These issues include clinicians' effect on treatment retention and outcome, professional characteristics, recovery status, adherence to protocols, countertransference, alliance, personality, beliefs about treatment, and professional practice issues. In an effort to improve the quality of care clinicians provide, the authors recommend that clinicians be selected and evaluated based on their "track record;" that more support be provided to clinicians; that the dissemination of empirically based knowledge be improved; and that clinician variables be assessed more broadly. Other recommendations are that clinicians be viewed as a key to improved treatment; that minimum standards for clinician effectiveness be established; that clinicians be educated outside of the substance-use disorder field; that consumers be educated about quality treatment; and that clinicians be targeted for interventions to improve their performance. Such interventions might include pay based on performance, clear criteria for what constitutes good quality work, formalized supervisory feedback, and the use of adherence ratings in clinical practice. 95 references