PARTICIPATION IN COMMUNITY RESIDENTIAL-TREATMENT AND SUBSTANCE-ABUSE PATIENTS OUTCOMES AT DISCHARGE

Objective: The study sought to identify patient characteristics that p redict participation in substance abuse treatment in community residen tial facilities (CRFs) and to examine the association between patient characteristics, participation in treatment, and outcomes at discharge from CRFs. Methods: A sample of 2,794 patients with substance abuse d isorders was assessed at entry into and discharge from a representativ e set of 88 CRFs nationwide. Results: In general, patients' psychologi cal distress, motivation for treatment, prior involvement in self-help , and social resources predicted more engagement in CRF services and a ctivities; prior inpatient treatment and the history of a psychiatric disorder predicted less engagement. These patient characteristics also predicted outcomes at discharge; more important, participation in tre atment was positively and independently associated with such discharge outcomes as completion of the program and moving into stable residenc e. In addition, there was some evidence that participation in treatmen t counteracted the negative effects of high-risk patient characteristi cs on outcome. Conclusions: Participation in treatment is as important a predictor of outcomes at discharge from CRFs as are patient charact eristics at intake to treatment. Suggestions are made about how provid ers can enhance patients' motivation to participate and remain in trea tment. (C) 1997 Elsevier Science Inc.