Client Outcomes II: Longitudinal Client Data from the Colorado Treatment Outcome Study

Shern, David L.; Wilson, Nancy; Coen, Anita Saranga; Patrick, Diane C.; Foster, Mark; Bartsch, David A.; Demmler, Jean

doi:10.2307/3350341

Cited by 235 publications

(127 citation statements)

References 16 publications

(13 reference statements)

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“…Repeated measures analysis with generalized estimating equations (GEE) indicated that, over the 2-year follow-up period, ongoing DTR attendance was significantly associated with a greater likelihood of drug/alcohol abstinence after controlling for other pertinent variables such as sociodemographic characteristics, primary misused substance, severity of mental health symptoms, number of past hospitalizations for drug addiction or psychiatric problems, and traditional 12 step attendance. In addition to the main effect for DTR attendance, the analysis also found main effects on (higher) drug/alcohol abstinence for: pre-baseline abstinence; lower psychiatric symptom severity (as measured by the Colorado Symptoms Index, Shern et al, 1994); and not receiving inpatient treatment during the study period (Laudet et al, 2004a).…”

Section: Effect Of Dtr On Drug/alcohol Abstinencementioning

confidence: 87%

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Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Magura

2008

Substance Use & Misuse

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Over five million adults in the U.S. have a co-occurring substance use disorder and serious psychological distress. Mutual aid ("self-help") can usefully complement treatment, but people with co-occurring substance use and psychiatric disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons recovering from cooccurring disorders. An evaluation of DTR was conducted by interviewing 310 persons attending 24 DTR meetings in New York City in 1998 and following them up for two years, in 1999 and 2000. The evaluation produced 13 articles in 12 peer reviewed journals, the main results of which are summarized here. The sample's characteristics were: mean age, 40 years; women, 28%; black, 59%; white, 25%; Hispanic, 14%; never married, 63%; live in supported community residence, 53%; high school graduate or GED, 60%; arrested as adult, 63%; diagnoses of: schizophrenia, 39%; major depression, 21%; or bipolar disorder; 20%; currently prescribed psychiatric medication, 92%; primary substance used, current or past: cocaine/crack, 42%; alcohol 34%; or heroin, 11%. Overall, the findings indicate that DTR participation has both direct and indirect effects on several important components of recovery: drug/alcohol abstinence, psychiatric medication adherence, self-efficacy for recovery, and quality of life. The study also identified several "common" therapeutic factors (e.g., internal motivation, social support) and unique mutual aid processes (helper-therapy, reciprocal learning) that mediate the influence of DTR participation on recovery. For clinicians, these results underline the importance of fostering stable affiliation with specialized dual focus 12-step groups for their patients with co-occurring disorders, as part of a comprehensive recovery-oriented treatment approach.

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Section: Effect Of Dtr On Drug/alcohol Abstinencementioning

confidence: 87%

“…Psychiatric symptom severity 13 Colorado Symptoms Index (Shern et al, 1994). E.g., "in the past month, how often have you: felt depressed?…”

Section: Installation Of Hope 12mentioning

confidence: 99%

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Magura

2008

Substance Use & Misuse

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“…These covariates are derived from either the baseline interview data or administrative data. The variables available for inclusion in Z were socio-demographics (e.g., age, gender, race/ethnicity, marital and parental status, education, employment, and income); social support ( Shern et al, 1994], range = 15-75, Cronbach alpha = 0.89); criminal and incarceration history (i.e., number of arrests and having a prison stay prior to baseline); whether the offender had a public attorney; and supervision type and intensity (e.g., number of completed and incomplete contacts with probation, and number of drug tests taken and number of positive tests). Some of these covariates, specifically measures of supervision and drug test results change over time; all other measures reflect an offender's situation at baseline and are therefore fixed in each time period.…”

Section: Discussionmentioning

confidence: 99%

Assessing the long-term impact of drug court participation on recidivism with generalized estimating equations

