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In order to examine the way ethical decisions are made, we asked ethicists, regulatory officials, and experienced researchers to review a set of scenarios that depict important ethical tensions in research. The method employed was "protocol analysis," a talk-aloud technique pioneered by cognitive scientists. Each individual was asked to make recommendations for courses of action. Later, we held a focus group of university faculty and staff with either institutional review board experience or research ethics training. They too were asked to recommend actions. The results show there are areas where the two data collection approaches agree, as well as areas of considerable difference. Implications for training in the responsible conduct of research are discussed. [ABSTRACT FROM AUTHOR]

Investigates the racial differences in the health status of non-institutionalized cognitively impaired older adults in rural areas in Arkansas. Basis in the examination of health status; Detection of high instrumental activities of daily living in African Americans; Factors effecting the health status of older adults.

Client control orientation is modeled as a force on program completion in alcohol treatment programs. A representative sample of adult alcohol abusers entering all state-funded programs in Missouri was recruited into the study and administered a pre-treatment interview including a locus of control scale. Official program records of completion and reason for non-completion were also accessed. The theoretical advantage of internal control orientation on client outcomes post-treatment was mitigated by its inverse relationship to a desire to change and to program completion. Possible reasons for an effect of locus of control on retention in program are explored. [ABSTRACT FROM AUTHOR]

In many countries, there is a mounting body of research that supports the hypothesis that alcohol and other drug dependency treatment works. This view is further advanced when indicators for success extend beyond abstinence to other quality of life issues. Most of the studies that reach these conclusions are conducted in controlled, enriched, small, singlesite programs. This 2-year prospective study reports findings similar to these other studies, but the sample was drawn from a large, multisite, government funded system of programs. The authors conclude that government expenditures on alcohol and drug abuse treatment are well spent, but more focused scrutiny and accountability is appropriate. [ABSTRACT FROM AUTHOR]

This paper reports on two surveys commissioned by the State of Missouri, Division of Drug and Alcohol Abuse, to begin the assessment of state supported treatment programs. The first survey, commissioned in 1989, was a retrospective study conducted a full year after the sample frame was discharged from treatment. The study was based primarily on client self-reports gleaned from a telephone survey. The process and products of this study led to substantial changes in the methodology employed in an ongoing three-year prospective study commissioned in 1991. This paper will discuss the results of the original survey, detail how this experience has shaped the prospective study, and briefly compare preliminary data, particularly response rates and the representativeness of the two samples. [ABSTRACT FROM AUTHOR]

Case management has become a popular method of service delivery in many human service fields, including mental health and alcohol and drug treatment. By focusing on the problems in living faced by clients, this style of helping has direct relevance for those who seek employee assistance services and those that sponsor them. Additionally, by embodying a generalist perspective, case managers are also adroit at assessing problems that emanate from organizational structure and culture. This paper explicates the philosophy of strengths-based case management services and offers practical examples of the case management process. [ABSTRACT FROM AUTHOR]

A comparison of the effectiveness of inpatient and outpatient services for alcohol and drug clients is presented. Controls for program completion and severity of substance use on entry to treatment are included. While inpatients do only as well as outpatients overall, inpatient services show significant advantage for particular classes of clients. Results, though preliminary, suggest that the recent call for a cutback in inpatient services is premature. [ABSTRACT FROM AUTHOR]

Prison overcrowding has fostered an interest in providing substance abuse treatment to inmates. Outcome evaluations to determine program effectiveness are viewed as essential. This paper argues that in order for a prison based substance abuse treatment outcome evaluation to achieve reliability and validity, a process evaluation is central. As part of the process evaluation, five groups within the correctional setting need to be considered: inmates, treatment staff, prison staff, prison administration, and the parole board. These five groups are discussed relative to three stages of development of substance abuse treatment in prison: program policy making, evolution, and viability. [ABSTRACT FROM PUBLISHER]