Introduction
The purpose of the project was to (a) identify and analyze the effective components of successful substance abuse treatment and vocational rehabilitation (VR) programs, (b) identify areas of social-cognitive dissonance between VR counselors and their clients that serve as obstacles to successful rehabilitation, and (c) examine the use of effective, culturally relevant treatment modalities different from those used in mainstream treatment programs.

Methodology
In 1993 a VR counselor survey was conducted to identify exemplary treatment centers for American Indians with alcoholism or drug abuse disorders. A similar, but shorter follow-up survey was conducted in 1996. Next, information was collected by written questionnaire and focus groups from VR counselors who work with American Indians with alcoholism or drug problems. Information was also obtained from American Indian VR clients, using both questionnaires and focus groups.

Results
1993 Treatment Center Survey. Most (18/31) of the treatment centers were located on a reservation. Almost half (14/31) were tribally operated; with (12/31) of the others operated by the Indian Health Service. The top five treatment orientations reported were: AA/Narcotics Anonymous (NA), generic outpatient treatment programs, outpatient drug-free programs, 28- day

Hazelden or Minnesota model inpatient treatment programs, and American Indian traditional healing. The percentage of counselors who were American Indian varied from 3% to 100%. Each center was asked what percent of their American Indian/Alaska Native client could be regarded as "successfully rehabilitated." Responses ranged from 1% to 95%, with an average of 45%. The highest success rate for an orientation was 76%, for the Native American Church; however, only one program had this orientation. Other treatment orientations claimed success rates averaging from 41.3% for the outpatient drug-free program (n = 17) to 48.4% for the Hazelden/Minnesota Model (n = 18). The average success rate claimed by American Indian traditional healing programs (n = 15) was 45%. 1996 Treatment Center Survey. Fourteen treatment centers, representing nine states, responded to the survey. Half of the treatment centers indicated that "most of " their treatment methodology was based on AA. The rest indicated that "some" of their treatment methodology was based on AA.