Matrix Model

The Matrix Model is an intensive outpatient treatment approach for substance 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.

The mission of this program is to improve the lives of individuals and families affected by alcohol and other drug use through treatment, education, and research.

Matrix participants were 38% more likely to stay in treatment and 27% more likely to complete treatment compared to nonparticipants. Stimulant drug-use indicators were significantly reduced during treatment for Matrix participants. They also produced more drug-free urine samples compared to nonparticipants.

The Matrix Model has been extensively disseminated over the past decade. The Matrix treatment manuals (Hazelden, 2005) have been acquired by agencies/providers in all 50 states. The Matrix Model for stimulant use disorders has been published by the Center of Substance Abuse Treatment (SAMHSA, 2006).

Dissemination and Training:
There are standard training curricula, fidelity instruments, quality assurance protocols, and outcomes management system protocols. Training procedures consist of an initial 2-day, core training session with follow-up training with the person at each site identified as the "Key Supervisor." This person receives additional training and ongoing guidance in clinical supervision and maintenance of fidelity. Key Supervisors have access to consultations with experienced Matrix clinicians, are listed on the Matrix website as Key Supervisors, and participate in a national listserve designed to connect all the Key Supervisors in the country.

Fidelity Assessment and Program Certification:
Programs that have received training from Matrix Institute trainers and have implemented the Matrix Model with a Key Supervisor are eligible to apply for certification from the Matrix Institute. This certification determines whether the program is operating according to fidelity. A determination is made on the basis of the fidelity assessments to not certify, or to award a Certificate of Compliance or a Certificate of Excellence valid for 3 years.

Matrix has trained people from Abu Dhabi, Nicaragua, Thailand, South Africa, New Zealand, Australia, Spain, Vietnam, Mexico, Brazil, Slovakia, Israel, Palestine, Curacao, Turkey, Saipan, Switzerland, Canada, Japan, and Egypt.

The manuals have been translated into Thai, Arabic, Farsi, Spanish, Portuguese, Vietnamese, Slovakian, Afrikaans, and Japanese.

Results of a multi-site, controlled trial of the Matrix Model for stimulant dependence found that Matrix participants were 38% more likely to stay in treatment compared with participants receiving treatment as usual (odds ratio = 1.384). Matrix participants were also 27% more likely to complete treatment than participants receiving treatment as usual. Stimulant drug-use indicators were significantly reduced during treatment for both Matrix participants and the treatment-as-usual participants. The frequency of methamphetamine use, as measured by the mean number of days used in the past 30 days, declined from 11 days at the beginning of treatment to 4 days at treatment discharge. Compared with a subgroup of participants receiving 12 weeks of total treatment at comparison sites, Matrix participants on average produced more drug-free urine samples (4.3 versus 3.3).