title: Non-attendance at counselling therapy in cocaine-using methadone-maintained patients: lessons learnt from an abandoned randomised controlled trial.
abstract: BACKGROUND
  Recently, the authors commenced a randomised controlled trial to study the effectiveness of cognitive behavioural coping skills (CBCS) to reduce cocaine usage in methadone-maintained patients' in a clinical setting by assessing attendance at treatment sessions and outcomes in terms of cocaine use. However, recruitment into the study stopped when it became apparent that attendance at counselling sessions was poor.
  
  
  OBJECTIVE
  The aim of the current study was to determine the reasons for both non-attendance and attendance from a patient's perspective at counselling sessions.
  
  
  METHODS
  A cross-sectional design was employed whereby participants who were recruited for the original study were interviewed utilising a semi-structured interview format.
  
  
  RESULTS
  Motivational inconsistencies were most frequently cited as the reason for dropping out of counselling, whereas a good relationship with staff was cited by attenders as the most important factors which aided their attendance at counselling sessions.
  
  
  CONCLUSIONS
  Selecting opiate-dependent methadone-maintained cocaine abusers on the basis of their urine toxicology and offering them counselling as a way of reducing their harmful drug use did not prove efficacious. Attempting to address cocaine misuse within this cohort may need a more stepped approach including brief interventions, such as motivational interviewing, or other enhancers of motivation before we can test the effectiveness of CBCS in this population.
authors.affiliation: Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Adelaide and Meath Hospital Dublin, Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Catherine.Darker@tcd.ie
authors.forename: C
authors.initials: C
authors.lastname: Darker
authors.forename: B
authors.initials: B
authors.lastname: Sweeney
authors.forename: H
authors.initials: H
authors.lastname: El Hassan
authors.forename: A
authors.initials: A
authors.lastname: Kelly
authors.forename: S
authors.initials: S
authors.lastname: O' Connor
authors.forename: B
authors.initials: B
authors.lastname: Smyth
authors.forename: J
authors.initials: J
authors.lastname: Barry
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000628:therapy*; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009042:Motivation; D058850:Opiate Substitution Treatment; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research
chemical_list: D008691:Methadone