Deborah Podus

University of California, Los Angeles, Los Angeles, California, United States

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Publications (17)29.99 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of the present meta-analysis was to answer the question: Can the Andrews principles of risk, needs, and responsivity, originally developed for programs that treat offenders, be extended to programs that treat drug abusers? Drawing from a dataset that included 243 independent comparisons, we conducted random-effects meta-regression and ANOVA-analog meta-analyses to test the Andrews principles by averaging crime and drug use outcomes over a diverse set of programs for drug abuse problems. For crime outcomes, in the meta-regressions the point estimates for each of the principles were substantial, consistent with previous studies of the Andrews principles. There was also a substantial point estimate for programs exhibiting a greater number of the principles. However, almost all of the 95% confidence intervals included the zero point. For drug use outcomes, in the meta-regressions the point estimates for each of the principles was approximately zero; however, the point estimate for programs exhibiting a greater number of the principles was somewhat positive. All of the estimates for the drug use principles had confidence intervals that included the zero point. This study supports previous findings from primary research studies targeting the Andrews principles that those principles are effective in reducing crime outcomes, here in meta-analytic research focused on drug treatment programs. By contrast, programs that follow the principles appear to have very little effect on drug use outcomes. Primary research studies that experimentally test the Andrews principles in drug treatment programs are recommended.
    Journal of Experimental Criminology 09/2013; 9(3):275-300. · 1.17 Impact Factor
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    ABSTRACT: Of the 13 principles of drug addiction treatment disseminated by the National Institute on Drug Abuse (NIDA), 7 were meta-analyzed as part of the Evidence-based Principles of Treatment (EPT) project. By averaging outcomes over the diverse programs included in the EPT, we found that 5 of the NIDA principles examined are supported: matching treatment to the client's needs, attending to the multiple needs of clients, behavioral counseling interventions, treatment plan reassessment, and counseling to reduce risk of HIV. Two of the NIDA principles are not supported: remaining in treatment for an adequate period and frequency of testing for drug use. These weak effects could be the result of the principles being stated too generally to apply to the diverse interventions and programs that exist or unmeasured moderator variables being confounded with the moderators that measured the principles. Meta-analysis should be a standard tool for developing principles of effective treatment for substance use disorders.
    Journal of substance abuse treatment 11/2011; 43(1):1-11. · 2.90 Impact Factor
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    ABSTRACT: The issue of disaster planning as related to relevant substance abuse issues is not a topic that has heretofore received much policy, practice, or research attention. This presentation will provide an overview of the substance abuse treatment system and discuss the types of vulnerabilities different types of treatment programs face. A primary focus will be on methadone maintenance treatment programs (MMTPs), which are the most vulnerable to disaster-related disruptions in continuity of care. The presentation will present qualitative data from a survey of 90 (of 141) MMTPs in the Gulf Coast states and qualitative data from interviews with 12 administrators, 37 staff, and 27 patients from a subset of programs that participated in the survey. Data were collected in 2008 and 2009 and cover programs in Alabama, Florida, Louisiana, Mississippi, and Texas. Findings to be presented include the characteristics of MMTPs, the types of direct and indirect disaster-related problems that programs have experienced, the relationships programs have with local agencies involved in disaster response, and possible strategies to improve emergency response policies with respect to MMTPs. Notable findings indicating the general lack of integration of MMTPs in local emergency response policies are that only 39.2% of MMTPs surveyed thought it likely they would get help from local disaster response agencies in an emergency and that over 30% of programs were not aware or only know a little about what emergency responders (e.g., police, mental health, emergency management, and the American Red Cross) would do in a disaster.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
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    ABSTRACT: This paper reports on the effects of Hurricanes Katrina and Rita on drug and alcohol treatment in Texas in 2005-2006. Findings are based on a secondary analysis of administrative data on 567 hurricane-related admissions and on interview data from a sample of 20 staff in 11 treatment programs. Katrina evacuees differed from Rita clients in terms of demographics and primary problem substances and treatment needs, while the experiences of program staff and needed changes to improve disaster readiness were more similar. Additional systematic research is needed to document the intermediate and long-term impacts of the storms in these and other affected areas.
    Substance Use &amp Misuse 10/2009; 44(12):1681-94. · 1.11 Impact Factor
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    ABSTRACT: Recipients of welfare benefits have elevated rates of mental health and substance-related problems relative to the general public; however, low acculturation among Latinos may be a protective factor for both conditions. Lower acculturation among Latinos is associated with lower levels of mental health and substance-related problems relative to highly acculturated individuals. To our knowledge, there are few published studies examining the potential protective effects of low acculturation, defined herein as Spanish language preference, among Latina participants in welfare programs. Screening and treatment of mental health and substance-related problems in this population are important because work requirements for benefits receipt have been implemented and mental health or substance-related problems may be barriers to meeting these requirements. This analysis assesses the prevalence of mental health and substance-related problems among female participants in California's response to 1990s federal welfare reform legislation--the California Work Opportunity and Responsibility to Kids (CalWORKs). Although mental health needs may be similar among CalWORKs recipients regardless of acculturation, substance-related problems may be less frequent among Spanish-speaking Latinas participating in the CalWORKs program. Low acculturation was not a significant predictor of mental health need but had a protective effect with regard to substance-problem risk after controlling for several other substance-problem risk variables.
    Journal of Ethnicity in Substance Abuse 02/2008; 7(3):268-91.
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    ABSTRACT: The Evidence-based Principles of Treatment (EPT) project is conducting meta-analytic research on drug abuse treatment studies to assess whether some of the National Institute on Drug Abuse's (1999) recommended "Principles of Drug Addiction Treatment are supported by empirical research over the past thirty years. NIDA's Principle 3 is that effective treatment attends to multiple needs of the individual (medical, psychological, vocational, etc.), not just the drug use. (a) A preliminary finding from the EPT review is that very few research reports discuss how the program they have studied is believed to fit clients' needs. (b) A preliminary EPT meta-analysis, which had to rely on the number of program services provided to clients as a crude indicator, found little or no correlation between the number of program services provided and subsequent reduction in drug use. NIDA's Principle 4 is that an individual's treatment and services plan should be assessed continually and modified as necessary to ensure that the plan meets the person's changing needs; programs that do follow this practice will have better outcomes than those that do not. (c) Relatively few research reports provide information on how (or whether) programs reassess treatment plans. (d) A preliminary EPT meta-analysis has shown a promising correlation between reassessment of treatment plans and subsequent reduction in drug use. Conditional relationships are the next line of research: under what conditions is an hypothesized principle of treatment associated with little or no success and under what conditions does that principle have strong research support?
    135st APHA Annual Meeting and Exposition 2007; 11/2007
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    ABSTRACT: To examine the effectiveness of contingency management (CM) techniques in treating substance use disorders (i.e. illicit drugs, alcohol, tobacco). Meta-analysis was used to determine the average effect size and potential moderators in 47 comparisons of the effectiveness of CM from studies based on a treatment-control group design and published between 1970 and 2002. The mean effect size (ES) of CM was positive, with a magnitude of d = 0.42 using a fixed effects model. The magnitude of the ES declined over time, following treatment. CM was more effective in treating opiate use (d = 0.65) and cocaine use (d = 0.66), compared with tobacco (d = 0.31) or multiple drugs (d = 0.42). Larger effect sizes were associated with higher researcher involvement, earlier studies and shorter treatment duration. Study findings suggest that CM is among the more effective approaches to promoting abstinence during the treatment of substance use disorders. CM improves the ability of clients to remain abstinent, thereby allowing them to take fuller advantage of other clinical treatment components.
    Addiction 12/2006; 101(11):1546-60. · 4.58 Impact Factor
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    Drug and Alcohol Dependence - DRUG ALCOHOL DEPENDENCE. 01/2006; 84(1):133-133.
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    ABSTRACT: A meta-analysis was conducted on 78 studies of drug treatment conducted between 1965 and 1996. Each study compared outcomes among clients who received drug treatment with outcomes among clients who received either minimal treatment or no treatment. Five methodological variables were significant predictors of effect size. Larger effect sizes were associated with studies with the following characteristics: smaller numbers of dependent variables, significant differences between groups at admission, low levels of attrition in the treatment group, a passive comparison group (no treatment, minimal treatment) as opposed to an active comparison group (standard treatment), and drug use determined by a drug test. Controlling for these methodological variables, further analyses indicated that drug abuse treatment has both a statistically significant and a clinically meaningful effect in reducing drug use and crime, and that these effects are unlikely to be due to publication bias. For substance abuse outcomes, larger effect sizes tended to be found in studies in which treatment implementation was rated high, the degree of theoretical development of the treatment was rated low, or researcher allegiance to the treatment was rated as favorable. For crime outcomes, only the average age of study participants was a significant predictor of effect size, with treatment reducing crime to a greater degree among studies with samples consisting of younger adults as opposed to older adults. Treatment modality and other variables were not related to effect sizes for either drug use or crime outcomes
    Drug and Alcohol Dependence 07/2002; 67(1):53-72. · 3.14 Impact Factor
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    ABSTRACT: A meta-analysis was conducted on studies using a treatment-comparison group design to evaluate HIV/AIDS risk-reduction interventions for clients enrolled in drug abuse treatment programs. Overall, the interventions studied were found to have a reliable positive (weighted) effect size (d = 0.31), and this was unlikely to be due to publication bias. Effect sizes for specific categories of outcome variables were 0.31 for knowledge, attitudes, and beliefs; 0.26 for sexual behavior; 0.62 for risk-reduction skills; and 0.04 for injection practices. A number of potential moderators were examined. Effect sizes were negatively correlated with the presence of predominantly ethnic minority samples and positively correlated with the number of intervention techniques used, the intensity of the intervention, intervention delivery at a later stage of drug treatment or within methadone treatment, and the presence of a number of specific intervention techniques.
