185277 An analysis of factors related to hypothetical substance abuse treatment preference within an incarcerated sample: Abstinence versus harm reduction

Tuesday, October 28, 2008

John W. Wax, BA , Department of Psychology, University of Montana, Missoula, MT
K. Michelle Peavy, MA , Department of Psychology, University of Montana, Missoula, MT
Bryan N. Cochran, PhD , Dept. of Psychology, University of Montana, Missoula, MT
According to the evidence based practice model of psychotherapy, clinicians should balance scientific knowledge, clinical judgment and patient preferences when implementing a treatment program (Spring, 2007). Understanding patient preference is not only vital to clinicians but may also assist in treatment development. However, according to Phillips, Rosenburg & Sanikop (2007), research comparing two primary theoretical models of substance abuse treatment (harm reduction and abstinence) has focused almost exclusively on the opinions of professionals rather than clients. In the present study, we divided current substance abusers based on their preference for harm reduction or abstinence based treatments and are examining associations between treatment choice and factors such as motivation to change, exposure to previous treatment, drug of choice and negative drug-related history (e.g. criminal history). Participants include fifty recently incarcerated inmates (current N=38) arrested for drug related charges in Montana. Participants were interviewed using a battery of measures including the University of Rhode Island Change Assessment Scale, (URICA: McConnaughy, Prochaska, & Velicer, 1983), the Addiction Severity Index (ASI: McLellan et al., 1992) and a forced hypothetical choice between harm reduction or abstinence treatments. Preliminary results indicate that 61% of participants report preferring a program emphasizing abstinence and 39% report preferring a program emphasizing harm reduction. Analyses will be conducted to determine factors related to participant preference for these two different treatment philosophies. In addition to guiding treatment development, understanding the factors that influence client choices may allow mental health professionals to improve communication when discussing treatment options with clients.

Learning Objectives:
1. Identify factors that may influence a client’s substance abuse treatment preferences. 2. Analyze risks and benefits of choosing a harm reduction or abstinence based substance abuse treatments for from a client, professional, and community perspective. 3. Communicate treatment options with clients more effectively by considering factors that influence treatment preference.

Keywords: Drug Abuse, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: While working on completing a double B.A. degree in psychology and human biology, I have conducted multiple literature reviews about best clinical practices, substance abuse treatment and theoretical models for treatment. I have interviewed inmates at the Missoula Detention Facility for almost one year about their substance use and abuse. For this project I received training in administering several semi-structured interviews and questionnaires assessing alcohol and substance use problems (e.g. the Addictions Severity Index). Finally, I worked as a Self-Over-Substance (S.O.S.) group leader for nearly three years. S.O.S is a harm-reduction model intervention targeted at University of Montana students who have been charged with drug related offenses. Many graduate therapy and clinical psychology students count leading S.O.S. groups towards their supervised clinical hours required for their graduation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.