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Psychological problems and client engagement in methadone treatment
G W Joe1, B S Brown, D Simpson
1Institute of Behavioral Research, Texas Christian University, Fort Worth 76129, USA.
The Journal of Nervous and Mental Disease
|November 1, 1995
Summary
Clients with psychological problems in methadone treatment attended more counseling sessions. This engagement correlated with reduced drug use, particularly for those discussing mental health issues.
Area of Science:
- Addiction Medicine
- Clinical Psychology
- Psychopathology
Background:
- Client engagement in addiction treatment is crucial for successful outcomes.
- Understanding factors influencing attendance in methadone programs is essential.
- Psychological comorbidities are common among individuals seeking treatment for opioid use disorder.
Purpose of the Study:
- To investigate the relationship between self-reported psychological problems at intake and client attendance in individual counseling.
- To examine whether discussing psychological issues in sessions impacts treatment outcomes.
- To assess the association between counseling attendance and substance use reduction.
Main Methods:
- A cohort of 462 clients in community-based methadone treatment, with at least 90 days in program.
- Categorization into 'no problems' (N=341) and 'high problems' (N=121) groups based on intake psychological symptoms.
- Comparison of attendance rates, session content, and substance use outcomes (drug-positive urines, illicit activity) between groups.
Main Results:
- Clients reporting psychological problems (anxiety, depression, psychopathology) were twice as likely to meet the recommended counseling attendance (2 sessions/month).
- The 'high problems' group more frequently discussed psychological issues during sessions.
- No significant differences in drug-positive urines or illicit activity at 3 months between groups.
- Within the 'high problems' group, attending ≥2 sessions/month was linked to reduced cocaine and speedball use.
Conclusions:
- Self-reported psychological problems at intake are a significant predictor of higher attendance in methadone treatment counseling.
- Increased engagement in individual counseling, particularly when discussing psychological issues, may contribute to reduced substance use.
- Targeted support for psychological comorbidities can enhance treatment adherence and potentially improve outcomes in opioid use disorder treatment.