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Factors predicting satisfaction in outpatient substance abuse treatment: a prospective follow-up study.

ABSTRACT: BACKGROUND:While treatment satisfaction has been associated with better outcomes in substance abuse treatment, there is an obvious need for a more profound understanding of what predicts client's satisfaction with treatment. This study elucidates factors relevant to treatment outcome measured at follow-up in terms of satisfaction with the treatment received. METHODS:The research was implemented as a multisite study in outpatient clinics (N?=?7) in southern and western Finland. Data consists of therapists (N?=?33) and their clients (N?=?327). Each consenting client beginning a treatment period was accepted as a research subject and all therapists at the clinics in question participated. The study was conducted as part of the clinic's normal activity. Clients were allocated to therapists according to a randomization list drawn up in advance. Apart from the randomisation and the completion of questionnaires, it did not interfere with the progress of treatment. Follow-up lasted 6 months. Multiple Classification Analysis (MCA) was used through combinations of variables organized by content, e.g. client demographics, previous substance use, therapist's characteristics and client's expectations. The analyses were based in part on conventional statistical testing (t -test, ?2-test, ANOVA). RESULTS:Among 37 independent variables few were statistically significant in the final model. The results suggest that high treatment expectations at baseline are a strong predictor of satisfaction at follow-up. Also, previous substance use predicted treatment satisfaction; people using multiple substances were less satisfied than those taking only one substance. Stronger predictors reduced the statistical significance of those independent variables that were statistically significant in the first analyses. Therefore, therapist's role in recovery and readiness to change should be also seen as antecedents to treatment satisfaction. CONCLUSIONS:It seems that treatment expectations are fulfilled among those participating in follow-up. Yet many are lost during treatment and by follow-up. Service users have experiential knowledge that differs from professionals' and policymakers' knowledge. It is clinically relevant to understand what factors affect client's satisfaction. Hence, it is possible to identify the population whose treatment should receive the most attention, how the client's experience, their commitment to treatment, and treatment effectiveness could be improved.

SUBMITTER: Kuusisto K

PROVIDER: S-EPMC7245787 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Factors predicting satisfaction in outpatient substance abuse treatment: a prospective follow-up study.

Kuusisto Katja K Lintonen Tomi T

Substance abuse treatment, prevention, and policy 20200524 1

<h4>Background</h4>While treatment satisfaction has been associated with better outcomes in substance abuse treatment, there is an obvious need for a more profound understanding of what predicts client's satisfaction with treatment. This study elucidates factors relevant to treatment outcome measured at follow-up in terms of satisfaction with the treatment received.<h4>Methods</h4>The research was implemented as a multisite study in outpatient clinics (N = 7) in southern and western Finland. Dat ...[more]

PMID: 32448254

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Project description:BackgroundCourt-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women's residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear.PurposeThis study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or increased stress, depression, anxiety, and PTSD symptomology contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women.MethodsMultiple regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N?=?141, Black: N?=?50, White: N?=?50) mandated or nonmandated (CJ: N?=?114, CPS: N?=?82, nonmandated: N?=?49) into residential SUD treatment to determine each group's treatment retention outcomes.ResultsWomen mandated to SUD residential treatment by the CPS system remained in treatment significantly longer (p?=?.046), compared to women not mandated, representing a 34.4% increase in retention. Findings further revealed a corresponding 2.3% decrease in retention (p?=?.048) for each one-unit increase in a patient's stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention (p?<?.001).ConclusionsPolicy and clinical considerations include (a) increasing case management support and wraparound services that meet the multiple service needs of women who are nonmandated to residential SUD treatment, and (b) incorporating a more nuanced treatment approach that manages mental health disorders and stress symptomology early in treatment when women are most vulnerable to relapse and treatment dropout.Trial registrationClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648 .

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Factors predicting satisfaction in outpatient substance abuse treatment: a prospective follow-up study.

Publications

Factors predicting satisfaction in outpatient substance abuse treatment: a prospective follow-up study.

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