More than a number : measuring ‘success’ in substance use treatment
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Caroline E. Trustey (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Connie T. Jones
Abstract: The Diagnostic and Statistical Manual of Mental Disorders (DSM) includes 11 criteria to consider when diagnosing an individual with substance use disorder (SUD), ranging from failure to fulfill role obligations to tolerance and withdrawal (American Psychiatric Association, 2013). Despite these 11 criteria used in diagnosis, only two criteria – treatment completion and changes in use – are typically used in outcome research. Researchers in SUD treatment have historically defined success in treatment as a reduction or cessation in one’s use of substances, along with treatment completion, whereas failure is correlated with relapse and/or an inability to complete treatment (Donovan et al., 2012; MacMaster, 2004; Peters et al., 2017). Developers of abstinence-based approaches initially intended for treatment goals in such programs to include cessation of substance use and improvements in quality of life (QoL; Stinchfield & Owen, 1998). However, for over sixty years, researchers have measured outcome as one’s ability to complete treatment and cease substance use (e.g., Cook, 1988; Hughto et al., 2021; Laundergan, 1982; Rossi et al., 1963). Recently, researchers have begun to explore secondary treatment effects – those changes that occur alongside changes in substance use – such as improvements in health and relationships (e.g., Pasareanu et al., 2015; Patterson et al., 2019; Tiffany et al., 2012a). Secondary treatment effects tend to mirror DSM criteria for SUD; as one’s consequences due to use and SUD symptomology decrease, their secondary treatment effects increase (American Psychiatric Association, 2013; Miller et al., 1995). Using the DSM criteria for SUD as a framework for both diagnosis and measuring ‘success’ in treatment, I examined success as a function of secondary treatment effects and QoL, as these are aligned with DSM criteria. To date, researchers have examined correlations between secondary treatment effects and substance use (e.g., Drummond et al., 2009; Patterson et al., 2019) as well as QoL and treatment (Pasareanu et al., 2015). However, most researchers study individuals who have completed treatment rather than the vast number of people who do not complete treatment. In this study, I explored the associations between change in substance use, secondary treatment effects, and quality of life, for individuals currently in treatment. Utilizing a cross-sectional, descriptive methodology I assessed whether QoL is associated with secondary treatment effects and substance usage. I analyzed the data using a basic correlation, a hierarchical regression with a commonality analysis, and a moderation analysis to explore the relationships, predictors, and moderations between secondary treatment effects, QoL, and changes in substance use. The results indicate that both secondary treatment effects and differences in substance use contribute to the variance in quality of life scores in individuals in treatment. Secondary treatment effects are marginally more predictive than the difference in use scores, however, the combination of the two variables accounts for more variance in scores than either measurement alone. A moderation did not exist between the predictor variables, implying that both secondary treatment effects and differences in use are individually and uniquely important in terms of the main effect. Limitations of this study included the cross-sectional design of data collection, the inclusion criteria of 28-days in treatment to participate, and the inability to know which individuals will and will not complete treatment in the future. This work contributes to scholarly efforts by broadening the measures used in determining treatment ‘success’ and outcomes in substance use treatment, as well as encouraging researchers and practitioners to view clients as holistic, multifaceted individuals in treatment.
More than a number : measuring ‘success’ in substance use treatment
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Created on 12/1/2022
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Additional Information
- Publication
- Dissertation
- Language: English
- Date: 2022
- Keywords
- Addiction, Mental health treatment, Quality of life, Substance use, Substance use treatment, Success
- Subjects
- Substance abuse $x Treatment
- Psychotherapy $x Outcome assessment