Treatment outcomes: First time versus treatment-experienced clients

Characteristics of First-Time Alcohol Treatment Seekers: The COMBINE Study

“…A SMALL BODY OF RECENT STUDIES has found that treatment-naive clients who are entering substance-use treatment for the fi rst time differ signifi cantly from treatment-experienced clients in various pretreatment characteristics and posttreatment outcomes (Cacciola et al, 2005;Grella and Joshi, 1999;Hser et al, 1997Hser et al, , 1999b. However, these studies have focused primarily on individuals entering drug treatment rather than alcohol treatment programs.…”

“…Previous studies of clients seeking drug treatment fi nd that about 50% are seeking treatment for the fi rst time Cacciola et al, 2005;Claus et al, 1999). The two groups vary widely with regard to their drug-use histories; the social contexts of their substance use; their treatment needs, motivations, and expectations; and their psychological and physical health (Cacciola et al, 2005;Hser et al, 1997;Neale et al, 2007).…”

“…The two groups vary widely with regard to their drug-use histories; the social contexts of their substance use; their treatment needs, motivations, and expectations; and their psychological and physical health (Cacciola et al, 2005;Hser et al, 1997;Neale et al, 2007). These differences may have implications for the conditions under which participants seek help, the type of treatment they select, and the likelihood of a successful treatment outcome.…”

“…These differences may have implications for the conditions under which participants seek help, the type of treatment they select, and the likelihood of a successful treatment outcome. Cacciola et al (2005) compared treatment outcomes of patients with substance dependence who are treatment naive with treatment-experienced clients. At treatment initiation, treatment-experienced clients were more likely to be male, were older, were less likely to be employed, were less likely to live with a substance user, perceived their substance-use problem to be more serious, and had a more severe drug-use problem.…”

“…At treatment initiation, treatment-experienced clients were more likely to be male, were older, were less likely to be employed, were less likely to live with a substance user, perceived their substance-use problem to be more serious, and had a more severe drug-use problem. Several other studies have shown that fi rst-time drug treatment seekers tend to identify fewer severe drug problems, report fewer additional psychiatric problems, and have fewer "life" problems, compared with those who report prior treatment experiences (Cacciola et al, 2005;Claus et al, 1999;Grella and Joshi, 1999;Hser et al, 1999a). Perhaps more importantly, treatment-naive drug-dependent patients were less likely to acknowledge the severity of their substance use and were less likely to display the treatment-related factors (i.e., motivation for change and desire for treatment) associated with successful treatment outcome than treatment-experienced patients (Cacciola et al, 2005;Claus et al, 1999;Hser et al, 1997;Zule et al, 1997).…”