Determinants and implications of initial treatment modality assignment of diagnosed alcohol abusers

Paula M. Morrissette (2006)

This study investigated (a) what specific clinical, demographic, insurance, and psychosocial variables are associated with initial treatment modality assignment? (b) what proportion of actual treatment modality assignment is consistent with ideal American Society of Addiction Medicine's (ASAM) treatment modality assignment guidelines? and (c) does agreement between ideal ASAM treatment modality assignment and actual assignment result in lower dropout rates and more appropriate lengths of stay? This study focused on assignment to specific modalities of treatment (inpatient detoxification, inpatient rehabilitation, intensive outpatient/day treatment, outpatient individual therapy) rather than treatment type (e.g., cognitive-behavioral). Utilizing both univariate and discriminant function analyses, results of this study identified that: (a) overall, clinical variables best differentiate treatment assignment to specific treatment modalities, (b) in the majority of cases (59.9%) actual treatment modality assignment was consistent with American Society of Addiction Medicine's (ASAM) treatment modality assignment guidelines, and (c) agreement between ideal ASAM treatment modality assignment and actual assignment did not result in lower dropout rates, but did result in more appropriate lengths of stay for Inpatient Detox.