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Focus on Alcohol & Drug Abuse: Improving Service Delivery for Individuals With Co-occurring Disorders: New Perspectives on the Quadrant Model

Dr. Keyser is a management scientist at RAND Corporation and associate director of RAND-University of Pittsburgh Health Institute, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213-2665 (e-mail: keyser{at}rand.org). Dr. Watkins is a senior behavioral scientist at RAND Corporation, Santa Monica. Ms. Vilamovska is a doctoral fellow at the Pardee RAND Graduate School and an assistant policy analyst at RAND Corporation, Santa Monica. Dr. Pincus is professor and vice-chair, Department of Psychiatry, Columbia University, New York, and senior scientist at RAND Corporation, Pittsburgh. Shelly F. Greenfield, M.D., M.P.H., served as editor of this column.

This column summarizes findings of a study that examined the usefulness of the quadrant model for improving service delivery for persons with co-occurring disorders. The authors discuss treatment recommendations, goals and barriers related to delivering care, policy recommendations for implementing evidence-based interventions, and strengths and limitations of the model. They conclude that although the quadrant model is useful for conceptualizing systems-level factors for improving delivery, its further development is unlikely to result in improved care at the clinical level. They call for research to develop and implement evidence-based practices targeted to specific populations of persons with co-occurring disorders.

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