Measuring outcomes for TC clients: Higher Ground Drug Rehabilitation Trust

Abstract

Purpose The purpose of this paper is to analyse the clinical outcome data collected as part of an 18-week, abstinence-based residential therapeutic community (TC) programme, Higher Ground Drug Rehabilitation Trust (Higher Ground) in New Zealand. Lessons and implications for routine collection of clinical outcome data are identified. Design/methodology/approach Higher Ground collects longitudinal data on all consenting clients using a battery of validated psychometric tools, with repeated measures at up to nine points in time from first presentation through to 12-month post-discharge follow up. Data analysis covered clients who entered Higher Ground between 1 July 2012 and 2 June 2015 (n=524). Findings Clients presented with histories of addiction which often had significant negative associations with their physical and psychological health, their relationships, work, accommodation and criminal behaviour. By the time they exited the programme, clinically and statistically significant improvements were seen across multiple indicators including: substance use and abstinence; symptoms of post-traumatic stress disorder, depression, anxiety and stress; and a range of social indicators. Research limitations/implications Attrition in follow-up research is a significant challenge, with people completing the TC programme being more likely to participate than those who do not. This limits generalizability in post-discharge data. There was no control group, making causal attribution a challenge. Identifying suitable benchmarks from the literature is challenging because of the variety of outcome measures and research methodologies used. Practical implications Tracking client outcomes longitudinally using psychometric tools is potentially valuable for TCs and their funding bodies, as it provides insights into patterns of client recovery that can inform ongoing service improvements and resource allocation decisions. However, significant challenges remain. Originality/value The study demonstrates the value, and practical challenges, of collecting high-quality outcome data in a TC setting.

Controlled Trial Examining the Strength-Based Grit Wellbeing and Self-Regulation Program for Young People in Residential Settings for Substance Use

“…However, other factors such as age, more severe substance use (i.e., higher scores for global substance use, alcohol, cannabis or methamphetamine use) or more serious mental health concerns (i.e., screening positive for PTSD or psychosis or higher scores for anxiety or depression) were not associated with early discharge, which counters some previous findings [ 62 ]. Retention in residential treatment is an ongoing challenge in recovery from substance use problems, and so is critical to address given strong evidence for better substance use outcomes with treatment retention and completion [ 63 , 64 , 65 , 66 , 67 ].…”

The recovery-oriented therapeutic community for addictions (ROTC): a response to contemporary substance use disorder treatments in the Philippines

“…This possibly means that Philippine Daytop TCs may not be enough to foster the lifelong requirements of continuing care for this chronic and relapsing disease. One study from New Zealand suggests the importance of following client outcomes after completion of the TC program to guide after-care services and post-treatment recovery support systems (King et al, 2016). These extensions of services are largely overlooked in Filipino TCs.…”

“…An aftercare program is also provided to continuously deliver the necessary support for clientele who will face life challenges after treatment. Follow-ups with clients after completing their programs is paramount in monitoring their recovery process (King et al, 2016).…”

“…The ROTC framework can be studied further by future research endeavors to look into its efficacy and improvements using practice-based evidence (Autrique et al, 2008). Future researchers can look into the treatment outcomes of the ROTC as the "therapeutic landscape of recovery" (Best, Byrne, Pullen, Kelly, Elliot and Savic, 2014;Best, Lubman, Savic, Wilson, Dingle, Haslam, Haslam and Jetten, 2014), evaluate its cultural relevance (Chenhall and Senior, 2013) in the Filipino setting, and examine the impact of its aftercare components (King et al, 2016) similar to studies from the Australasian regions. With the probable influx of studies exploring the efficiency of ROTC as a treatment modality, it will also be a great opportunity to disseminate information and formal trainings to encourage professionals to engage in the challenging work of substance use disorder treatment.…”

Operationalising the quality of life construct in studies of alcohol and drug residential rehabilitation programme clients: A systematic review

“…AOD residential rehabilitation programmes provide intensive support to clients that cannot realistically be delivered in a community setting . Through structured programmes, delivered within a live‐in community of peers, AOD residential rehabilitation assists clients to develop coping and life skills , with treatment typically comprising group work, psychosocial interventions (such as cognitive behaviour therapy or motivational interviewing), vocational activities and living skills .…”