The Matrix Model

Substance Use Prevention or Treatment Does Not Currently Meet Criteria

The Matrix Model is an intensive outpatient therapeutic intervention for the treatment of substance use disorders and addiction in adults. The program aims to eliminate substance use, improve knowledge of substance abuse and relapse, improve participants’ relationships, and support personal growth. Participants learn about issues related to addiction and relapse and develop strategies for addressing needs. The Matrix Model integrates components of cognitive behavioral therapy, contingency management, relapse prevention, early recovery skills, and motivational interviewing. Participants engage in a variety of group- and individual-based supports. Clinicians may also encourage family involvement or recommend other social supports. Urine tests are used to monitor drug use of program participants. Individuals also participate in a 12-step program as a part of the Matrix Model treatment plan.


The Matrix Model does not currently meet criteria to receive a rating because no studies of the program that achieved a rating of moderate or high on design and execution demonstrated a favorable effect on a target outcome.


Date Research Evidence Last Reviewed: Feb 2021


Sources

The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: The California Evidence-based Clearinghouse for Child Welfare, the program or service developer’s website, the program or service manual, and the studies reviewed.


This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

The Matrix Model is designed for adults with substance use disorders.

Dosage

Clients participate in treatment at least three hours a day, three days per week for 16 weeks. After this initial phase, treatment may be extended for up to 32 additional weeks through continuing care. Clients may participate in twice-weekly relapse prevention groups for up to 10 additional weeks and weekly social support groups for up to 32 additional weeks. Clients participate in ongoing weekly 12-step meetings. Weekly urine tests are used to monitor drug use.

Location/Delivery Setting
Recommended Locations/Delivery Settings

The Matrix Model treatment is typically delivered in outpatient clinics.

Education, Certifications and Training

CLARE|MATRIX provides 2-day core training workshops for clinicians on the Matrix Model. The workshops consist of an overview of the Matrix Model components, information on how to implement or adapt the Matrix Model, and experiential exercises. CLARE|MATRIX also provides training workshops for supervisors that focus on observations of sessions and use of fidelity instruments. Supervisors may participate in monthly or bi-monthly follow-on phone conversations to support their work for up to a year following training.

Treatment program sites are certified through the Matrix Model Certification Process. Certification provides the site with recognition that its treatment program meets clinical and structural fidelity to the Matrix Model. In order to qualify to be certified, a site must have a trained Matrix Model key supervisor and have been implementing the Matrix Model for at least 6 months.

Program or Service Documentation
Book/Manual/Available documentation used for review

Obert, J. L., Rawson, R. A., McCann, M. J., & Ling, W. (2014). The Matrix Model: Intensive outpatient alcohol & drug treatment program. Hazelden.

Available languages

The Matrix Model offers some materials in English, Spanish, Arabic, Persian, Armenian, Korean, and Russian.

Contact Information for Developers

Website: https://www.clarematrix.org/

Phone: (310) 314-6200

Email: training@clarematrix.org

Results of Search and Review Number of Studies Identified and Reviewed for The Matrix Model
Identified in Search 26
Eligible for Review 2
Rated High 0
Rated Moderate 1
Rated Low 1
Reviewed Only for Risk of Harm 0
Outcome Effect Size
and Implied Percentile Effect
N of Studies (Findings) N of Participants Summary of Findings
Adult well-being: Parent/caregiver substance use 0.10
3
1 (2) 85 Favorable: 0
No Effect: 2
Unfavorable: 0

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.

Outcome Effect Size
and Implied Percentile Effect
N of Studies (Findings) N of Participants Summary of Findings Months after treatment
when outcome measured
Adult well-being: Parent/caregiver substance use 0.10
3
1 (2) 85 Favorable: 0
No Effect: 2
Unfavorable: 0
-
Rawson, 1995
Grams of cocaine used/week 0.20
8
- 85 - 12
Number of cocaine use days -0.01
0
- 85 - 12

*p <.05

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.

Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.

Full citations for the studies shown in the table are available in the "Studies Reviewed" section.

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers.

Studies Rated Moderate

Study 11118

Rawson, R. A., Shoptaw, S. J., Obert, J. L., McCann, M. J., Hasson, A. L., Marinelli-Casey, P. J., Brethen, P. R., & Ling, W. (1995). An intensive outpatient approach for cocaine abuse treatment. The Matrix Model. Journal of Substance Abuse Treatment, 12(2), 117-127.


Studies Rated Low

Study 11105

Freese, T. E., Obert, J., Dickow, A., Cohen, J., & Lord, R. H. (2000). Methamphetamine abuse: Issues for special populations. Journal of Psychoactive Drugs, 32(2), 177-182.

Galloway, G. P., Marinelli-Casey, P., Stalcup, J., Lord, R., Christian, D., Cohen, J., Reiber, C., & Vandersloot, D. (2000). Treatment-as-usual in the methamphetamine treatment project. Journal of Psychoactive Drugs, 32(2), 165-175.

