Retention and patient engagement models for different treatment modalitiesin DATOS

A model to explain treatment retention in terms of process components - the rapeutic involvement and session attributes for the Ist month - and patient background factors were tested in long-term residential (LTR), outpatient drug free (ODF), and outpatient methadone (OMT) treatments. The data was co llected in the national Drug Abuse Treatment Outcome Studies (DATOS), and i ncluded 1362 patients in LTR, 866 in ODF, and 981 in OMT programs. Structur al equation models showed there were positive reciprocal effects between th erapeutic involvement and session attributes in all three modalities, and t hese variables had direct positive effects on treatment retention. Motivati on at intake was a strong determinant of therapeutic involvement. Other pat ient background factors were significantly related to retention, including pretreatment depression, alcohol dependence, legal pressure, and frequency of cocaine use. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.