The backgrounds and roles of ex-addict ( EXA ) and non-ex-addict (NEA) paraprofessional methadone maintenance and drug-free out-patient counselors were contrasted with those of degreed professional counselors (PRO). There was no evidence of differential assignment of clients to counselors based on drug use, drug treatment, criminal, educational, and employment histories. The three counselor groups were remarkably similar in their participation in 11 areas of job activities ranging from counseling duties per se through administrative support functions. The only reliable difference was the greater involvement of EXAs in counseling and community education activities which took them outside the program.

The progress in treatment of 302 methadone maintenance and drug-free outpatient clients was examined as a function of the background of their 82 counselors. Counselors were either ex-addict paraprofessionals (EXAs), non-ex-addict paraprofessionals (NEAs), or degreed professional counselors (PROs). Client progress was assessed in five areas: drug use, criminality, educational activities, employment, and life quality. In the first four areas, status at treatment entry contrasted with that at two subsequent measurement points: the first interview and a 4-month follow-up. In no area of evaluation were outcomes substantially more favorable for clients of one counselor group over another. It was concluded that the three counselor groups were equally effective.

Three groups of methadone maintenance and drug-free outpatient counselors, ex-addict paraprofessionals (EXAs), non-ex-addict paraprofessionals (NEAs), and degreed professional counselors (PROs), were contrasted in terms of their views of drug abuse and drug treatment, their attitudes toward and expectations for their clients, and in terms of their clients' attitudes toward them. Across groups, counselors agreed on the major cause of drug abuse, the critical factor in treatment, the definition of treatment success, and their expectations for client success. While clients of the three groups viewed their counselors are equally able to understand them and were equally confident of the counselors, the clients of EXAs saw their counselors as more knowledgeable about critical issues of drugs and the street scene, were more willing to bring personal problems to their counselors, and expected and desired more participation from their counselors in both counseling-related and personal problems.

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