Promoting continuing care adherence among substance abusers with co-occurring psychiatric disorders following residential treatment.
Epidemiological data from treatment and community samples of individuals with substance use disorders indicate that the rates of co-occurring psychiatric disorders are high and that these disorders are associated with poor treatment adherence and outcomes. A growing body of research indicates that continuing care adherence interventions positively impact treatment outcome. However, it is unclear whether these interventions are effective for individuals with co-occurring psychiatric disorders. This paper explores this question with data from 150 participants who were randomized to receive a behavioral continuing care adherence intervention involving contracting, prompting and reinforcing attendance (CPR), or standard treatment. Fifty-one percent of the participants had one or more co-occurring Axis I or Axis II psychiatric disorders in addition to a SUD diagnosis. Among individuals with co-occurring disorders, those who received the CPR intervention show increased duration of treatment and improved 1-year abstinence rates compared to those who received STX. Additionally, effects of the CPR intervention were generally more pronounced among persons with co-occurring Axis I and/or Axis II disorders than those without these disorders. Treatment implications are discussed.
DeMarce
Josephine M
JM
Veterans Affairs Medical Center, Salem, Virginia 24153, United States. josephine.demarce@va.gov
Lash
Steven J
SJ
Stephens
Robert S
RS
Grambow
Steven C
SC
Burden
Jennifer L
JL
D003266:Continuity of Patient Care / Q000592:standards* / Q000706:statistics & numerical data; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D012114:Residential Treatment; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy