COMMUNITY RESIDENTIAL PROGRAM POLICIES, SERVICES, AND TREATMENT ORIENTATIONS INFLUENCE PATIENTS PARTICIPATION IN TREATMENT

The study sought to identify community residential program characteris tics that predict patients' participation in treatment and to examine the association between these characteristics, participation, and outc omes at discharge from treatment. A sample of 2,790 patients with subs tance abuse disorders was assessed at entry into and discharge from 87 community residential facilities (CRFs). The CRFs were assessed using a survey that obtained information about program size and staffing, p olicies and services, and treatment orientation. High expectations for patients' functioning, clear policies, structured programming, a high proportion of staff in recovery from substance abuse problems, and mo re emphasis on psychosocial treatment were associated with patients' p articipation in program services and activities. Higher expectations f or functioning and a strong treatment orientation enhanced participati on more among better functioning patients; program support and structu re enhanced participation more among impaired patients. Participation in treatment independently predicted outcomes at discharge even after both patient and program characteristics were controlled. These findin gs show that community residential program policies, services, and tre atment orientations play a key role in influencing patients' engagemen t in treatment, which, in turn, improves patients' outcomes at dischar ge.