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Matrix Model Intensive Outpatient Program

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Matrix Model Intensive Outpatient Program has been rated by the CEBC in the area of: Substance Abuse Treatment (Adult).

Target Population: Adults with substance abuse disorders

Brief Description

The Matrix Model Intensive Outpatient Program is an intensive outpatient treatment approach for substance abuse and dependence. The intervention consists of relapse-prevention groups, education groups, social-support groups, individual counseling, and urine and breath testing delivered over a 16-week period. Patients learn about addiction and relapse, receive direction and support from a trained therapist, become familiar with self-help programs, and are monitored by urine testing. It is a cognitive/behavioral approach imbued with a motivational interviewing style.

Program Goals:

The overall goals of Matrix Model Intensive Outpatient Program are:

  • Abstinence or decreased alcohol or other drug use
  • Understanding of addiction and relapse
  • Knowledge of relapse prevention skills
  • Development of pro-social behaviors

Essential Components

The essential components of the Matrix Model Intensive Outpatient Program include:

  • Using manualized Matrix materials
  • Attending 2 Relapse Prevention groups (8-12 participants) per week and one Family Education group
  • Attending 2 Early Recovery Skills groups (8-12 participants) per week in month one
  • Being subject to weekly urine/breath testing
  • Using cognitive/behavioral references
  • Reading and discussing a topic in each group

Child/Adolescent Services

Matrix Model Intensive Outpatient Program does not directly provide services to children/adolescents.

Parent/Caregiver Services

Matrix Model Intensive Outpatient Program does not directly provide services to parents.

Adult Services

Matrix Model Intensive Outpatient Program directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

  • Substance abuse disorders

Delivery Setting

This program is typically conducted in a(n):

  • Outpatient Clinic

Homework

Matrix Model Intensive Outpatient Program includes a homework component:

Participants are asked to adhere to scheduled activities.

Languages

Matrix Model Intensive Outpatient Program has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • One full-time counselor per 25 clients
  • Adequate space for group of 12
  • One room large enough to accommodate clients and families for family/education (25-30 people)
  • DVD or VHS player

Minimum Provider Qualifications

Receive initial 2-day training followed by 2-day "key supervisor" training.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Both onsite and at the Los Angeles clinics.

Number of days/hours:

2 days standard training plus 2 days Key Supervisor training.

Implementation Information

Since Matrix Model Intensive Outpatient Program is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Matrix Model Intensive Outpatient Program.

Formal Support for Implementation

There is formal support available for implementation of Matrix Model Intensive Outpatient Program as listed below:

Key supervisors have ongoing access to Matrix trainers and clinicians for consultation.

Fidelity Measures

There are fidelity measures for Matrix Model Intensive Outpatient Program as listed below:

Detailed treatment manuals with guide for each treatment component and each session are available from the Substance Abuse and Mental Health Services Administration (SAMHSA, www.samhsa.gov) and Hazelden publishing (www.hazelden.org/web/go/matrix).

Implementation Guides or Manuals

There are implementation guides or manuals for Matrix Model Intensive Outpatient Program as listed below:

There are 2 fidelity measures: one for content, and one for program structure.

Research on How to Implement the Program

Research has not been conducted on how to implement Matrix Model Intensive Outpatient Program.

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Rawson, R. A., Obert, J. L., McCann, M. J., & Ling, W. (1991). Psychological approaches to the treatment of cocaine dependence – A neurobehavioral approach. Journal of Addictive Diseases, 11(2), 97-120.

Type of Study: Open trial; within-group pre/post-test design
Number of Participants: 486 (Beverly Hills: n=314, Rancho Cucamonga: n=172)

Population:

  • Age range — 20-40 years; Mean 29.6 years
  • Race/Ethnicity — 76% Caucasian/Anglo, 15% African American, 8% Hispanic, 1% Other
  • Gender — 74% male, 26% female
  • Status — Participants were volunteers who were interviewed at the Beverly Hills & Rancho Cucamonga, CA, Matrix Center offices.

