RESUMEN
Patient nonattendance to scheduled sessions results in excessive costs to mental health and substance abuse providers and compromises the care of clients. This paper presents a comprehensive review of interventions that have been shown to increase session attendance rates in these settings. Unique to other review papers, reliability estimates were performed in the selection and evaluation of obtained studies. Reliability of article selection and evaluation strategies was excellent (.80 to .88). Study results indicate several attendance improvement methods appear to be particularly promising, such as scheduling appointments promptly, reminder letters and telephone calls, soliciting patient commitment, and helping to resolve obstacles to attending the session. The specific manner in which these interventions are implemented appears to influence session attendance rates. Moreover, some attendance improvement interventions are clearly effective in some settings, but not others. Specific recommendations are provided in light of the study findings.
Asunto(s)
Promoción de la Salud/estadística & datos numéricos , Trastornos Mentales/epidemiología , Servicios de Salud Mental/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Little is known about the reliability and validity of self-and collateral reports of adolescent drug use frequency within adolescent treatment samples. Therefore, in the present study drug counselors systematically obtained contemporaneous reports of adolescent marijuana use frequency from 31 conduct-disordered and drug abusing youth, and separately, their parents, during each outpatient treatment session for 6 months. A urine drug screen was also scheduled to occur during each treatment session. At the conclusion of treatment, a blind assessor obtained retrospective reports of the youths' frequency of marijuana use during each of the six months of treatment from both the adolescents and their parents using the Timeline Follow-Back (TLFB) procedure. With only one exception (i.e., parents reported that their children had used marijuana more often in the first month of treatment according to the retrospective TLFB method, as compared with the contemporaneous method), contemporaneous and retrospective reporting methods yielded similar information throughout each of the 6 months of treatment for both youth and their parents. A significant positive relationship between urinalysis testing and youth reports of their drug use was found for each of the 6 months of treatment. Similar relationships with urinalysis testing were generally found to exist in both parent report methods (i.e., contemporaneous, retrospective) across the 6 months of treatment. The results suggest adolescents and their parents provide consistent reports of marijuana use frequency throughout treatment, and that these reports are corroborated utilizing standardized retrospective reporting methods and urinalysis testing. Future directions are discussed in light of these findings.
Asunto(s)
Instituciones de Atención Ambulatoria , Abuso de Marihuana/epidemiología , Abuso de Marihuana/rehabilitación , Periodicidad , Adolescente , Adulto , Niño , Femenino , Humanos , Incidencia , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Variaciones Dependientes del Observador , Prevalencia , Psicometría , Estudios RetrospectivosRESUMEN
There has been recent pressure for practitioners to consider cultural variables when implementing evidence-based interventions. Therefore, the Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale (SSICECTS) was empirically developed to address this issue. First, psychometric properties of a 6-item scale were evaluated in 279 individuals of various ethnicities. Results indicated two factors accounting for 71% of the variance (ethnic cultural importance and ethnic cultural problems). Internal consistency and convergent validity were satisfactory. Ethnic minority participants demonstrated significantly higher scores than did Caucasians, suggesting this scale may be particularly applicable in ethnic minority populations. In a second study, a controlled trial was conducted to examine clinical utility of the semistructured interview component in a subsample of 151 participants. Participant interviewees were queried about their basic demographic information and were subsequently instructed to evaluate the interviewers' performance. Interviewees were then randomly assigned to receive the SSICECTS or a parallel semistructured interview regarding exercise. After participants completed their respective semistructured interviews, they were again instructed to evaluate the interviewers. Results indicated both semistructured interviews enhanced evaluations. However, interviewers who administered the SSICECTS were perceived as having greater knowledge and respect of participants' ethnic culture.
Asunto(s)
Aculturación , Cultura , Etnicidad , Entrevistas como Asunto , Psicoterapia/métodos , Adolescente , Adulto , Demografía , Femenino , Humanos , Masculino , Psicometría , Encuestas y CuestionariosRESUMEN
The extent to which adolescent drug treatment outcome studies address ethnicity was systematically examined. Reliability coefficients were calculated for both the search methodology used to obtain these outcome studies and the extent to which ethnicity was addressed along several dimensions. The resulting coefficients were highly reliable. Findings indicated that although investigators of 94% of the outcome studies considered ethnicity to some extent, only 28% of these studies incorporated ethnicity into their design, and only 6% of studies involved statistical analyses to examine differential response to treatment or moderating effects of ethnicity with a sufficient number of ethnic minority participants. Overall, results indicated that there is much work to do regarding the examination of ethnicity in controlled treatment outcome studies involving adolescent substance abusers. Indeed, modifications were rarely made to the treatment components to accommodate ethnicity-related variables. Future recommendations are presented in light of these findings.
Asunto(s)
Etnicidad/estadística & datos numéricos , Trastornos Relacionados con Sustancias/etnología , Trastornos Relacionados con Sustancias/terapia , Adolescente , Humanos , Trastornos Relacionados con Sustancias/epidemiología , Resultado del TratamientoRESUMEN
As evidenced in the literature, there has been a recent interest in understanding drug and alcohol use in ethnic minority populations, particularly among adolescents. Although epidemiological and treatment outcome research involving substance use and abuse has improved among ethnic minority groups, this information has yet to be sufficiently integrated. This paper provides a comprehensive review of the extent of drug and alcohol use and related problems among ethnic minority youth, including patterns of use and treatment implications and recommendations.
Asunto(s)
Trastornos Relacionados con Sustancias/etnología , Adolescente , Negro o Afroamericano/estadística & datos numéricos , Áreas de Influencia de Salud , Cultura , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Prevalencia , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
One hundred eighty-eight drug-abusing and conduct-disordered adolescents and their parents provided retrospective reports of the youths' frequency of alcohol and illicit drug use for each of the 6 months preceding their initial session in an outpatient treatment program. Youths' and parent reports of youths' drug and alcohol use for each month were similar. For marijuana and alcohol, frequency reports were related for each month, whereas hard drug reports were related only for the 4 months preceding intake. Relationships among alcohol and hard drug reports were strong during Months 1, 2, and 4 preceding intake, whereas strength of relationship among marijuana reports was similar throughout the 6 months.