Correlates of early attrition in a therapeutic community's treatment of drug abuse
Therapeutic Communities have been a popular type of treatment for drug addicts. These facilities base their treatment approach on the assumption that drug addiction is a learned behavior which is reinforced by the social network within which the drug addict functions. While theoretically the programs developed from this social learning theory are reasonable, these treatment facilities have been plagued by extremely high drop-out rates and have had difficulty retaining their clients.^ The purpose of this study was to identify some of the factors that are associated with the premature discharge of drug addicts from a therapeutic community. It was hypothesized that various psychological variables (impulsivity, interpersonal needs, depression, anxiety, schizophrenic and paranoid indicators) and perceptual factors (the view the residents hold of the treatment environment and the staff's assessment of the residents) would correlate with premature attrition.^ All new, male residents of a 90 day Veteran's Administration therapeutic community who stayed in treatment 76 or less days were participants in this study. Over a one year period of time, a total of 115 residents were administered the FIRO-B, the MMPI and the Drop-out Scale of the Ward Atmosphere Scale within three days of their admission. Three subgroups of drop-outs were derived based on their time spent in treatment--45 residents in the immediate drop-out group, 41 residents in the rapid drop-out group and 19 residents in the slow drop out group. The results of the analyses found little to distinguish the groups from one another. The only descriptive variable that was significantly different was race. Furthermore, none of the psychological or perceptual variables reached significant levels. The group as a whole did score above the mean on the MMPI scales of depression, schizophrenia, and paranoia. Scaled scores on the Manifest Anxiety Scale were within average limits. Explanation as to the results achieved concerned the locale of the therapeutic community on the grounds of a psychiatric hospital and the lack of stability of affective states over time. Suggestions for research included the establishment of longer time periods to define the three sub-categories of drop-outs and the use of multiple administrations of the self-report tests to discern the residents' psychological and perceptual changes during their stay in treatment. ^
Debra Heidecorn Goldman,
"Correlates of early attrition in a therapeutic community's treatment of drug abuse"
(January 1, 1996).
ETD Collection for Fordham University.