De Leon G, Schwartz S
Am J Drug Alcohol Abuse. 1984;10(2):267-84. doi: 10.3109/00952998409002785.
The present research is the first in a systematic investigation of retention in therapeutic communities (TCs). Findings are reported from an interrelated set of analyses clarifying retention rates and the temporal pattern of dropout. Retention information was obtained on all admissions to a nonrandom sample of seven traditional (long-term) TCs during February 1-August 15, 1979. Results showed that: (a) Across the seven programs, the 12-month retention rates ranged from 4 to 21%. Program differences were generally nonsignificant. (b) Less than 17% of admissions were readmissions. Among these, however, the number of days before initial dropout was a significant predictor of long-term retention. (c) The temporal pattern of dropout was uniform across programs. Dropout was highest within the first 14 d and declined thereafter, indicating that practically all dropouts leave within 3 months. (d) Based upon rates adjusted for those who had left treatment ("survivor rates"), estimates indicated that the likelihood of continued retention increased significantly with longer stay in treatment. (e) The temporal pattern of dropout was remarkably stable, evident in both replicational and comparative analyses; the latter involved the entire residential drug-free modality in several data systems. The present findings establish that the temporal pattern of retention is orderly, predictable, and has utility for program management and treatment planning, although the phenomenon of retention itself remains to be explained.
本研究是对治疗社区(TCs)留存情况进行系统调查的首个研究。报告了一系列相关分析的结果,这些分析阐明了留存率和退出的时间模式。获取了1979年2月1日至8月15日期间七个传统(长期)治疗社区非随机样本中所有入院者的留存信息。结果显示:(a)在这七个项目中,12个月的留存率在4%至21%之间。项目差异通常不显著。(b)不到17%的入院者是再次入院者。然而,在这些人中,首次退出前的天数是长期留存的一个重要预测因素。(c)各项目的退出时间模式是一致的。退出率在最初14天内最高,之后下降,这表明几乎所有退出者都在3个月内离开。(d)根据对那些已离开治疗者调整后的比率(“留存率”)估算,结果表明治疗时间越长,继续留存的可能性显著增加。(e)退出的时间模式非常稳定,在重复分析和比较分析中都很明显;后者涉及多个数据系统中的整个无毒品居住模式。目前的研究结果表明,留存的时间模式是有序的、可预测的,并且对项目管理和治疗规划有用,尽管留存现象本身仍有待解释。