Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.
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.
Ball
Samuel A
SA
Yale University School of Medicine, Department of Psychiatry, Division of Substance Abuse, United States VA Connecticut Healthcare System, West Haven, CT 06516, United States. samuel.ball@yale.edu
Carroll
Kathleen M
KM
Canning-Ball
Monica
M
Rounsaville
Bruce J
BJ
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000523:psychology*; D010551:Personality; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy*