PAC 499 Module 2 Problem Statement and Research Questions Example

From "Why Do Clients Leave?" to Three Answerable Questions: The Problem Statement for a Peer Welcome Call Capstone

Student Name

Psychology and Addiction Studies Program, Aspen University

PAC 499: Senior Capstone

Instructor Name

Month Day, Year

From "Why Do Clients Leave?" to Three Answerable Questions: The Problem Statement for a Peer Welcome Call Capstone

In Module 1, Jordan, a composite addiction studies senior interning at Bluegrass Recovery Services, the invented outpatient program in Lexington, Kentucky, chose early dropout as a capstone topic and proposed that a peer phone each new client the day after admission. This paper states the problem, the purpose and the research questions. The student and the site remain fictional, and the figures are illustrative; the cited studies are real.

The Problem

Between January and June, only fifty-two percent of Bluegrass's new admissions were still coming to services a month after intake. The remaining forty-eight percent stopped coming, most of them within the first two weeks. This pattern matters because time in treatment is linked to outcomes. In a national study of drug abuse treatment programs, Simpson et al. (1997) found that clients who stayed with their programs for more weeks were doing better when researchers checked on them later, with roughly three months of outpatient care marking the point where gains became clear. Clients who leave in their first two weeks receive too little treatment for these benefits to occur.

What Programs Can Do

Retention is not fixed. McCarty et al. (2007) described NIATx, an improvement collaborative in which treatment agencies used process improvement methods, testing small changes and measuring their effects, to reduce waiting times and increase retention. Participating agencies reduced the days between first contact and treatment and increased the proportion of clients who continued in treatment. Many of the changes were simple, such as same-day appointments, reminder calls and making the first visit more welcoming. The study shows that programs can raise retention through practical changes they control.

Why Peers?

Eddie et al. (2019) systematically reviewed research on peer recovery support services, in which people with lived experience of addiction and recovery support others. Peer support was associated with improvements in treatment engagement, relationships with providers, satisfaction and substance use in several studies. The authors noted that many studies had methodological limitations, such as small samples and lack of comparison groups, and that research on specific peer roles, such as engagement in the first days of treatment, was limited.

The Gap

The gap, then, is twofold. In the literature, peer support is promising but has been little studied as a tool for early engagement in outpatient treatment. At Bluegrass, nothing in the current process reaches clients between intake and their first group, the period when many leave.

Purpose

This project asks whether calling every new client within a day of admission, with a peer on the line, is associated with higher thirty-day retention at Bluegrass, and to understand how clients and peer specialists experience the call.

Refining the Research Questions

Who Is Affected

The problem has costs for several groups. For clients, early dropout means losing treatment at the point of highest risk, when craving is strong and supports are thin. For families, it means renewed fear and, for some, renewed involvement with courts or child welfare. For the program, it means wasted intake time, appointments held for clients who never return while others wait to start and funding tied to retention measures. For counselors, it means the discouragement of watching clients disappear after one or two visits, and for the peer specialists, who remember their own early weeks, it means watching others leave at the point where they themselves nearly did. A problem statement that names these costs shows why the question is worth a semester of work.

How the Questions Fit Together

The three questions are designed to support each other. The first, about retention, provides a measurable result the site can act on. The second, about clients' experience, helps explain that result, whether retention rises or not, and may reveal reasons for dropout that the numbers cannot show. The third, about delivering the call, addresses whether the practice could continue after the capstone ends. A project that answered only the first question might show a change without explaining it; a project that answered only the second might produce rich stories with no evidence of effect. Together they make the project more useful to the site.

Definitions

Intake is the first appointment at which a client completes assessment and is admitted to the program. Thirty-day retention means attending at least one scheduled service between days twenty-five and thirty-five after intake. A peer recovery specialist is a staff member with lived experience of recovery who holds state certification. A welcome call is a guided phone conversation a peer specialist holds with a new client no later than the day after intake.

Scope and Limits

The project will not determine whether the call causes changes in retention, since clients will not be randomly assigned and other changes at the site could affect retention. It will not measure long-term outcomes such as substance use. It focuses on one site, so its findings may not apply elsewhere. These limits will be stated in the final report.

Conclusion

Bluegrass loses nearly half its new clients in the first month, and Simpson, Joe and Brown show why that matters. McCarty and colleagues show that programs can raise retention through small, tested changes, and Eddie and colleagues show that peer support is promising but little studied for early engagement. Three research questions, about retention, clients' experience and the delivery of the call, give the capstone a focus it can answer.

References

Eddie, D., Hoffman, L., Vilsaint, C., Abry, A., Bergman, B., Hoeppner, B., Weinstein, C., & Kelly, J. F. (2019). Lived experience in new models of care for substance use disorder: A systematic review of peer recovery support services and recovery coaching. Frontiers in Psychology, 10, Article 1052. https://doi.org/10.3389/fpsyg.2019.01052

McCarty, D., Gustafson, D. H., Wisdom, J. P., Ford, J., Choi, D., Molfenter, T., Capoccia, V., & Cotter, F. (2007). The Network for the Improvement of Addiction Treatment (NIATx): Enhancing access and retention. Drug and Alcohol Dependence, 88(2-3), 138-145. https://doi.org/10.1016/j.drugalcdep.2006.10.009

Simpson, D. D., Joe, G. W., & Brown, B. S. (1997). Treatment retention and follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors, 11(4), 294-307. https://doi.org/10.1037/0893-164X.11.4.294