DOCUMENT RESUME

ED 214 048 CG 015 782

AUTHOR Aiken, Liona S.; And OthersTITLE A Study of Volunteers in Drug Abuse Programs.

Treatment Research Report.INSTITUTION Temple Univ., Philadelphia,, Pa. Inst. for Survey

Research.SPONS AGENCY National Inst. on Drug Abuse (DHHS/PHS), Rockville,

Md. Div. of Prevention and Treatment Development.REPORT NO DHHS-ADM-81-1147PUB DATE 81CONTRACT NIDA-271-77-4516NOTE 19p.

EDRS PRICEDESCRIPTORS

MF01/PC01 Plus Postage.*Counselor Role; Drug Abuse; *Drug Rehabilitation;Job Performance; *Paraprofessional Personnel; PeerEvaluation; *Personnel Evaluation; *ProfessionalPersonnel; Role Perception; Staff Role; *Volunteers;Work Attitudes

ABSTRACTVolunteers have made significant contributions to

mental health by assisting with institutional care, outpatientcounseling, aftercare, and research. To describe the use ofvolunteers in drug abuse treatment programs, volunteers were studiedby a telephone survey of administrators -in 123 programs that had atleast five volunteers and a single treatment modality, and byin-person interviews with volunteers and paid counselors for 15programs. The volunteers were classified into three occupationalgroups, i.e., specialized professionals, counselors, andnoncounseling support personnel. The results indicated that: (1) thecounselor category had the largest number of volunteers; (2)volunteer professionals were often psychologists or lawyers; (3)activities of volunteer and paid staff differed in degree rather thankind; (4) drug-free and therapeutic community programs differed inbackground, type of volunteer, and kind of volunteer activity; and(5) main sources of volunteers were colleges, communityorganizations, and former clients from a program. The findingsinuicate a need for more volunteers as well as a pattern ofsuccessful programs using volunteers in the field of drug abuse.(NRB)

************************************************************************ Reproductions supplied by EDRS are the best that can be made *

* from the original document. *

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National Institute on Drug Abuse

TREATMENTRESEARCH i

REPORT

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U.S. DEPARTMENT OF EDUCATIONNATIONAL INSTITUTE OF EDUCATION

EDUCATIONAL RESOURCES INFORMATIONCENTER (ERIC)

(:). this document has been reproduced asreceived from the pmson or orgenizatronoriginating n

X Minor changes have been made to improvereproduction duality

APoints of view or opinions stated in this document do not necessards represent official NIEposition or policy

A STUDYOF VOLUNTEERS

IN

DRUG ABUSEPROGRAMS

Leona S. AikenLeonard A. LoScuitoMary Ann Ausetts

Institute for Survey ResearchTempi. UniversityPhila phia, PA

441

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health Service

Alcohol, Drug Abuse, and Mental Health Administration

The'Treatment Research Reports and Monograph Series are issued by the TreatmentResearch and Assessment Branch, Division of Prevention and TreatmentDevelopment, National Institute of Drug Abuse (NIDA). Their primary purpose is toprovide' reports to the, drug abuse treatment community on the service delivery andpolicy-oriented findings from Branch-sponsored studies, innovative service deliverymodels for different client populations, innovative treatment management andfinancing techniques, and treatment outcome studies.

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This publication was written for the National Institute on Drug Abuse by the Institute for Survey Research,Temple University, Philadelphia, Pennsylvania, under contract No. 271-77-4516.

All materials appearing in this report are in the public domain and may be reproduced or copied withoutpermission from the National Institute on Drug Abuse or the authors. Citation as to source is appreciated.

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DHHS Publication No. (ADM)81-1147Printed 1981

FOREWORD

Volunteer workers have made significant contributions to mental health by assisting with institutional care,outpatient counseling, aftercare, and even research. Much effort has been expended in studying the roles ofvolunteer workers in the mental health field. However, little has been known about the role of the volunteerin the drug abuse field even though volunteers constitute one -fifth of all drug treatment staff andone-fourth of all drug abuse counseling staff.

This study goes a long way in clarifying volunteers' roles and activities, their backgrounds and jobsatisfactions. The investigators also examine the reservations paid staff feel about volunteer activity and

the benefits both administrative and counseling staffs derive from their work with volunteers.

This study not only provides useful information about the current state of volunteerism in the drug abusefield but should also influence future programmatic and research activities.

Rebecca-S. AsheryTreatment Research and Asssessrnent BranchDivisior, of Prevention and Treatment DevelopmentNational Institute on Drug Abuse

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SUMMARY

The purpose of this study was to describe the use of volunteers in drug abuse treatment programs along anumber of dimensions such as functions and activities, volunteer background, and staff attitude towardvolunteers. Volunteers in drug abuse programs were studied in two phases: (I) a telephone survey ofadministrators in 123 programs meeting the criteria of having at least five volunteers and a singletreatment modality; andc(2) in-person interviews with volunteers and paid ccinselors for 15 programs.Volunteers were classified into three occupational groups

a) Specialized professionals, including physicians, lawyers, psychiatrists, nurses, and social workersb) Counselorsc) Support personnel with noncounseling or administrative functions.

Some of the study's findings were as follows

o The counselor category had the largest number of volunteers.

o The two most frequently occurring types of volunteer professionals were psychologists and lawyers.

o Programs in the sample were more likely to have volunteer staff only rather than paid staff only in thecategories of physicians, psychiatrists, vocational counselors, social workers, nurses, and lawyers.

o It should be noted that the activities of volunteers and paid staff differed in degree rather than kind.

o Volunteer counselors' experience with drugs ranged from 8 percent who had tried heroin to 80 percentwho had used marijuana and alcohol to excess.

o Drug free and therapeutic community programs differed in background and type of volunteer and in kindof volunteer activity.

o Main sources of volunteers were colleges, community organizations, and former clients from the program.

