Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Malcolm Robertson

Second Advisor

Dr. C. Richard Spates

Third Advisor

Dr. Elaine Phillips

Fourth Advisor

Dr. Lester W. Wright


The past 20 years have witnessed a significant increase in the number of published studies comparing inpatient with outpatient substance dependence treatment The majority of these studies have reported no benefit for those recipients receiving more intensive treatment However, the outpatient treatment investigated in these studies has typically been day treatment often involving 27 hours a week of participation, and not intensive outpatient treatment (IOP), which involves 12 or fewer hours of participation per week. Additionally, few published studies have compared alcohol and cocaine dependent populations. This study was designed to compare effectiveness of the residential and intensive outpatient levels of treatment for both alcohol and cocaine dependent populations.

Forty-eight participants were randomly selected from a total pool of 132 eligible participants and assigned to one o f four groups: (1) alcohol dependent in residential treatment; (2) alcohol dependent in IOP treatment; (3) cocaine dependent in residential treatment; and, (4) cocaine dependent in IOP treatment.

The groups were compared at intake, 10 days, 30 days, and 60 days after entering treatment on the following variables: drug/alcohol use, employment status, denial, 12 step participation, relapse prevention skills, medical status, psychiatric status, and social support. Data was gathered from four scales of the Addiction Severity Index (McLellan et al., 1980), as well as an assessment developed by the author.

Results indicate that both residential and IOP treatments are effective in reducing problems related to drug and alcohol use, as well as improving employment status, denial, 12 step participation, relapse prevention skills, and psychiatric status. However, improvement did not occur in the areas of medical status or social support for either group. There were few significant differences between the residential and IOP groups in areas of improvement. Additionally, significant differences were not apparent between the alcohol and cocaine dependent groups. Relapse rates were similar for all groups. Overall, the results support the use of IOP treatment as a viable alternative to residential treatment for alcohol dependent and cocaine dependent patients at a cost of roughly one third that of residential placement

Access Setting

Dissertation-Open Access