Krebs

Lindquist

Koetse

et al. 2007

Drug and Alcohol Dependence

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Drug courts are one of the most common strategies for dealing with the large proportion of criminal offenders who are drug-involved, yet methodological limitations limit the conclusions that can be drawn from many existing evaluations of their effectiveness. The current study examined the longterm impact of drug court participation compared to regular probation on the recidivism of 475 druginvolved offenders under supervision in Hillsborough County, Florida. Using a combination of selfreported data (collected through in-person interviews at baseline, i.e., the beginning of supervision) and administrative records, the study employed a repeated measures framework (examining five sixmonth time periods from baseline to 30 months post-baseline) and generalized estimating equations to compare the likelihood of being arrested between drug court participants and a matched sample of comparison offenders. The results indicate that participation in drug court was associated with a significant decrease in the likelihood of being arrested in the 12 to 18 months post-baseline time period. Although the drug court effect was somewhat delayed (it was not significant prior to 12 months) and short-lived (it was not significant after 18 months), the fact that significant program effects were observed during a time period that coincides with the conclusion of drug court participation for graduates and a time period well beyond initial program exposure, suggests that drug court participants are more likely than comparable offenders not exposed to drug court to remain arrest free when no longer under community supervision.

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“…The Colorado Symptom Index (CSI); 29 The GAIN Substance Problems Scale (GAIN SPS) 30 The Vocational Time-Line Follow-Back Questionnaire (VTLFB) 31 The Comorbid Conditions (CMC) list [32][33][34] The Community Integration Scale (CIS) [35][36][37] The Health, Social, Justice Service Use (HSJSU) inventory.…”

Section: Methodsmentioning

confidence: 99%

Cognitive Interviewing Methods for Questionnaire Pre-Testing in Homeless Persons with Mental Disorders

et al. 2011

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In this study, cognitive interviewing methods were used to test targeted questionnaire items from a battery of quantitative instruments selected for a large multisite trial of supported housing interventions for homeless individuals with mental disorders. Most of the instruments had no published psychometrics in this population. Participants were 30 homeless adults with mental disorders (including substance use disorders) recruited from service agencies in Vancouver, Winnipeg, and Toronto, Canada. Six interviewers, trained in cognitive interviewing methods and using standard interview schedules, conducted the interviews. Questions and, in some cases, instructions, for testing were selected from existing instruments according to a priori criteria. Items on physical and mental health status, housing quality and living situation, substance use, health and justice system service use, and community integration were tested. The focus of testing was on relevance, comprehension, and recall, and on sensitivity/acceptability for this population. Findings were collated across items by site and conclusions validated by interviewers. There was both variation and similarity of responses for identified topics of interest. With respect to relevance, many items on the questionnaires were not applicable to homeless people. Comprehension varied considerably; thus, both checks on understanding and methods to assist In addition, there are five site coordinators (one for each city where the study is carried out) and numerous lead service and housing providers. CEA is lead for quantitative measurement and data collection at the national level; MLP and KSM are site research coordinators; SWH is lead investigator for the Toronto site; ACH was an undergraduate medical research student for the summer of 2009; and PNG is the national research lead. 36comprehension and recall are recommended, particularly for participants with acute symptoms of mental illness and those with cognitive impairment. The acceptability of items ranged widely across the sample, but findings were consistent with previous literature, which indicates that "how you ask" is as important as "what you ask." Cognitive interviewing methods worked well and elicited information crucial to effective measurement in this unique population. Pretesting study instruments, including standard instruments, for use in special populations such as homeless individuals with mental disorders is important for training interviewers and improving measurement, as well as interpreting findings.

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Client Outcomes II: Longitudinal Client Data from the Colorado Treatment Outcome Study

Cited by 235 publications

References 16 publications

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Assessing the long-term impact of drug court participation on recidivism with generalized estimating equations

Cognitive Interviewing Methods for Questionnaire Pre-Testing in Homeless Persons with Mental Disorders

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