Huber, A., Lord, R. H., Gulati, V., Marinelli-Casey, P., Rawson, R., & Ling, W. (2000). The CSAT methamphetamine treatment program: Research design accommodations for "real world" application. Journal of Psychoactive Drugs, 32(2), 149-156.

Reiber, C., Galloway, G., Cohen, J., Hsu, J. C., & Lord, R. H. (2000). A descriptive analysis of participant characteristics and patterns of substance use in the CSAT methamphetamine treatment project: The first six months. Journal of Psychoactive Drugs, 32(2), 183-191.

Zweben, J. E., Cohen, J. B., Obert, J., Vandersloot, D., & Marinelli-Casey, P. (2000). Conducting trials in community settings: The provider perspective. Journal of Psychoactive Drugs, 32(2), 193-199.

Obert, J. L., London, E. D., & Rawson, R. A. (2002). Incorporating brain research findings into standard treatment: An example using the Matrix Model. Journal of Substance Abuse Treatment, 23(2), 107-113.

Rawson, R. A., Marinelli-Casey, P., Anglin, M. D., Dickow, A., Frazier, Y., Gallagher, C., Galloway, G. P., Herrell, J., Huber, A., McCann, M. J., Obert, J., Pennell, S., Reiber, C., Vandersloot, D., & Zweben, J. (2004). A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence. Addiction, 99(6), 708-717.

Obert, J. L., Brown, A. H., Zweben, J., Christian, D., Delmhorst, J., Minsky, S., Morrisey, P., Vandersloot, D., & Weiner, A. (2005). When treatment meets research: Clinical perspectives from the CSAT Methamphetamine Treatment Project. Journal of Substance Abuse Treatment, 28(3), 231-237.

Rawson, R. A., Gonzales, R., Pearce, V., Ang, A., Marinelli-Casey, P., & Brummer, J. (2008). Methamphetamine dependence and human immunodeficiency virus risk behavior. Journal of Substance Abuse Treatment, 35(3), 279-284. https://doi.org/10.1016/j.jsat.2007.11.003

This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.


Studies Not Eligible for Review

Study 11099

Bottlender, M., & Soyka, M. (2005). Efficacy of an intensive outpatient rehabilitation program in alcoholism: Predictors of outcome 6 months after treatment. European Addiction Research, 11(3), 132-137.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11100

Brand, M., Rojas, J., Fareed, S., & Koos, E. (2013). ExecuCare: Outpatient treatment for impaired professionals. Addictive Disorders & Their Treatment, 12(1), 11-18. https://doi.org/10.1097/ADT.0b013e318246f4c6

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11101

Carrico, A. W., Flentje, A., Gruber, V. A., Woods, W. J., Discepola, M. V., Dilworth, S. E., Neilands, T. B., Jain, J., & Siever, M. D. (2014). Community-based harm reduction substance abuse treatment with methamphetamine-using men who have sex with men. Journal of Urban Health, 91(3), 555-567. https://doi.org/10.1007/s11524-014-9870-y

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11102

Donovan, D. M., Daley, D. C., Brigham, G. S., Hodgkins, C. C., Perl, H. I., Garrett, S. B., Doyle, S. R., Floyd, A. S., Knox, P. C., Botero, C., Kelly, T. M., Killeen, T. K., Hayes, C., Kau'i Baumhofer, N., Seamans, C., & Zammarelli, L. (2013). Stimulant abuser groups to engage in 12-step: A multisite trial in the National Institute on Drug Abuse Clinical Trials Network. Journal of Substance Abuse Treatment, 44(1), 103-114. https://doi.org/10.1016/j.jsat.2012.04.004

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11103

Doumas, D. M., Blasey, C. M., & Thacker, C. L. (2005). Attrition from alcohol and drug outpatient treatment: Psychological distress and interpersonal problems as indicators. Alcoholism Treatment Quarterly, 23(4), 55-67. https://doi.org/10.1300/J020v23n04_04

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11104

Freedle, L. R., Altschul, D. B., & Freedle, A. (2015). The role of sandplay therapy in the treatment of adolescents and young adults with co-occurring substance use disorders and trauma. Journal of Sandplay Therapy, 24(2), 127-145.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11106

Gottheil, E., Weinstein, S. P., Sterling, R. C., Lundy, A., & Serota, R. D. (1998). A randomized controlled study of the effectiveness of intensive outpatient treatment for cocaine dependence. Psychiatric Services, 49(6), 782-787.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11107

Gouse, H., Magidson, J. F., Burnhams, W., Remmert, J. E., Myers, B., Joska, J. A., & Carrico, A. W. (2016). Implementation of cognitive-behavioral substance abuse treatment in Sub-Saharan Africa: Treatment engagement and abstinence at treatment exit. PloS ONE, 11(1), e0147900. https://doi.org/10.1371/journal.pone.0147900

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11108

Hill, E., Gomez, E., & Jeppesen, G. L. (2007). Adolescent resiliency: A multidisciplinary approach. Annual in Therapeutic Recreation, 15, 59-73.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11109

