Who is serving drug abuse clients: Treatment delivery by professionals versus paraprofessionals, by paid staff versus volunteers

In two national studies we have detailed who is treating drug addicts, and, from staff evaluation and client progress, how well they are providing these services. In our first study, we contrasted three groups of paid counselors in drug-free outpatient (DF) and methadone maintenance (MM) modalities: 1) professional counselors with no addiction background who held at least a bachelor of arts degree (PROs); 2) ex-addict paraprofessional counselors who did not hold a bachelor's degree (EXAs); and 3) non-ex-addict paraprofessional counselors who had neither a bachelor's degree nor a history of drug addiction (NEAs). These counselor groups were contrasted in terms of their functions and activities in the program, their attitudes to clients, the attitudes of clients to them, and the progress of their clients in treatment. In the second study we examined the services provided by volunteers in more than 100 drug-free outpatient and therapeutic community (TC) programs nationwide. Here we detailed the services provided by both specialized volunteers such as physicians, lawyers, and psychologists, and, more importantly for our purposes here, by volunteer counselors. We explored the views of program administrators and paid counselors on the worth of program volunteers, and on the staff support, training, and supervision required to use volunteers. We examined in some detail sources of volunteers and their motivations for and satisfactions with volunteering.