title: Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: utility of a mixed methods approach.
abstract: OBJECTIVE
  Staff interactions with their clients are an important factor in the quality of care that is provided to people in drug treatment. Yet there is very little research that addresses staff attitudes or clients' perceptions of discrimination and prejudice by staff with regard to treatment outcomes. This research aimed to assess whether perceptions of discrimination by staff predict drug treatment completion.
  
  
  METHODS
  The study used a mixed methods approach. Ninety-two clients in residential rehabilitation facilities in Sydney were administered a series of quantitative measures assessing drug history, severity of drug use, treatment history, perceptions of staff discrimination and treatment motivation. Clients were followed up regularly until an outcome (dropout or completion) was obtained for the full sample.
  
  
  RESULTS
  Perceptions of discrimination were a significant predictor of treatment completion, with greater perceived discrimination associated with increased dropout. Qualitative interviews with 13 clients and eight health-care workers from these treatment services were then conducted to gain insight into how perceived discrimination may impact on treatment experiences. Clients and staff discussed how they would address the issue of perceived discrimination during the current treatment experience.
  
  
  CONCLUSIONS
  Adopting a mixed methods approach facilitated exploration of the impact of perceived discrimination on treatment from both clients' and health-care workers' perspectives. This methodology may also enhance interpretation and utilisation of these findings in drug treatment.
authors.affiliation: National Centre in HIV Social Research, University of New South Wales, Sydney, Australia. l.brener@unsw.edu.au
authors.forename: Loren
authors.initials: L
authors.lastname: Brener
authors.forename: William
authors.initials: W
authors.lastname: von Hippel
authors.forename: Courtney
authors.initials: C
authors.lastname: von Hippel
authors.forename: Ilyse
authors.initials: I
authors.lastname: Resnick
authors.forename: Carla
authors.initials: C
authors.lastname: Treloar
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009517:New South Wales; D010352:Patient Dropouts / Q000523:psychology; D010465:Perception; D011287:Prejudice; D012114:Residential Treatment / Q000379:methods; D012720:Severity of Illness Index; D016320:Substance Abuse Treatment Centers / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult