Ethical and Methodological Issues in Evaluating a Perinatal Addiction Treatment Program with a Fluid Population

Abstract

A naturalistic field study was used to evaluate a fluid sample population in an addiction treatment program. This article presents the methodological and ethical issues in program evaluation confronted by the author and the approaches developed to address them. Methodological issues include credibility and fittingness of instruments, lack of standardization of histories, replication, trust issues of subjects, attrition, client follow-up, and rapidly changing subject population. Ethical issues include informed consent, interpretation of data from a cultural bias-free perspective, and client follow-up. A semistructured interview schedule allowed for standardization of the questioning format and replication of data gathering. Triangulation of data enhanced validity and internal stability. A fluid sample frame can optimally reflect the population in the program under study if available resources are used effectively while protecting patient rights to privacy, confidentiality, and freedom from manipulation.