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1 – 10 of 418
Article
Publication date: 11 September 2019

Victoria Defelippe, Anna Schlütter, Annelen Meriaan, Bjorn Winkens, Veronika Kavenská, Gary Saucedo Rojas and Matteo Politi

Substance abuse is a major public health concern, with over millions of people suffering from it worldwide. Although there is an abundance of treatment options, many of these…

Abstract

Purpose

Substance abuse is a major public health concern, with over millions of people suffering from it worldwide. Although there is an abundance of treatment options, many of these rehabilitative trajectories are subject to “drop-out”. In addition, “drop-out” is a significant risk factor for relapse. There is an urgent demand for effective treatment, which would enable patients to reduce abuse and prevent relapse. Takiwasi is an addiction treatment centre that combines traditional Amazonian plant medicine with conventional western medicine and psychotherapy. The purpose of this paper is to explore whether socio-demographics factors, such as education level and occupation, psychiatric comorbidities and primary drug use, are associated with treatment non-completion of Ayahuasca (AYA)-assisted addiction therapy.

Design/methodology/approach

Data on the first treatment episode of 121 patients were collected from the patient database from the years 2012 to 2017. To determine whether there is an association between the variables of interest and treatment non-completion, a χ2 analysis and a logistic regression analysis were performed.

Findings

Of the 121 patients analysed, 48.2 per cent completed their treatment, whilst 51.8 per cent did not. Students compared to those who are employed showed significantly higher odds for treatment non-completion (p=0.006; OR=3.7; 95% CI=1.5–9.6). Other variables in the multivariable analysis showed no significant relationship with treatment non-completion. While several limitations restricted the study, the findings suggest that the AYA-assisted treatment in Takiwasi may benefit from additional support for patients who are students. Moreover, it is advised to conduct more long-term follow-up of patients in order to gain better insight into the outcome of treatment at an AYA-assisted treatment centre.

Originality/value

It appears that AYA-assisted therapy in a therapeutic community is a feasible type of treatment for addiction, for which further studies should elucidate the role of motivation in relation to socio-demographic factors and type of addiction in the risk of treatment non-completion.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 40 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 13 November 2017

Jake Shaw and Robert Edelmann

The purpose of this paper is to investigate the relationship between personality disorder (PD) treatment readiness and dropout from three community-based offending behaviour group…

Abstract

Purpose

The purpose of this paper is to investigate the relationship between personality disorder (PD) treatment readiness and dropout from three community-based offending behaviour group programmes.

Design/methodology/approach

At the pre-programme stage, measures of PD and treatment readiness were administered to 186 offenders participating in either a cognitive skills programme, a general violence programme or a programme for domestically abusive men. Demographic and risk data were also obtained from the offender assessment system. At a one-year follow-up, comparisons were made between the risk, personality and treatment readiness profiles of programme completers and non-completers.

Findings

It was hypothesised that PD would be associated with low levels of treatment readiness at the pre-group stage and that both low levels of treatment readiness and PD would predict subsequent programme non-completion. Only antisocial personality disorder (ASPD) was associated with low overall treatment readiness, although antisocial, paranoid, schizoid, negativistic and borderline traits were associated with the facet of low self-efficacy. Non-completion was not predicted by younger age or recidivism risk scores and was most strongly predicted by the presence of a cluster A PD, as well as ASPD, low pre-group motivation and mixed race and white ethnicity.

Research limitations/implications

Paranoid and antisocial personality pathology present important obstacles to effective offending behaviour group work in the community. This illustrates that further consideration needs to be given to these important responsivity factors in future delivery and evaluation of these programmes.

Originality/value

The study provides a detailed analysis of factors associated with non-completion of three community-based offending behaviour programmes in the UK.

Details

Journal of Forensic Practice, vol. 19 no. 4
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 1 October 2002

Cassie Thomas

Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co‐epidemic of HIV, tuberculosis has already…

1567

Abstract

Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co‐epidemic of HIV, tuberculosis has already started to make a comeback in wealthier countries. The WHO’s solution to this global tuberculosis epidemic is the DOTS strategy, the implementation of which presents many problems. The two issues most common to the majority of locations are delay in presentation for treatment and non‐completion of treatment. This review looks at the reasons for these problems in the less developed world, and addresses some solutions. The main reasons for delayed presentation are: a lack of understanding about TB; the stigma associated with the disease; the inaccessibility of treatment; and a preference for private practitioners. The main reasons for non‐completion of treatment are: the stigma of the disease; a lack of information; dissatisfaction with the treatment and its delivery; and inaccessibility of treatment. Successful implementations of the DOTS strategy need to address all these issues. There is little evidence that DOT enhances treatment completion unless combined with other strategies. Community‐based, patient‐orientated DOTS appears to be an appropriate way of addressing many of these issues. The involvement of volunteers in community‐based strategies is common, but needs more research in order for this strategy to realise its full potential.

Details

Journal of Management in Medicine, vol. 16 no. 5
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 21 August 2007

Darryn Snell and Alison Hart

The purpose of this paper is to explore the debate surrounding quality of training as it has unfolded in Australia and how concerns about high non‐completion rates have entered…

1878

Abstract

Purpose

The purpose of this paper is to explore the debate surrounding quality of training as it has unfolded in Australia and how concerns about high non‐completion rates have entered the debate.

Design/methodology/approach

This paper bases its discussion of quality in VET training on analysis of qualitative data collected from focus groups and one‐on‐one interviews conducted with employers, Institutes of Tertiary and Further Education, registered training organisations, trade unions and local, State and Commonwealth government representatives located in the southeastern part of Victoria, Australia.

Findings

The paper shows that throughout many parts of the world a growing concern has emerged about the quality of training for apprentices and trainees in what has become an increasingly deregulated environment dominated by private interests. In Australia, where non‐completion rates can be as high as 50 percent of those who commence training, government leaders at both State and Federal levels are taking a renewed interested in understanding the relationship between quality of training and non‐completion rates. The paper finds that data suggesting training quality in Australia is being threatened by fully on‐the‐job training, the narrowing of training skills, the loss of transferable skills and a lack of training. It argues that these factors have contributed to high rates of non‐completions among apprentices and trainees and that poor regulation of quality standards, government subsidies to employers and training organisations and abuse are contributing to these quality problems.

Originality/value

The paper presents useful insights into the relationship between quality in training and attrition among apprentices and trainees in regional Australia.

Details

Education + Training, vol. 49 no. 6
Type: Research Article
ISSN: 0040-0912

Keywords

Article
Publication date: 2 February 2023

Victoria Jade Pointon and Rachel Roberts

The purpose of this paper is to examine the psychometric characteristics of male offenders who joined a democratic therapeutic community and their relationship to attrition.

Abstract

Purpose

The purpose of this paper is to examine the psychometric characteristics of male offenders who joined a democratic therapeutic community and their relationship to attrition.

Design/methodology/approach

Residents who left therapy prematurely during the assessment phase (N = 46) and residents who left therapy prematurely during core therapy (N = 202) were compared to residents who completed therapy (N = 52) on two psychometric measures: Raven’s Standard Progressive Matrices and The Blame Attribution Inventory.

Findings

A multinomial logistic regression analysis showed higher levels of external blame can predict attrition during therapy; those with higher levels of external attribution are significantly more likely to leave therapy prematurely, including both during the assessment phase and during core therapy. Raven's Standard Progressive Matrices score did not significantly predict whether an individual left therapy prematurely.

Originality/value

Support was found for existing research within the academic evidence base. The findings have both empirical and clinical utility, suggesting during the assessment phase of therapy, practitioners can identify residents that may require additional support to maintain engagement, minimising the potential for premature departure. The implications of the findings are discussed, with suggestions made for future research.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 44 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 1 April 2006

Alina Morawska and Matthew Sanders

Despite the importance of increasing engagement and minimising attrition and drop‐out in parenting interventions, there is a paucity of empirical evidence examining factors…

907

Abstract

Despite the importance of increasing engagement and minimising attrition and drop‐out in parenting interventions, there is a paucity of empirical evidence examining factors related to engagement and participation. The range of factors examined in relation to engagement is generally limited in scope and variety, focusing on variables of convenience rather than utilising a theoretically‐driven approach.The aim of this article is to review the factors related to parental engagement with interventions and to describe strategies and implications for improving engagement with parenting interventions. Several policy and practice implications are identified: (1) Poor parental engagement may threaten or compromise the capacity of parenting programmes to deliver valued outcomes. Viable engagement strategies need to be a core part of prevention and early intervention parenting programmes; (2) Agencies delivering parenting services need a proactive engagement strategy, which includes strategies to prevent drop‐out, as well as strategies to actively respond to parental disengagement; (3) Research is needed to test the efficacy and robustness of different engagement enhancement strategies. Empirical tests are needed to test the effectiveness of different engagement strategies in order to ensure that the most efficient, cost‐effective and efficacious approach is used in order to engage parents. Investment of research effort to improve parental engagement is likely to have a high yield in terms of programme efficiency, utility and cost effectiveness. We conclude that research examining how to improve engagement and decrease non‐completion is needed to strengthen the population level value of parenting programmes as preventive interventions.