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CONTENTS

Page

FOREWORD 3

SUMMARY 4

INTRODUCTIONStudy Issues and PurposesBackground 7

METHOD 9Phase I - Telephone Survey 9

Phase II - On-Site Survey 9

Limitations of the Study 9Questionnaires and Interviews 9

Data Analysis 0

FINDINGS 0Volunteer Background and Characteristics 0

Training and Experience 0

Hours of Work 0

Length of Time Worked as a Volunteer 0

Volunteer Job Satisfaction 0

Sources and Types of VolunteersMotivation for VolunteeringSelection of Volunteers

Distribution of Volunteers and Paid Staff ;1Total Number of Volunteers 11

Volunteers Versus Paid Staff IIFunctions of Volunteers 12

Specialized Volunteers 13

Volunteer Counselors 13

Noncounseiing Volunteer Functions' 1'Comparison of Volunteer and Paid Staff 15

Volunteer Aid to Counselors 15

Paid Counselors' Rating of Volunteers 15

Drug Use Among Volunteers and Paid Counselors 16

Attitudes of Administrators Who Have No Volunteers in Their Programs 17

SUMMARY AND CONCLUSIONS 18

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S

A STUDY OF VOLUNTEERSIN DRUG ABUSE PROGRAMS

Leona S. AikenLeonard A. LoSciutoMary Ann Ausetts

Institute for Survey ResearchTemple University, Philadelphia, Pennsylvania

Introduction

Study Issues and Purposes

This is a descriptive report of a two-partinvestigation on the use of volunteers in drug abusetreatment programs. The study was motivated bythe substantial use of volunteers in the Overallstaffing of drug treatment programs throughoutthe country. Although there have been manystudies on volunteers in the mental health field,little is known about the role of volunteers workingin drug abuse piograms. The purpose of the studyis to provide information about volunteers in thefield of drug abuse. The study describes volunteerbackground and characteristics, functions ofvolunteers, comparison of volunteer functions withpaid staff, drug use by volunteers, Volunteermotivation and job satisfaction, and other aspectsof vo'...Inteerism.

Background

Each year all drug treatment programs in thecountry are examined through the National DrugAbuse Treatment Utilization Surveys (NDATUS) todocument, among other things, the staff com-position of programs. Information is collected onthe numbers of volunteer versus paid staff in eachof 11 staff categories. Table 1 shows the findingsfor 1976, 1977, and 1978.1

'Summaries appear in the following documents:

a. For 1977-1978, see Data from the NationalDrug Abuse Treatment Utilization Survey(NDATUS). NIDA Statistical Series, SeriesF, Number 6, Final Report, April 1978.

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Overall, the proportion 0f all staff who werevolunteersin 1978 .was 17 percent, a sizable dropfrom 24 pe cent in 1976. However, it still indi-cates a substantial dependence by the programs onvolunteer participation.

The predominant category of volunteer wascounselor, which represented 40 percent of allvolunteers in 1976, 53 percent in 1977, and56 percent in 1978.

Lawyers were unique in that each year there weremore volunteer than paid lawyers.

A substantial number of volunteers fell into the"noncounseling" category that included, for exam-ple, hotline, social services, and clerical supportworkers.

The number of volunteer administrative staff fellfrom 14 percent in 1976 to 6 percent in 1978.

According to the Surveys of 1977 and 1978,volunteers constitute almost one-fifth of all drugtreatment staff. The proportion is even higheramong drug counselors, with volunteers consti-tuting almost one-fourth of all counselors in thesesame years. In addition, there is a difference involunteer use within modalities with volunteersbeing more involved in residential and outpatientthan methadone maintenance programs.

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b. For 1976, see Data from the National DrugAbuse Treatment Utilization Survey(NDATUS). NIDA Statistical.; Series, SeriesF, Number 3, Executive Report, April 1977.

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Table 1.-Actual numbers of paid and volunteer staff in treatment service units

Staffing categories19761 19772 19783Paid Volunteer Paid Volunteer Paid VolunteerNumber Percent Number Percent Number Percent Number Percent Number Percent Number Percent

Physicians 1,746 4 476 3 1,339 4 165 2 11 1,401 4 244 4Psychiatrists 1,686 4 220 2 1,141 3 99 1 1,426 4 154 2Psychologists 2,299 5 389 1,551 5 160 2 2,111 6 232 3Social Workers (MSW) 2,947 6 394 3 1,946 6 312 4 2,083 6 233-.-Nurses 4,3621 10 377 3 3,569 11 183 3 3,746 10 233 3Lawyers 24 341 2- 91 148 2 96 -- 210 3Counselors 13,59' 30 5,789 40 11,812 36 3,825 53 13,274 38 4,034 56Degreed Counselors (BA, MA) (4) (4) (4) (4) 7,009 20 960 13oo Non-Degreed Counselors (4) (4) (4) (4) 6,265 18 3,074 43Vocational Specialists (5) (5) h57 2 145 2 772 2 97 1Administrative Staff 9,657 21 1,984 . 14 7,603 23 389 5 7,687 22 420 6Other 9,096 20 4,414 31 3,534 11 1,849 25 3,042 8 1,404 19TOTAL 45,591 100 14,384 100 33,243 100 7,275 100 35,638 100 7,261 100

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Based on 3,878 treatment service units2Based on 3,107 treatment service units.

3Based on 3,248 treatment service units.

4There was only one category for counseling staff in 1976 and 1977 which included degreed and nondegreed counselors.5This category was not included in 1976.

Note: This table was Compiled from Data from the National Drug Abuse Treatment Utilization Survey (NDATUS).Series F, Number 3, Elqcecutive Report, April 1977 and Series F, Number 6, Final Report, April 1978.

INIDA Statistical Series,

Method

The study was performed in 1979 in two phases:(I) A telephone survey of the administrators ofnearly 311 the therapeutic corhmunity, outpatientdrug free, and methadone m3intenance treatmentprograms across the, countri which had five ormore yolunteers listed in NtTIJS 1978, andtelephone interviews with a inistrators of .15programs that had no volunteers to identifyreasons for nonutilization. (2) Based on data fromphase I, visits were made to f.5 programs acrossthe country in the drug free outpatient and,residential modalities which made especiallyextensive use of volunteers. Face-to-face inter -views were conducted with a variety of volunteersand with paid counselors.

For purposes of the investigation, volunteers weredefined as people' who work for no pay and for atleast I hour per week in the program. Studentswho might be doing internships in a program wereincluded in the definition so long as they were notbeing paid. In this regard, course credit was notconsidered pay.

The role of the volunteer covers a wide range oftasks, including community edication, interagencyrelationships, program administration, counselingin the community, client administration, personalaid ,o clients, socializing with clients, psycho-logical/psychiatric services, medical/dental ser-vices, legal services, and research.

Phase! - Telephone Survey

The programs were selected from the 1978NDATUS File which contains data on 3,248 drugabuse treatment units representing 97 percent ofall known drug abuse treatment facilities in thenation. Approximately 7,260 volunteers staffeddrug abuse treatment units during that year. Thetwo major stratification variables for programsampling were region of the country and treat-ment modality. The continental United States wasdivided into four regions for sampling, theNortheat.t, North Central, South, and West. Thiswas to assure a representative sample throughoutthe country. Data were not analyzed by regions.Three treatment modalities were considered: drugfree outpatient and/or daycare (OF), residentialdrug free of therapeutic community (TC), andmethadone maintenance (MM). Only thoseprograms that could be clearly identified as fittinginto one of these three categories were retainedfor study. Multimodality progiams were elimi-nated. By having only unimodality programs,comparisons between modalities could be- made,Out of 138 programs meeting the criteria (at leastfive volunteers and a unimodality program), tele-phone interviews were completed with admini-stratots of 123 or 89 percent of the `eligible

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programs. In addition, telephone interviews 'wereconducted with administrators of 15 programs thatdid not have volunteers but satisfied the sameCriteria and sampling variables.

The 138 programs selected represent the universepf unimodality programs using significant numbersof volunteers. Consequently, data from the 123programs participating in the study can be viewedas reflecting the concerns and issues of all uni-modality programs with large volunteer staffs.

Phase II - On-Site Survey

Site visits were made to 15 of the 123 programswhose administrator,s had been interviewed inPhase I. Criteria for selection were programs witha substantial number of volunteers in both spe-cialized and nonspecialized categories including,wherever possible, volunteer counsellors. Pro-grams were distributed across th" -Iur regions ofthe country with at least one DE aid TC programin each region. In all, nine DF and six TC pro-grams were visited. Methadone programs were notincluded in the site visits because of their limiteduse of volunteers.

Limitations of the Study

The fact that multimodality programs were notincluded in the study could be considered alimitation. While it could be assumed that theresponsibilities of volunteers would be similar,attitudes of volunteers in multimodality programscould differ.

Only two MM programs were studied. Very fewMM programs had at least live volunteers, andmost were parts of larger multimodality pro-grams. Only six MM programs met the specifiedcriteria.

Clients were not interviewed for the study, so itwas pot possible to ascertain their attitudestow;rdthe volunteers and the quality of servicethey felt they received.

Questionnaires and Interviews

Four questionnaires were used to interview thefollowing four groups (a) administrators of 123programs that had at least five yolunteers, (b)adminstrators of 15 programs without volunteers,(c) 51 paid counselors in 15 programs2, and (d) 108volunteers in these same 15 programs. Eachquestionna ire was -high ty structured and dealt withrespondent demographics as well as volunteers'function, background, training, experience, andperceived impact.

2Some of the paid counselors were alsoresponsible for supervisory functions.

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Data Analysis

Because of the nature of the syrdy, the statisticsare typically descriptive. Volunteer functions arereported separately for DF and TC prograrris, aswell as in the aggregate, whenever they variedwith the type of program. With regard to strat-ification by rnodaljty in Phase I, of the 123programs with completed interviews, 95 were DF;another 26, TC; and 2, MM. Because of the dearthof kIM programs; only DF aQd TC data arereported separately; aggregates inch1de the two

-MM programs. Other 'subgroup analyses (e.g., bydemographics) generally did not reveal differences

r in either Phase I or Phase II. Only when thedifferences were evident are they discussed in thisreport.

Findings

Volunteer Background and Characteristics

The 108 volunteers interviewed in Phase 11 (on-siteportion) of the survey were classified into threeoccupational groups: ill specialized professionals(N=3I) with backgrounds as physicians, law,:ers,psychiatristt, nur.es, social workers, etc.; (2) coun-selors (N-47) with or without academic degreesv, ho were mainly responsible for counseling, and(3) noncounseling personnel (N=30) such as admin-istrative support staff, tutors, and hotline coun-selors. Forty-nine of the volunteers were mate,and 59 were female. They had a median age of 31and mean age of 33. The overwhelming majorityof volunteers (92.5 percent) were white. Two-thirds had B.A. degrees or above, 41.8 percent

4were students, 56.4 percent were single, (i.e.,never married, separated, or divorced), and 65.7percent were ernIlloyed as paid workers elsewhere.

Among the 31 professionals, 67.7 percent weremale, while only 36.2 percent of the 47 counselorswere male. Sixteen percent of the counselors and16.6 'percent of the volunteers in noncounselingfunctions reported addiction backgrounds, whilenone of the professionals reported such.

Training -and experience. More DP than TCadministrators reported that volunteers in theirprograms had prior experience in other drug abuseprograms. Fully 25 percent- of--TC administratorsreported that none of their volunteers had previousexperience, while fewer than 10 percent of DF,adininistrators did so.

All 106 programs that had volunteer counselorsprovided in-servic e ti dining. The majority of bothCounselor and noncounselor volunteers had at leastone college course in counseling and other relevanttopics. Furthermore, 44 percent of these volun-teers had rec eived trainink in counseling throughprevious programs in whicf, they had worked.

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The counselor group appeared to be somewhatbetter trained than the noncounseling group, espe-tallylon the- effects of drugs and on drug laws andtheir enforcement. It phould be noted that all butone of the programs sampled also supervised vol-unteer counselors continuously. Most of the pro-grams assigned a staff member direct responsi-bility for the treatment provided by volunteers totheir clients.

Specialized professionals generally . receivedprogram training, or at least an orientation to theprogram. dealing with drug abuse and treatment.Health professionals, moreover, tended to havetaken a number of courses in psychology and othercounseling-related topics during their under-graduate or postgraduate careers.

Hours of work. The median number of hoursworked by volunteers in the sampled programs wasabout 10 per week: However, professionals weremuch more likely to work only a few hours aweek, while counselors were likely to work wellbeyond the 10-hour median.

Length o time worked as a volunteer. Half thevolunteers interviewed had worked for less than 2years in their program. Fewer than 25 percenthad worked more than 4 years at the currentprogram, and none had worked ,Ionger than 9year's. As one might expect, those who had workedin the prograrm longer were less likely to bestudents and -more likely to be older andemployed. Professionals were more likely jo havebeen volunteers longer than the counseling andnoncounseling volunteers.

Volunteer job satisfaction. rtigh levels of satis-facti'on were expressed by volunteers with theirprogram roles. Indeed, all volunteers reported thatthey were satisfied or very satisfied with theirroles. The most frequent reasons for this highdegree of satisfaction were fulfillment and enjoy-ment from helping others, enjoyment of cowork-ers, and enjoyment of putting one's skills to work.

No volunteers planned to leave the programsbecause of any dissatisfaction, and the vastmajority felt that volunteers were needed and wellaccepted by administrators, clients, and counselorsalike. In particular, 81 percent of the volunteerssaw themselves as well accepted by administratorsas people to help with program policy making andplanning. 'Eighty percent thought they were wellaccepted b9 paid counselors in terms of givingclient services. Further, 96 percent gave the samejudgment about clients' acceptance of volun-teers. Counselors substantiated this by reportinlthat cli nt feedback concerning the volunteers waspositive. It should be noted that few volunteerssuggested any substantial need for improvement intheir situations, although one-third felt that moreclient contact would increase their job satis-faction.

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Sources and types of volunteers. Administrators_were asked the extent to which five sources ofvolunteers were tapped: colleges, community.organizations, advertising is the -media, formerclients of the program, and former clients of otherprograms. The most frequently cited sourcesacross modalities were colleges (88 percent),followed by commtrity organilations (76 percent)and former clients from the progrim (74 percent).

The majority of volunteers interviewed first heardabout the program& need for volunteers throughfriends, family, or their own experience with theprogram. Other, information was transmittedthrough teachers, employees, or other .school/workrelated individuals (23 percent), the media (9 per-cent), or direct explorations such as calls byrespondent or program (5 percent).

Most volunteer counselors (85 percent) made thefirst contact with the program. For volunteer

--professionals, however, it was about evenly dividedas to whether the program or the volunteer madethe initial contact.

iii.Differences emerged between modalities in thesource of volunteers. Colleges were the mostfrequent source for DF programs; former clientsJon TC programs.

Motivation for volunteering. Two sets of motivesare often contrasted, each thought to be primaryin attracting volunteers. These sets may besummed up as "altruism" on one hand, and"self-improvement" on the other. In this studyboth were found to be operative. Volunteers weregiven several choices of "main motivations" tovolunteer in the first place. In order of frequencyof choice, 83 percent said they desired to helppeoPle and to help with a societal problem, and65 percent wished to learn something new. Morethan half 157 percent) wished to pick up experiencefor later job opportunities. Curiosity (18 percent)and available time (17 percent) were far behind infrequency of choice. It would seem therefore thatrecruiting strategies need to take account ofaltruistic and self-actualization motives.

Professionals reported altruistic motives morefrequently than the other groups. Counselors onthe other- hand were very much 'concerned with

-..-gaining knowledge and experience for the future.

Only about one-third of the respondentsvolunteered for their *particular program spe-cifically because it was a drug abuse program.About half the volunteer counselors said they didso partly because of a personal, family, or friend'sexperience with drugs. Only one professionalreported such an experience as a motivator.

Selection of volunteers. Numbers of applicationsand screening activities varied widely across pro-grams. Three-quarters of the programs received

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over 20 applications (median=30). The median ofacceptance was SI percent; only one-fifth ofprograms accepted over 75 percent of theapplicants. ..

Distribution of Volunteers and Paid Staff

- Total number of volunteers. The 123 programswith at least 5 volunteers had a median of justunder 25 volunteers per program. Wheri consideredby m6dality,-,the medians were 29 and 14 for theDF and TC modalities, respectively (see -table 2

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for a summary of the distributiori numbers- ofvolunteers in the program).

,Volunteers versus paid staff. The percentage ofSampled programs having at least one volunteer ineach staff category listed' in table 3 wasdetatmined. The same was done for paid staff.Eighty percent had at least one volunteer_counselor, and 92.6 percent had at least one paidadministrative support person. Over half theprograms had both paid and volunteer counselors

'and support staff.

Table 2.-- Distribution of number ofvolunteers in programs

Total number of volunteers in programs

Total number of volunteers Percent of programs

N=4,699 N=123

5 to 10 16.3II to 15 17.116 to 20 8.921 to 30 16.331 to 50 13.851 to 75 13.075 to 100 6.5Over 100 8.1

Total number of volunteers by modality

Total number of volunteers

N=4,699

Percent of programsDF

N=95 N =26 115 to 10 11.6 30.8II to 15 16.8 19.216 to 20 8.4 11.521 to 30 14.7- 19.231 to 50' 14.7 11.551 to 75 15.8 3.875 to 100 8.4 0.0Over 100 9.5 3.8

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Table 3.--Percentage of programs' having paid staff and/or volunteers by staff category

Staff category

.Percent of programswith at least one

volunteer

Percent ofprograms withat least onepaid staff

memberPercent of programs with paid

and/or volunteer staff

Allprograms

QFN 295

TCN.26 Both

Paid Volunteeronly only Neither

'Physician 27.3 29.5 23 1 18.2 5.8 12.4 21.5 60.3

Psychiatrist 26.7 26.6 26.9 24.6 3.3 21.3 23.0 52.5

Lawyer 61.8 62.1 61.5 13.8 1 11.4 2.4 50.4 35.8

Psychologist 39.0 42.1 30.8 48.8 21.1 27.6 17.9 33.3

Social Worker (MSW) 33.3 36.8 19.2 30.1 13.8 16.3 19.5 50.4

Vocational Counselor 24.3 24.7 23.1 18.3 3.5 14.8 20.9 60.9

Nurse 34.1 39.9 15.4 21.1 12.2 8.9/ 22.0 56.9

Counselors 80.5 76.8 92.3 89.4 71.5 17.9 8.9 1.6

Counselor with at leastbachelor's degree 68,3 67.4 69.2 84.6 56.9 27.6 11.4 4.1

Counselor without4 (...,''

bachelor's degree 44.7 32.9 69.2 49.6 25.2 24.4 19.5 30.9

Hotline Worker 46.3 54.7 19.2 2.4 2.4 0.0 43.9 53.7

Administrative SupportStaff 57.9 50.5 80.8 92.6 52.1 40.5 5.8 1.7

I N.123; includes two methadone maimenance programs.

Over 60 percent of the programs had at least onevolunteer lawyer, more than any other specializedprofessional. Half the programs had only volunteerlawyers.

Psychologists . were the next most commonspecialized volunteers in each modality.

Those programs fhat uso,1 staff in specializedcategories were more likely to have "volunteerstaff only" in the categories of physicians, psychia-trists, vocational counselors, soci.l workers,nursossand lawyers than to have "paid staff only."

Hotline counseling appears to be a volunteerfunction. No programs sampled had "paid only"hotline staff, and only 2.4 percent of the programshad both paid and volunteer staff. About 95percent of the programs with hotlines used onlyvolunteers for that service.

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Functions of Volunteers

More than half of all volunteers were involved incounseling clients in individual sessions. Less thanone-third of the volunteers had more extensivepersonal contact with clients, such as providingsocial activities, working with clients in thecommunity, and providing personal aid to clients.In contrast to these overall figures, more thanone-third of the volunteer professionals counseledclients, while more than half participated inprogram administration.

Students reported involvement in a greater numberof program activities than did other volunteergroups. As might be expected, they were lessinvolved than nonstudents in program admin-istration.

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Those who reported addiction backgrounds weremore likely to facilitate and provide client socialactivities. They are evidently seen as peers of theclients and therefore appropriate for this role.

ThoF who volunteer in outpatient drug freesettings are more likely than those in therapeuticcommunities to provide hotline counseling and toperform administrative activities such as clericaland service duties, filling out client forms.learning about community resources, and doingstaff training. Volunteers in TCs were more likelythan volunteers in DF programs to reportthemselves as facilitating and providing clientsocial activities.

It is noteworthy that while over 80 percent of DEprogram administrators reported that volun.eersspent time becoming familiar wan communityresource agencies to learn where to make refer-rals, only 40 percent of TC administratorsreported volunteer activity in this area Moreover,in fully 70 percent of DF programs, volunteersparticipated in training, while this was so for only46 percent of the TC programs. The high edu-cational level of DF volunteers may partiallyexplain these differences. Length of service wasalso associated with assignment. In both modal-,ities length of volunteer service (which was, ofcourse, correlated with age) was positively corre-lated with assignment to administrative functionsas opposed to direct client service activities.

Specialized volunteers. Volunteer professionalswere more likely to provide consultation to coun-selors about clients or to see clients on atemporary basis than to have clients of their ownin the program. This pattern held for volunteerpsychiatrist, psychologists, and vocational coun-selors. Lawyers were far more :ikely to beconsulted about-legal .problems than to representclients in court. lq contrast, physicians mostfrequently provided direct medical care to clientsduring the course of treatment. Also, in over halfthe DF programs with MSW volunteers, the MSWshad clients of their own.

