The treatment is a directive, nonconfrontational approach that focuses on current issues and behavior change. Several evaluations of the model have supported its usefulness and efficacy with methamphetamine (MA) users who appear to respond to treatment similarly to cocaine users, many of whom continue to show improvements at follow-up. The evaluations show cocaine and MA users respond positively during treatment and appear, at least in some cases, to sustain gains for periods of more than 2 years. A multisite trial of the model at seven sites in California, Hawaii, and Montana is underway, and this trial may provide more definitive information regarding the efficacy of the model in general and with specific populations. As more becomes known about MA-related cognitive impairment, treatment techniques may be modified to accommodate intellectual and perceptual levels of these patients. 12 references and 1 figure