Effectiveness of treatment elements in a residential-work therapy program for veterans with severe substance abuse.
OBJECTIVE
This study evaluated outcomes of a residential-work therapy program for veterans with chronic, severe substance use disorders.


METHODS
Admission and three-month outcome data were gathered for 496 veterans treated in the Department of Veterans Affairs' Compensated Work Therapy-Transitional Residence program. Multivariate techniques were used to assess the relationship between admission risk factors, treatment elements, and outcome measures.


RESULTS
Substantial improvement was observed in substance abuse and most other outcome domains, with 65 percent of the sample reporting no substance use during the three months after discharge. The most powerful baseline prognostic factors were functional status and frequency of social contact. Of 14 significant relationships observed between the intensity of treatment elements and outcomes, 12 were in the expected direction, associating more intensive treatment with improvement. The largest number of significant relationships with outcome were observed for weekly toxicology screens, earnings, and length of stay.


CONCLUSIONS
The study results support the effectiveness of a rehabilitative approach to the treatment of severe substance abuse that combines residential support with demands for responsible behavior.
Rosenheck
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Department of Veterans Affairs Northeast Program Evaluation Center, VA Connecticut Healthcare System, West Haven 06516, USA.
Seibyl
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D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D017831:Diagnosis, Dual (Psychiatry) / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D012044:Regression Analysis; D012720:Severity of Illness Index; D012759:Sheltered Workshops / Q000191:economics / Q000592:standards*; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology*