Program and Client Characteristics as Predictors of the Availability of Social Support Services in Community-Based Substance Abuse Treatment Programs (original) (raw)
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Outpatient Drug and Alcohol Treatment Programs: Predictors of Treatment Effectiveness
International Journal of Mental Health and Addiction, 2020
Although there is extensive literature on the processes and outcomes of drug and alcohol dependence treatments, little is known about specific predictors of treatment effectiveness. The present study aims to identify the predictors of abstinence in outpatient drug and alcohol dependence treatments, as well as the predictors of treatment effectiveness, according to a biopsychosocial approach. The study followed a cross-sectional research design. Participants (n = 290) were recruited from an outpatient treatment of the Intervention Division in Addictive Behaviors and Dependencies (DICAD), in the northern region of Portugal. A convenience sample was used. Data was collected using questionnaires administered at the facilities of the DICAD, in a private, quiet room. Results indicate that predictors of abstinence were involvement in treatment, psychopathology symptoms, and treatment program (i.e., outpatient drug vs alcohol dependence treatments). The full model of logistic regression analysis was significantly reliable (χ 2 (3) = 33.93, p < 0.001), with 72.5% successfully predicted for the non-substance abuse group and a 53.1% accurate prediction rate for the substance abuse group. The predictors of treatment effectiveness, according to a biopsychosocial approach, were social support and the treatment program. The full model was significantly reliable (χ 2 (2) = 68.28, p < 0.001), with 33.0% successfully predicted for the treatment effectiveness group and a 91.1% accurate prediction rate for the non-treatment effectiveness group. Results suggest that interventions need to focus not only on reducing substance abuse, but also on decreasing psychopathology and promoting therapeutic involvement, acting as predictors of abstinence. Furthermore, interventions must focus on promoting social support and the treatment program, acting as predictors of treatment effectiveness, according to a biopsychosocial approach.
Behavior and Social Issues, 2006
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The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT), in carrying out its mission to improve access to and the quality of substance abuse treatment services, initiated the Targeted Capacity Expansion (TCE) program-a national initiative, to encourage community-based organizations to expand their existing treatment capacity and implement strategies to evaluate treatment outcomes. Additionally, CSAT sought to provide substance abuse treatment services in communities that had substantial unmet treatment needs. Grantees funded under the TCE program were required to participate in local, regional and national training workshops that covered a variety of topics ranging from program evaluation, interviewing skills, strategies for increasing client follow-up, and data collection. This paper reports the preliminary findings from two components of the TCE program. The results indicate that (1) CSAT was successful in closing gaps in substance abuse treatment services nationally; (2) the TCE initiative provided enhanced treatment substance abuse treatment services to typically underserved populations; (3) substance abuse behaviors and criminal activity resulting from substance abuse were significantly reduced; and (4) critical quality of life factors were improved. q
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Journal of Prevention & Intervention in the Community, 2021
Abstract Substance abuse disorders (SUDs) create significant and pervasive health and economic burdens in the U.S. and the world. After primary treatment has ended, supportive social environments are critically important to prevent relapse and to sustain long-term sobriety. Although approaches to SUDs and treatment vary internationally, studies in the United States indicate that a major risk factor for SUD relapse are lack of social environments to support sustained remission from substance use after primary treatment has ended. Evidence suggests that abstinence is enhanced when individuals are embedded in drug-free settings that support abstinence. Longabaugh, Beattie, Noel, and Stout proposed a theory of social support that engages two processes: general social support, which affectspsychological functioning, and abstinence-specific social support, which supports ongoing abstinence from substance use.
