Retention and patient engagement models for different treatment modalities in DATOS

Joe, George W.; Simpson, D. Dwayne; Broome, Kirk M.

doi:10.1016/s0376-8716(99)00088-5

Cited by 278 publications

(231 citation statements)

References 52 publications

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“…Subjects may have reduced drug use in efforts to avoid transfer to the intensive (3 to 9 hours of weekly counseling) services associated with the routine MSC treatment condition. The combination of the transfer effects and a drop-out rate of 23% reduced power to detect differences between the groups, although the drop-out rate is comparable to other studies of opioid-dependent subjects (Joe, Simpson, & Broome, 1999). Evaluation of this treatment intervention, unaffected by the "rescue" procedure employed in the present study, would be very instructive.…”

Section: Study Limitationsmentioning

confidence: 56%

A behavioral treatment for opioid-dependent patients with antisocial personality

Neufeld¹,

Kidorf

Kolodner

et al. 2008

Journal of Substance Abuse Treatment

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Antisocial personality disorder (APD) is associated with increased problem severity in treatment seeking opioid dependent patients. Treatment studies have reported mixed results but generally show that APD patients make progress that is often comparable to drug dependent patients without the personality disorder. Much of this work is based on secondary analyses of studies evaluating responses to a variety of drug abuse treatment interventions. The present study reports on a randomized prospective trial evaluating a behavioral approach for managing opioid dependent patients with APD. Subjects (N=100) met DSM criteria for opioid dependence and APD using a structured clinical interview, and were randomly assigned to the experimental condition (n = 51) that used a highly structured contingency management intervention, or control condition (n = 49) that reflected standard methadone treatment. Subjects in the experimental group had significantly better counseling attendance and some indication of lower psychosocial impairment compared to the control group. The experimental intervention increased attendance in subjects with low, as well as high levels of psychopathy, and with and without other psychiatric comorbidity. These findings support the development of interventions more tailored to APD drug-dependent patients.

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Section: Study Limitationsmentioning

confidence: 56%

A behavioral treatment for opioid-dependent patients with antisocial personality

Neufeld¹,

Kidorf

Kolodner

et al. 2008

Journal of Substance Abuse Treatment

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“…As scheduled treatment durations varied according to the service attended and the client's funding situation (ranging from 3 months to 12 months), clients were considered to have completed treatment if they stayed in treatment for a minimum of 90 days. A 90-day period that has been established as a minimum treatment threshold for positive outcomes in previous research (Gossop et al, 1999b;Joe et al, 1998Joe et al, , 1999. Length of retention (in days) was recorded for each client; for those staying longer than 90 days, a 90 was recorded.…”

Section: Methodsmentioning

confidence: 99%

The role of the early therapeutic alliance in predicting drug treatment dropout

Meier

Donmall

McElduff

et al. 2006

Drug and Alcohol Dependence

124

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Background: To investigate the role of the therapeutic alliance in predicting length of retention in residential drug treatment. Methods:The study recruited 187 clients starting residential rehabilitation treatment for drug misuse in three UK services. Counsellor and client information was assessed at intake, and the average total scores of client and counsellor ratings on the WAI-S (obtained during weeks 1 to 3) were use as the alliance measure. Length of retention and treatment completion (stay beyond 90 days) were used as measures of retention.Results: Clients with weak counsellor rated alliances dropped out of treatment significantly sooner than clients with strong counsellor-rated therapeutic alliances, whether or not the model adjusted for individual counsellor effects and potential confounders including psychological wellbeing, treatment motivation and readiness, coping strategies, and attachment style. The client rated alliance did not predict length of retention. Apart from the alliance, pre-treatment crack use, secure attachment style and better coping strategies were associated with shorter retention, whereas greater confidence in treatment, older client age and better education predicted treatment completion. Counsellors with greater experience of delivering drug counselling retained clients longer. Conclusions:The findings of this study stress the importance of treatment professionals attending to the therapeutic alliance in drug treatment, as counsellors' alliance ratings were found to be amongst the strongest predictors of dropout. Using alliance measures as clinical tools may help treatment practitioners to become aware of the risk of disengagement early on. Prospective studies are needed to evaluate whether strategies of reallocating clients with poor alliances to different counsellors lead to improvements in retention.

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“…Further, of those who do enter a treatment program for substance abuse, approximately half will drop out before completing treatment (Joe, Simpson, & Broome, 1999;Wierzbicki & Pekarik, 1993). Thus, there is a tremendous need to identify persons with substance-use disorders proactively to facilitate treatment involvement and/or self-change.…”

Section: Introductionmentioning

confidence: 99%

Computer-based brief motivational intervention for perinatal drug use

Ondersma

Chase

Svikis

et al. 2005

Journal of Substance Abuse Treatment

159

135

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Computer-based brief motivational interventions may be able to reach a high proportion of at-risk individuals and thus have potential for significant population impact. The present studies were conducted to determine the acceptability and preliminary efficacy of a computer-based brief motivational intervention (the motivation enhancement system, or MES). In Study 1, quantitative and qualitative feedback from 30 postpartum women and 17 women in treatment for drug use were used to modify the software. In Study 2, 50 urban postpartum women who reported drug use in the month before pregnancy completed the intervention and provided repeated within-session ratings of state motivation. In Study 3, 30 women were randomly assigned to intervention or control conditions with 1-month follow-up. Overall, women rated the MES as highly acceptable and easy to use and reported significant increases in state motivation at postintervention and at 1-month follow-up (d = .49). These preliminary results are encouraging and suggest that further work in this area is warranted.

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Retention and patient engagement models for different treatment modalities in DATOS

Cited by 278 publications

References 52 publications

A behavioral treatment for opioid-dependent patients with antisocial personality

A behavioral treatment for opioid-dependent patients with antisocial personality

The role of the early therapeutic alliance in predicting drug treatment dropout

Computer-based brief motivational intervention for perinatal drug use

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