The influence of treatment exposure and client background variables on outpatient drug-free retention: A sample of African-American women crack cocaine abusers

• Main Author: Levi, Deborah Baht
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-1997
• Subjects: African American Studies; African Americans; Black studies; Clinical psychology; Cocaine; Drug abuse; Nursing; Outpatient care facilities; Psychotherapy; Public health; Womens studies
• ISBN: 9780591316544; 0591316544

Several attempts have been made to identify client characteristics and treatment factors as predictors of retention in outpatient drug-free treatment among cocaine abusers. However, relatively few retention studies are available about African-American women crack cocaine abusers. Using a hypothesized model of retention among women in substance abuse treatment as a conceptual framework, this study investigates the influence of treatment exposure and client background variables on three months retention for African-American women crack cocaine abusers in outpatient drug-free retention. Empirical research documents that the longer clients remain in drug treatment, the better their outcomes. Client records were reviewed for 232 African-American women crack cocaine abusers (mean age 31.20 years), using existing data from the Drug Abuse Treatment Outcome Study, a national study on drug treatment effectiveness. There were 121 women who stayed 90 or more days in treatment compared to 111 women who stayed less than 90 days. A total of 31 client and treatment variables were screened by regressing retention on each of them separately, using logistic regression. Eleven of the variables were significant at the.20 level. These 11 variables were simultaneously entered into a multiple logistic regression analysis. Six significant variables (at p = $\le$.20) from this multiple logistic regression analysis were entered into a final logistic regression model. The final model revealed that service-specific treatment predicted three month retention in outpatient drug-free treatment among African-American women crack cocaine abusers at the.05 level of significance. Prior drug treatment history, criminal justice status, and child custody concerns were not predictive of 90 days or more retention. Other significant findings were that living with others, health status, partner support, and motivation and readiness for treatment were all powerful predictors of three months retention in outpatient drug-free treatment. The significant findings all have implications for drug treatment and health policy. The hypothesized finding that the likelihood of retention is higher for African-American women who participated in service-specific treatment demonstrates a need for a two-pronged treatment approach: training of counselors in service-specific treatment, and the requirement that service-specific treatment be delivered to clients as an integral part of drug treatment.