Aftercare Sessions Research Articles

A randomized pilot trial of two parenting interventions for fathers in residential substance use disorder treatment

Residential substance misuse treatment programs for men typically do not integrate treatment for intimate partner violence (IPV) or parenting despite significant overlap between substance misuse, IPV and child maltreatment. A randomized trial compared two fatherhood focused interventions in 6-month residential substance misuse treatment programs. Fathers for Change (F4C) is an integrated intervention targeting IPV and child maltreatment. Dads ‘n’ Kids (DNK) is a psychoeducational intervention focused on child development and behavioral parenting skills. Sixty-two fathers were randomly assigned to F4C or DNK. They received 12 weeks of individual treatment while in the residential facility and were offered 4 aftercare sessions following discharge. They were assessed prior to treatment, at the time of residential discharge, following completion of the intervention booster sessions, and 3 months following intervention. Overall, both groups showed significant reductions in affect dysregulation, anger, and IPV. F4C fathers showed significantly greater decreases in affect dysregulation problems. There were no significant differences between groups on IPV but men who received F4C may have been less likely to use substances after leaving residential treatment. Integration of fatherhood focused interventions were possible and welcomed by residents at the facilities. F4C showed some benefit over DNK in terms of affect dysregulation symptoms and substance use relapse.

A survey to determine usual care after cancer treatment within the United Kingdom national health service

BackgroundApproximately one third of cancer survivors in the United Kingdom face ongoing and debilitating psychological and physical symptoms related to poor quality of life. Very little is known about current post-cancer treatment services.MethodsOncology healthcare professionals (HCPs) were invited to take part in a survey, which gathered both quantitative and free text data about the content and delivery of cancer aftercare and patient needs. Analysis involved descriptive statistics and content analysis.ResultsThere were 163 complete responses from 278 survey participants; 70% of NHS acute trusts provided data. HCPs views on patient post-cancer treatment needs were most frequently: fear of recurrence (95%), fatigue (94%), changes in physical capabilities (89%), anxiety (89%) and depression (88%). A median number of 2 aftercare sessions were provided (interquartile range: 1,4) lasting between 30 and 60 min. Usually these were provided face-to-face and intermittently by a HCP. However, sessions did not necessarily address the issues HCPs asserted as important. Themes from free-text responses highlighted inconsistencies in care, uncertain funding for services and omission of some evidence based approaches.ConclusionProvision of post-cancer treatment follow-up care is neither universal nor consistent in the NHS, nor does it address needs HCPs identified as most important.

The influence of aftercare sessions on sociomedical development after an inpatient psychosomatic rehabilitation

The aim of this study was to examine the influence of aftercare sessions in a psychosomatic rehabilitation on the sociomedical development. The after care group was compared with treatment as usual. In a prospective, controlled and randomized longitudinal study data about the state of health and job status were assessed at 4 measured time points. As an indicator of the sociomedical development the current employment status was used. Aftercare treatment (n=139) included 2-4 interview contacts (via telephone or face-to-face) within the first 3 months after discharge from inpatient psychosomatic rehabilitation. A control group (n=62) received treatment as usual. 3 and 9 months after the end of rehabilitation participants in the aftercare showed a better sociomedical development than the participants in the control condition.

Randomized clinical evaluation of a light-cured base material for complete dentures

The purpose of this study was to compare plaque adhesion, tissue reaction, and technical complications for complete dentures based on visible light-cured resin (VLCR) or on conventional poly(methyl methacrylate) (PMMA). A stratified randomized cohort study was designed with 52 patients treated with a complete denture in the maxilla (n = 28), the mandible (n = 2), or both (n = 22). Seventy-four dentures were manufactured, 38 of PMMA and 36 of VLCR. Investigators and patients were unaware of the nature of the denture base material. Plaque adhesion, tissue reaction, and technical complications were investigated 4 weeks after denture insertion (baseline). Recall investigations were performed after 6, 12, and 24 months. After 6, 12, and 24 months, plaque adhesion was significantly higher for VLCR dentures than for PMMA dentures. Tissue reaction was comparable for both groups, however. After 6, 12, and 24 months, need for repair was significantly greater for VLCR prostheses. The mean number of additional aftercare sessions per patient after 24 months was 50 % higher for VLCR than for PMMA. Good oral hygiene must be established by patients treated with VLCR dentures, to remove biofilm from these dentures. Increased aftercare must also be taken into account when this material is used. VLCR might be a viable alternative to PMMA for patients with allergic reactions to residual monomer or benzoyl peroxide.

