Original ArticlePredictors of Change in the Provision of Services Within Outpatient Substance Abuse Treatment ProgramsKnight, Danica Kalling PhD; Edwards, Jennifer R. PhD; Flynn, Patrick M. PhDAuthor Information Institute Behavioral Research, Texas Christian University, Fort Worth. Correspondence: Danica Kalling Knight, PhD, Institute Behavioral Research, Texas Christian University, Fort Worth, TX 76129 ([email protected]). This work was supported by grant R01 DA014468 from the National Institute on Drug Abuse. The interpretations and conclusions, however, do not necessarily represent the position of the National Institute on Drug Abuse, National Institutes of Health, or Department of Health and Human Services. More information (including data collection instruments that can be downloaded without charge) is available on the Internet at www.ibr.tcu.edu, and e-mail can be sent to [email protected]. The authors thank the Gulf Coast, Great Lakes, Northwest Frontier, and South Coast Addiction Technology Training Centers for their assistance with recruitment and training. They also thank staff at the individual programs, who participated in assessments and training in the Treatment Costs and Organizational Monitoring project. Journal of Public Health Management and Practice: November/December 2010 - Volume 16 - Issue 6 - p 553-563 doi: 10.1097/PHH.0b013e3181cb4354 Buy Metrics AbstractIn Brief The current study examines patterns and predictors of change over a 2-year period in whether outpatient core and wraparound services are offered on-site or by referral. A sample of 69 outpatient nonmethadone programs from 4 US regions provided organizational information across a 2-year period. Services provided within outpatient substance abuse programs were relatively stable over time, particularly with regard to core therapeutic services. The use of referral networks to provide a broader array of wraparound services increased, with programs adding services that reflect recent national initiatives toward program improvement, namely pharmacotherapy, medical diagnosis and treatment, and psychiatric services. Organizational factors such as parent affiliation, counselor caseload, staff size, budget change, and proportion of dually diagnosed clients were related to change in core and wraparound services. Dynamic organizational factors such as staff size and budgets can serve as barriers to and/or facilitate change in service provision over time and have managerial and policy implications. This study examines patterns and predictors of change over a 2-year period in whether outpatient core and wraparound services are offered on-site or by referral. © 2010 Lippincott Williams & Wilkins, Inc.