Treatment Retention Satisfaction, and Therapeutic Progress for Justice-Involved Individuals Referred to Community-Based Medication-Assisted Treatment

Abstract

Background: Limited research has examined factors associated with medication-assisted treatment for justice-involved individuals. Objectives: The current study used a mixed-method design to examine the influence of client- and counselor-level factors on 90-day treatment retention, satisfaction, and progress for justice-involved individuals referred to medication-assisted treatment. Methods: The effects of co-occurring disorders (i.e., psychiatric symptoms, anxiety, depression), social functioning (i.e., social support, self-esteem), substance use severity, and treatment motivation on treatment retention, treatment satisfaction, and treatment progress while controlling for counselor-level variance were assessed through multilevel modeling. Results: Fewer co-occurring disorders and more social support were related to greater treatment satisfaction and progress. A higher level of treatment motivation was associated with greater treatment progress. Mediation of treatment satisfaction on the relationship between client-level factors and treatment progress also was tested. Depression was negatively associated with treatment satisfaction, which in turn led to lower ratings of treatment progress. Social support was positively correlated with treatment satisfaction, which in turn was positively correlated with treatment progress. The association of client substance use severity with treatment retention differed between counselors, so did the association of co-occurring disorders and treatment motivation with treatment satisfaction. Qualitative analyses that were derived from counselors’ perception of factors relating to recovery success underscored the importance of integrated interventions, social support, treatment motivation, and therapeutic alliance, and their associations with treatment outcomes. Conclusions/Importance: The current findings highlight the importance of integrated treatment services, collaborating with community corrections, and teaching clients strategies for dealing with deviant peers as to facilitating recovery.

Keywords:

• Treatment retention
• treatment satisfaction
• client-level factors
• counselor-related factors
• treatment progress
• mixed-methods design
• medication-assisted treatment
• community substance treatment for justice-involved individuals

Additional information

Funding

This study was funded by a grant to Texas Christian University (DA016190, K. Knight, Principal Investigator) from the National Institute on Drug Abuse, the National Institutes of Health (NIDA/NIH), with support from the Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Disease Control and Prevention (CDC), the National Institute on Alcohol Abuse and Alcoholism (all part of the U.S. Department of Health and Human Services); and from the Bureau of Justice Assistance of the U.S. Department of Justice. The interpretations and conclusions, however, do not necessarily represent the position of the NIDA, National Institutes of Health, or Department of Health and Human Services or the other government agencies that supported the research.