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

Follow-up studies of drug user treatment generally find significant improvements in client functioning, but information about the therapeutic components associated with client behavioral changes over time is limited. An integrative model developed previously to predict treatment retention was expanded and applied to post-treatment outcomes. This study is based on 321 daily opioid users treated in three methadone treatment clinics. Effects of pre-treatment motivation, treatment process measures representing therapeutic relationship, counseling session attendance, and length of treatment are examined in relation to measures of family relations, peer deviancy, return to treatment, drug use, and criminality in the year after treatment. Models were tested in two stages. The first was built on a during-treatment process model for predicting time in treatment to include post-treatment outcomes. The second model was expanded further to include the effects of intervening social support variables as predictors of post-treatment drug and criminality outcomes. The results supported both models and emphasize the importance of considering social influences and related community contextual factors that affect recovery dynamics.