Location / Institution: Two Matrix Center offices (Beverly Hills & Rancho Cucamonga)

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This large-scale open trial was conducted to provide a foundation for future systematic studies of the Matrix Model for Adults. Participants volunteered to participate in the evaluation of the Matrix Model for Adults to treat cocaine abuse. Weekly urine samples taken on a random basis were used to measure substance use, in addition to participants’ self-report. Of those participants who completed the six-month phase of treatment, similar proportions in both sites completed the Matrix Model for Adults program with no cocaine use detected by urinalysis or self-report (Beverly Hills – 44%; Rancho Cucamonga – 40%). Limitations of the study include the lack of a no-treatment control group and follow-up assessments.

Length of post-intervention follow-up: None.

Shoptaw, S., Rawson, R. A., McCann, M. J., & Obert, J. L. (1994). The Matrix Model of outpatient stimulant abuse treatment: Evidence of efficacy. Journal of Addictive Diseases, 13(4). 129-141.

Type of Study: Randomized double-blind controlled trial
Number of Participants: 146

Population:

  • Age range — Doesn’t specify; average 31 years
  • Race/Ethnicity — 26.7% African American, 61.6% Caucasian, 11.7% Latino
  • Gender — 19% females, 81% males
  • Status — Participants all met DSM-III-R diagnoses for stimulant abuse or dependence.

Location / Institution: Matrix Institute on Addictions, UCLA Department of Psychiatry, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the effectiveness of Matrix Model for Adults outpatient stimulant treatment by associating subjects’ in-treatment abstinence data, treatment lengths, and weekly treatment activities to their 6-month abstinence outcomes. Participants were randomly assigned to one of three treatment conditions: Matrix Model for Adults treatment only, Matrix Model for Adults treatment plus desipramine (an antidepressant that may reduce cocaine withdrawal symptoms), or Matrix Model for Adults treatment plus placebo. Measures to assess drug use and behaviors included the Addiction Severity Index (ASI), Behavioral Change Index (BCI), Center for Epidemiological Studies-Depression (CES-D), as well as urinalyses and self-report measures during treatment, at 6-months, and 12-months after treatment entry. Results showed that those who received longer Matrix Model for Adults treatment episodes demonstrated better abstinence outcomes. Ethnicity was one subject characteristic that associated significantly with outcome; African American subjects, for example, had significantly fewer weeks in treatment than Caucasian subjects. Methamphetamine-dependent participants showed significantly better abstinence outcomes than cocaine participants in attaining abstinence for 3 consecutive weeks, for 8 consecutive weeks, and at 6-month follow-up. Through 6 months of treatment, participants averaged 67.3% negative results on the drug tests. Limitations include the lack of a no-treatment control group and the variation in lengths of treatment among participants.

Length of post-intervention follow-up: Varied; 6-month follow-up, but some had 6 months of treatment.

Rawson, R. A., Shoptow, S. J., Obert, J. L., McCann, M. J., Hasson, A. L., Marinelli-Casey, P. J., Ling, W. (1995). An intensive outpatient approach for cocaine abuse treatment: The Matrix Model. Journal of Substance Abuse Treatment, 12(2), 117-127.

Type of Study: Randomized controlled trial
Number of Participants: 100

Population:

  • Age range — Mean = 31 years
  • Race/Ethnicity — 50% Caucasian, 27% African American, 23% Latin American
  • Gender — Doesn’t specify, but average subject was male
  • Status — Participants were all cocaine abusers seeking treatment.

Location / Institution: Matrix Institute in California

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Participants were randomly assigned to a Matrix Model for Adults treatment condition or to a condition of referral to treatment at “other available community resources.” Measures to assess drug use included urinalyses, time-line follow-back self-report technique, and the Addiction Severity Index (ASI). Psychosocial functioning was measured using the Profile of Mood States (POMS) and the Center for Epidemiologic Studies-Depression (CES-D). Both groups of subjects reported significant reductions in their cocaine use over the 12-month study period. A notable limitation of the study is the variation in treatment length among subjects. Note: Two additional non-randomized studies are also described in this paper.

Length of post-intervention follow-up: 6-11 months (treatment ranged from 4 weeks to 6 months, with 12-month post-intake follow-up).

Rawson, R. A., Marinelli-Casey, P., Anglin, M. D., Dickow, A., Frazier, Y., Gallagher, C., The Methamphetamine Treatment Project Corporate Authors. (2004). A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence. Addiction, 99, 708-717.

