Rudolf H Moos1, Bernice S Moos. 1. Center for Health Care Evaluation, Department of Veterans Affairs and Stanford University, Palo Alto, CA, USA. bmmos@stanford.edu
Abstract
AIMS: This study examined the influence of the duration and intensity of the first episode of treatment for previously untreated individuals with alcohol use disorders on short-term and long-term outcomes, and the effect of additional treatment and delayed treatment on outcomes. DESIGN, SETTING, PARTICIPANTS: A sample of alcoholic individuals (n = 473) was recruited at alcoholism information and referral centers and detoxification units and was surveyed at baseline and 1 year, 3 years and 8 years later. MEASUREMENTS: At each contact point, participants completed an inventory that assessed their treatment utilization since the last assessment and their current alcohol-related, psychological and social problems. FINDINGS: Compared with individuals who remained untreated, individuals who entered treatment relatively quickly and who obtained a longer duration of treatment had better short- and long-term alcohol-related outcomes and better short-term social functioning. Individuals who obtained a longer duration of additional treatment had better alcohol-related outcomes than individuals who obtained no additional treatment but, among individuals who delayed treatment entry, the duration of treatment was not associated with treatment outcomes. In general, the intensity of treatment was not related to better outcomes. CONCLUSIONS: Rapid entry into treatment and the duration of treatment for alcohol use disorders may be more important than the intensity of treatment. Treatment providers should consider structuring their programs to emphasize continuity, rather than intensity of care.
AIMS: This study examined the influence of the duration and intensity of the first episode of treatment for previously untreated individuals with alcohol use disorders on short-term and long-term outcomes, and the effect of additional treatment and delayed treatment on outcomes. DESIGN, SETTING, PARTICIPANTS: A sample of alcoholic individuals (n = 473) was recruited at alcoholism information and referral centers and detoxification units and was surveyed at baseline and 1 year, 3 years and 8 years later. MEASUREMENTS: At each contact point, participants completed an inventory that assessed their treatment utilization since the last assessment and their current alcohol-related, psychological and social problems. FINDINGS: Compared with individuals who remained untreated, individuals who entered treatment relatively quickly and who obtained a longer duration of treatment had better short- and long-term alcohol-related outcomes and better short-term social functioning. Individuals who obtained a longer duration of additional treatment had better alcohol-related outcomes than individuals who obtained no additional treatment but, among individuals who delayed treatment entry, the duration of treatment was not associated with treatment outcomes. In general, the intensity of treatment was not related to better outcomes. CONCLUSIONS: Rapid entry into treatment and the duration of treatment for alcohol use disorders may be more important than the intensity of treatment. Treatment providers should consider structuring their programs to emphasize continuity, rather than intensity of care.
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