Predicting aftercare participation and success after residential substance use treatment

In brief

Problematic substance use is a chronic condition with a high relapse rate. Research shows that residential treatment helps maintain recovery when combined with long-term continuing care, or aftercare. Aftercare begins once the individual has completed residential treatment and can take the form of 12-step programs, structured outpatient sessions led by an addiction counsellor, and individual counselling.

Researchers set out to examine the individual and treatment characteristics that are associated with an individual’s participation in an aftercare program after they complete residential treatment, and to examine the recovery outcomes of individuals who participate in some form of aftercare (individual counselling, 12-step program, or structured outpatient group sessions led by an addiction counsellor).

In our latest Research Snapshot, we look at the results of this study. To read it click here.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What you need to know

Individuals who receive treatment for problematic substance use have a high rate of relapse, but aftercare programs can help them improve their likelihood of long-term recovery. Clients who complete longer residential treatment programs and those who are more satisfied with their residential treatment program are more likely to attend aftercare.

What did the researchers do?

Researchers set out to examine the individual and treatment characteristics that are associated with an individual’s participation in an aftercare program after they complete residential treatment, and to examine the recovery outcomes of individuals who participate in some form of aftercare (individual counselling, 12-step program, or structured outpatient group sessions led by an addiction counsellor).

The researchers enrolled 367 adults who completed abstinence-based residential substance use treatment between 2004 and 2007 at Bellwood Health Services in Toronto, Canada. More than half of participants were admitted for alcohol addiction and over a quarter for cocaine addiction. About a third had a psychiatric problem, such as depression, anxiety, or personality disorder.

The researchers measured:

  • the individual’s motivation to enter substance use treatment using the Treatment Entry Questionnaire (TEQ);
  • the individual’s satisfaction with the initial residential treatment using the Client Satisfaction Questionnaire-8 (CSQ-8);
  • the number of days spent in inpatient treatment using the client’s admission and discharge dates;
  • the client’s recovery progress at 6 months using telephone interviews with the client and with another person the client identified as knowing them well;
  • attendance in various types of aftercare;
  • recovery maintenance by calculating the extent to which participants reduced their substance use 6 months after treatment.

What did the researchers find?

After six months, about three quarters of participants said they were attending aftercare regularly.

Those who had completed residential treatment of longer duration were more likely to attend a 12-step program or individual substance use counselling. Clients who rated their satisfaction with residential treatment the highest and those who did not have a psychiatric diagnosis were more likely to attend a structured outpatient group sessions.

Women were more likely than men to attend individual counselling, as were clients who had a longer stay in residential treatment.

The results show that aftercare attendance does lead to positive substance use outcomes after six months. Also, client satisfaction with residential treatment and the duration of this treatment were significantly related to aftercare attendance at the site of the initial residential program.

What are the limitations of this research?

This study was limited in that participants used self reports to indicate their use of aftercare and post-treatment substance use. This limitation was minimized by interviewing individuals who knew the participants well to corroborate the self reports. The high rate of agreement between the two groups shows that self reports are a good indicator of recovery status.

How can you use this research?

This research may help program planners looking to develop residential treatment and aftercare substance use programs that are effective in helping clients achieve their long-term recovery goals.

About the researchers

Simone Arbour is Research and Program Quality Coordinator at Bellwood Health Services, Toronto, Ontario (a part of the Edgewood Health Network).
Janice Hambley is Clinical Psychologist at Bellwood Health Services.
Victoria Ho is an addiction therapist at Bellwood Health Services.

This Research Snapshot is based on their article: “Predictors and Outcome of Aftercare Participation of Alcohol and Drug Users Completing Residential Treatment,” which was published in Substance Use & Misuse, volume 46, 2011, doi:10.3109/10826084.2011.572941

Keywords

Substance use, residential treatment, aftercare, recovery, counselling

This Research Snapshot is based on an article that has been critically appraised for quality and susceptibility to bias.

Evidence Exchange Network (EENet) has partnered with the Knowledge Mobilization Unit at York University to produce Research Snapshots in the field of mental health and addictions in Ontario.