Type of Study: Randomized controlled trial
Number of Participants: 978

Population:

  • Age range — 18+ years
  • Race/Ethnicity — 60% Caucasian, 18% Hispanic, 17% Asian/Pacific Islander
  • Gender — 45% male, 55% female
  • Status — Participants were all methamphetamine (MA)-dependent & were recruited through a variety of means, including media advertisements, referrals from community agencies, and word of mouth.

Location / Institution: Eight community out-patient settings: Women’s Addiction Treatment Center of Hawaii, Honolulu, HI; San Mateo County Alcohol and Drug Services, Belmont, CA; New Leaf Treatment Center, Concord, CA; Matrix Institute on Addictions, Costa Mesa, CA; Matrix Institute on Addictions, Los Angeles, CA; The Family Recover Center, Eye Counseling and Crisis Services, San Diego, CA; Journey Recovery Chemical Dependency Treatment Program, Billings, Montana; East Bay Community Recovery Project, Hayward, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Over an 18-month period between 1999 and 2001, treatment-seeking, methamphetamine (MA)-dependent people were randomly assigned to receive either treatment as usual (TAU) or a manualized 16-week treatment (Matrix Model for Adults). Measures to assess drug use included the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) MA-dependence checklist, the Addiction Severity Index (ASI; fifth edition), as well as weekly urine samples. Participants in the Matrix Model for Adults condition provided more MA-negative urine samples during the treatment period across all but the drug-court site. In overall analyses, the Matrix Model for Adults approach showed better treatment retention and program completion than the TAU condition. However, at discharge and 6-month follow-up, participants in both conditions demonstrated nearly a threefold reduction in mean days of MA use from baseline; the in-treatment superiority of the Matrix Model for Adults approach was not demonstrated at post-treatment measurement points.

Length of post-intervention follow-up: 2-8 months (16 weeks/4 months of Matrix Model for Adults treatment; 6 and 12-month follow-ups post-admission).

References

Show references...

Obert, J. L., Brown, A. H., London, E. D. & Rawson, R. (2002). Incorporating brain research findings into standard treatment: An example using the Matrix Model. Journal of Substance Abuse Treatment, 23, 107-113.

Obert, J. L., Brown, A. H., Zweben, J., Christian, D., Delmhorst, J., Minsky, S., …Weiner, A. (2005). When treatment meets research: Clinical perspectives from the CSAT Methamphetamine Treatment Project. Journal of Substance Abuse Treatment, 28, 231–237.

Rawson, R. A., Huber, A., Brethen, P. R., Obert, J. L., Gulati, V., Shoptaw, S. J., & Ling, W. (2002). Status of methamphetamine users 2-5 years after oupatient treatment. Journal of Addictive Diseases, 21, 107-119.

Rawson, R. A., McCann, M. J., & Obert, J. L. (2005). The Matrix Model Handouts and Worksheets. The Family Unit Spanish CD-Rom. Center City, Minnesota: Hazelden.

Rawson, R. A., McCann, M. J., & Obert, J. L. (2005). The Matrix Model Handouts and Worksheets. Spanish CD-Rom. Center City, Minnesota: Hazelden.

Rawson, R. A., Obert, J. L., McCann, M. J., & Mann, A. J. (1986). Cocaine treatment outcome: Cocaine use following inpatient, outpatient, and no treatment. In L.S. Harris, (Ed.). Problems of drug dependence: Proceedings of the 47th Annual Scientific Meeting, the Committee on Problems of Drug Dependence (pp. 271-277). NIDA Research Monograph Series, Number 67. DHHS Pub. No. (ADM) 86-1448. Rockville, MD: National Institute on Drug Abuse.

Contact Information

Name: Michael McCann, MA
Agency/Affiliation: Matrix Institute on Addictions
Website: www.matrixinstitute.org
Email:
Phone: (310) 478-6006
Fax: (310) 478-6117

Date Research Evidence Last Reviewed by CEBC: June 2012

Date Program Content Last Reviewed by Program Staff: April 2014

Date Program Originally Loaded onto CEBC: July 2010