Factors affecting dropout from residential treatment for patients with substance use disorders. A case study with emphasis on both patient and clinician perspectives

The underlying mechanisms of drop out in residential substance use disorder (SUD) treatment were investigated from the users' perspective to identify what impacts their drop-out. A survey-based design was used in this study of patients who had decided to drop-out from residential SUD treatment with a therapeutic community approach. The survey included items such as patient satisfaction, psychological burden, and treatment-related factors such as staff competence. We found a high psychological burden among the dropout population. Patients who had considered dropout before leaving treatment reported significantly more difficulty from program-related treatment factors. The patients reported confidence in staff competence. A need for increased access to staff was reported, especially among those actively considering drop-out. Our results suggest that dropping out might not be an impulsive act but a result of prior consideration and decision-making. The study has important clinical implications for social and health services to consider to reduce dropout.