Predictors of Residential Treatment Completion Among Individuals with Co-Occurring Substance and Mental Disorders

Although the efficacy of treatment has been supported in prior research, a significant number of individuals with co-occurring substance and mental disorders does not engage in, stay and complete their treatments. Accordingly, understanding the factors related to treatment completion for this vulnerable population is one of primary research priorities in social work. The purpose of this study is to determine factors of treatment completion for individuals with co-occurring substance and mental disorders in three residential treatment sites, geographically situated in California and Tennessee. The participants were 1,143 voluntary individuals with co-occurring disorders receiving treatment at three residential treatment centers in Memphis, TN, Palm Spring, CA, and Malibu, CA. All participants received an intake assessment by a multidisciplinary team which provides the basis for an individual treatment plan to address substance use, psychiatric disorder, and medical and social service needs. A sample consists of 61.2% male and 89.2% Caucasian. The descriptive statistics as well as Cox regression were utilized. The mean of the length of stay was 31 (SD=19.3) and 37.3% either completed or partially completed their treatment. Women have a higher rate of treatment completion compared to men. Bivariate analysis indicates that Addiction Severity Index (ASI) composition scores were significantly different between treatment completers and non-completers in areas of employment/support composition and psychiatric composition. More specifically, treatment completers had a higher mean both in employment/support and psychiatric compositions. Cox regression indicated a gender, ethnicity, and ASI family composition were significantly associated with the timely likelihood of treatment completion. Women and Caucasian were more likely to complete their treatment compared to men and non-white (African American and Latino). ASI family composition score were negatively associated with the likelihood of treatment completion. The findings indicate a variety of factors that might be incorporated into pretreatment assessments—so that therapists can initiate preventive measures to decrease attrition and improve treatment completion. This study also highlights the need for the continual development for the intake profiles for individuals with co-occurring substance and mental disorders with high risk of future treatment dropouts.