Levine, H. J., Turner, W., Reif, S., Janas, D., & Gastfriend, D. R. (2003). Determining service variations between and within ASAM levels of care. Journal of Addictive Diseases, 22(Suppl 1), 9-25.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11110

Magidson, J. F., Gouse, H., Burnhams, W., Wu, C. Y. Y., Myers, B., Joska, J. A., & Carrico, A. W. (2017). Beyond methamphetamine: Documenting the implementation of the Matrix model of substance use treatment for opioid users in a South African setting. Addictive Behaviors, 66, 132-137. https://doi.org/10.1016/j.addbeh.2016.11.014

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11111

Masaeli, N., Zarkob, H., Kheirabadi, G., Soleimani, N., & Amini, M. (2018). The effect of Matrix Model on depression, anxiety, and quality of life in methamphetamine users and their caregivers. Addictive Disorders & Their Treatment, 17(4), 186-190. https://doi.org/10.1097/ADT.0000000000000136

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11112

McLellan, A. T., Hagan, T. A., Meyers, K., Randall, M., & Durell, J. (1997). "Intensive" outpatient substance abuse treatment: Comparisons with "traditional" outpatient treatment. Journal of Addictive Diseases, 16(2), 57-84.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11113

Miotto, K., Hillhouse, M., Donovick, R., Cunningham-Rathner, J., Charuvastra, C., Torrington, M., Esagoff, A. E., & Ling, W. (2012). Comparison of buprenorphine treatment for opioid dependence in 3 settings. Journal of Addiction Medicine, 6(1), 68-76. https://doi.org/10.1097/ADM.0b013e318233d621

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11114

Mitchell, S. G., Gryczynski, J., Schwartz, R. P., O'Grady, K. E., Olsen, Y. K., & Jaffe, J. H. (2013). A randomized trial of intensive outpatient (IOP) vs. standard outpatient (OP) buprenorphine treatment for African Americans. Drug and Alcohol Dependence, 128(3), 222-229. https://doi.org/10.1016/j.drugalcdep.2012.08.027

Mitchell, S. G., Gryczynski, J., Kelly, S. M., O'Grady, K. E., Jaffe, J. H., Olsen, Y. K., & Schwartz, R. P. (2014). Treatment outcomes of African American buprenorphine patients by parole and probation status. Journal of Drug Issues, 44(1), 69-82.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11115

Morgenstern, J., Bux, D. A., Labouvie, E., Morgan, T., Blanchard, K. A., & Muench, F. (2003). Examining mechanisms of action in 12-Step community outpatient treatment. Drug and Alcohol Dependence, 72(3), 237-247.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11116

Mousavi, S. G., Sharbafchi, M. R., Salehi, M., Peykanpour, M., Karimian Sichani, N., & Maracy, M. (2015). The efficacy of N-acetylcysteine in the treatment of methamphetamine dependence: A double-blind controlled, crossover study. Archives of Iranian Medicine, 18(1), 28-33. https://doi.org/0151801/AIM.008

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11117

Perngparn, U., Limanonda, B., Aramrattana, A., Pilley, C., Areesantichai, C., & Taneepanichskul, S. (2011). Methamphetamine dependence treatment rehabilitation in Thailand: A model assessment. Journal of the Medical Association of Thailand, 94(1), 110-117.

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11119

Rychtarik, R. G., Connors, G. J., Whitney, R. B., McGillicuddy, N. B., Fitterling, J. M., & Wirtz, P. W. (2000). Treatment settings for persons with alcoholism: Evidence for matching clients to inpatient versus outpatient care. Journal of Consulting and Clinical Psychology, 68(2), 277-289.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11120

Shoptaw, S., Rawson, R. A., McCann, M. J., & Obert, J. L. (1994). The Matrix model of outpatient stimulant abuse treatment: Evidence of efficacy. Journal of Addictive Diseases, 13(4), 129-141.

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 11121

Spinola, S., Park, A., Maisto, S. A., & Chung, T. (2017). Motivation Precedes Goal Setting in Prediction of Cannabis Treatment Outcomes in Adolescents. Journal of Child & Adolescent Substance Abuse, 26(2), 132-140. https://doi.org/10.1080/1067828X.2016.1237917

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11122

Sweeney, P. J., Schwartz, R. M., Mattis, N. G., & Vohr, B. (2000). The effect of integrating substance abuse treatment with prenatal care on birth outcome. Journal of Perinatology, 20(4), 219-224.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11123

Timko, C., Sempel, J. M., & Moos, R. H. (2003). Models of standard and intensive outpatient care in substance abuse and psychiatric treatment. Administration and Policy in Mental Health, 30(5), 417-436.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 11124

Weinstein, S. P., Gottheil, E., & Sterling, R. C. (1997). Randomized comparison of intensive outpatient vs. individual therapy for cocaine abusers. Journal of Addictive Diseases, 16(2), 41-56.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).