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INDIVIDUAL/FACILITY CONGRUENCE AND TREATMENT OUTCOME: AN EXAMINATION
Conference poster   Peer reviewed

INDIVIDUAL/FACILITY CONGRUENCE AND TREATMENT OUTCOME: AN EXAMINATION

Robert Charles Sterling, Stephen P. Weinstein and Krystal Stober
Annals of behavioral medicine, v 39(S1), pp 39-39
Apr 2010
DOI: https://doi.org/10.1007/s12160-010-9169-5

Abstract

The primary aim of this study was to examine whether admission differences in levels of spirituality predisposed alcohol-dependent individuals to favorable or unfavorable outcomes following admission to one of two inpatient facilities that differed in the degree to which spirituality was incorporated into the environment of care. It was hypothesized that individuals whose admission level of spirituality was congruent with the treatment program’s orientation and who as such were considered optimally placed (i.e., “matched”) for treatment would evince better post-treatment outcomes. Four-hundred and five participants completed the Addiction Severity Index, measures of spirituality (Daily Spiritual Experiences Scale) and psychosocial well-being at treatment intake. The average length of stay was 26.11 (SD=7.47) days. Two hundred thiry-two of these individuals completed follow-up telephone interviews three months post-discharge. A 2x4 ANCOVA, using admission ASI reports of days drinking as a covariate and self-reported days drinking in the month prior to follow-up as the criterion yielded a significant interaction term, F (3, 230) = 2.89, p = .04. Examination of the means indicated a paradoxical effect as subjects desirous of having spirituality incorporated into the environment of care and who by virtue of the treatment program they had entered were considered "matched" for treatment, reported more drinking days than those considered “mismatched.” Most interestingly, individuals reporting little interest in having spirituality incorporated into their treatment experience who entered the less spiritual program evinced the poorest outcomes (i.e., most follow-up days drinking). Similar effects were noted for self-reported days experiencing alcohol-related problems, p = .056. While previous findings from our group have posited an overall favorable effect of congruence on in-treatment measures (i.e., abstinence efficacy, days desiring alcohol), the current findings suggest that these effects may not be robust over time.

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