Factors Associated With Retention in Alcohol and Other Drug Treatment Among Disadvantaged Communities in Cape Town, South Africa

Abstract

Retention in alcohol and other drug (AOD) treatment is strongly associated with positive outcomes. To design interventions to improve outcomes, it is therefore important to uncover the factors contributing to treatment retention. To date, South African AOD research has not examined the factors associated with retention among disadvantaged communities. This study aimed to address this gap by exploring client-level factors associated with retention in AOD treatment. Secondary data analysis was conducted on cross-sectional survey data collected from 434 persons residing in disadvantaged communities in the Cape Town metropolitan area who had accessed AOD treatment in 2006. Multiple regression analyses revealed that race, therapeutic alliance, abstinence-specific social support, and anxiety were significant partial predictors of treatment retention. Black African participants spent significantly fewer days in treatment than "Coloured" individuals. Findings point to the need to improve treatment retention among Black African clients specifically. For clients from poor South African communities, treatment retention rates can be improved by increasing abstinence-specific social support, improving perceptions of AOD treatment, and strengthening the counselor-client therapeutic alliance.