Predictors of Treatment Outcomes in Men and Women Admitted to a Therapeutic Community

Abstract

This study compared factors that predict treatment outcomes in men and women randomly assigned to two therapeutic communities differing primarily in length of inpatient and outpatient treatment. Based on the prior research literature comparing treatment outcomes of men and women, we formulated the following research question: Do factors that predict drug use at follow-up, postdischarge arrest, and employment at follow-up differ for men and women? Self-reports and objective measures of criminal activity and substance abuse were collected at pre- and posttreatment interviews. Separate regression analyses were conducted for men and women for each of the three outcome variables. The results showed that the predictors of outcome for men and women were similar. Clients who completed the 12-month treatment programs had better outcomes regardless of gender. Men and women who completed treatment were characterized at follow-up by substantial reductions in drug use and arrests and by increased employment. Results further suggested that the longer residential treatment program had a particularly beneficial impact on women. Number of prior arrests was also associated with postdischarge outcomes for women. Women with more arrests at admission were more likely to have a postdischarge arrest and less likely to be employed at follow-up. This finding provides invaluable information about which women may be at greater risk for relapse and in need of additional services. We conclude that completion of treatment is the key predictor of treatment outcomes for both men and women.

Substance abuse treatment entry, retention, and outcome in women: A review of the literature

“…Related work (Messina et al, 2000) found that history of physical abuse predicted positive urine drug screens at follow-up for women, but not for men. Conversely, Fiorentine and colleagues (1999) found few differences in men's and women's outcomes when examining history of abuse; when they did find a difference, abuse predicted only men's outcomes .…”

Distress Tolerance as a Predictor of Early Treatment Dropout in a Residential Substance Abuse Treatment Facility.

“…Although evidence indicates that treatment does indeed lead to continued abstinence for a number of individuals (Gossop, Marsden, Stewart, & Treacy, 2002;Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997;Messina, Wish, & Nemes, 2000), a large percentage of individuals entering treatment for substance abuse either dropout of treatment early or relapse soon after treatment termination (Carmichael, Linn, Pratt, Ted, 1977;Crits-Christoph & Siqueland, 1996;Hubbard et al, 1997;Ravndal & Vaglum, 2002;Simpson, Joe, & Brown, 1997). This is especially true in long term residential treatment which has the lowest rate of completion compared to other treatments.…”

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

“…Aside from specific therapies, some studies stated that post-rehabilitation support was provided, usually in the forms of community based intervention or a monitored halfway house (Carroll & McGinley, 2000). One study included aftercare as part of the measured longitudinal data (Messina, Wish, & Nemes, 2000), but did not report the specific effect of aftercare. Overall, insufficient information was reported to compare program types, or services provided.…”

“…A pair of studies engaged previously graduated residents a mean of 6 years after graduation (Fernández -Montalvo et al, 2008;Fernández-Montalvo et al, 2007). A further two studies included post program time points as part of longitudinal research, with a mean follow-up length of 17 months (Dekel et al, 2004;Messina et al, 2000). No other followups were reported.…”

“…Five studies included two time points with the gap between measured points varying in length from 4 -15 months post program completion, and were in pre and post format (Bankston et al, 2009;Dekel et al, 2004;López-Goñi et al, 2010;Messina et al, 2000;Zoccali et al, 2007). Two studies used multiple measurement points and a prospective design (Marcus et al, 2009;Miles et al, 2008).…”