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Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium

Ilse Goethals (UGent) , Wouter Vanderplasschen (UGent) , Stijn Vandevelde (UGent) and Eric Broekaert (UGent)
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Abstract
Background: Research on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients’ early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument. Methods: Data was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients’ early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process). Results: Clients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients’ ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients’ ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores. Conclusions: Special attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients’ (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the induction stage of a TC program.
Keywords
CRIMINAL-JUSTICE, TREATMENT RETENTION, ADDICTION TREATMENT, TREATMENT INSTRUMENT, MOTIVATION, OUTCOMES, DIMENSIONS, ENGAGEMENT, DATOS, READINESS, Therapeutic communities, Treatment process, Motivation, Psychological distress, Demographics

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Chicago
Goethals, Ilse, Wouter Vanderplasschen, Stijn Vandevelde, and Eric Broekaert. 2012. “Fixed and Dynamic Predictors of Treatment Process in Therapeutic Communities for Substance Abusers in Belgium.” Substance Abuse Treatment Prevention and Policy 7 (43): 1–12.
APA
Goethals, Ilse, Vanderplasschen, W., Vandevelde, S., & Broekaert, E. (2012). Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY, 7(43), 1–12.
Vancouver
1.
Goethals I, Vanderplasschen W, Vandevelde S, Broekaert E. Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY. 2012;7(43):1–12.
MLA
Goethals, Ilse, Wouter Vanderplasschen, Stijn Vandevelde, et al. “Fixed and Dynamic Predictors of Treatment Process in Therapeutic Communities for Substance Abusers in Belgium.” SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 7.43 (2012): 1–12. Print.
@article{3058768,
  abstract     = {Background: Research on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients{\textquoteright} early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument. Methods: Data was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients{\textquoteright} early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process). Results: Clients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients{\textquoteright} ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients{\textquoteright} ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores. Conclusions: Special attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients{\textquoteright} (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the induction stage of a TC program.},
  author       = {Goethals, Ilse and Vanderplasschen, Wouter and Vandevelde, Stijn and Broekaert, Eric},
  issn         = {1747-597X},
  journal      = {SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY},
  keyword      = {CRIMINAL-JUSTICE,TREATMENT RETENTION,ADDICTION TREATMENT,TREATMENT INSTRUMENT,MOTIVATION,OUTCOMES,DIMENSIONS,ENGAGEMENT,DATOS,READINESS,Therapeutic communities,Treatment process,Motivation,Psychological distress,Demographics},
  language     = {eng},
  number       = {43},
  pages        = {1--12},
  title        = {Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium},
  url          = {http://dx.doi.org/10.1186/1747-597X-7-43},
  volume       = {7},
  year         = {2012},
}

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