Focus on the family as a factor in differential treatment outcome

The prognostic relationship between prehospital living arrangements and treatment outcome was explored. Drug (N = 17) and alcohol (N = 19) patients who had lived with parents, wives, nonrelatives, or alone before voluntary admission to an inpatient substance abuse program were compared on changes in social dysfunctioning and symptomatology as a result of treatment. Ratings on each patient's level of dysfunctioning and symptomatology were made following intake into the program and within a 3-day period after receiving a regular discharge. While treatment had a positive effect on all groups, multivariate analysis of covariance showed a significant (P less than .009) differential rate of improvement between the pretreatment residential setting groups. Those who had lived alone or with nonrelatives prior to admission changed the most, becoming significantly less dysfunctional and symptomatic. Those coming from parental families changed the least improvement, while those who had lived with their spouses showed moderate improvement. Findings were consistent for both drug and alcohol patients. Results indicate that the type of home environment from which substance abusers come before engaging in treatment significantly influences their receptivity to rehabilitation. Findings suggest the need for assessment of the family environment and utilization of community resources as a means of enhancing adjustment.