Bright Spot: Matrix Model

Photo by Rémi Walle on Unsplash

This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

Overview

Detailed Description

The Matrix Model is an intensive outpatient treatment approach for stimulant abuse and dependence that was developed through 20 years of experience in real-world treatment settings. 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 issues critical to addiction and relapse, receive direction and support from a trained therapist, become familiar with self-help programs, and are monitored for drug use by urine testing. The program includes education for family members affected by the addiction. The therapist functions simultaneously as teacher and coach, fostering a positive, encouraging relationship with the patient and using that relationship to reinforce positive behavior change. The interaction between the therapist and the patient is realistic and direct, but not confrontational or parental. Therapists are trained to conduct treatment sessions in a way that promotes the patient's self-esteem, dignity, and self-worth.

Expected Outcomes

The expected outcomes are:

Increase in treatment retention
Increase in treatment completion
Decrease in drug use during treatment

Cost Details

Publicly funded treatment costs for Matrix Model services are approximately $1,900 per client. Average reimbursement from private insurance/managed care is approximately $3,500. The costs include:

The Matrix Adult Model with DVDs - $599
2-day, on-site training - $5,000 for up to 20 participants
2-day, off-site training - $500 per participant
2.5-day advanced Key Supervisor training (includes Matrix fidelity Instruments) - $1,000 per participant

Key Steps for Implementation

Matrix is provided in an individual/family or group setting three times per week for 16 weeks. Before implementing Matrix, providers should ensure that service authorizations are made for the entire 16-week period required by the treatment model. Providers should note that Matrix's focus on retention of challenging clients can improve both clinical outcomes and the agency's fiscal bottom line. Matrix delivery requires both extensive training and qualified clinical supervision to be delivered correctly. There are no official therapist/licensure requirements for this practice. However, providers should use staff who are trained in cognitive behavioral therapy and can for bill outpatient counseling services. To be sure that the program is being used correctly, staff will need to perform routine chart reviews and patient outcome assessments. A free publication Client's Handbooks: Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders was published by the Substance Abuse Mental Health Services Administration, Center for Substance Abuse Treatment.

Special Infrastructure

Outpatient setting

Training

The therapist manuals, patient binder, DVDs, and other materials provide useful information to both therapists and administrators relevant to implementation. Implementation materials also include a family component, which is at a skill level consistent with substance abuse staff who may not have had formal family therapy training. Implementation materials have also been translated into several languages. A variety of trainings across the country are provided almost weekly, in addition to available coaching and supervisor training. Training includes a discussion that supports systems adoption and successful technology transfer. Quality assurance is supported by process and performance fidelity assessment, including routine chart reviews and patient outcome assessment

Types of Staff

There are no official therapist/licensure requirements for this practice. However, providers should use staff who are trained in cognitive behavioral therapy and can for bill outpatient counseling services.

Outcome Measures

Outcome:

Successful (Stopped drug use; or, returned to work/school; or attended 75% or more of scheduled program)
Unsuccessful (Continued drug use; or, attended less than 75% of scheduled program)
Referred to another program
Global assessment of outcome
Employment/educational status
Relationships/family
Abuse of primary substance
Secondary drug/alcohol problem
Psychiatric problems
Legal problems
Living arrangements
Physical health
Global assessment of functioning: family involvement
Client satisfaction (as measured through a survey)

Process Measures

Attendance