Restructuring Services for Drug Abusing TANF Women (Morgenstern, PI)

The primary goal of this study is to rigorously evaluate the effectiveness and costs of two contrasting approaches to organizing and structuring substance abuse treatment for women entering welfare-to-work programs. One approach will deliver standard care. The alternative approach will deliver care based on an innovative, public health model. Evidence-based interventions will serve as the core components of the innovative approach. The context of this study is a naturally occurring experiment. The State of New Jersey is conducting a welfare demonstration project in two counties. Women in welfare-to-work programs with substance abuse problems will be randomly assigned to two intervention conditions, standard care or innovative care. This study will evaluate the two-year outcomes of the demonstration project. In addition, the study will compare outcomes and costs of the substance abusing women in the demonstration with those of a comparison group of non-symptomatic women in welfare-to work programs. The study sample will consist of 600 women diagnosed with DSM-IV substance abuse only, and 600 women diagnosed with DSM-IV substance dependence who are participants in the demonstration. In addition, 200 non-symptomatic women in welfare-to work programs will be studied. All study participants will be recruited at two welfare offices, assessed at baseline, and followed in-person at 3, 6, 12, 18, and 24 months. The study will examine treatment utilization patterns, and substance abuse, employment and other psychosocial outcomes. In addition, a full cost study including cost-effectiveness and cost-benefit analyses will be conducted.