Improving the retention rate for residential treatment of substance abuse by sequential intervention for social anxiety

Abstract

BackgroundResidential drug rehabilitation is often seen as a treatment of last resort for people with severe substance abuse issues. These clients present with more severe symptoms, and frequent psychiatric comorbidities relative to outpatients. Given the complex nature of this client group, a high proportion of clients seeking treatment often do not enter treatment, and of those who do, many exit prematurely. Given the highly social nature of residential drug rehabilitation services, it has been argued that social anxieties might decrease the likelihood of an individual entering treatment, or increase the likelihood of them prematurely exiting treatment. The current paper reports on the protocol of a Randomised Control Trial which examined whether treatment of social anxiety prior to entry to treatment improves entry rates and retention in residential drug rehabilitation.Method/designA Randomised Control Trial comparing a social skills treatment with a treatment as usual control group was employed. The social skills training program was based on the principles of Cognitive Behaviour Therapy, and was adapted from Ron Rapee’s social skills training program. A permutated block randomisation procedure was utilised. Participants are followed up at the completion of the program (or baseline plus six weeks for controls) and at three months following entry into residential rehabilitation (or six months post-baseline for participants who do not enter treatment).DiscussionThe current study could potentially have implications for addressing social anxiety within residential drug treatment services in order to improve entry and retention in treatment. The results might suggest that the use of additional screening tools in intake assessments, a focus on coping with social anxieties in support groups for clients waiting to enter treatment, and greater awareness of social anxiety issues is warranted.Australian New Zealand clinical trials registryAustralian New Zealand Clinical Trials Registry (ACTRN) registration number: ACTRN12611000579998

Treinamento em habilidades sociais para usuários de drogas: revisão sistemática da literatura

“…Para atingir os objetivos propostos, foram identificados cuidados metodológicos nos estudos, como a escolha aleatória dos participantes, grupo controle e follow-up de três meses a dois anos em intervenções integradas ao THS. Ressalta-se que, de acordo com um estudo teórico acerca da utilização do THS em usuários de drogas, há indicação de um follow-up de dois e três meses (Staiger et al, 2014). Dessa forma, o follow-up torna-se um importante recurso metodológico, especialmente no Treinamento em Habilidades Sociais, permitindo identificar se as mudanças no repertório de habilidades sociais se mantêm tempos após a intervenção.…”

“…No Brasil, por sua vez, a internação hospitalar possui como um dos principais objetivos a desintoxicação, com internação de 21 dias em média (Crauss e Abaid, 2012). Assim, há desafios na implantação do THS em hospitais brasileiros, se for considerado o período mínimo de quatro semanas para a intervenção ocorrer (Staiger et al, 2014), além das complicações clínicas envolvidas na primeira semana de tratamento, em que podem ocorrer sintomas de abstinência. Nessa perspectiva, acredita-se que o THS pode ser inserido em diferentes pontos da Rede de Atenção Psicossocial, como Comunidades Terapêuticas e Centros de Atenção Psicossocial Álcool e Drogas (CAPS AD).…”

Faktorer som virker inn ved frafall i døgnbehandling for pasienter med ruslidelser. En case studie med vekt på både pasient- og behandlerperspektivet

“…Det mentale stresset kan ha vaert en konsekvens av gjentagende aktivering av den sosiale angsten forårsaket av eksponering av individet, både enkeltvis og i grupper. Staiger, Kyrios, Williams, Kambouropoulos, Howard og Gruenert (2014) påpekte at høy grad av sosiale interaksjoner, samhandling og intervensjoner i terapeutiske samfunn representerer store utfordringer for individer med sosial angst. En studie foretatt ved et terapeutisk samfunn for voksne fant høyere nivåer av stress assosiert med økt risiko for frafall.…”

“…Det kan synes som om behovet for behandling tilpasset høy sosial angst ikke var tilstrekkelig ivaretatt. Resultatene fra en randomisert studie av Staiger et al (2014) indikerte at man i større grad også bør fokusere på sosial angst for å redusere brudd. Muligens kunne et mer intensivt behandlingsprogram for hans sosiale angst fremmet retensjon.…”

Qualitative study of welcome houses: a recent initiative designed to improve retention in therapeutic communities

“…These have included changing staffing structures , altering induction procedures (Harrison et al, 2007), and providing more interventions and support in the community before residential treatment (Staiger et al, 2014;Vanderplasschen, Vandevelde & Broekaert, 2014;Vandevelde et al, 2015). WHs constitute an additional innovation, but they need further empirical investigation prior to any widespread implementation.…”