The Data. Projects conducted follow-up interviews with clients 6 months after discharge from treatment, to obtain information about their post-discharge drug use, criminal involvement, parenting status, and other areas of post-treatment functioning. Similar information about clients’ pre-treatment situations was obtained at treatment admission, providing a basis for examining pre-post change.¹

Alcohol and Drug Use. The percentage of clients reporting use of specific substances during the 6 months following RWC/PPW discharge was much lower than these same clients’ reported use rates during the 6 months before treatment (Exhibit 2). As shown, the change was consistently large, for alcohol and all major drugs.

Overall, 60% of RWC/PPW clients reported being completely alcohol- and drug-free (abstinent) throughout the 6 months following discharge. An additional 13% reported having relapsed at some time since discharge, but having been completely alcohol- and drug-free in the 30 days before the post-discharge interview. These are remarkable findings, especially considering the chronicity, severity, and resistance to previous treatment of these clients’ chemical dependencies.

Criminal Involvement. Criminal activities supporting or reflecting clients’ chemical dependencies were reported for many RWC/PPW women in the period before treatment.

Such problems were much less widespread during the 6 months following treatment discharge:

• 7% of clients were arrested for alcohol or drug offenses (selling drugs, public intoxication, driving while intoxicated, etc.) in the 6 months following discharge, a marked decline from 28% in the year before treatment;
• There was a similar decline, from 32% to 11%, in the percentage of clients arrested for non-substance offenses such as shoplifting, burglary, prostitution, or assault;
• 16% of clients reported committing alcohol or drug offenses in the month before the 6-month follow-up, down from 36% in the month before treatment entry; and
• A similar decline was seen, from 36% to 9%, in the percentage of clients acknowledging commission of any non-substance offenses.

Economic Well-Being. Many RWC/PPW projects provided vocational training and other programs aimed at increasing clients’ self-sufficiency. Beneficial effects of these efforts were evident in several measures from the 6-month follow-up:

• The percentage of clients receiving continued educational/vocational training in the 6 months after treatment was 21%, as compared to 5% before treatment;
• The current (past 30 day) employment rate was 38% after treatment, as compared to 7% before treatment;
• The percentage of clients reporting employment as their principle source of income during the 6 months after treatment was 29%, as compared to 11% before treatment;
• The percentage of clients reporting illegal activities (selling drugs, burglary/theft, prostitution, etc.) as their principle source of income during the 6 months after treatment was 2%, as compared to 7% before treatment.

Personal Relationships. Many clients entered treatment with histories of family and other relationships that contributed to their chemical dependencies. Widespread changes in such relationships were evident following treatment. For example,

• The percentage of clients living with an alcohol- or drug-involved spouse or partner declined from 45% to 12%; and
• The percentage of clients reporting that they and their family use drugs together declined from 26% to 4%.

Parenting Status. Many RWC/PPW clients entered treatment under judicial observation or other circumstances where their chances of regaining or maintaining custody of their children was much in question. Clients’ post-treatment outcomes in this area were a major indicator of the success of the treatment. Often, these results were positive:

• 75% of the clients had physical custody of one or more children 6 months after treatment discharge, an increase from the 54% who had custody of any children shortly before entering treatment;
• 19% of the clients had one or more children living in foster care 6 months after treatment discharge, down from 28% before treatment; and
• In the 6 months following discharge, 11% of the clients had one or more children removed from their care by the local Child Protective Services system; 47% had experienced one or more such removals at some time (ever) before entering treatment.

Length of Stay and Client Outcomes. RWC/PPW projects were designed to provide up to 6-12 months of treatment, depending on the project. Actual length of stays tended to be shorter than the upper limit target. Across projects, the average client length of stay was about 5 months (145 days), but some clients had much shorter stays in treatment: 18% of admitted clients left within the first month of treatment, and an additional 21% stayed for only 1-3 months. As might be expected, outcomes tended to be better for comparatively long-staying clients than for those who left early. For example, in the 6 months following discharge, clients who stayed in treatment longer than 3 months differed from those who left within the first 3 months of treatment (i.e., within 90 days) in that they were:

• More likely to remain alcohol or drug free (68% vs. 48%);
• Less likely to be arrested (9% vs. 20%);
• More likely to report employment as their main source of income (36% vs. 19%);
• Less likely to report living with an alcohol- or drug-involved spouse or partner (9% vs. 17%);
• More likely to report having custody of one or more of their children (82% vs. 64%); and
• Less likely to report having had any children removed from their custody by local Child Protective Services agencies (7% vs. 16%).

Group Differences in Client Outcomes. At the onset of treatment, RWC/PPW clients were diverse in many respects. They came from different race/ethnicity backgrounds. Many reported significant mental health problems, while others did not. Many reported having been victims of sexual or other abuse, while other clients did not report such problems. Many had completed high school (or equivalent), while many others had not. These are among a great many intake client characteristics that were NOT predictive of post-treatment alcohol or drug abstinence vs. relapse. It appears that RWC/PPW treatment was consistently effective for clients of widely diverse needs and backgrounds.

1. Footnote: Outcome analyses are limited to 32 projects that were able to provide usable post-discharge interview data for at least half of their time-eligible clients. Collectively, these projects submitted follow-up interviews for 1,131 (62%) of 1,838 former clients who were time-eligible for follow-up during the study period. Follow-up response rates were not even across client subgroups, however. Most notably, the response rate was an impressive 80% for clients who were in treatment for 6 months or more, but it was only 46% for clients who left treatment within the first 30 days. Accordingly, each project’s outcome data were statistically adjusted to compensate for the under-representation of short-stay clients. All reported client outcome findings are non-response-adjusted; they are more accurate, albeit less favorable (positive) than the raw, unadjusted data