Investigating Patients’ Perceptions of Residential Substance Use Treatment. Is Drop Out a Deliberate or Impulsive Act?

Abstract

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.

Who believes psychedelic-assisted therapies work? Risky cannabis use and other factors are associated with positive treatment-outcome expectancies

“…Further, should a psychedelic-assisted approach for CUD gain sufficient scientific and regulatory support, the cannabis use-expectancy relationship may allow for the consideration of additional treatment options for clients who exhibit low treatment acceptability for existing SUD treatments (as these may involve aspects that are impractical, cost prohibitive, or associated with high discontinuation rates for various clinical subpopulations; Gaston et al, 2010;López-Goñi et al, 2008;Nash, 2020;Ormbostad et al, 2021;Ravndal et al, 2005). This associaton could be similarly clinically relevant should a psychedelic-assisted therapy gain approval for other conditions that are commonly comorbid with cannabis use disorder (e.g., depression, anxiety; Onaemo et al, 2021), which seems more likely.…”

A Prospective Biopsychosocial Repeated Measures Study of Stress and Dropout from Substance Addiction Treatment

“…The treatment-related factors that patients reported as being difficult included group therapy, the work structure, sharing accommodations with other patients, and not having access to clinical staff. 60 …”

“…57 Recent research points to psychological factors and psychological distress as important factors in predicting dropout. 16,[58][59][60][61] Research has found associations between psychological stress and retention through the use of questionnaires that capture stress levels, such as the Symptom of Stress 58 inventory and Hopkins Symptom Checklist. 54,58,59 In a study from 2021, 60 Ormbostad et al investigated whether dropout was a deliberate or impulsive act.…”

“…16,[58][59][60][61] Research has found associations between psychological stress and retention through the use of questionnaires that capture stress levels, such as the Symptom of Stress 58 inventory and Hopkins Symptom Checklist. 54,58,59 In a study from 2021, 60 Ormbostad et al investigated whether dropout was a deliberate or impulsive act. They found that patients who dropped out of treatment had high levels of emotional distress and reported difficulty with program-related factors, such as rules and limit-setting.…”

“…The treatment-related factors that patients reported as being difficult included group therapy, the work structure, sharing accommodations with other patients, and not having access to clinical staff. 60 In residential treatment of SUD, the social environment with the other patients and the staff is an important part of the treatment process. Studies point to both the therapeutic alliance 57 and the therapeutic environment [62][63][64] as important factors for treatment retention.…”