Details

Journal of Children's Services, vol. 1 no. 1
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 4 July 2016

Lalage Dorothy Sanders, Carolyn Mair and Rachael James

– The purpose of this paper is to evaluate the use of two psychometric measures as predictors of end of year outcome for first year university students.

Abstract

Purpose

The purpose of this paper is to evaluate the use of two psychometric measures as predictors of end of year outcome for first year university students.

Design/methodology/approach

New undergraduates (n=537) were recruited in two contrasting universities: one arts based, and one science, in different cities in the UK. At the start of the academic year, new undergraduates across 30 programmes in the two institutions were invited to complete a survey comprising two psychometric measures: Academic Behavioural Confidence scale and the Performance Expectation Ladder. Outcome data were collected from the examining boards the following summer distinguishing those who were able to progress to the next year of study without further assessment from those who were not.

Findings

Two of the four Confidence subscales, Attendance and Studying, had significantly lower scores amongst students who were not able to progress the following June compared to those who did (p < 0.003). The Ladder data showed the less successful group to anticipate a poorer performance at graduation relative to their year group than did the other group (p < 0.05).

Originality/value

The results suggest that these two psychometric measures could be instrumental in predicting those at risk of non-completion; such identification could enable the targeted use of limited resources to improve retention. Given the background of limited resources in which institutions are exhorted to improve retention rates, this approach, facilitating the early identification of those at risk of non-completion, could enable focused use of additional support to reduce attrition.

Details

Journal of Applied Research in Higher Education, vol. 8 no. 3
Type: Research Article
ISSN: 2050-7003

Keywords

Article
Publication date: 22 January 2024

Matthew David Phillips, Rhian Parham, Katrina Hunt and Jake Camp

Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for…

Abstract

Purpose

Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Design/methodology/approach

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Findings

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

Originality/value

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

Details

Advances in Autism, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3868

Keywords

Article
Publication date: 1 May 2005

Roger Harris and Michele Simons

Proposes to provide a description of the factors that underlie retention and to develop a model of the process of retention.

3422

Abstract

Purpose

Proposes to provide a description of the factors that underlie retention and to develop a model of the process of retention.

Design/methodology/approach

A qualitative study was conducted in a selected number of occupational areas. Interviews were conducted with apprentices and trainees employed under a contract of training; apprentices/trainees who had recently completed their contract of training; employers/workplace supervisors and teachers/trainers.

Findings

Provides information about a range of factors and how they combined to shape the process of retention. Recognises that some of the identified factors are more amenable to interventions to enhance retention than others.

Research limitations/implications

The study did not attempt to cover all occupations in which apprentices are employed, or to provide any ranking of importance of factors in relation to the retention process. The study encourages a holistic understanding of the process of retention and emphasises the dynamic nature of this process over the period of a contract of training.

Practical implications

A useful source of information for those concerned with designing interventions that target factors that are most amenable to promoting enhanced retention in apprenticeships.

Originality/value

This paper addresses the often neglected process of retention and offers some guidance in the design of interventions to promote retention in apprenticeships.

Details

Education + Training, vol. 47 no. 4/5
Type: Research Article
ISSN: 0040-0912

Keywords

Article
Publication date: 21 September 2012

Mary Jinks, Mary McMurran and Nick Huband

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

1388

Abstract

Purpose

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

Design/methodology/approach

The authors provide an overview of the studies conducted to date. These are a systematic review of the literature examining non‐completion of psychosocial treatment by people with personality disorder, a systematic review of assessments to measure treatment engagement, and a Delphi survey of both staff and patients' views on factors that impact on engagement in psychosocial treatment for this client group.

Findings

Poor engagement with psychosocial treatment is an issue for clients with personality disorder and rates of non‐completion are high. Discontinuation of treatment is associated with adverse clinical outcomes. Although a number of assessments exist for measuring engagement, none can be described as comprehensive and few are adequately validated. Engagement factors identified from the survey were broadly in keeping with previous work, but additional factors specific to this client group were identified. A treatment readiness model for people with personality difficulties is described.

Practical implications

Research outputs from the project are a set of specifications for good practice in facilitating engagement, and a web‐based training package aimed at helping staff improve their understanding of their clients' engagement issues.

Originality/value

The findings will be useful to service managers as well as clinicians working directly with people with personality difficulties. Improving client engagement will improve clinical outcomes and service cost‐efficiency.

Details

Mental Health Review Journal, vol. 17 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

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