“Hello, May We Help You?” A Study of Attrition Prevention at the Time of the First Phone Contact with Substance-Abusing Clients

Abstract

The problem of early attrition from treatment is pervasive throughout community mental health and is particularly high for substance-abusing clients. In spite of the severity of this problem and the potential for successful interventions, there have not been many studies that attempt to reduce the dropout rate of drug abusers. The purpose of this research was to test the effectiveness of attrition prevention procedures at the time of the client's first phone contact with the clinic. Callers were either given an appointment or told to come to the clinic the same day. A second variable was the presence or absence of an experimenter-initiated dialogue designed to help subjects predict possible obstacles to attendance and to generate potential solutions to those barriers. Subjects in the same day conditions showed at a higher rate than those given appointments, but the addition of the dialogue had no effect on client behavior. The results are discussed in terms of how mental health professionals can find cost effective interventions that prevent drug abuse treatment dropout.

Individual and system influences on waiting time for substance abuse treatment

“…The likelihood of treatment-seeking substance abusers actually entering treatment after assessment is often <50% (Donovan, Rosengren, Downey, Cox, & Sloan, 2001;Stark, Campbell, & Brinkerhoff, 1990). In part, this is related to substance abusers' limited tolerance for treatment wait time, with longer waits associated with higher rates of pretreatment attrition (Festinger, Lamb, Kountz, Kirby, & Marlowe, 1995;Hser, Maglione, Polinsky, & Anglin, 1998;Kaplan & Johri, 2000).…”

Motivation et persévérance au traitement :

“…D'autres chercheurs (Bell, 1985;Craig, 1985;De Leon, Melnick, Kressel, Jainchill, 1994;Keso & Salaspuro, 1990 ;Stark, Campbell & Brinkerhoff, 1990;Stark, 1992) (Bergeron & al., 2000).…”

Why can’t patients last the wait?

“…However, in North America waiting lists for substance use treatment experience a 50% attrition rate. [1][2][3][4][5] Kaplan and Johri (2000) found that the average tolerance for waiting for treatment is one month, and that 40% of substance users will drop from a waiting list within the first two weeks of being on one. 6 According to the Center for Substance Abuse Treatment approximately one million people are waiting for publicly funded treatment.…”