, Lismore Base Hospital, Lismore, Australia.
Mental health and behavioural science, Graduate Medicine, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
Subst Abuse Treat Prev Policy. 2018 Sep 24;13(1):33. doi: 10.1186/s13011-018-0170-5.
Program attrition is a major problem in substance use treatment. It is not clear which client and treatment variables are related to successful completion. This study aimed to identify client variables associated with Therapeutic Community (TC) completion. A secondary aim was to investigate changes in entry and exit scores on psychosocial outcome measures.
Retrospective quantitative analysis of data collected from 193 Australian TC residents, over 3.5 years. Variables measured included: demographics; Depression, Anxiety, Stress Score (DASS-21) and World Health Organisation Quality of Life 8 questions (WHOQOL-8).
Completion rates were 30.6%. High Money WHOQOL-8 scores, suggestive of minimal financial stressors, positively predicted completion. Multivariate analyses showed that negative predictors of completion were: amphetamine being primary substance of concern, aggression, high Relationship WHOQOL-8 scores, suggestive of positive relationships, and younger or older age. Those in the program demonstrated clinically significant psychological improvement and significant improvement in all quality of life scores over time. The degree of psychometric improvement was most pronounced in those who completed the course, with the exception of depression, stress, and money problems.
The findings provide an understanding of specific predictors of program completion which may help to identify high-risk clients and inform program improvement. Early attrition rates may be reduced by monitoring and supporting high-risk clients. Overall, psychometric improvement occurred amongst both completers and non-completers overtime but is most prominent amongst course completers, with the exception of depression, stress, and money problems. Future research could potentially focus on amphetamine users and shortened TC programs, focusing on acute psychosocial intervention.
项目淘汰是物质使用治疗中的一个主要问题。目前尚不清楚哪些客户和治疗变量与成功完成治疗相关。本研究旨在确定与治疗社区（TC）完成相关的客户变量。次要目标是调查进入和退出心理社会结果测量时的分数变化。
对来自 193 名澳大利亚 TC 居民的数据进行了 3.5 年的回顾性定量分析。测量的变量包括：人口统计学；抑郁、焦虑和压力量表（DASS-21）和世界卫生组织生活质量 8 问量表（WHOQOL-8）。
完成率为 30.6%。WHOQOL-8 金钱维度分数高，表明财务压力较小，这对完成治疗有积极预测作用。多变量分析显示，完成治疗的负预测因子包括：关注的主要物质为安非他命、攻击性、关系维度 WHOQOL-8 分数高，表明人际关系积极，年龄较小或较大。参加者在心理上表现出显著的临床改善，所有生活质量评分随时间推移都有显著改善。在完成课程的人中，心理测量学改善程度最为明显，除抑郁、压力和金钱问题外。
这些发现提供了对完成治疗的具体预测因素的理解，这可能有助于识别高风险客户并为项目改进提供信息。通过监测和支持高风险客户，可以降低早期淘汰率。总体而言，无论是完成者还是未完成者，在整个治疗过程中，心理测量学的改善都在发生，但在完成课程的人中最为明显，除了抑郁、压力和金钱问题外。未来的研究可能集中在安非他命使用者和缩短的 TC 项目上，重点关注急性心理社会干预。
