Promoting continuing care adherence among substance abusers with co-occurring psychiatric disorders following residential treatment

Addict Behav. 2008 Sep;33(9):1104-12. doi: 10.1016/j.addbeh.2008.02.008. Epub 2008 Feb 23.

Abstract

Epidemiological data from treatment and community samples of individuals with substance use disorders indicate that the rates of co-occurring psychiatric disorders are high and that these disorders are associated with poor treatment adherence and outcomes. A growing body of research indicates that continuing care adherence interventions positively impact treatment outcome. However, it is unclear whether these interventions are effective for individuals with co-occurring psychiatric disorders. This paper explores this question with data from 150 participants who were randomized to receive a behavioral continuing care adherence intervention involving contracting, prompting and reinforcing attendance (CPR), or standard treatment. Fifty-one percent of the participants had one or more co-occurring Axis I or Axis II psychiatric disorders in addition to a SUD diagnosis. Among individuals with co-occurring disorders, those who received the CPR intervention show increased duration of treatment and improved 1-year abstinence rates compared to those who received STX. Additionally, effects of the CPR intervention were generally more pronounced among persons with co-occurring Axis I and/or Axis II disorders than those without these disorders. Treatment implications are discussed.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Continuity of Patient Care / standards*
  • Continuity of Patient Care / statistics & numerical data
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Humans
  • Male
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Residential Treatment
  • Substance Abuse Treatment Centers
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy