Implementation of Cognitive-Behavioral Substance Abuse Treatment in Sub-Saharan Africa: Treatment Engagement and Abstinence at Treatment Exit.

Journal: PloS one

Volume: 11

Issue: 1

Year of Publication: 2016

Affiliated Institutions:  Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Cape Town, South Africa. Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, Massachusetts, United States of America. City of Cape Town Health. Substance Abuse, Cape Town, South Africa. South African Medical Research Council, Alcohol Tobacco and Other Drug Research Unit, Cape Town, South Africa. School of Nursing, University of California San Francisco, San Francisco, California, United States of America.

Abstract summary 

This study documented the treatment cascade for engagement in care and abstinence at treatment exit as well as examined correlates of these outcomes for the first certified Matrix Model® substance abuse treatment site in Sub-Saharan Africa.This retrospective chart review conducted at a resource-limited community clinic in Cape Town, South Africa, assessed treatment readiness and substance use severity at treatment entry as correlates of the number of sessions attended and biologically confirmed abstinence at treatment exit among 986 clients who initiated treatment from 2009-2014. Sociodemographic and clinical correlates of treatment outcomes were examined using logistic regression, modeling treatment completion and abstinence at treatment exit separately.Of the 2,233 clients who completed screening, approximately 44% (n = 986) initiated treatment. Among those who initiated treatment, 45% completed at least four group sessions, 30% completed early recovery skills training (i.e., at least eight group sessions), and 13% completed the full 16-week program. Approximately half (54%) of clients who provided a urine sample had negative urine toxicology results for any substance at treatment exit. Higher motivation at treatment entry was independently associated with greater odds of treatment completion and negative urine toxicology results at treatment exit.Findings provide initial support for the successful implementation the Matrix Model in a resource-limited setting. Motivational enhancement interventions could support treatment initiation, promote sustained engagement in treatment, and achieve better treatment outcomes.

Authors & Co-authors:  Gouse Hetta H Magidson Jessica F JF Burnhams Warren W Remmert Jocelyn E JE Myers Bronwyn B Joska John A JA Carrico Adam W AW

Study Outcome 

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Citations :  Marinelli-Casey P, Domier CP, Rawson RA. The gap between research and practice in substance abuse treatment. Psychiatr Serv. 2002;53(8):984–7.
Authors :  7
Identifiers
Doi : e0147900
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States