Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 28Matching and Differential TherapiesProviding Substance Abuserswith Appropriate TreatmentKATHLEEN M. CARROLLBroadly defined, matching individuals to treatment means providing the individualwith the treatment approach that is likely to maximize outcome. Thepast 20 years have been marked by both tremendous progress and increasingmethodological rigor in substance abuse research, and hence, the developmentof a much wider range of empirically supported pharmacotherapies and behavioraltherapies. Availability of a broader range of therapies has likewise heightenedinterest in differential treatment research, whether it be matching individualsto specific treatment approaches, matching patients to different levelsof services, or identifying predictors of response to specific therapies.To date however, empirical evidence supporting specific, a priori matchingstrategies has been modest at best (Magura et al., 2003; McKay, Cacciola,McLellan, Alterman, & Wirtz, 1997; McLellan & McKay, 1998; ProjectMATCH Research Group, 1993, 1997), in part due to the complexity of treatmentdecisions for many patients, who typically present for treatment with acomplex array of substance use, psychiatric, legal, medical, and social problems,as well as limits of the service delivery system in accommodating the needs ofdiverse patients (Gastfriend, Lu, & Sharon, 2000). The complexities and challengingmethodological requirements of matching research have also hamperedprogress in this area (Moyer, Finney, Elworth, & Kraemer, 2001).There is some more consistency in the literature, however, regardingpatient prognostic variables that have emerged across patient populations.637