Abstract
Background:
Treatment retention is a major factor contributing to favourable outcome in
the treatment of substance misuse, but the literature remains very limited.
Despite evidence of the association of personality with drug use
experimentation and relapse, surprisingly little is known about its role in
the treatment process. Clients’ personality functioning as measured by
malleable and context sensitive characteristic adaptations in treatment are
of concern.
Aims:
This study examines whether, and to what extent, personality functioning
contributes to or hinders treatment completion. This paper examined the
extent to which service users’ characteristic adaptations may be potential
determinants of treatment completion.
Methodology:
A longitudinal multi-site design was utilised, examining the therapy process
in a naturalistic setting in five inpatient treatment units. The study
examined whether service users’ characteristic adaptations (SIPP-118)
predict completion, while controlling psychosocial, motivational and
treatment engagement indicators involving n = 340 participants from 5
inpatient centres. Multivariate regression analyses were
applied to examine the predictive role of characteristic adaptations on
treatment completion.
Results:
Findings indicated that certain dysfunctional characteristic adaptations
emerged as strong predictors of treatment completion. Dysfunctional levels
on Self-control and Social concordance were significant predictors of drop
out from treatment. Individuals with low capacity to tolerate, use and
control one’s own emotions and impulses were almost three times more likely
to drop-out compared to those without [OR] = 2.73, Wald = 6.09,
P = .014, 95% CI [1.2, 6.0]. Individuals with
dysfunctional levels on the ability to value someone’s identity, withhold
aggressive impulses towards others and work together with
others were 2.21 more times more likely to complete
treatment [OR] = 2.21, Wald = 4.12, P = .042, 95% CI [1.0,
4.7]. The analysis at the facet level provided additional insight.
Individuals with higher adaptive levels on Effortful Control were 46% more
times likely to complete treatment than the group [OR] = 4.67, Wald =
10.231, P = .001, 95% CI [1.81, 12.04], 47% more likely on
Aggression regulation [OR] = 4.76, Wald = 16.68, P <
.001, 95% CI [2.1, 10.3], and 26% more likely on Stable self-image [OR] =
2.62, Wald = 6.75, P < .009, 95% CI [0.9, 3.0].
Conclusions:
These findings extend our knowledge of the predictive role of characteristic
adaptations in treatment completion and highlight the clinical utility of
capturing these individual differences early on. Delineating the role of
characteristic adaptations in treatment may provide the basis for enhancing
treatment effectiveness through individualized interventions that are
scientifically driven and may open new avenues for the scientific enquiry of
personality and treatment.
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