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Biomedical subjects

W S Condelli

Publications and source records attributed to W S Condelli.

14 recordsLinked to original sources
PubMed2000

Treatment refusal/attrition among adults randomly assigned to programs at a drug treatment campus: The New Jersey Substance Abuse Treatment Campus, Seacaucus, NJ.

The New Jersey Substance Abuse Treatment Campus was funded to assess the feasibility of establishing a new model for delivering substance abuse treatment services and to serve as a research laboratory for conducting comparative evaluations of those services. The 350-bed campus was designed to improve treatment effectiveness by providing special services needed by underserved populations, and reduce treatment costs by serving large numbers of clients, centralizing services, and sharing facilities. First-time clients who met preliminary eligibility requirements during phone screening were randomly assigned to therapeutic community and chemical dependency programs. We used data collected on 1,573 adults who were ultimately accepted for admission to analyze treatment refusals and attrition during the 25 days after admission. Only 6.4% of the clients refused admission when informed of their treatment assignment. Planned duration of the residential phase of treatment, gender, and language spoken (English/Spanish) interacted with one another and differentially predicted treatment refusal/attrition. These findings may be useful for understanding treatment refusal and attrition in substance abuse treatment programs.

Adult↗
PubMed1997

Intermediate care programs to reduce risk and better manage inmates with psychiatric disorders.

Intermediate Care Programs were jointly established by the New York State Office of Mental Health and Department of Correctional Services to reduce risk and better manage inmates with psychiatric disorders. In an earlier study, we collected data from the mental health and corrections records of 209 inmates who were admitted to Intermediate Care Programs. Our analysis of those data showed there were significant reductions in the mean number of serious problem behaviors, correctional restrictions, and mental health crisis services during the six months before and after admission. In the present study, we used Wilcoxon tests to assess changes in the distribution of scores on variables assessed by the earlier study. The Wilcoxon tests showed there were significant changes in the distribution of scores on most of the variables. We then focused on inmates who scored positive on the respective variables, either before admission or after admission, and determined the percentage who improved, stayed the same, or worsened on those variables. The highest reductions occurred in mental health observations (65%), suicide attempts (63%), and emergency medications (43%). Lower reductions occurred in correctional infractions and restrictions (26% to 31%). Overall, the data from this study and our earlier one suggest that Intermediate Care Programs are effective in reducing risk and managing inmates with psychiatric disorders.

Adult↗
PubMed1994

Domains of variables for understanding and improving retention in therapeutic communities.

This paper discusses the value of different domains of variables for understanding and improving retention in therapeutic communities for substance users. Retention is important because therapeutic communities have high rates of attrition, and no other variables have been found that have practical implications for improving client outcomes from programs. Research shows that most client variables do not predict retention, and those that do are generally weak and sporadic predictors. Treatment entry variables have been stronger and more consistent predictors of retention. The small amount of research that has been done on program and treatment variables suggests they are important predictors of retention. Research needs to focus less on client variables and more on variables from the other domains if it is to be more useful for understanding and improving retention in therapeutic communities.

Adult↗
PubMed1994

Intermediate care programs for inmates with psychiatric disorders.

Inmates with psychiatric disorders are a growing and difficult to manage population in federal and state prisons. An exploratory study was done of New York State's Intermediate Care Programs for inmates with psychiatric disorders. The study assessed whether there was a reduction in disruptive and harmful behaviors, and in the correctional restrictions and mental health services used to address those behaviors, among admissions to programs. Data came from corrections and mental health records of 209 inmates who had been in the program and prison for at least six months. Significant reductions were found in very serious rules infractions, suicide attempts, correctional discipline, and three mental health services: crisis care, seclusion, and hospitalization.

Female↗
PubMed1993

Do methadone patients substitute other drugs for heroin? Predicting substance use at 1-year follow-up.

Data were analyzed from the nationwide Treatment Outcome Prospective Study (TOPS) to assess whether current and former methadone patients substitute other drugs for heroin. The sample comprised 513 heroin users who were admitted to methadone programs in 10 cities across the United States and followed for at least 1 year. Structured face-to-face interviews were administered at admission and at follow-up to assess use of six substances: cocaine, amphetamines, illegal methadone, tranquilizers, marijuana, and alcohol. The study found a decline in the use of all substances except alcohol. Patients who substantially reduced or eliminated their use of heroin during the follow-up year were more likely to decrease their use of other drugs than were patients who continued to use heroin on a weekly or more frequent basis. These findings suggest that methadone programs indirectly reduce patients' use of cocaine, amphetamines, illegal methadone, tranquilizers, and marijuana, insofar as they are successful in eliminating or decreasing heroin use. Similar reductions in drug use were found among patients who were not enrolled in methadone programs during the follow-up year. These findings do not support the commonly held belief that heroin addicts substitute other drugs for heroin.

Adult↗
PubMed1993

Exposure to methadone programs and heroin use.

