Engagement and Retention in Outpatient Alcoholism Treatment for Women

Abstract

Reviews of the dropout literature note significant attrition from addiction treatment. However, consistent predictors have not been identified and few studies have examined factors related to retention and engagement for women in gender-specific treatment. The current study consisted of 102 women and their partners randomized to individual or couples outpatient alcoholism treatment. Women attended more treatment sessions if they were assigned to individual treatment, older, had fewer symptoms of alcohol dependence, had more satisfying marital relationships, had spouses who drank, and had matched preference for treatment condition. Women were more engaged in treatment (i.e., completed more assigned homework) if they had fewer children at home, fewer alcohol dependence symptoms, later age of onset of alcohol diagnosis, more satisfying marital relationships, and spouses who accepted or encouraged their drinking. Results highlight important associations of treatment and relationship variables with treatment retention and engagement.

Predictors of Utilization of an Addiction-Specific Behavioural Couple Therapy in Alcohol Dependence

“…We assumed that relationship satisfaction played an important role for utilization, which was supported by prior findings for men [10] and women [11]. Nevertheless, our results do not support this assumption.…”

“…In prior studies in outpatient settings, age was not a significant predictor for the utilization [8, 10, 11]. A possible explanation for this difference could be the pre-selection of our BCT-sample: all individuals had already decided upon (an individual) inpatient treatment.…”

“…Previous studies did not permit a comparison concerning gender (only female individuals [9, 11] or only male individuals [8]). Women often have concerns that their partners would not support the conjoint treatment [9].…”

“…For addiction symptoms (e.g., number of symptoms or age when drug problems cropped up first) and comorbid psychiatric symptoms, inconsistent results were found [9, 10]. Two studies examined the relationship satisfaction indicating that greater relationship satisfaction was associated with an individual’s increased probability of utilizing BCT [10, 11]. …”

Role of Two Clusters of Male Alcoholics in Treatment Retention

“…There is some evidence that the following client-centered factors are related to early discontinuation of treatment: young and single patients, high severity of substance use, and lack of family stability. With regard to treatment-centered factors, positive therapeutic alliance, good clinician experience, and proactive participation of family members have been associated with lower attrition rates [32]. On the other hand, studies have shown mixed results with regard to depression symptoms [33].…”