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Influence of Counselling on Retention in Drug Treatment

This study examines the effects of counselling on retention in drug treatment programs. It highlights the importance of individual staff members and the provision of adequate counselling. The study also explores the relationship between counsellor characteristics and client retention.

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Influence of Counselling on Retention in Drug Treatment

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  1. Counselling in drug treatment Dr Petra MeierSchool of Health and Related Research, Sheffield University, p.meier@shef.ac.uk The studies Retention survey • 3-year NHS-funded cohort study examining “Effects of pre-treatment and treatment process factors on retention and outcome” and follow-on work funded by NTA • National survey on extent & nature of counselling in drug services (2002) • Cohort study of treatment process in residential rehabilitation services (2002-2004) • Nationalsurvey on retention in rehabs (2005) • Services providing more individual counselling retain clients longer • Services with smaller counsellor caseloads • retain clients longer • Comment • In residential rehabilitation, provision of an adequate amount of counselling can positively influence retention. * * Counselling Survey 2002 Sample of 326 services (66% response rate). Retention Survey 2005 Sample of 57 rehabilitation providers (66% response rate) Cohort study 2002-04 187 clients and 24 counsellors in residential rehabs, • Cohort study (continued)… • Counsellor demographics, training & qualifications, ex-user? • Client drug use, physical & mental health, motivation etc • - Weekly alliance ratings (client & counsellor) • - Retention for 90+ days • Outcome at 3 months Cohort study *significant at p<.05 • Large differences between counsellors: Six counsellors retained 70% or more of their clients, five counsellors lost 70+% of clients to dropout • Counsellors with a higher caseload lost more clients . • Counsellor rated alliance predicts retention (controlling for other client and counsellor characteristics). • Alliance predicts positive in-treatment changes such as increases in social support, self-esteem, psychological well-being and confidence in treatment. • Comment • This study highlights the importance of the • individual staff member. Counselling survey • 87% services provided some individual counselling • Workers without counselling training provided counselling in 74% of services. • The majority of services provide one hour of counselling per week. • Comment • Prior research shows that monthly counselling is not effective but 2-5 counselling sessions per week were associated with improved outcomes. UK counselling falls somewhere in between. • Effectiveness has only been demonstrated for highly qualified, experienced counsellors, but in the UK most of those providing one-on-one support are not trained counsellors. *differences significant at p<.005 References *differences significant at p<.01 Meier, Donmall & Heller, Journal of Substance Use 2004, 9(1), 44-51 Meier, Donmall, McElduff, Barrowclough, & Heller, Drug & Alcohol Dependence 83, 57-64, 2006 Meier, Donmall, Barrowclough, McElduff, Heller, Addiction 100, 500-511, 2005 Meier, P. & Best, D. (2006). Programme factors that influence completion of residential treatment. Drug and Alcohol Review 25, 349-355

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