Services received and treatment outcomes in day-hospital and residential programs

Abstract

This longitudinal health services study (N=733) 1) examines the impact of services received on 6-month outcomes and 2) compares day hospital to residential programs on services received. Services were measured at 2, 4, and 8 weeks post-baseline using a version of the Treatment Services Review (TSR). Higher odds of total sobriety at 6 months were associated with greater participation in a) extracurricular (but not curricular) 12-step meetings, b) sober recreational events, and c) educational sessions. Program effects also emerged. Unexpectedly, extracurricular 12-step meeting attendance and odds of having a sponsor were lower among residential (vs. day hospital) participants through 4 weeks-despite higher participation in curricular 12-step meetings among residential participants at 2 weeks. Still, residential participants reported higher involvement in sober recreation and informal peer socialization across most analyses. Findings suggest that residential and day hospital programs might maximize outcomes by facilitating optional 12-step involvement and sober recreation, respectively.

Physical Abuse in U.S. Children: Risk Factors and Deficiencies in Referrals to Support Services

“…The study findings indicate that these 8 million children have about double the odds of being physically abused, consistent with two prior studies with smaller sample sizes (Chaffin, Kelleher, & Hollenberg, 1996;Connell, Bergeron, Katz, Saunders, & Tebes, 2007). Although evidence suggests that effective treatment options for alcohol and drug abuse are available (Witbrodt et al, 2007;Zenmore & Kaskutas, 2008), less than half of parents with compulsive use of alcohol or drugs are provided with substance abuse services. Given these study findings, screening for substance abuse by health care providers and CPS case workers might help identify children at high risk for physical abuse.…”

Is it beneficial to have an Alcoholics Anonymous sponsor?

“…Here, they reported that across several substance dependence categories, having an AA sponsor significantly increased the odds of abstinence at 6 and 12 month follow-up interviews. In contrast to these positive findings, in a large longitudinal health services study Zemore and Kaskutas (2008) found that having a sponsor at 2, 4, and 8 weeks after presentation for treatment did not increase the odds of complete abstinence at 6-month follow-up, with abstinence defined as the 30-day period before the 6-month interview. Consistent with this negative finding, in a 1-year naturalistic single-group design of inner-city drug injection users Crape, Latkin, Laris & Knowlton (2002) reported that while 12-step attendance was strongly predictive of complete abstinence at 1-year follow-up (24.2% versus 48.7% abstinent), having a 12-step sponsor was unrelated to abstinence.…”

“…How can we reconcile the pattern of our findings with the extant literature? In particular, studies have offered mixed conclusions about the benefit, if any, associated with AA sponsorship in the first 6-months of AA affiliation (e.g., Witbrodt & Kaskutas, 2005; Zemore & Kaskutas, 2008) but most studies have reported that, at one year and later, AA sponsorship was significantly associated with increased abstinence (e.g., Bond et al, 2003). Our findings suggested exactly the opposite.…”

What Promotes Wisdom in 12-Step Recovery?

“…We conducted one-way analysis of covariance (ANCOVA) tests to examine TSPQ-2F items in relation to wisdom (FVS) scores, treating rates of 12-step meeting attendance as a covariate to better understand aspects of 12-step participation, consistent with investigations that have examined individual aspects of 12-step participation apart from meeting attendance (Cloud, Ziegler, & Blondell, 2004; Timko, Sutkowi, & Moos, 2010; Tonigan & Rice, 2010; Widtbrodt & Kaskutas, 2005; Zenmore & Kaskutas, 2008). Individual ANCOVAs were necessary because of the disproportionate number of items ( n = 21) in relation to available cases ( n = 116).…”