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Abstract
In an effort to increase engagement in effective treatment, we offered a choice of alternate evidence-based treatments to 137 alcohol- or cocaine-dependent adults (110 males, 27 females), who entered an intensive outpatient programme (IOP) but disengaged within the first 8 weeks. We hypothesised that disengaged patients would choose and subsequently attend alternatives to IOP when given the chance, that their choices would be consistent with their previously-stated preferences, and that demographic and clinical characteristics would be predictive of alternatives chosen. Of 96 participants reached by phone, 19% chose no treatment; 49% chose to return to IOP; 24% chose individual psychotherapy; 6% chose telephone counselling; 2% chose naltrexone with medication management. There were few relationships between participant characteristics and choices made upon disengagement. Participants who chose alternative treatments were equally likely to attend their chosen treatment as those who chose IOP. Limited interest in alternative treatments may reflect allegiance to IOP, which was initially chosen by all participants. Implications for implementation of patient-centred adaptive treatment are discussed.
Declaration of interest
The authors report no conflicts of interest. This research was supported by NIDA grants P60-DA-05186 and K24 DA029062, NIAAA grant P01-AA016821, and by the Department of Veterans Affairs. There was no involvement of a pharmaceutical company in funding this research. The sponsors played no role in preparation of this article. There was no medical writing or editorial assistance with the preparation of this article.