Client characteristics and treatment retention in an outpatient drug -free chemical dependency program
Substance abuse and dependence have detrimental effects at both micro and macro societal levels. Even so, these disorders appear to be amenable to treatment and persons who receive treatment for such problems generally achieve positive outcomes. However, reported substance abuse treatment dropout rates have varied greatly and no consistent “treatment dropout” profile has been detected. This study aimed to describe the characteristics of clients entering an intensive outpatient chemical dependency treatment program and to examine how these variables differed between clients who were retained in treatment to completion and clients who dropped out of treatment prematurely. Additionally, it explored whether meaningful subgroups of this sample could be identified. Results indicated that age, marital status, income, psychological comorbidity, substance(s) of use, and extent of substance use were related to treatment retention. Cluster analysis findings delineated four subgroups of clients based on age, negative consequences related to substance use, and ASI composite scores across medical, employment, alcohol and drug, legal, social, and psychiatric domains. Identified subgroups appeared to vary along two broad dimensions: degree of functional impairment and type(s) of substance use. Results are compared and contrasted with the existing substance abuse treatment literature. Study limitations are discussed, along with implications regarding theory building, assessment, and treatment interventions. Future investigations at the individual program level are recommended to guide the design, implementation, and evaluation of clinically-relevant and empirically-driven assessment procedures and treatment interventions to enhance substance abuse treatment retention and outcomes within a particular program.