The Washington circle engagement performance measures’ association with adolescent treatment outcomes

• Published in: Drug and alcohol dependence Vol. 124; no. 3; pp. 250 - 258
• Main Authors: Garnick, Deborah W, Lee, Margaret T, O’Brien, Peggy L, Panas, Lee, Ritter, Grant A, Acevedo, Andrea, Garner, Bryan R, Funk, Rodney R, Godley, Mark D
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-08-2012; Elsevier
• Subjects: Addictive behaviors; Adolescent; Adolescent substance abuse treatment; Adolescents; Adult and adolescent clinical studies; Biological and medical sciences; Child; Clinical outcomes; Desintoxication. Drug withdrawal; Drug addiction; Female; Follow-Up Studies; Humans; Male; Medical sciences; Miscellaneous; Outcomes; Outpatient treatment; Outpatients; Performance measures; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk-Taking; Substance abuse; Substance abuse disorders; Substance Abuse Treatment Centers; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Treatment; Treatment engagement; Treatment Outcome; Treatments; United States; North America; Washington; America; Adolescent substance abuse treatment; Performance measures; Outcomes; Treatment engagement; Human; Performance evaluation; Drug addiction; Prognosis; Poison withdrawal; Treatment efficiency; Substance abuse; Association; Addiction; Adolescent; Evolution; Treatment compliance; Performance
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2012.01.011

Abstract Background For adolescents, substance use disorder (SUD) treatment outcomes (e.g., abstinence, problematic behaviors) often cannot be measured soon enough to influence treatment trajectory. Although process measures (e.g., treatment engagement) can play an important role, it is essential to demonstrate their association with outcomes. This study explored the extent to which engagement in outpatient treatment was associated with outcomes and whether demographic/clinical characteristics moderated these relationships. Methods This is a prospective study of adolescents ( N = 1491) who received outpatient treatment for SUDs at one of 28 treatment sites taking part in a national evidence-based practice implementation initiative. Information from the Global Appraisal of Individual Needs interviews at intake and six-month follow-up, as well as encounter data, were used. Adjusted hierarchical logistic models were used to estimate effects of engagement on six-month outcomes. Results Sixty-one percent of adolescents engaged in outpatient treatment. Adolescents engaging in treatment had significantly lower likelihoods of reporting any substance use (OR 0.60, 95% CI 0.41, 0.87), alcohol use (OR 0.63, 95% CI 0.45, 0.87), heavy alcohol use (OR 0.53, 95% CI 0.33, 0.86), and marijuana use (OR 0.64, 95% CI 0.45, 0.93). This association of engagement with abstinence outcomes was not limited to any particular group. Treatment engagement, however, was not associated with adolescents’ self-report of illegal activity or trouble controlling behavior at follow-up. Conclusion At the individual level, the Washington Circle engagement measure was a predictor of some positive outcomes for adolescents in outpatient treatment. Efforts to better engage adolescents in treatment could improve quality of care.