Ressourcenaktivierung bei Patienten

BackgroundStarting from Klaus Grawe’s draft of a general psychotherapy, the patient’s resources and resource-activating interventions have received increasing attention in empirical research.ObjectiveThe effectiveness of standardized writing instructions for the activation of patients’ resources before participating in internet chat aftercare groups for psychosomatic patients was examined.MethodIn a randomized controlled trial writing instruction for the activation of patients’ resources was given in 52 out of 102 internet chat aftercare sessions. The effects of this minimal intervention on the patients’ activity and the number of positive emotion words expressed during the chat session were examined. Additionally, the effects on patients’ self-esteem, attachment, orientation, control and well-being after the group sessions were assessed.ResultsPatients reported higher levels of self-esteem, orientation, control and well-being after chat sessions with a resource-activating intervention. No differences between intervention and control groups were detected on the text-based variables activity and number of positive emotion words.ConclusionsStandardized minimal interventions for the activation of patients’ resources seem to be promising for enhancing the effectiveness of therapeutic Internet chat groups.

Effects of Contingency Management on Substance Abuse Continuing Care Participation

The purpose of the present study was to evaluate the effectiveness and feasibility of adding a contingency management (CM) component to the standard substance abuse treatment program available to substance-dependent veterans. Participants included 36 substance-dependent male veterans who completed the Veterans Affairs Medical Center residential or day treatment program. Participants were enrolled in either the CM or standard treatment program. The CM group included 6 substance-dependent male veterans who agreed to participate in a 6-month CM program. In this program, veterans were rewarded with vouchers for attending aftercare sessions and submitting breath and urine samples that were negative for alcohol and other drugs. The standard treatment group included 30 substance-dependent male veterans who completed the residential or day treatment program immediately before the initiation of the CM program. Veterans who participated in the adjunctive CM program attended significantly more aftercare sessions than those in the standard treatment group during both the 6-month CM program and the 6 months after the discontinuation of the program. Initial findings indicate that CM may be a useful means of increasing treatment attendance among veterans with substance use disorders. The difficulties encountered during the process of integrating the CM component into the standard treatment program are discussed.

Counselor Incentives to Improve Client Retention in an Outpatient Substance Abuse Aftercare Program

Pay for performance, the provision of financial incentives for favorable performance, is increasingly under study as an evidence-based practice. This study estimated the improvement in client retention from offering incentives to 11 substance abuse counselors providing outpatient aftercare treatment. During the incentive period, a counselor could earn a bonus of $100, in addition to his regular compensation, for each client who completed at least five aftercare sessions (the "milestone" which we considered the minimum adequate dose of the aftercare curriculum). We evaluated this and a similar, 12-session incentive using a logistic regression in which the retention "milestone" was the dependent variable and the proportion of time in the incentive condition was the independent variable. Among the 123 clients offered this aftercare program, their probability of completing at least 5 sessions was 59% with the incentive compared to 33% beforehand (odds ratio 4.1, P<.01). These findings suggest that counselor incentives are an effective strategy to improve client retention in substance abuse treatment.

A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others.

In a randomized clinical trial, 90 concerned significant others (CSOs) of treatment-refusing illicit drug users were assigned to either (a) community reinforcement and family training (CRAFT), which teaches behavior change skills, (b) CRAFT with additional group aftercare sessions after the completion of the individual sessions; or (c) Al-Anon and Nar-Anon facilitation therapy (Al-Nar FT). All protocols received 12 hr of manual-guided individual treatment. Follow-up rates for the CSOs were consistently at least 96%. The CRAFT conditions were significantly more effective than Al-Nar FT in engaging initially unmotivated drug users into treatment. CRAFT alone engaged 58.6%, CRAFT + aftercare engaged 76.7%, and Al-Nar FT engaged 29.0%. No CSO engaged a treatment-refusing loved one once individual sessions had been completed.

Treating Drug Offenders with Moral Reconation Therapy: A Three-Year Recidivism Report

70 male felony offenders treated with the cognitive behavioral approach of Moral Reconation Therapy during and after incarceration were assessed for rearrests and reincarceration 38 months after their release. They were compared to a nontreated control group of 82 male felony offenders. Recidivism in the treated group was 24.3% as compared to 36.6% for the control group. Analysis showed that steps completed significantly correlated with rearrests and recidivism and that the correlation between number of aftercare sessions and recidivism approached significance.

