Substance use disorder treatment programs in Switzerland and the USA: Program characteristics and 1-year outcomes.
OBJECTIVE
This study compared matched samples of substance use disorder (SUD) patients in Swiss and United States (US) residential treatment programs and examined the relationship of program characteristics to patients' substance use and psychosocial functioning at a 1-year follow-up.


METHODS
The study used a prospective, naturalistic design and a sample of 10 public programs in the German-speaking part of Switzerland and 15 US public treatment programs.


METHODS
A total of 358 male patients in Swiss programs were matched on age, marital status and education with 358 male patients in US programs. A total of 160 Swiss and 329 US patient care staff members also participated.


METHODS
Patients completed comparable inventories at admission, discharge and 1-year follow-up to assess their substance use and psychological functioning and receipt of continuing care. Staff members reported on program characteristics and their beliefs about substance use.


RESULTS
Compared to Swiss patients, US patients had more severe substance use and psychological problems at intake and although they did not differ on abstinence and remission at follow-up, had somewhat poorer outcomes in other areas of functioning. Swiss programs were longer and included more individual treatment sessions; US programs included more group sessions and were more oriented toward a disease model of treatment. Overall, length of program, treatment intensity and 12-step orientation were associated with better 1-year outcomes for patients in both Swiss and US programs.


CONCLUSIONS
The sample of Swiss and US programs studied here differed in patient and treatment characteristics; however, in general, there were comparable associations between program characteristics and patients' 1-year outcomes. These findings suggest that associations between treatment processes and patients' outcomes may generalize from one cultural context to another.
Moggi
Franz
F
University Hospital of Psychiatry Bern, Switzerland. moggi@puk.unibe.ch
Giovanoli
Anna
A
Strik
Werner
W
Moos
Bernice S
BS
Moos
Rudolf H
RH
D000328:Adult; D001294:Attitude to Health; D003431:Cross-Cultural Comparison; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D009042:Motivation; D015397:Program Evaluation; D011446:Prospective Studies; D012114:Residential Treatment; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology