This article draws attention to some empirical patterns in the research literature that raise questions concerning how effective the dominant modes of therapy are and whether coercive treatment is similarly successful. Several classic studies show that although clients in treatment programs do improve on their drug use, so do comparison groups comprised of people who drop out. Furthermore, this pattern of change seems to apply regardless of treatment philosophy. Contradictory assumptions among some of the programs cloud the interpretation of what brings the changes about. In addition, it is far from clear that coerced clients move closer to therapeutic objectives because of longer stays in treatment. The article concludes with recommendations for future research to address some of these issues.
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