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Factors associated with compliance of alcoholics in outpatient treatment
B Nielsen1, A S Nielsen, O Wraae
1Department of Psychiatry, Odense University Hospital, Denmark.
Abstract:
Predictors of compliance with psychosocial treatment were examined in a clinical sample of 150 patients seeking outpatient treatment for alcohol problems. Predictor variables were as follows: a) patient characteristics at the beginning of treatment and b) treatment characteristics of a matching model developed from the Conceptual System Theory. This model was based on the conceptual level of patients and therapists, and on the structure of the treatment. Using logistic regression analysis, we identified predictors of compliance in the motivation phase (first four consultations) and the active treatment phase (the remainder of the agreed treatment period of 12 months). Predictors of compliance in the motivation phase were a) therapists with a high conceptual level, characterized by an attitude toward the patients of empathetic and reflective listening; b) disulfiram; and c) psychopharmacological treatment. The only patient-related predictors of compliance in the active treatment phase were a) age below 40 and b) the presence of family and social problems, both factors predicting noncompliance. The only treatment-related predictor variables were a) the matching of patients with the structure of treatment and b) disulfiram during the first month of treatment, both factors predicting compliance. Two years after the beginning of treatment, those patients who completed the motivation phase as well as the active treatment phase had a significantly better psychosocial function than the noncompliant patients.
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