Dataset Information

Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study.

ABSTRACT:

Background

Court-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.

Purpose

This 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.

Methods

Multiple 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.

Results

Women 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?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 registration

ClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648 .

SUBMITTER: Rivera D

PROVIDER: S-EPMC7927366 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study.

Rivera Dean D Dueker Donna D Amaro Hortensia H

Substance abuse treatment, prevention, and policy 20210302 1

<h4>Background</h4>Court-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.<h4>Purpose</h4>This study compared the number of days retained in residential SUD treatment among three re ...[more]

PMID: 33653374

Similar Datasets

Project description:BackgroundCourt-mandated substance use disorder (SUD) treatment, compared to nonmandated treatment, has been associated with increased retention and completion. However, due to limitations of previous studies, whether child protective services (CPS) and criminal justice (CJ) mandated treatment improve treatment completion and retention among women in residential treatment remains unclear.PurposeThis study investigated differences in treatment completion and progress based on three clinical discharge outcomes (i.e., completer, noncompleter with significant progress, and noncompleter without significant progress). We hypothesized that women mandated by (1) CJ will have a better treatment discharge outcome (i.e., treatment completer and noncompleter with satisfactory progress) compared to women who are CPS mandated; (2) CPS will have a better treatment discharge outcome (i.e., treatment completer and noncompleter with satisfactory progress) compared to nonmandated women.MethodsStudy staff conducted multinomial logistic regression analyses on data for a diverse sample of 161 women mandated or nonmandated (CJ: N = 71, CPS: N = 66, nonmandated: N = 24) into residential SUD treatment to determine each group's clinically defined treatment discharge outcomes while controlling for covariates.ResultsMultinomial logistic regression analyses revealed that being mandated by the CJ system predicted being a treatment completer compared to those who were CPS mandated (RR = 9.88, p = .009). The study found no differences in discharge status of completer without satisfactory progress between those who were CPS mandated and those who were CJ mandated or nonmandated. For women mandated by the CPS system compared to nonmandated women, the risk of being a treatment completer relative to noncompleters with satisfactory progress was not significant (RR = 1.08, p = .897). Analyses showed that being mandated by the CJ system predicted an improved clinically defined discharge outcome of treatment completer compared to women who were nonmandated to treatment (RR = 10.74, p = .016). In several of the models, drug and alcohol craving was associated with increased odds of being a noncompleter of treatment without satisfactory progress.ConclusionsThis study demonstrates that improved treatment completion and discharge status cannot be assumed based solely on being mandated by the CJ or CPS systems. As evidenced by variability in treatment discharge outcomes within and among referral groups, the paper suggests directions for future research.

Project description: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.

Dataset Information

Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study.

Background

Purpose

Methods

Results

Trial registration

Publications

Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets