TREATMENT GOALS, CONTINUITY OF CARE, AND OUTCOME IN A DAY HOSPITAL SUBSTANCE-ABUSE REHABILITATION PROGRAM

Objective: Relationships between day hospital treatment goals, self-he lp group participation, and substance use outcome were examined for 18 0 alcohol- or cocaine-dependent male patients in a day hospital Vetera ns Administration substance abuse program. Method: The primary goals a ssessed were completion of the day hospital program and participation in posttreatment self-help groups. For subjects who completed the day hospital program, progress toward three other goals was also assessed: decreased denial, endorsement of 12-Step beliefs, and participation i n self-help groups during the day hospital program. The outcome measur es were urine toxicology and self-reports of alcohol or cocaine use at 4- and 7-month post-intake follow-up interviews. Results: Day hospita l completion and participation in posttreatment self-help groups predi cted better outcome. Self-help participation also predicted outcome af ter day hospital completion was controlled. Among subjects who complet ed the day hospital program, the other three goals did not predict sub stance use outcome. However, involvement with self-help groups during the day hospital program and decreases in denial Predicted continued i nvolvement with self-help groups. Conclusions: Patients who complete d ay hospital substance abuse rehabilitation and then continue to partic ipate in self-help groups are likely to have lower rates of alcohol an d cocaine use during follow-up. Furthermore, the beneficial effect of self-help group participation does not appear to be strictly the resul t of motivation or some other patient characteristic.