Literature DB >> 19594791

Client-reported reasons for non-engagement in drug and alcohol treatment.

Carolyn Coulson1, Felicity Ng, Marjan Geertsema, Seetal Dodd, Michael Berk.   

Abstract

INTRODUCTION AND AIMS: To examine client-reported reasons for missed early appointments at a drug and alcohol treatment service and to compare characteristics of those who missed appointments with those who attended. DESIGN AND METHODS: Clients who missed a first or second appointment between 1 May and 31 August 2007 at a public community-based outpatient treatment facility were invited to participate in a semistructured telephone interview. This consisted of an open-ended question asking the reason(s) for nonattendance, followed by a questionnaire of items for therapeutic alliance and service satisfaction, perceived impact of substance use and previous treatment experience, mostly rated on Likert scales. Database information on demographic and clinical variables was gathered for all clients who were accepted for treatment within the study time frame. Characteristics of those who missed a first or second appointment (n = 66) were compared with those who attended at least their first two appointments (n = 97).
RESULTS: Of clients who missed their appointments, 80.6% provided reasons for nonattendance, which included extraneous factors (50.0%), service shortcomings (29.7%), no further need for service (16.2%) and motivational ambivalence (4.1%). They generally had high ratings of therapeutic alliance and service satisfaction and identified their substance use as having a negative impact on their lives. Clients who missed appointments were more likely to be male, unmarried and have a history of polysubstance use. DISCUSSION AND
CONCLUSIONS: Extraneous issues relating to the client may be a dominant obstacle in early treatment engagement. Efforts to overcome these issues may therefore improve early engagement.

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Mesh:

Year:  2009        PMID: 19594791     DOI: 10.1111/j.1465-3362.2009.00054.x

Source DB:  PubMed          Journal:  Drug Alcohol Rev        ISSN: 0959-5236


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