About the Study

Funding Agency: Kentucky Division of Substance Abuse and the Center for Substance Abuse Treatment (CSAT)

Purpose: This project was initiated to provide treatment in an isolated area of South- eastern Kentucky. The three counties targeted for this Project had only two outpatient counselors and less than two case managers. While the local community mental health center, Kentucky River Community Care, provided services for substance abuse clients in these three counties, data show that most clients are seen for very brief episodes (1-4 visits) and that the complexity of their needs are seldom if ever adequately addressed.

This Project was designed to specifically address the unique needs of Appalachian substance abusers – particularly those with various co-occurring conditions and disorders. The Project created a Community/University Partnership with the Kentucky River Community Care regional mental health center and the UK Center on Drug and Alcohol Research and expanded and enhanced substance abuse treatment services. This Project addressed the unmet needs of Appalachian substance abusers by expanding outpatient treatment and by creating case management that promoted treatment retention and clients’ access to services. The comprehensive case management service led to networking with area churches, social service agencies, the courts, law enforcement, hospitals, primary care providers, and local businesses to develop essential services such as AA and NA meetings. The case managers and clinicians built and developed a better infrastructure for substance abuse treatment services throughout the three county area. The Project included: (1) A focused, strengths-based case management program in all three counties; (2) Expanded the capacity for outpatient therapy in all three counties; (3) Individualized treatment plans and case management service plans for each client; (4) Improved local networks of supportive services for substance abusers; and (5) Establishment of an eight-bed recovery house for clients.

The goal was 160 new clients per year or 480 for the three year period. The project admitted 792 clients over three and one-half years. One of the original goals of the project was to retain clients in treatment for at least 3 months. Of the 792 clients, the average length of stay (intake date to date of last visit) was 145.6 days or 4.8 months. For the 792 clients there were 13,732 outpatient services for an average of 17.3 total services per client over the 4.8 months that service was provided on average to the clients. The University of Kentucky role was to develop the grant for the project and to evaluate program activities.



  1. To examine substance use patterns among rural substance abuse clients in three Appalachian counties of Kentucky. 
  2. To examine co-occurring mental health symptoms, chronic pain, and histories of brain injury among rural substance abuse clients seeking treatment in a community mental health center in three Appalachian counties of Kentucky.

Contact Information

Robert Walker
Phone: 859-257-6623
Email: jrwalk0@uky.edu