Modeling year 1 outcomes with treatment process and post-treatment social influences

Follow-up studies of drug user treatment generally find significant improve ments in client functioning, but information about the therapeutic componen ts associated with client behavioral changes over time is limited. An integ rative model developed previously to predict treatment retention was expand ed and applied to posttreatment outcomes. This study is based on 321 daily opioid users treated in three methadone treatment clinics. Effects of pretr eatment motivation, treatment process measures representing therapeutic rel ationship, counseling session attendance, and length of treatment are exami ned in relation to measures of family relations, peer deviancy, return to t reatment, drug use, and criminality in the year after treatment. Models wer e tested in two stages. The first was built on a during-treatment process m odel for predicting time in treatment to include post-treatment outcomes. T he second model was expanded further to include the effects of intervening social support variables as predictors of post-treatment drug and criminali ty outcomes. The results supported both models and emphasize the importance of considering social influences and related community contextual factors that affect recovery dynamics.