Psychiatric Services, 2006
Objective: This study examined the outcomes of individuals with co-occurring disorders who received drug treatment in programs that varied in their integration of mental health services. Patients treated in programs that provided more on-site mental health services and had staff with specialized training were expected to report less substance use and better psychological outcomes at follow-up. Methods: Participants with co-occurring disorders were sampled from 11 residential drug abuse treatment programs for adults in Los Angeles County. In-depth assessments of 351 patients were conducted at treatment entry and at follow-up six months later. Surveys conducted with program administrators provided information on program characteristics. Latent variable structural equation models revealed relationships of patient characteristics and program services with drug use and psychological functioning at follow-up. Results: Individuals treated in programs that provided specific dual diagnosis services subsequently had higher rates of utilizing mental health services over six months and, in turn, showed significantly greater improvements in psychological functioning (as measured by the Brief Symptom Inventory and the RAND Health Survey 36-item short form) at follow-up. More use of psychological services was also associated with less heroin use at follow-up. African Americans reported poorer levels of psychological functioning than others at both time points and were less likely to be treated in programs that provided mental health services. Conclusions: Study findings support continued efforts to provide specialized services for individuals with co-occurring disorders within substance abuse treatment programs as well as the need to address additional barriers to obtaining these services among African Americans. General population surveys and clinical studies have demonstrated that a majority of individuals with drug abuse problems have a co-occurring mental disorder (1-3). Individuals with co-occurring mental and substance use disorders have higher rates of treatment use compared with individuals with only one disorder (4-6), although most individuals with cooccurring disorders do not receive adequate treatment for either or both disorders (7-9). National survey data show that over half of adults with co-occurring disorders received neither substance abuse nor mental health treatment in the past year (10). Several studies have demonstrated that patients with serious mental disorders are prevalent within substance abuse treatment programs (ranging from about one-fifth to one-half) (11-13). Yet access to mental health services among individuals in substance abuse treatment
Program Structure and Counselor–Client Contact in Outpatient Substance Abuse Treatment
Health Services Research, 2008
Objectives. To examine organizational structural attributes associated with counselorclient contact. Data Sources. Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. Study Design. The study uses a naturalistic design to investigate organizational structure measures--ownership, accreditation, and supplemental services--as predictors of time in counseling and case management, and caseload size, controlling for geographic differences. Data Collection. Directors at 116 outpatient drug-free treatment programs located in four regions across the U.S. (Great Lakes, Gulf Coast, Northwest, and Southeast) voluntarily completed a survey about program structure. Primary Findings. Clients received more counseling hours in programs that were ''intensive,'' publicly owned, accredited, and had a lower proportion of recently hired counselors. More case management hours were offered in ''intensive,'' private-for-profit or publicly owned (versus private-nonprofit) programs, serving a lower proportion of dual-diagnosis clients, and providing more on-site supplemental services. Smaller caseloads were found in programs that were accredited and had a smaller average client census and a lower proportion of criminal justice referred clients. Conclusions. Organizational attributes are related to counselor-client contact and may have implications for staff turnover and service quality.
Trends in comprehensive service availability in outpatient drug abuse treatment
Journal of Substance Abuse Treatment, 2003
Comprehensive medical and psychosocial services are essential to quality addiction treatment, but their availability declined in the 1980s. To determine whether this downward trend in the availability of comprehensive services continued in the 1990s, we analyzed data from a national panel study of outpatient substance abuse treatment units in 1990, 1995, and 2000. Response rates were greater than 85%. Regarding the availability of comprehensive services, including physical examinations, routine medical care, mental health services, financial counseling and employment counseling, administrators reported whether any substance abuse treatment client received the service in the past year. With the exception of physical examinations, whose reported availability increased from 1990 to 1995, and financial counseling, whose reported availability decreased during the same time, the reported availability of comprehensive services changed little during the 1990s. These findings highlight the continuing need to monitor access to comprehensive services and other quality markers in addiction treatment over time.
Alcoholism Treatment Quarterly, 2012
We examined the relationship between treatment quality, using during-treatment process measures, and mutual help group (e.g., Alcoholics Anonymous) attendance after outpatient substance use disorder (SUD) treatment for 739 clients in the Alcohol and Drug Services Study. Logistic regression models estimated any and regular mutual help attendance after treatment. Clients referred to mutual help groups were significantly more likely to attend any mutual help after treatment. Results were mixed for facility offered mutual help groups; treatment engagement and retention were not significant. These findings offer treatment providers further evidence of the importance of referring clients to post-treatment mutual help groups, an effective, low-cost option.