. Author manuscript; available in PMC: 2015 Jun 1.

Published in final edited form as: Subst Use Misuse. 2014 Mar 10;49(7):891–901. doi: 10.3109/10826084.2014.891615

TABLE 1.

Counselor Identified Barriers to Effective Substance Abuse Treatment, Major Themes and Subthemes

Themes	Lack of Funding	Transportation	Bureaucratic Challenges	Lack of Interagency Cooperation
Subthemes	Difficult meeting needs of non-English speaking clients	Challenges getting to treatment facilities, especially in rural areas¹	Lack of case management	No continuum of care
	Lack of technological resources – i.e. computers			Lack of detoxification facilities
	Heavy caseloads and understaffing			Lack of mental health services
	Fewer treatment options for rural clients¹			Lack of mental health services
	Lack of educational resources for clients		Excessive paperwork	Clients must improvise to access treatment services
	Limited continuing education opportunities for counselors		Excessive paperwork	Clients must improvise to access treatment services
	Lack of good facilities (e.g., building resources)	Client distance from treatment centers	Delays getting clients into treatment in rural areas¹	Challenges meeting housing needs of clients
	Lack of good facilities (e.g., building resources)	Reliance on friends/family for transportation	Delays getting clients into treatment in rural areas¹	Need for dental and medical services

Dark grey boxes represent subthemes from urban focus groups ONLY; white boxes represent subthemes from rural focus groups ONLY; light grey boxes represent subthemes present in BOTH rural and urban focus groups

Both rural and urban counselors recognize that there are fewer treatment options, as well as challenges and delays getting clients into treatment in rural communities.