The aims of this study were to: (a) assess the effects of various patterns of exposure to methadone programs on heroin use; (b) assess the effects of other patient, program, and treatment variables; and (c) identify variables that promote the type of exposure to methadone programs that is most effective for reducing heroin use. The sample was 526 patients who were admitted from 1979 to 1981 into 17 methadone programs that participated in the Treatment Outcome Prospective Study. The study differs from previous research in that it addresses the time that patients spent in methadone programs during the follow-up period in defining exposure patterns. Heroin use was lowest among patients who were continuously exposed to methadone programs. Retention was highest among patients who attended programs that informed them of their methadone dose levels, were easy to access, and provided them with high quality social services.

Adult↗
PubMed1992

Predicting cocaine use among methadone patients: analysis of findings from a national study.

Findings from a large-scale national study of clients admitted to publicly funded drug treatment programs between 1979 and 1981 were used to determine whether cocaine use by current and former methadone patients could be predicted. The sample for this analysis comprised 526 daily or weekly heroin users admitted to 17 methadone maintenance programs. The study found that cocaine use by both current and former methadone patients showed an overall decline during the follow-up year; that patients who stopped using heroin after entering treatment were much more likely to quit using cocaine than were their heroin-using counterparts; and that the odds of initiating cocaine use after admission to a methadone program were much higher among patients who continued using heroin. These findings suggest that methadone programs may be able to reduce cocaine use among some patients by improving their effectiveness in reducing heroin use.

Adult↗
PubMed1991

Cocaine use by clients in methadone programs: significance, scope, and behavioral interventions.

Widespread use of cocaine by methadone clients is undermining the effectiveness of methadone treatment programs in reducing illicit drug use, decreasing criminal behavior, and slowing the spread of the human immunodeficiency virus (HIV). In response, methadone programs are implementing a range of behavioral interventions to manage this growing problem. Many of these interventions, however, have yet to be evaluated for effectiveness for reducing cocaine use among methadone clients. Interventions that are effective for cocaine use in the general population may not be as effective with cocaine users in methadone programs because these clients differ from other cocaine users in ways that are likely to affect how they respond to the interventions. This paper reviews the literature on the significance and scope of the problem of cocaine use by methadone clients and on the behavioral interventions that have been evaluated for these clients.

Adolescent↗
PubMedDate not supplied

Fixed and dynamic predictors of client retention in therapeutic communities.

This exploratory study assessed the value of fixed and dynamic variables for predicting client retention in therapeutic communities. Fixed variables included demographic and background characteristics that had been used to predict client retention and outcomes in previous research. Dynamic variables included circumstances under which clients joined programs and their motivations for seeking treatment. The sample comprised 753 admissions to 5 traditional therapeutic communities for substance abusers. Although both fixed and dynamic variables predicted client retention, the strongest predictors were two dynamic variables. One was ex-addict interviewers' predictions of whether clients would stay long enough in the program to benefit from treatment. The other was whether clients had spent most of their time with large groups of people, as opposed to spending most of their time with small groups or alone, before using drugs. Program and treatment variables need to be taken into account along with client variables to better understand and improve retention in therapeutic communities and other types of drug abuse treatment programs.

Adult↗
PubMedDate not supplied

Relationship between time spent in treatment and client outcomes from therapeutic communities.

Research found that therapeutic communities and other types of residential programs are effective in reducing drug use, unemployment, and criminal behavior and that length of time spent in treatment is an important predictor of client outcomes from programs. Studies vary considerably, however, in terms of the amount of time they found clients need to stay in treatment to produce those outcomes. Data collected for the Treatment Outcome Prospective Study (TOPS) were analyzed to explore the relationship between time spent in treatment and client outcomes from therapeutic communities and other types of residential drug treatment programs. The analysis took into account client characteristics and whether clients received drug treatment during the follow-up year. The results indicate there is a stronger relationship between time spent in treatment and client outcomes from therapeutic communities than was suggested in earlier analysis of TOPS data.

Adolescent↗
PubMedDate not supplied

Strategies for increasing retention in methadone programs.

Data from the nationwide Treatment Outcome Prospective Study were analyzed to develop strategies for increasing patient retention in methadone programs. The sample comprised 351 daily or weekly heroin users who were admitted to 17 publicly funded methadone programs and completed intake, one month in treatment, and one-year follow-up questionnaires. The analysis suggests three strategies for increasing patient retention: providing more high-quality social services, making programs more easily accessible, and individualizing treatment. The analysis also identifies characteristics of patients and programs to which these strategies should be targeted to increase patient retention in methadone programs.

Adult↗
PubMedDate not supplied

Issues to consider when predicting retention in therapeutic communities.

Many studies have focused on retention in therapeutic communities (TCs) because research shows that retention is an important predictor of client outcomes from these programs. A comparison of the three largest studies found there was little overlap between predictors of retention in TCs. Treatment Outcome Prospective Study data were analyzed to assess whether these findings may have been due to differences in times when the data were collected, measures of length of stay, and domains of variables used to predict retention. While the results suggest that each of these factors contributed to some differences between predictors of retention, the predictors still were unable to explain more than a small amount of the variance in retention. Research indicates that other variables need to be taken into account if future studies are to be more successful in predicting retention in TCs.

Adult↗