The specialized volunteers brought to the programmore than just their own services. Administratorsmentioned that volunteers in every speciality pro-cured resources from the community for the pro-gram by organizing other specialists of the sametype for the program, by referring clients outsidetic program for services, and by obtaining fund-ing. In a similar veint-specialized volunteers of alltypes were involved in community relations andcommunity 'education, though this was mentionedless frequently than. the procuring of services.

Another consistent theme across types of spe-cialists was their patticipation in the administra-tive functioning of the program. Volunteersserved on Boards of Directors and participated in

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policy development, planning, and evaluation.Moreover, psychologists, psychiatrists, and MSWsparticipated heavily in in-service training of coun-selors.

Only MSWs showed a marked discrepancy in theavailability and use of volunteer professionalsbetween modalities. Very few TCs relative to DFprograms had MSWs, and the MSWs in DF pro-grams were much more Involved in service deliv-ery to clients and their families than were those inTCs.

Volunteer counselors. Most of the 123 programs inthe telephone survey had volunteer counselors,with only 23 percent and 8 percent of the TC andDF programs, respectively, having no volunteercounselors; both MM programs had volunteercounselors. Eleven programs in the study had onlyvolunteer counselors, and 22 used paid counselorsexclusively.

In addition to volunteer counselors, over half theDF programs had volunteer hotline workers forover-the-phone counseling. In contrast, only20 percent of TC programs and no MM programhad any volunteers who served this function. Only2 percent of programs that had hotline workershad paid staff in that capacity.

Noncounseling volunteer functions. The largestnumber of noncounseling volunteers functioned asadministrative support staff, defined as indi-viduals who deal with the administrative andbusiness functiorls. of the program rather than thetherapeutie functions. Volunteers were used inhalf tne DF programs and Lilly 80 percent of TCprograms as well as in both MM programs. Evenwith the high rate of volunteerism in this cate-gory, only .5.8 percent of all programs left theadministrative function wholly to volunteers, lessthan any other c .tegory.

Noncounseling volunteers could be divided Intothose who provide services directly to clients andthose who provide services to the program. Theformer functior occurred substantially more oftenin TC programs; the latter, in DF programs. Fivedifferent services to clients were identified:(1) social services and psychological care(19.8 percent), (2) recreation and entertainment(13.5 percent). (3) support services, e.g., cooking,driving (:0.3 percent), (4) training and skilldevelopment (8.7 percent), and (5) physical healthcare (4.8 percent). Four services to the programemerged: administrative. functions, such as mem-bership on Boards of Directors, governing com-mittees, and community Boards (13.5 percent);consultation to the program (12.7 percent); pro-vision of resources and community contact for theprogram (12.7 percent); and provision of supportfor the business side of the program, such asaccountant or bookkeeper (4.0 percent).

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Table 4.Evaluation by paid counselors of potential and/or actual volunteer performance

(N=51 counselors)

Activity

AIPercent indicatingvolunteers havebeen involvedin activity

B2

Mean rating ofactual orpotentialperformance4 = excellent1=poor

C3Percent believingactivity could beperformed byvolunteers only

Providing community education, that is, talkingto community groups about drug abuse and drugabuse treatment.

Performing clerical and service tasks, such astyping letters, answering phones, carryingmessages, or cleaning and making repairs.

Filling out forms which de'al with clientadmission, progress, or discharge.

Managing clients in the center, from the pointof view of controlling and coordinating clienttraffic or disciplining clients.

Providing social activities for clients udder theauspices of the program, for example, a picnicfor clients in the program.

Working with clients in the community, forexample, visiting clier.ts at work, accom-panying them on job interviews, visiting themin the hospital, or appearing for them in court.

Becoming familiar with community resourceagencies in order to know exactly where tosend clients for these services in the community.

Providing personal aid to clients, for example,accompanying them to community resourceagencies, helping them out at home, or helpingthem deal with people in their neighborhoods.

Administering clients, that is, deciding whetherclients will be accepted into the program, whatthe clients' treatment regimen will be, andwhether the clients should remain m theprogram.

Discussing client treatment and progress instaff meetings.

Administering other staff members in theprogram, for example, making out workschedules, making staff decisions.

Administering the program, for example,making up budgets, reviewing and revisingprogram policIes, evaluating effectiveness ofservices provided.

68.0% 3.26(.12)4(12.8%)

62.7%

92.2 3.16(.11) 59.2(13.7%)

68.0 2.91(.14) 33.3(26.1%)

76.0 2.80(.14) 36.7(25.5%)

63.3 3.20(.10) 70.8(15.6%)

48.0 2.94(.11) 43.8(28.3%)

72.5 3.20(.12) 66.7(23.4%)

68.6 2.92(.13) 52.1(25.5%)

43.1 2.50(.16) 9.8(52.1%)

86.3

38.0

49.0

Counseling clients in individual counseling 88.2sessions.

14

3.00(.12)(22.4%)

2.32(.17)(57.4%)

2.(2597.%(.418))

2.96(.14)(26.5%)

I rl

19.6

30.0

12.2

29.4

Table 4.--Evaluation by paid counselors of potential and/or actual volunteer performancecon.

Activity

AIPercent indicatingvolunteers have'oeen invo;vedin activity

B2

Mean rating ofactual orpotentialperformance4 = excellentI =poor

C3Percent believingactivity could beperformed byvolunteers only

Counseling clients in group counseling sessions. 86.3 2.88(.12) 25.5(28.5%)

Doing hotline counseling over the telephone. 63.3 3.16(.15) 59.6(18.4%)

Administering and interpreting psychological 35.3 2.4 3(.20) 30.0tests. (47.5%)

Training other staff members, for example,explaining procedures and rules to new staffmembers, participating as instructors in

60.8 2.98(.17)(29.1 ,)

42.9,

training programs.