An experimental investigation of the influence of aftercare on alcoholic relapse.

SummaryOne hundred and fifty‐five subjects who had completed a 4‐week residential treatment programme for alcoholism were assigned to one of three aftercare groups: (1) mandatory aftercare in which subjects were contracted to attend four aftercare sessions during the initial 3 months following discharge; (2) voluntary aftercare in which aftercare participation was entirely at the clients' discretion; and (3) no aftercare in which clients were dissuaded from attending aftercare until their fourth month following discharge from inpatient treatment. No differences between groups were found with respect to relapse rate, satisfaction with lifestyle and trait anxiety. In addition, subjects who did not attend aftercare at the treatment centre were not found to make greater use of alternate sources of aftercare (i.e. Alcoholics Anonymous (AA), physicians and other treatment resources). Despite the fact that aftercare participation was not found to be related to outcome, an apparent demand for aftercare was evidenced. In that regard, 66% of the subjects in the Voluntary Group requested aftercare.It is suggested that the results of this study are consistent with the body of literature which contends that there is no advantage to extended therapy in the treatment of alcoholism. Furthermore, the possibility is raised that previous research efforts that have found a positive relationship between aftercare and outcome may have been confounded ty the issue of ‘patient compliance’ with the terms of treatment. That is, subjects who comply with the terms of treatment tend towards better outcomes irrespective of whether the terms of treatment call for aftercare or not. In conclusion, the authors recommend greater individualized aftercare planning for alcoholics and suggest a greater emphasis on ‘processing relapses’.

Predicting attendance at follow-up evaluations in alcoholism treatment outcome research.

The potential utility of an early-warning system involving the use of attendance at scheduled clinical appointments to predict attrition of research subjects from follow-up evaluations was investigated. Subjects (N = 92) discharged from an inpatient alcoholism treatment program into a treatment outcome study were monitored on their aftercare attendance for 1 year postdischarge. Attendance at clinical aftercare sessions during the follow-up year was correlated significantly with attendance at the research project's quarterly follow-up evaluations (p less than .001) and with total number of research evaluations completed (p less than .001). Number of weeks spent in aftercare before dropping out also improved prediction of attendance or nonattendance at quarterly follow-up evaluations during the first 6 months postdischarge (p less than .01). The findings suggest that monitoring attendance at clinical services may be a useful step in minimizing attrition of research subjects from follow-up evaluations.

Increasing attendance at alcohol aftercare using calendar prompts and home based contracting

The effect of an appointment-keeping intervention on attendance at aftercare was examined for 50 male participants in an inpatient alcohol treatment program. Subjects received either a calendar prompt and home-based attendance contract intervention (Experimental group, N = 25) or standard aftercare treatment arrangements (Control group, N = 25). Participants were followed for eight aftercase sessions over a 6-month period. Results showed significant attendance differences between groups for the first seven aftercare sessions, with nearly twice as many experimental subjects as control subjects attending aftercare sessions. Further, significantly fewer experimental than control subjects (24% fewer) were dropped from the alcohol program for three consecutive nonattendances. The present study provides an effective technology for increasing aftercare attendance and thus potentially increasing the probability of long term maintenance of alcohol treatment effects.

Prediction of attrition in alcoholic aftercare by scores on the Embedded Figures Test and two Piagetian tasks.

80 patients (mean age 47.8 yrs) in an alcoholic rehabilitation program were tested for field dependence with the Embedded Figures Test (EFT) and for logical reasoning with 2 Piagetian tasks: the pendulum and plant problems. 31 Ss completed all 10 wks of outpatient aftercare. Of those who dropped out, 67% were field dependent (EFT score greater than the sample median of 135 sec), and 76% were either preoperational or concrete operational, as defined by their scores on the 2 logic tests. The number of aftercare sessions attended correlated -.50, .49, and .59 with scores on the EFT, the pendulum problem, and the plant problem, respectively (all p < .001). The best predictor, the plant problem, accounted for 36% of the variance in the dropout rate. Results suggest that cognitive factors play a more important role in alcoholics' response to treatment than has been recognized. (15 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved)