Responding to treatment dropout: A review of controlled trials and suggested future directions

Abstract

This article reviews the evidence in support of current treatment dropout responses designed for use in outpatient, psychosocial-based alcohol and other drug (AOD) treatment settings. A total of 17 publications meeting the inclusion criteria were identified for this review, reporting findings from 19 randomised controlled trials or controlled clinical trials. The methodological quality of these studies was largely sound; however, a lack of contextual information made it difficult to generalise the reported findings across treatment settings and the effectiveness of the reported strategies was modest at best. Future possibilities in dropout response research are subsequently discussed and a novel conceptual framework, termed treatment-fit, is described in detail. It is anticipated that the findings and ideas presented in this article will assist AOD treatment providers formulate an informed response to client dropout. It is also the authors’ intention to promote a fundamental shift in how treatment dropout is understood. Achieving such a shift, as will be argued, may result in a truly effective response to treatment dropout.

• Addiction
• dropout
• retention
• review
• treatment-fit

Acknowledgements

This study was undertaken with financial assistance from the Waitemata District Health Board (WDHB) and a John Dobson Memorial scholarship.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.