Predictors of participation in aftercare sessions and self-help groups following completion of intensive outpatient treatment for substance abuse.
OBJECTIVE
The goals of this study were to identify predictors of greater participation in aftercare treatment sessions and self-help groups during the first 3 months following completion of a 4-week intensive outpatient rehabilitation (IOP) program.


METHODS
The subjects were 138 male veterans who met DSM-III-R criteria for lifetime diagnoses of both alcohol and cocaine dependence (n = 67), alcohol dependence only (n = 48) or cocaine dependence only (n = 23); completed an IOP program; and expressed a desire to enter a formal aftercare program. Analyses examined relationships between predictor variables from five different domains and number of aftercare sessions and self-help groups attended in the last week of each month of the follow-up period.


RESULTS
Of the many potential predictor variables that were examined, only remission from cocaine and alcohol dependence during IOP and higher AIDS risk behavior scores in the prior 6 months contributed independently to the prediction of greater participation in aftercare. Further analyses identified several variables that were differential predictors of participation in individualized relapse prevention aftercare versus standard 12-step focused group aftercare. More years of cocaine use, greater current legal problems and a lack of current alcohol dependence predicted greater self-help participation at the level of a trend.


CONCLUSIONS
The achievement of remission from substance use dependence during IOP may be an important criterion for moving to the next level of care. However, the results of the present study also point to the need for an increased focus on factors present during the course of aftercare in future studies of retention in aftercare following outpatient rehabilitation.
McKay
J R
JR
Department of Psychiatry, University of Pennsylvania School of Medicine, Treatment Research Center, Philadelphia 19104, USA.
McLellan
A T
AT
Alterman
A I
AI
Cacciola
J S
JS
Rutherford
M J
MJ
O'Brien
C P
CP
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control / Q000635:transmission; D000328:Adult; D000359:Aftercare / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000523:psychology*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D012008:Recurrence; D012657:Self-Help Groups; D012944:Social Support; D014728:Veterans / Q000523:psychology*