D. Dwayne Simpson

Texas Christian University | TCU · Institute of Behavioral Research

For more than 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services and various cognitive and behavioral interventions. Emphasis has been on studies in real-world settings and the use of multivariate methodologies to address evaluatio...

Systematic evaluations of efforts to transfer research-based interventions and procedures into general practice at community drug treatment programs have been limited. However, practical experiences as well as results from studies of technology transfer and organizational behavior in related fields provide a basis for proposing a heuristic model of...

Longer retention has been the most consistent predictor of favorable drug abuse treatment outcomes, but key therapeutic and patient engagement indicators of treatment process need to be more clearly established. An integrative model representing treatment dynamics was tested for explaining long-term program retention. It was based on a multisite sa...

Evidence from specialized treatment evaluations and large-scale natural studies of treatment effectiveness is organized conceptually into a "treatment model" for summarizing how drug treatment works. Sequential relationships between patient and treatment program attributes, early patient engagement, recovery stages, retention, and favorable outcome...

The process of innovation adoption was investigated using longitudinal records collected from a statewide network of almost 60 treatment programs over a 2-year period. Program-level measures of innovation adoption were defined by averaged counselor ratings of program training needs and readiness, organizational functioning, quality of a workshop tr...

The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (1-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for trea...

Finding brief effective treatments for criminal justice populations is a major public need. The CJ-DATS Targeted Intervention for Corrections (TIC), which consists of six brief interventions (Communication, Anger, Motivation, Criminal Thinking, Social Networks, and HIV/Sexual Health), were tested in separate federally-funded randomized control stud...

Increasing numbers of women in prison raise concerns about gender-specific problems and needs severity. Female offenders report higher trauma as well as mental and medical health complications than males, but large inmate populations and limited resources create challenges in administering proper diagnostic screening and assessments. This study foc...

Treatment providers need tools which are designed to identify risk, treatment needs, and monitor client engagement. These are essential components in substance abuse treatment for offender populations. This study evaluated a flexible set of 1-page modular assessments known as the TCU Short Forms and compared them with the measures of global domains...

The present paper addresses basic evaluation and procedural concepts that are involved in the process of implementing sustainable oral health behavioral and social interventions. It is part of a series of thematic articles describing cutting-edge methods for conducting oral health interventions research. Core components for effective intervention i...

Women who enter drug abuse treatment programs are likely to report histories of sexual abuse that may impact psychosocial functioning, retention, and outcomes. This study investigates differences at admission between women with and without sexual abuse histories who entered an outpatient methadone treatment program in Texas. In a sample of 137 wome...

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A two-phase proc...

The impact of motivational factors on AIDS high-risk behavior after participation in an AIDS intervention program was explored among 208 out-of-treatment injecting drug users (IDUs). It was hypothesized that lower risk behavior would be evident at follow-up among IDUs who indicated higher concern about their susceptibility to AIDS prior to interven...

Organizational functioning is a key ingredient in the successful implementation of evidence based practices (EBPs) and EBTs. Tools are available to assess the organization and begin to remedy identifiable weaknesses that may inhibit the process of innovation adoption. Similar to what occurs with treatment patients, organizations have varying levels...

This article reviews the history of substance abuse treatment and its evaluation. The authors comment on key aspects of this history and its implications for the future. Research has been a key factor in the support of substance abuse treatment and the expansion and improvement of treatment options. Despite the progress in the field, organizational...

Psychosocial functioning and criminal thinking of methamphetamine-using inmates were examined before and after their completion of primary treatment in three in-prison drug treatment programs (one "outpatient" and two different modified therapeutic communities [TCs]). The sample consisted of 2,026 adult male inmates in 30 programs in Indiana. Data...

Implementing innovations in social and health-related service programs is a dynamic stage-based process. This article discusses training, adoption, implementation, and practice as sequential elements of a conceptual framework for effective preparation and implementation of evidence-based innovations. However, systems need to be prepared for change...

An increasingly important treatment group is the expanding population of methamphetamine-using female offenders. This study focused on women methamphetamine-using offenders (n = 359) who were treated either in a modified TC program (CLIFF-TC: n = 234) designed for non-violent offenders with significant impairment from methamphetamine use or the sta...

Clients entering treatment with cocaine problems are difficult to engage and retain in treatment. Crack users, a subset of cocaine users, are especially difficult to treat. This study investigated whether type of cocaine used (crack or non-crack) was related to retention in treatment. The sample consisted of 900 clients in 13 long-term residential...

Factors that contributed to long-term recovery from cocaine dependence were examined as part of a 5-year national follow-up study of 708 patients from 45 treatment programs in eight U.S. cities. Outcomes from 33% of the sample were highly favorable at follow-up, including no drugs detected in urine or hair specimens, no self-reported use of any dru...

A total of 175 Mexican American youth aged 15-17 when they entered a drug prevention program during 1981-1985 were followed up 4 years later. More frequent pre-admission use of inhalant drugs was associated with higher levels of alcohol use, legal problems, and cognitive functioning problems during the same period, as well as more negative outcomes...

Research in psychology and communication shows a strong advantage for visual displays in comparison with typical language, and technological innovations in computer graphics and printing capabilities now make them cost-effective as well. It can be argued that the greater use of evidence-based visualization strategies can enhance communication occur...

Therapeutic rapport between counselors and clients in drug user treatment has been shown to be an important predictor of follow-up outcomes. This naturalistic study investigated the relationship of counseling rapport to drug-related topics discussed in counseling sessions in a sample of 330 clients and nine counselors. These voluntary clients had b...

There has been considerable debate about the effectiveness of drug treatment in reducing offending and drug use, with limited support for the effectiveness of the UK Drug Intervention Programme to reduce offending through diversion into treatment. The current paper examines drug users diverted into treatment in one UK city to assess their treatment...

Client functioning and treatment engagement were examined in relation to staff attributes and organizational climate across a diverse sample of drug treatment and outreach programs in England. Self-rating assessments were obtained from 1,539 clients and 439 counselors representing 44 programs, and results were interpreted using comparable data from...

The results of the treatment evaluation research based on the Drug Abuse Reporting Program (DARP) are summarized and discussed. The DARP is a data system containing almost 44,000 admissions during 1969 to 1973 to 52 treatment programs located throughout the United States and in Puerto Rico. The current report focuses on the findings of a number of...

To examine organizational structural attributes associated with counselor-client contact. Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. The study uses a naturalistic design to investigate org...

Most counselors working with substance-abusing clients recognize the importance of addressing parenting issues within the context of treatment. This exploratory study describes a researcher-agency partnership aimed at improving the parenting skills of agency clients. "Partners in Parenting" (PIP) is based upon client-centered, Adlerian, and behavio...

As a result of limited budgets, many treatment programs are forced to operate for extended periods at or beyond their capacity. The resulting pressure and stress on treatment staff can be taxing and lead to serious problems, including job burnout. Although the concept of burnout within other social service professions has been broadly researched, l...

Treatment programs are expected to change their clients. To adopt evidence-based practices to improve their therapeutic effectiveness in dealing with drug-related problems of clients, they also are expected to change themselves. The process of innovation adoption and implementation is the focus of studies included in this special journal issue. Col...

Assessments of treatment staff training needs, preferences, and barriers can help guide and improve training activities and transfer evidence-based technologies into clinical practice. The Texas Christian University (TCU) Program Training Needs (PTN) assessment consists of 54 items organized into seven domains: Program Facilities and Climate, Progr...

Because work environment is central to understanding job performance, drug counselor perceptions of their programs and their skills were examined in relation to their attitudes about innovations training and its utilization. Latent profile analysis of measures on organizational climate and staff attributes for 1047 counselors from 345 programs defi...

The prevailing emphasis on adopting evidence-based practices suggests that more focused training evaluations that capture factors in clinician decisions to use new techniques are needed. This includes relationships between postconference evaluations and subsequent adoption of training materials. We therefore collected training assessments at two ti...

A key goal of drug abuse treatment providers is getting their clients to engage and participate in therapeutic activities as a first step toward deriving longer-term benefits. Much research had focused on personal characteristics that relate to client engagement; program characteristics have received less attention. This study explored client and p...

Organizational functioning within substance abuse treatment organizations is important to the transfer of research innovations into practice. Programs should be performing well for new interventions to be implemented successfully. This study examined the characteristics of treatment programs that participated in an assessment and training workshop...

This study focused on the relationship between organizational functioning factors measured in a staff survey using the Texas Christian University (TCU) Organizational Readiness for Change assessment and client-level engagement measured by the TCU Client Evaluation of Self and Treatment in drug treatment programs. The sample consisted of 531 clinica...

Corrections officials frequently use private contractors to operate in-prison, therapeutic community (TC) treatment programs. However, the recurrent competitive bidding process inherent in state agencies contracting for services sometimes results in a treatment-provider change. Few studies have focused on whether this change leads to better or wors...

Monitoring drug-abuse-treatment delivery and progress requires the use of validated instruments to measure client motivation, psychosocial and cognitive functioning, and other treatment-process dynamics. As part of the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies project for examining client-performance indicators...

Expectations about future behavior have been shown to have a positive relationship with subsequent behavior. For patients in drug treatment, recovery should manifest changes in drug use and in cognitive perceptions of being able to refrain from use. The present study identified latent patterns of the longitudinal relationship between drug use expec...

Innovate and adapt are watchwords for substance abuse treatment programs in today's environment of legislative mandates, effective new interventions, and competition. Organizations are having to evolve - ready or not - and those that are ready have superior chances for success and survival. The Texas Christian University Organizational Readiness fo...

Few studies have examined the impact of corrections-based drug abuse treatment programs on changes in social functioning. The current study, therefore, examines social functioning (i.e., hostility, risk taking, and social conformity) among 406 probationers in a modified therapeutic community. Data are collected prospectively and include intake, dur...

Substance abuse is common among probationers, and treatment programs have become an integral part of community corrections. The current study presents findings from a modified therapeutic community (TC) serving drug abusing probationers in a large metropolitan area. Findings show that treatment dropouts were more likely to be rearrested for a serio...

To better understand why some drug abuse treatment programs are more effective than others, USA research about organizational functioning and its role in the provision of treatment services was extended through a study of a delivery system in another country. The Texas Christian University (TCU) organizational functioning and readiness for change i...

Risk assessments generally rely on actuarial measures of criminal history. However, these static measures do not address changes in risk as a result of intervention. To this end, this study examines the basic psychometric properties of the TCU Criminal Thinking Scales (TCU CTS), a brief (self-rating) instrument developed to assess cognitive functio...

Women entering drug abuse treatment programs who report a history of sexual abuse are also likely to report poorer psychosocial functioning, more drug-related problems, and more family-of-origin problems. This study investigates outcome differences at follow-up between women with and those without sexual abuse histories who were treated at an outpa...

This study examined the role of total session exposure on during-treatment outcomes in a sample of 298 methadone maintained clients. The total number of minutes actually spent in counseling sessions during a 6-month period was used to create a measure of client exposure to treatment. Clients were divided into three groups: low (< 270 minutes), medi...

Treating cocaine use by opiate-dependent clients in methadone programs is a well-documented challenge. Both behavioral (contingency management) and cognitive (relapse prevention) interventions have shown promise in helping engage these clients in treatment. In this study, the effectiveness of combining contingency management with a cocaine-specific...

Three types of individual drug abuse counseling were investigated in a private methadone clinic in order to replicate and extend previous work on node-link mapping techniques (two dimensional graphic approaches for visualizing problems and solutions). Standard counseling, enhanced counseling with free-form maps (f-maps), and enhanced counseling wit...

Recent methodological advancements for structural equation modeling were used to test a comprehensive version of the TCU Treatment Model, especially for addressing the hypothesized sequential relationships of early engagement components (participation and therapeutic relationship) and early recovery (psychosocial and behavioral changes) that contri...

The development of the Client Problem Profile and Index are described, and initial concurrent and predictive validity data are presented for a sample of 547 patients in outpatient methadone treatment. Derived from the TCU Brief Intake for drug treatment admissions, the profile covers 14 problem areas related to drug use (particularly cocaine, heroi...

This study used data from the national Drug Abuse Treatment Outcome Studies (DATOS) to investigate the associations that pre-treatment depression and hostility have with drug use and criminal behavior at 1 year and 5 year follow-up in patients with and without additional treatment involvement in the year prior to each follow-up. Following a natural...

Patient attributions for their own long-term recovery were obtained in a 5-year followup of 432 admissions to 18 outpatient methadone treatment programs. Subjects were classified into two groups - recovering and non-recovering-strictly defined and based on both biological and self-report measures of no opioid or cocaine use, less than daily use of...

Obituary for Robert Glenn Demaree (1920-2002). Demaree's career endeavors included human factors research, training, performance measurement, criterion prediction, and multivariate analytic applications. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

Brief but comprehensive instruments measuring patient motivation, psychosocial functioning, treatment process, social network support, and services received are needed for monitoring drug abuse treatment delivery and patient progress. Combining this information across patients within a program also provides useful indicators about institutional com...

A comprehensive assessment of organizational functioning and readiness for change (ORC) was developed based on a conceptual model and previous findings on transferring research to practice. It focuses on motivation and personality attributes of program leaders and staff, institutional resources, and organizational climate as an important first step...

Long-term (5-year) outcomes of community treatment for cocaine dependence were examined in relation to problem severity at treatment entry and treatment exposure throughout the follow-up period. Interviews were conducted at 1 and 5 years after treatment for 708 subjects (from 45 programs in 8 cities) who met DSM-III-R criteria for cocaine dependenc...

The intensive, time-limited, short-term inpatient modality treatment for substance abuse appears to have positive outcomes despite its brevity. This study examined patient characteristics and posttreatment experiences to understand who is likely to benefit from this treatment and under what circumstances. Our sample included 748 patients in 12 shor...

Studies of community-based substance abuse treatment indicate that motivation for treatment is critical for retaining clients in the program and for their becoming therapeutically engaged in the recovery process. Relatively little work, however, has examined the effect of motivation on therapeutic engagement in criminal justice settings. Baseline a...

Based on the importance of during-treatment activities for improving outcomes, relationships between patient background, treatment readiness, and therapeutic engagement were examined in a national sample of adolescents admitted to 20 treatment programs representing three modalities. Patients with higher readiness for treatment at intake subsequentl...

This study examined the association between counseling rapport and drug abuse treatment outcomes. Two cohorts of outpatients who were being treated with methadone in four cities were studied. Cohort 1 comprised 354 patients in community-based nonprofit programs, and cohort 2 comprised 223 patients from a private for-profit program. Logistic regress...

Although there is increasing emphasis on providing drug treatment programs for women that address their specific needs (including parenting and childcare), some women still fail to complete treatment. Because of the limited information about the barriers involved, this study examines pretreatment characteristics as predictors of program completion...

Follow-up studies of drug user treatment generally find significant improvements in client functioning, but information about the therapeutic components associated with client behavioral changes over time is limited. An integrative model developed previously to predict treatment retention was expanded and applied to post-treatment outcomes. This st...

Although court referral to methadone maintenance treatment is rare, individuals with an official legal status (i.e., parole, probation, or awaiting trial) commonly enter this setting. Relatively few studies, however, have assessed the impact of this factor on client outcomes. A sample of 710 clients admitted to methadone maintenance was followed up...

Greater improvement in posttreatment outcomes has been shown in programs that tailor frequency and type of services to unique client needs. Using a sample of 635 clients (199 females and 436 males) admitted to three community-based methadone treatment programs, this study examined gender differences in services needed and provided during the first...

parenting skills, and cocaine cessation for methadone clients. The manuals employ a user-friendly format to help counselors present information, explore feelings and attitudes, and build client skills and self-efficacy in areas of recovery-related functioning. With the See Manuals, page 2. exception of the cocaine intervention, these manuals are st...

month CM protocol allowed clients to earn one star for each positive recovery behavior. Stars were awarded immediately for clean drug screens and for attending counseling sessions. Clients were assigned randomly to a reward condition for redeeming their collection of stars for prizes. A high reward group could redeem prizes after earning 4 stars, w...

Clients are less likely to drop out of residential drug treatment programs prematurely when they are either internally motivated (i.e., having a high level of treatment readiness) or externally pressured by the legal system to enter, participate, and remain in treatment. However, little is known about the combined impact these factors have on treat...

Self-efficacy has been shown to be related to outcomes from interventions for alcohol and tobacco abuse but relatively little attention has been focused on it in evaluations of treatment for illicit drug abuse. Almost no research has examined offenders involved with drugs. The current study, therefore, adapted the Alcohol Abstinence Self-efficacy S...

Although the importance of gender-sensitive programming for women has been acknowledged, few studies have examined outcomes from male-centered interventions in substance abuse treatment programs. Data were collected from 122 male clients in a court-mandated residential treatment program who participated in a study of a psychoeducational group inter...

A meta-analysis was conducted on contingency management interventions in outpatient methadone treatment settings. The outcome measure of interest was drug use during treatment, as detected through urinalysis. The results confirm that contingency management is effective in reducing supplemental drug use for these patients. The analysis of behavioral...

Clients in outpatient methadone treatment (OMT) who abuse cocaine or alcohol are difficult to engage and retain in treatment. The impact a triple addiction to these drugs has on treatment was the focus of this study (N = 127). Admission characteristics, treatment response, and retention were compared among clients dependent on opiates only (O), opi...

Early dropout or failure to engage in drug abuse treatment is a common problem in correctional settings. This study presents findings from 339 felony probationers man - dated to a 6-month modified therapeutic community (TC) in lieu of imprisonment. Early dropout was related to cocaine dependence, having a history of psychiatric treatment, being une...

Motivational readiness for engaging in drug treatment is a common problem for probationers mandated to criminal justice programs, particularly for those with limited educational experience. This study presents initial findings on the impact of a new four-session treatment readiness program that includes an array of cognitive engagement strategies....