Kleinman P H, Kang S Y, Lipton D S, Woody G E, Kemp J, Millman R B
Department of Public Health, Cornell University Medical College, New York, New York 10001.
Am J Drug Alcohol Abuse. 1992;18(1):29-43. doi: 10.3109/00952999209001609.
Retention in outpatient psychotherapy of 148 crack and cocaine abusers was examined. The clients were predominantly Black (63%) and Hispanic (21%), predominantly male (87%), and the majority (66%) had completed no more than 12 years of high school. Clients entered treatment in a low-cost treatment center in New York City between June 1987 and November 1988. Forty-two percent (62) of the subjects were seen for one or two research interviews only, and did not return to begin therapy. Of the 86 persons who came to at least one therapy session, 30% (26) dropped out before the third session, 28% (24) dropped out between the third and fifth sessions, and 42% (36) were retained for six or more sessions. Short-term and longer-term retentions were analyzed separately, using a battery including sociodemographic variables, treatment history, psychiatric symptomatology, number of arrests, and drug use variables. None of the variables considered was significantly related to short-term retention. There were large although not significant differences in longer term retention by therapist. Longer-term retention was associated significantly with being White (contrasted with being Black) and being young. Nonsignificant but large associations were found between longer-term retention and having few arrests, being Hispanic (contrasted with being Black), and having low SCL-90 scores. Results are compared with previous findings about retention in drug and alcohol treatment. It is suggested that future research on retention in treatment focus less on client variables and more on therapist and program variables.
对148名快克可卡因和可卡因滥用者在门诊心理治疗中的留存情况进行了研究。这些客户主要是黑人（63%）和西班牙裔（21%），主要为男性（87%），且大多数（66%）完成的学业不超过高中12年级。1987年6月至1988年11月期间，客户在纽约市的一个低成本治疗中心接受治疗。42%（62名）受试者仅接受了一两次研究访谈，未再回来开始治疗。在86名至少参加过一次治疗的人中，30%（26名）在第三次治疗前退出，28%（24名）在第三次至第五次治疗期间退出，42%（36名）接受了六次或更多次治疗。分别使用一系列包括社会人口统计学变量、治疗史、精神症状学、被捕次数和药物使用变量的指标，对短期和长期留存情况进行了分析。所考虑的变量中，没有一个与短期留存有显著关联。不同治疗师的长期留存情况虽无显著差异，但差异较大。长期留存与白人（与黑人相比）以及年轻显著相关。长期留存与被捕次数少、西班牙裔（与黑人相比）以及SCL - 90得分低之间存在虽不显著但较大的关联。将结果与之前关于药物和酒精治疗留存情况的研究结果进行了比较。建议未来关于治疗留存情况的研究应少关注客户变量，多关注治疗师和项目变量。
