De Leon G, Hawke J, Jainchill N, Melnick G
Center for Therapeutic Community Research (CTCR) at National Development and Research Institutes, Inc. (NDRI), 16th Floor, 2 World Trade Center, New York, NY 10048, USA.
J Subst Abuse Treat. 2000 Dec;19(4):375-82. doi: 10.1016/s0740-5472(00)00124-0.
Evaluation research documents a firm relationship between retention and treatment outcomes among substance abusers in therapeutic communities (TCs). However, most admissions leave treatment prematurely, particularly in the first months after admission. This paper reports findings from a controlled study that assessed the efficacy of an intervention to reduce early dropout in a residential TC. In the "Senior Professor" (SP) intervention, the most experienced clinical and managerial staff in a TC program were utilized to conduct program induction seminars during the first weeks of admissions, traditionally the period of the highest rate of dropout. Rates of short-term retention (30 days of treatment) were compared for the experimental cohort (N=362), who received the intervention, and a cohort of admissions (N=243), who received standard or non-enhanced treatment. Findings showed that the SP intervention significantly reduced the likelihood of early dropout compared with controls. The enhanced effects are most evident for the new inductees with the lowest levels of motivation. Some theoretical and clinical implications are discussed as to the utilization of experienced staff to increase retention among new inductees with relatively lower motivational levels, who are at greatest risk for early dropout.