A Referral System That Matches Drug Users to Treatment Programs: Existing Research and Relevant Issues

Abstract

Matching clients to treatment has been a topic of great interest to clinicians and researchers in the field of alcohol and drug abuse. Currently, several nationwide efforts are attempting to establish central intakes in communities using computerized systems. This article includes a brief literature review to provide an assessment of the current knowledge about matching that can be used to support a matching system guided by expert knowledge. A conceptual framework for the development of an expert-guided system to be used in a central intake or referral agency is then described. A drug treatment referral system that matches drug users to appropriate treatment programs requires several interlinked components: (1) an accurate list of available programs with comprehensive descriptors characterizing the programs, including the nature and kinds of services provided; (2) an assessment instrument that can be easily and routinely administered is needed for determining clients' characteristics and needs; and (3) results of that assessment instrument are used to match clients with the most appropriate available programs according to a set of decisional guidelines, which is the most critical component of the referral system. Component-specific issues that need to be addressed in developing an expert-guided referral system are discussed. The paper concludes that an expert-guided system using profile matching, although constrained by the resources available in a community, is likely to improve client outcomes and program efficiency over the current haphazard utilization practices of unstructured referral. Development of a matching index that can predict client outcome is necessary to provide empirical directions for future research and improved practice.