    Journal of Consulting and Clinical Psychology 07/2001; 69(3):389-405. · 4.85 Impact Factor
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    ABSTRACT: In comparison with studies of client characteristics and treatment processes, limited research has been conducted on how program features of drug dependence treatment programs may affect client outcomes. Of particular interest are those characteristics of programs that may have a clinically significant impact on outcomes and that are amenable to change within programs. This study examines the impact of various program factors on client outcomes using data from a meta-analysis of drug dependence effectiveness studies (n = 143). Because of heterogeneity among studies, the data are analyzed in terms of type of outcome variable (drug use and crime), type of design (single-group and treatment-comparison group), and type of treatment (methadone maintenance, therapeutic communities, outpatient drug free, and detoxification). For the more valid treatment-comparison group studies, the weighted mean effect size was 0.29 for drug use outcomes and 0.17 for crime outcomes. Program factors found to be significantly correlated with effect size in one or more modalities were decade of treatment, researcher involvement in treatment delivery, maturity of the program, counselor/client ratio, treatment implementation, treatment exposure, and methadone dosage.
    Substance Use &amp Misuse 01/2000; 35(12-14):1931-65. · 1.11 Impact Factor
  • M L Prendergast, D Podus
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    ABSTRACT: This paper discusses different concepts or views of what constitutes effective treatment for drug dependence and how these views are involved in policy decisions regarding treatment. The paper reviews the rise of evidence-based medicine, discusses the emergence of efficacy research, effectiveness research, and other types of outcome-based evaluations of drug user treatment, but notes that despite a growing consensus among researchers on the effectiveness of drug user treatment, substantial public skepticism about the value of treatment still exists in the United States. The paper argues that one of the primary reasons for the lack of public consensus in the United States is that there is wide disagreement over which type of problem drug dependence is and for whom it may be a problem. The paper reviews some of the most common models and their implications for evaluating effectiveness, and argues that it is the differences in perspective among these models that are at the heart of policy debate over drug treatment policy in the United States. The paper concludes that because evaluation research as currently practiced does not address these issues, its utility for policy purposes is limited in the American context.
    Substance Use &amp Misuse 01/2000; 35(12-14):1629-57. · 1.11 Impact Factor
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    ABSTRACT: Recent studies have emphasised differences in leadership styles between women and men. Women have an ldquointeractiverdquo leadership style while men are more ldquodirectiverdquo and ldquoauthoritative.rdquo Social network analysis is used to examine differences in eight mental health case management teams, half formally supervised by women and half by men. The techniques used are graphical displays and measures of centrality. Results show male leaders as the most central team member for both instrumental and expressive relations. Female leaders, however, do not adhere to a single leadership style. Team centralisation also differs with gender composition of teams influencing leadership differences.
    Administration and Policy in Mental Health and Mental Health Services Research 02/1999; · 3.44 Impact Factor
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    ABSTRACT: The authors investigated the impact of provider characteristics on the performance of clinical case managers. Case managers in a large California county were interviewed using a structured instrument that assessed service linkage, assertive outreach, and family management. Findings indicate that assertive outreach was done more often by more experienced case managers, and less often by those with larger caseloads. Belief in the efficacy of an activity was associated with doing it much more frequently.
    Administration and Policy in Mental Health and Mental Health Services Research 10/1998; 26(1):21-32. · 3.44 Impact Factor
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    Journal of Substance Abuse Treatment 01/1998; 15(3):267-70. · 3.14 Impact Factor
  • Research In Community & Mental Health. 9:11-28.
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    ABSTRACT: This paper presents field-tested methods of measuring the costs of mental health services and their outcomes in a countywide public sector mental health service system for seriously mentally ill adults that features case management teams as the primary service delivery unit.
    Research in the Sociology of Health Care. 14:305-325.