Home > Effectiveness Bank Bulletin. [Effect of assessment instruments on adherence to treatment]

(2012) Effectiveness Bank Bulletin. [Effect of assessment instruments on adherence to treatment]. Drug and Alcohol Findings, 21 Jun,

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The effect of using assessment instruments on substance-abuse outpatients' adherence to treatment: a multi-centre randomised controlled trial.
Raes V., De Jong C.A.J., De Bacquer Dirk. et al. BMC Health Services Research: 2011, 11:123.

Young adult multi-drug users in Belgium who often soon dropped out of treatment were much more likely to stay in counselling when their therapists structured sessions by feeding back assessments of their motivation and recovery resources.

At issue in this Belgian study was whether offering regular feedback on assessment results to inform and structure counselling means patients stay for more sessions, the presumption being that if they do, they will also benefit more. The study was conducted at five outpatient drug treatment centres from the same parent organisation which treat people commonly using several drugs and who often attend treatment patchily. In this trial the researchers provided a manual for the feedback programme and trained the centres' staff in its use, but had no direct influence over the intended or actual duration of treatment, which was left to the discretion of staff and patients.

For all patients, initial assessment of the severity of drug and related problems was measured by the European Addiction Severity Index (EuropASI) interview schedule, covering: physical and psychological health;, education, work, and income; drinking and drug use; and legal and relationship problems. Patients randomly allocated to the control group simply carried on with treatment as usual, not even being asked to participate in the trial. The other roughly half of the patients were asked to join the trial and allocated to the feedback programme, involving making assessments and feeding the results back at the next counselling session, procedures which replaced the usual content of the sessions. Assessments were made of the patient's readiness to change their substance use, and later of the resources available to them (assessed by both counsellor and patient) to improve their lives, akin to the 'recovery capital' thought important in overcoming addiction. Also assessed were their wishes to change these areas of their life. Assessments and feedback were repeated over treatment, offering opportunities to promote and assess therapeutic and personal progress.

In all 111 control group patients attended for initial assessment and 116 in the feedback programme, but 16 of the latter refused to participate in the feedback programme. Nevertheless their outcomes were included in the main analyses. Patients were typically young single men in their late twenties using cannabis, stimulants, and/or opiates, nearly half of whom were living with their parents.

In theory all the feedback assessments could be completed at least once in seven sessions, so the first yardstick was how many patients stayed for at least one further session – eight in all, not counting the initial assessment. In practice however, 90% of the assessment and feedback activities took place within the first 12 sessions, so completion of at least this number was chosen as the second outcome measure.

Item Type
Publication Type
International, Review, Article
Drug Type
All substances
Intervention Type
Treatment method, Psychosocial treatment method, Screening / Assessment
21 June 2012
Drug and Alcohol Findings
21 Jun
For full text of article - click 'publication' on the related link below.
Accession Number
HRB (Electronic Only)
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