I Question A: "Since you've worked in this program, have volunteers ever been involved in ACTIVITY?"2 Question B: "(If volunteers wc.e to do this), how would rate the (likely) quality of their performance?

Would it be excellent, good, fair, or poor?"3 Question C: "Could this function be satisfactorily performed if only volunteers were involved?"4 Number in parentheses beside mean rating is standard error of the mean. Number in parentheses below

rating is percentage of counselors rating _performance as fair or poor.

Comparison of Volunteer and Paid Staff,

When the activities of volunteers and paid staffare compared, the differences between the twogroups are largely of degree rather. than kind.Areas of significant volunteer involvement (e.g.,counseling, community education, clerical duties)are also areas of significant paid staff involvement.

However, a clear differentiation between paid andvolunteer staff occurred in all areas of admin-istration. Volunteers were less often involved inadministrative functions than paid staff and leastoften involved in such duties relative to all othertasks they performed.

In addition, while all paid counseling staff werereportedly involved in working with communityagencies and pri-.mg elements of in-servicetraining/orientation, volunteers were less likely toprovide these services.

Volunteer aid to counselors. As noted above,volunteer professionals of ten provide technicalinformation and/or services to the paid counselingstaff of a program. Paid counselors were asked todescribe their requests for such aid and theirsatisfaction with the outcomes of these requests.

15

In the 15 prograMs investigated Phase II,counselors (N=51) had most often worked withpsychologists (61 percent), followed by lawyers(41 percent). These were also the two most fre-quently occurring types of volunteer Kofessionalsin treatment programs. At the other end of thecontinuum, paid counselors reported leastexperience working with MSWs and vocationalcounselors (29 percent and 16 percent, respectively).

A clear pattern emerged across categories ofvolunteer professionals with regard to the type ofrequests volunteers made to them. Counselorswere much more likely to ask for information froma specialist for use in working with a client(87 percent) than to request that the specialistactually see the client (58 percent). The onlyexception was vocational counselors who wererequested to see clients.

Paid counselors' rating of volunteers. When paid-counselors were asked to rate volunteer jobperformance (real, if observed; estimated, if riotobserved), over two-thirds of the counselorsreported volunteer performance to be good orexcellent. However, ratings varied across activi-ties (see table 4).

ci

Volunteers received their highest ratings from paidcounselors on activities which involved superficialor no contact with clients, or which were notcentral to the counseling function or to themanagement of the program. These included pro-viding community education, spending time becom-ing familiar with community resource agencieswhich might serve clients, performing clerical andservice tasks, providing social activities forclients, and providing hotline counseling.

Where activities involved greater contact withclients, e.g., controlling and disciplining clients inthe .center or group counseling of clients, ratingsof volunteer performance declined somewhat,though not substa.itially. Slightly over a quarter ofthe counselors rated individual and/or groupcounseling by volunteers fair or poor.

Volunteers received their lowest ratings onactivities involving adminstration of the program,staff, and clients. For these activities, over halfthe counselors rated actual or potential perform-ance of volunteers as fair or poor. It is of interestto note that these activities were reported both bythe administrators and by counselors to be ones inwhich volunteers had low levels of actual involve-ment.

There was very close correspondence (R=85)between performance ratings and judgments bycounselors as to whether particular activitiescould be handled by volunteers alone. Over halfthe counselors believed that providing communityeducation, becoming familiar with communityresource agencies, providing social activities forclients, doing hotline counseling, and performingclerical and service tasks could be done byvolunteers alone. In contrast, only about a third orfewer of the counselors felt that volunteers couldcompletely take over individual and/or grOupcounseling, controlling and disciplining clients inthe center,. and filling out forms dealing withclient admission, progress, and discharge, ordiscussing client treatment and progress in staffmeeting. Administrative functions received thelowest rating in this regard.

Activities by volunteers which were central to thecounselors' activities received very low ratings.This is exemplified by the 70.8 percent of coun-selors who believed that volunteers could com-pletely take over the provision of social activitiesfor clients as opposed to 27.4 percent who thoughtvolunteers could take over counseling.

Paid counselors who endorsed interaction betweenclients and nonspecialized volunteer counselors(14=49) were asked to specify the level ofsupervision of volunteers they felt was required.For recreational activities with clients, the vastmajority of counselors felt that only intermittentsupervision was required. However", half the coun-

16

selors felt that almost constant supervision wasrequired for volunteers counseling clients. Theseresponses mirror paid counselors' views of thecapability of volunteers in handling recreationalversus counseling activities with clients.

When asked to compare paid and volunteer coun-selors on a number of dimensions, over 70 per-cent of paid counselors felt volunteer counselorswere less knowledgeable about drugs. Moreover,44.7 percent of the paid counselors reported vol-unteer counselors to be less dedicated, and 46.8percent felt they were less able to takeresponsibiiity in the program (see table 5).

drug use among volunteers and paid counselors.Both administrators and paid counselors wereasked about the drug use history of the volunteers(see tables 6, 7, 8, and 9). Fully 83 percent ofadministrators indicated that some proportion oftheir volunteers had used drugs on a regular basisprior to becoming volunteers. Paid counselorsgave similar estimates of the history of drug useby volunteers. Administrators took a moderate or

Table 5.--Paid counselors' opinionson volunteer counselors' abilities

(N=47I)

QuestionPercent

More Equal Less

"Are the volunteers moreknowledgeable, equally knowl-edgeable, or less knowl-edgeable about drugs thanare paid counselors?"

"Do the volunteers have moreempathy, equal empathy, orless empathy towards clientsthan do paid counselors?"

