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Abstract
Background: Retention in substance abuse treatment is difficult but essential for positive post-treatment outcomes.
Aims: The present study is the first to explore factors related to retention in a long-term specialist residential substance abuse treatment programme for women in Australia.
Methods: Archival data (e.g. socio-demographic, substance use, mental health, and length of stay) were collected from a sample of 71 women admitted to the programme between January 1997, and November 2002. Participants were divided into two groups based on their length of stay in the programme: less than 90 days (n = 42) and 90 days or more (n = 29).
Results: A substantial proportion of the sample experienced comorbid substance abuse and mental health problems, with 60.6% (n = 43/71) reporting evidence of comorbidity (either a previous psychiatric diagnosis, or having been prescribed psychiatric medications). Overall, only 13% of residents completed the programme. Longer retention was associated with demographic (older age and shorter duration of substance use), drug use (having recently used heroin), and social variables (being single, less family adversity, and a higher level of social support and functioning).
Conclusions: Modifications to residential rehabilitation should be trialled, including: flexibility in the duration of programmes; bonding and engagement strategies for younger women and those with social difficulties and adverse family histories; relationship and/or substance use interventions for partners; and flexible integrated interventions for comorbid substance use and mental health problems.
Acknowledgements
Many thanks to the staff and clients of the residential service described in this paper, without whom this study would not have been possible. Thanks to Louise Thornton who assisted in the preparation of this manuscript.