Abstract

Introduction: Persons discharging from residential or inpatient substance use treatment experience the highest level of vulnerability to relapse in first three months post treatment. To support the ongoing recovery efforts of persons discharging from residential and inpatient substance use treatment, it is important to identify clients’ likely prognosis for post treatment abstinence. Subjective evaluations based on AOD counselors’ clinical impressions of the clients’ prognoses for abstention serve as an important predictor of post treatment outcomes. However, there has been limited study to date of the factors associated with AOD counselors’ subjective ratings of their clients’ prognosis for post treatment abstention.

Methods: A de-identified dataset of 200 clients admitted to abstinence-based residential SUD treatment between August 1, 2017, and March 1, 2018 was obtained. The sole dependent variable of interest in this study was the clients’ prognosis rating for abstention assigned by their primary AOD Counselor when the participants’ treatment episode ended.

Results: Based on the likelihood ratio tests, the following variables were found to be significant predictors of AOD counselor ratings for clients’ prognoses for post treatment abstention: gender (p < .028), past 30 days of use of primary substance used reported at intake (p < .001), number of lifetime inpatient psychiatric episodes (p < .026), use of alcohol and marijuana in combination (p < .026), readiness to change - no severity (p < .046), and readiness for change - mild to moderate severity (p < .025).

Conclusion: The results highlight the importance of assessment for and stabilization of psychiatric symptoms as well as withdrawal symptoms from high levels of pretreatment methamphetamine use in order to enhance treatment completion rates. Furthermore, the findings demonstrate the importance of assessing pretreatment readiness for change and motivation in order to successfully engage clients and use targeted interventions to enhance readiness to change, thereby improving treatment retention and completion rates.