"Have the volunteers them-selves been more involved,equally involved, or lessinvolved in the drug culturethan have paid counselors?"

"Are the volunteers moreable to take responsibility,equally as able to takeresponsibility, or less able totake responsibility in theprogram than are paid staff ?"

"Are the volunteers morededicated, equally as dedi-cated, or less dedicated thanpaid counselors to the pro-gram rnisssion?"

2.1 25.5 72.3

8.7 65.2 26.1

13.3 42.2 44.4

2.1 51.1 46.8

8.5 46.8 44.7

'Four of the 51 paid counselors interviewed werein a program which had no volunteer counselors.

1 7

Table 6.Administrators' estimates ofvolunteers' histofies of drug use

(N1=123)

Percent

All 3.3Most 8.9Some 30.1A few 40.7None 13.0Refused to answer 1.6Don't know " 2.4

even positive view of the prior drug use history ofvolunteers, believing either- that prior drug use didnot interfere with current volunteer work or thatit actually facilitated understanding.

Volunteer counselors were asked specifically abouttheir own drug use. They reported a wide range ofexperience with drugs, although slightly less usagefor most drug categories compared to paidcounselors. Experience ranged from a low of8 percent for lifetime use of heroin to more than80 percent for marijuana and alcohol to excess.Sixteen percent of all volunteer counselors con-sidered themselves ex-addicts. Fourten of the123 programs drew all their volunteers from thepopulation of former treatment clients.

Table 7.Administrators' estimates ofnumber of volunteers with history of

drug abuse treatment

(N=102)

PercentA

All 16.7Most 3.9Some 13.7A few 34.3None 28.4Refused to answer 1.0Don't know 2.0

Nearly all paid counselors reported that they hadused marijuana at least once; two-thirds, morethan 10 times. At least two-thirds had tried hal-lucinogens, cocaine, amphetamines, barbiturates,and/or other sedatives, hypnotics, and tranquil-izers, with at least one-third of the counselorsreporting use of these drugs on more than 10occasions. One-sixth had used heroin more than 10times. More than two-fifths (46.2 percent) hadbeen in treatment previously for drug abuse, andmore than half (53.8 percent) considered them-selves to be ex-addicts.

Attitudes of administrators who have no volunteersin their programs. Administrators who had novolunteers in their programs were also interviewed

17

Table 8.--Administrators' attitudes aboutthe drug use history of volunteers

(N=123)

Percent"Volunteers ideally should have no 4.9history of drug use or drug treatment."

"Previous use of drugs by volunteersdoes not interfere with their work inthe program."

"Previous use of drugs by volunteersmakes them better able to understandthe problems of drug abuse."

No opinion

Don't know

No answer

44.7

39.0

2.4

4.1

4.9

Note: "No answer," "no opinion," and "don'tknow" are documented because of the sensitivenature of the questions.

in this study. Programs were selected randomlywithin the strata alreaay established for the largerstudy. In all, 15 adminstrators wereinterviewed-5 MM, 6 DF, and 4 TC. Effort wasmade to understand their perceptions of thebenefits 'and/or limitations of vounteers and theirreasons for not using them.

The attitudes of these administrators toward theuse of volunteers were quite favorable, althoughsome reservations wire expressed about thetraining and experience necessary to docounseling. The most frequently given reason fornot hiring volunteers was that they wereunavailable. However, few of the administratorsquestioned had actually attempted to recruitvolunteers. Not surprisingly, it appeared thatwhen administrators believed they had sufficientpaid staff and also perceived logistical problems inhiring, recruiting, tra.ning, and supervision ofvolunteers, little effort was made to obtainvolunteers.

Table 9.Paid counselors' estimatesof number of volunteers with

history of drug abuse

(N ;50)

MostSomeA fewNone

Percent

6.030.048.016.0

s

Summary and Conclusions

Volunteers were divided into three types: spe-cialized professionals, counselors, and noncoun-selors who worked in administrative supportactivities. Differences in extent tc whichvolunteers were employed varied with type ofvolunteer and treatment modality. Of the spe-cialized volunteers, lawyers and psychologistswere used most frequently by programs. Inaddition, lawyers stood out as a special category inthat they were more likely to serve as volunteersthan s paid staff. The most frequently citedsource for volunteer recruitment was colleges,follower by community organizations and formerclients from the program. any first heard aboutthe programs' need for vo untee-r* through friends,family, or their own experiences with theprogram. Motivations for volunteering can besummarized as either altruism or self-improve-ment. Professionals reported altruistic motiveswhereas counselors were concerned with gainingknowledge and experience for the future. It shouldbe noted that all programs with volunteers pro-vided them with in-service training, and most had

18

a paid staff member directly responsible for thevolunteers. Activities of volunteers mirrored thatof pa!d staff with differences in degree of activityrather than kind. In addition, activities differedsomewhat by treatment modality.

There was a consistently positive response ofadministrators, paid counselors, and volunteersregarding the role and activities of volunteers, thesingle exception being paid counselors' lowerrating of volunteers' delivery of counseling ser-vices. That finding points up the importance ofproviding orientaton to paid counseling staffregarding the roles and functoning of volunteers.

In summary, with volunteers constituting17 percent of the drug treatment staff, their roleis a vital and necessary one which appears toenhance services to the client. Without volunteertit can be assumed that client services wouldsuffer. This study attests to the sLccess ofvolunteers in the field of drug abuse. On the otherhand, it also opens questions notaddressed in thisreport concerning the field's dependence onvolunteers and lack of sufficient funding for paidstaf. f.

I

S GO' ERNMENT PRIMINI, OF F -Iss/61501