment suffered from several long-standing inadequacies: weak infrastructure, inconsistent quality of services, limited access to treatment, and inadequate service coordination and continuity. Authors of the previous chapters have illustrated those ...


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pp. 201-214


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pp. 215-224


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pp. 225-233

E-ISBN-13: 9780791487518
Print-ISBN-13: 9780791455937
Print-ISBN-10: 0791455939

Page Count: 243
Illustrations: 35 tables, 10 figures
Publication Year: 2003

Series Title: SUNY series, The New Inequalities

Research Areas


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Subject Headings

  • Drug abuse -- United States.
  • Drug abuse -- Treatment -- United States.
  • Alcoholism -- United States.
  • Alcoholism -- Treatment -- United States.
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