Ball Samuel A, Carroll Kathleen M, Canning-Ball Monica, Rounsaville Bruce J
Yale University School of Medicine, Department of Psychiatry, Division of Substance Abuse, United States VA Connecticut Healthcare System, West Haven, CT 06516, United States.
Addict Behav. 2006 Feb;31(2):320-30. doi: 10.1016/j.addbeh.2005.05.013. Epub 2005 Jun 17.
Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.
以往的研究已经确定了药物滥用治疗早期脱落的风险因素，但尚未从客户的角度评估辍学原因。从24名过早终止门诊治疗的客户那里收集了访谈和自我报告评估数据，以评估他们辍学的主观原因，以及这些原因与人口统计学和临床变量之间的关联。表明客户动机问题或与项目工作人员冲突的量表项目得到了最普遍的认可。参与者症状的严重程度和干扰预约的后勤问题作为辍学原因被报告得较少。人口统计学、药物滥用和动机阶段指标与辍学的主观原因很少相关。相比之下，适应不良人格功能指标与许多辍学原因密切相关，尤其是对项目内隐私和边界问题的担忧。这项初步评估的结果将指导开发一种针对辍学风险因素和重新参与治疗的工具及干预措施。
