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This study provides new evidence regarding the relation of coerced care to posttreatment substance use and addiction severity while controlling for two important factors: readiness to change and addiction severity at admission to treatment. The initial study sample consisted of 289 people who agreed to participate in a prospective study of substance abuse treatment outcomes in five large outpatient programs in Ohio. The findings reported here are based on analyses for the 141 (48.8 percent of the original sample) individuals who completed a six-month follow-up interview using the short form of the Addiction Severity Index. These data indicate that legally coerced participants were more likely than noncoerced participants to report abstaining from alcohol and other drugs in the 30 days before their follow-up interview. They were also more likely to demonstrate reduced addiction severity at follow-up. Readiness to change at admission showed no relation to treatment outcomes.

The profession of social work has a unique role in preventing and treating alcohol and other drug problems. In human services settings shared beliefs or ideologies of care are expected to have substantial influence over the way in which problems are perceived and the types of service technologies used. Thus, it is important that social work professionals be cognizant of what beliefs they hold and how their beliefs about substance abuse treatment and prevention may affect practice. This article discusses current ideologies of care in the substance abuse arena, including the disease/abstinence, psychosocial, ecological, and harm-reduction approaches. In addition, this article examines managers' beliefs about substance abuse programs to determine if there are differences between those who have a social work background (that is, hold at least one social work degree) and those who do not. Suggestions for social work practice and future research also are provided.

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