There are many more individuals who have significant substance abuse problems and are in need of treatment than actually seek help. However, t ere is relatively little known about the help-seeking process. Also, a high percentage of those who do seek treatment drop out while awaiting admission, in particular as the length of the waiting period for publicly funded treatment increases. Despite the clinical and administrative concern expressed about the attrition process, little research has been conducted to either understand it better or to intervene in it. The proposed project is meant to address both of these areas, focusing on the following specific aims: (1) Characterize the population of multiple substance abusing individuals who present to an assessment center for evaluation and consideration for state-supported treatment; (2) investigate the help-seeking process by examining the relationship of the precipitants to treatment seeking and perceived barriers to treatment receipt to other characteristics; (3) determine the characteristics predictive of waiting list attrition among this population; (4) determine the stated reasons for attrition among those awaiting treatment admission from interviews with a sample of the drop-outs; (5) evaluate the relative efficacy of an """"""""attrition prevention"""""""" intervention for those on the waiting list through a randomized clinical trial; (6) develop a typology of individuals most likely to benefit from the """"""""attrition prevention"""""""" intervention, suggesting possible client-intervention matching effects; and (7) determine the relative difference in subsequent service utilization between those individuals who either drop off the waiting list and those who enter treatment as well as between those who are assigned to the """"""""attrition prevention"""""""" intervention and those assigned to the standard waiting list conditions. A total of 1200 drug abusers seeking treatment through a state-funded county assessment center will be recruited to participate in the study. Of these, 200 will be randomized to a special attrition prevention program, consisting of motivational counseling and group-delivered case management. The remaining subjects will be provided the standard pre-placement services offered by the assessment center. All subjects who drop off the waiting list and a sample of those who enter treatment will be followed up and assessed to determine factors associated with either attrition-or persistence. Archival data will also be collected from a state data base to evaluate the utilization of substance abuse treatment and other social services. It is expected that the attrition prevention program will lead to a reduced rate of attrition from the waiting list, a greater likelihood of completing treatment that has been entered, and a reduced utilization of services.
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| Downey, L; Rosengren, D B; Donovan, D M (2000) To thine own self be true: self-concept and motivation for abstinence among substance abusers. Addict Behav 25:743-57 |
