Some Likely Alternative Explanations for Improvements during Drug Abuse Treatment: Maturation, Statistical Regression, History, Criterion Contamination
The intensive funding of drug abuse treatment programs is predicated on the assumption that treatment processes are effective in reducing criminal behavior, drug use and other asocial behaviors of drug abusers. Evaluations of the extent to which these goals are accomplished usually proceed by way of comparing well measured indices of pretreatment to post-treatment changes in levels of drug usage, criminal activities, and employment. Somewhat less frequently changes in other variables such as psychosocial adjustment, personality characteristics, and utilization of institutions of social support also are investigated. These data are then analyzed by a variety of methods ranging from straightforward univariate comparisons of pretreatment and posttreatment levels to technologically more advanced multivariate techniques such as analysis of covariance and stagewise multiple regression and correlation, which are used primarily for comparing effectiveness of different modalities of treatment. These latter multivariate techniques statistically equate members of diverse groups for significant preexisting differences in treatment modalities as rival explanations for the observed changes in the outcome measures. One undesirable consequence of the ease with which such multivariate analyses can be performed is that investigators of treatment outcomes have eschewed the use of untreated control groups in favor of statistical procedures for assessing improvements that use intact treatment groups as their own controls. The resulting absence of untreated comparison groups in the evaluation designs severely limits the basis for crediting treatment with a causal influence on these improvements.
KeywordsCriminal Justice System Drug Abuse Treatment Drug Abuser Methadone Maintenance Heroin Addiction
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