Prior treatment experience related to process and outcomes in DATOS

Using data collected from cocaine-abusing patients who participated in the Drug Abuse Treatment Outcome Studies (DATOs), we contrasted patients in tre atment for the first time and patients having extensive histories of prior treatment to identify factors associated with better outcomes in each group . Compared with first-timers, treatment-experienced patients had less favor able post-treatment outcomes. Indicators of early engagement in DATOS treat ment predicted post-treatment abstinence for both groups. Importantly, the interaction of treatment history and several process measures affected post -treatment abstinence. For example, individual counseling and program compl iance had greater impacts on abstinence among treatment repeaters in outpat ient drug-free programs than for first-timers. social support and environme ntal context were significantly related to abstinence. These findings confi rm the importance of considering treatment process and aftercare in develop ing and implementing strategies to optimize treatment for patients with dif ferent treatment histories. (C) 1999 Elsevier Science Ireland Ltd. All righ ts reserved.