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

Coulson, Carolyn, Ng, Felicity, Geertsema, Marjan, Dodd, Seetal and Berk, Michael 2009, Client-reported reasons for non-engagement in drug and alcohol treatment, Drug and alcohol review, vol. 28, no. 4, pp. 372-378, doi: 10.1111/j.1465-3362.2009.00054.x.

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Title Client-reported reasons for non-engagement in drug and alcohol treatment
Author(s) Coulson, Carolyn
Ng, Felicity
Geertsema, Marjan
Dodd, SeetalORCID iD for Dodd, Seetal
Berk, MichaelORCID iD for Berk, Michael
Journal name Drug and alcohol review
Volume number 28
Issue number 4
Start page 372
End page 378
Total pages 7
Publisher Wiley - Blackwell Publishing
Place of publication Oxford, England
Publication date 2009-07
ISSN 0959-5236
Keyword(s) substance abuse
treatment engagement
therapeutic alliance
service delivery
Summary 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.
Language eng
DOI 10.1111/j.1465-3362.2009.00054.x
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Australasian Professional Society on Alcohol and other Drugs
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