Comparing Therapeutic Treatment Goals Across Settings for Those in or At-Risk for Substance Use Treatment in West...

Despite the variety of treatment programs for those with or at risk for substance use disorders (SUD), relatively little is known about treatment goals beyond substance use reduction across treatment settings. Understanding these treatment goals may inform the tailoring of treatment and improve implementation.

This study compares treatment goals across 4 years at 3 treatment facilities. All sites were situated in West Alabama, a geographic region known for substantial health, economic, and educational disparities as well as behavioral and mental health stigma. Psychosocial treatment goals were examined by site using de-identified psychotherapy notes and a modified version of an established treatment goal coding inventory (the Bern Inventory of Treatment Goals).

Of 306 individuals who consented to research, 48.37% (N = 148) attended at least one psychotherapy treatment session using evidence-based treatment approaches with a focus on substance use reduction. Session notes indicated, as expected, that the most common treatment goals across sites focused on SUD prevention or recovery. Many other treatment goals were mentioned targeting anxiety, trauma, somatic symptoms, interpersonal relations, exploration of self, and personal growth. While interpersonal treatment goals such as navigating parenthood predominated across sites, specific problems and symptoms as well as subcategories within well-being/functioning, exploration of self and personal growth varied.

Many core treatment goals for SUD are consistent across settings among those at risk for or receiving treatment. However, specific treatment goals vary by site and stage of recovery (e.g., prevention to maintenance of positive change). Issues of lifespan development inform psychotherapeutic themes categorized through modification of an established treatment goal coding inventory. Counseling and psychotherapy can augment patients' quality of life across many treatment goals, including substance use reduction and recovery maintenance, and this is critical to holistic recovery health outcomes.