title: Pre-treatment expectations in clients: impact on retention and effectiveness in outpatient substance abuse treatment.
abstract: BACKGROUND
  Common factors are important for the therapy outcome and also mediate the specific factors of therapy. As one of the common factors, client's expectations towards treatment have been understudied.
  
  
  OBJECTIVE
  The aim was to examine the pre-treatment expectations of outpatient substance abuse treatment clients (N=327, 111 females, 216 males) and its impact on retention, effectiveness and satisfaction at 6-month follow-up.
  
  
  METHODS
  Dependent variables included the clients' attitudes towards the twelve-step principles and participation, medical treatment and therapists' role.
  
  
  RESULTS
  An emphasis on the importance of medical treatment at baseline predicted dropping out. Similarly, it predicted a lower percent days abstinent (PDA6) at 6 months follow-up in comparison to those who did not consider medical treatment important for recovery. Percent days abstinent increased with a more positive attitude to mutual support. At follow-up, those who had assessed the therapist's role in recovery to be most important at the baseline were most satisfied with the treatment.
  
  
  CONCLUSIONS
  The client's pre-treatment expectations have an impact on treatment retention and effectiveness. Further effort should be made to study how clients' image of treatment could be improved and also how the commitment of the clients with multiple problems could be improved.
authors.affiliation: School of Social Sciences and Humanities, University of Tampere, Tampere 33014, Finland. katja.n.kuusisto@uta.fi
authors.forename: Katja
authors.initials: K
authors.lastname: Kuusisto
authors.forename: Vesa
authors.initials: V
authors.lastname: Knuuttila
authors.forename: Pekka
authors.initials: P
authors.lastname: Saarnio
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000523:psychology*; D001290:Attitude; D015928:Cognitive Behavioral Therapy; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology*; D017060:Patient Satisfaction; D011614:Psychotherapy, Brief; D011619:Psychotropic Drugs; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013695:Temperance; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs