Improving Treatment Compliance: Counseling and Systems Strategies for Substance Abuse and Dual Disorders by Daley and Zuckoff discusses what counselors can do to help substance abuser and the dually diagnosed stay in treatment. The strategies described may be used in inpatient, residential, or outpatient settings. Not only do Daley and Zuckoff described what individual counselors can do, but also how agencies as a whole can reorganize to reduce the dropout rates of their treatment programs.
Many substance abusers fail to enter treatment programs. Often times, even when they do enter into treatment, they do not complete treatment. Statistics show that those who remain in treatment longer are less likely to relapse than those who dropout of treatment early. Although some substance abusers may stay in treatment over a long period of time, some may continue to relapse as they are not fully committed to treatment. For example, they may inconsistently attend counseling by missing scheduled appointments or by be tardy for their appointments. According to Daley and Zuckoff, treatment compliance is the most important issue facing substance abuse counselors.
Daley and Zuckoff point out that treatment compliance can be seen on a continuum. I thought that this was an interesting point, as I had never really looked at compliance to treatment as falling on a continuum. I was already aware that substance abuse can be viewed as being on a continuum from no use to use to abuse to dependence. It, therefore, makes sense to me that treatment compliance should also be viewed as something that can fall along a continuum. According to Daley and Zuckoff the continuum of treatment compliance goes from minimal to partially to mostly compliant.
Daley and Zuckoff offer some tips for gauging how compliant with treatment a client is or will be. For example, counselors can simply ask clients direct questions regarding their use of drugs and adherence to treatment. Furthermore, monitoring clients voluntary attendance to self-help meetings may allow counselors to gauge how committed a client is to his or her recovery. Keeping up with their mediations (especially for those who are dually diagnosed) is yet another way for a counselor to determine how compliant to treatment a client is. Lastly, completing “out-of-office” therapeutic assignments, as well as blood and urine screens is another technique counselors may employ.
Connors, G.J., et al. (2004). Substance Abuse Treatment and the Stages of Change. New York: The Guilford Press.