Engagement in Alcohol Treatment: The Client's Experience of, and Satisfaction with, the Assessment Interview

Abstract

Clients' experiences of routine alcohol assessment interviews at a therapeutic day unit were studied in order to enhance understanding of the factors associated with subsequent engagement in treatment. The paper describes the development and use of the Client's Experiences and Satisfaction Questionnaire. The main finding from its use with 131 clients, was a positive association between the client's perceptions of the quality of the therapeutic relationship established during the interview, and subsequent engagement in treatment. Large differences were found between the engagement rates of different workers. Clients who were being referred for the first time and those with a SADQ score below 30 were less likely to engage. The findings are augmented with quotes from the clients themselves.

Engagement and Retention in Outpatient Alcoholism Treatment for Women

“…offered, counselor characteristics, program barriers, program awareness of dropout as a problem, and treatment modality (individual, couples, group) 8, 24 . Positive therapeutic alliance consistently has been related to lower attrition rates 25, 26, 27 . Counselor characteristics such as gender and race have not been related to client attrition, but clinician experience has been related to attrition 28 .…”

A quantitative and qualitative exploration of client‐therapist interaction and engagement in treatment in an alcohol service

“… Studies have suggested that differences in the effectiveness of therapists may be related to the therapist's ability to maintain a facilitative stance in the face of client resistance or hostility. The current study, examined a sample of audiotaped sessions from Hyams, Cartwright, and Spratley's (1996) study of engagement in an alcohol treatment service in an attempt to see whether the therapists' effectiveness at engaging clients in treatment was related to client‐therapist interaction in assessment interviews. It was hypothesized that there would be (1) more overall negative interpersonal behaviour (2) more negative interpersonal behaviour by the therapist and (3) more negative interpersonal complementarity in interviews where the client failed to engage.…”

Relationship Factors in Treating Substance Use Disorders

“…Several of the studies we have already considered in the context of discussing the research concerned with the therapeutic alliance also confirm the importance of these variables for process and outcome in the context of substance use disorders (e.g. Chafetz et al, 1962;Hyams et al, 1996;Miller et al, 1993;Milmoe et al, 1967;VaUe, 1981). These studies suggest the following principle:…”

“…There also is the Counselor Evaluation of Client Form, on which counselors rate their client on rapport, motivation, and self-confidence (Simpson et al, 1995). Finally, one study used the Client Experiences and Satisfaction Questionnaire, on which clients assess their relationship with a counselor and how well the counselor treated and understood them (Hyams, Cartwright, & Sprately, 1996) .…”

“…When a client applies for treatment, the quality of the intake assessment interview may be especially important. In a study of alcohol treatment, Hyams et al (1996) asked clients to use the Client Experiences and Satisfaction Questionnaire to describe the quality of the relationship a counselor established with them during an initial intake interview. Clients who felt more at ease with their counselor, and who felt that their counselor liked and understood them and was warm and friendly toward them, were more likely to subsequently engage in treatment.…”