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In Germany, short leave is an integral part of treatment in forensic psychiatric hospitals. It is believed that the practice has many benefits for patients' well-being and their treatment progress. However, the risk of an incident in the form of absconding or new offenses may be especially heightened during unsupervised short leave. This study analyzes the impact of unsupervised short leave on treatment progress using a pre-post design with follow-up and a sample of 298 forensic psychiatric patients. Furthermore, incidents on short leave were considered in the analysis. The results of the study suggest that unsupervised short leave can foster treatment progress. However, they also reveal that incidents during leave can disrupt the progress of treatment. [ABSTRACT FROM AUTHOR]

Background: Limited research has examined factors associated with medication-assisted treatment for justice-involved individuals. Objectives: The current study used a mixed-method design to examine the influence of client- and counselor-level factors on 90-day treatment retention, satisfaction, and progress for justice-involved individuals referred to medication-assisted treatment. Methods: The effects of co-occurring disorders (i.e., psychiatric symptoms, anxiety, depression), social functioning (i.e., social support, self-esteem), substance use severity, and treatment motivation on treatment retention, treatment satisfaction, and treatment progress while controlling for counselor-level variance were assessed through multilevel modeling. Results: Fewer co-occurring disorders and more social support were related to greater treatment satisfaction and progress. A higher level of treatment motivation was associated with greater treatment progress. Mediation of treatment satisfaction on the relationship between client-level factors and treatment progress also was tested. Depression was negatively associated with treatment satisfaction, which in turn led to lower ratings of treatment progress. Social support was positively correlated with treatment satisfaction, which in turn was positively correlated with treatment progress. The association of client substance use severity with treatment retention differed between counselors, so did the association of co-occurring disorders and treatment motivation with treatment satisfaction. Qualitative analyses that were derived from counselors' perception of factors relating to recovery success underscored the importance of integrated interventions, social support, treatment motivation, and therapeutic alliance, and their associations with treatment outcomes. Conclusions/Importance: The current findings highlight the importance of integrated treatment services, collaborating with community corrections, and teaching clients strategies for dealing with deviant peers as to facilitating recovery. [ABSTRACT FROM AUTHOR]

The authors of this study explored the differences in treatment progress between men and women who were addicted to drugs. The differential rate of completion of/dropout from treatment in men and women with substance dependence was established. Moreover, comparisons between completers and dropouts, accounting for gender, were carried out for several variables related to treatment progress and clinical profile. A sample of 183 addicted patients (96 male and 87 female) who sought outpatient treatment between 2002 and 2006 was assessed. Information on socio-demographic, consumption, and associated characteristics was collected. A detailed tracking of each patient’s progress was maintained for a minimum period of 8 years to assess treatment progression. The treatment dropout rate in the whole sample was 38.8%, with statistically significant differences between women (47.1%) and men (31.3%). Women who dropped out of treatment presented a more severe profile in most of the psychopathologic variables than women who completed it. Moreover, women who dropped out from treatment presented a more severe profile than men who dropped out. According to these results, drug-addicted women showed worse therapeutic progress than men with similar histories. Thus, women must be provided with additional targeted intervention to promote better treatment outcomes. [ABSTRACT FROM PUBLISHER]

We investigated client motivations for concealing vs. disclosing secrets and how concealment and disclosure relate to therapeutic process and outcome. Of 115 participants who were currently in psychotherapy, most had revealed a secret and about half were concealing a secret in psychotherapy. Concealed secrets were most likely to be sexual in nature and were concealed due to shame or embarrassment. Disclosed secrets were most likely to be related to relationships and were disclosed because clients felt they could trust their therapists and because they thought they could benefit from sharing the secret. Clients were most likely to report that they would choose to share their concealed secret if keeping it prevented them from making progress in therapy, and about half of the clients keeping a secret thought they would eventually disclose it. Reflecting back, clients thought they experienced equal levels of negative and positive emotion when they first disclosed their secret, but currently felt more positive and less negative about disclosing. Concealment was negatively related to the real relationship. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Objective:Research on the effects of Rogers's therapeutic relationship conditions has typically focused on the unilateral provision of empathy, unconditional positive regard, and congruence from therapist to client.Method:This study looked at both client and therapist mutuality of the Rogerian therapeutic conditions and the association between mutuality and treatment progress in the first three psychotherapy sessions. Clients (N= 62; mean age = 24.32; 77% female, 23% male) and therapists (N= 12; mean age = 34.32; nine female and three male) rated one another using the Barrett-Lennard Relationship Inventory after the first and third session.Results:Both clients and therapists perceived the quality of the relationship as improved over time. Client rating of psychological distress (CORE-OM) was lower after session 3 than at session 1 (es= .85, [95% CIs: .67, 1.03]). Hierarchical multiple regression was used to test the predictive power of mutually high levels of the therapeutic conditions on treatment progress. The association between client rating of therapist-provided conditions and treatment progress at session 3 was higher when both clients and therapists rated each other as providing high levels of the therapeutic conditions (R2change = .073,p< .03).Conclusions:The findings suggest mutuality of Rogers's therapeutic conditions is related to treatment progress. [ABSTRACT FROM AUTHOR]

Many discretionary decisions made by criminal justice practitioners are partly influenced by progress reports submitted by treatment providers, however little research has examined how clinician ratings of treatment progress relate to subsequent success in the community. This study examined whether ratings completed by clinicians on a large sample of probationers (N = 419) enrolled in a therapeutic community were predictive of reincarceration post-treatment. The measurement characteristics and the factor structure of the assessment tool were also of interest. Results showed a clear four-factor solution with no significant relationship between the derived factors and reincarceration. Implications for policy and practice are incorporated. [ABSTRACT FROM PUBLISHER]

Systems to provide feedback regarding treatment progress have been recognized as a promising method for the early identification of patients at risk for treatment failure in outpatient psychotherapy. The feedback systems presented in this article rely on decision rules to contrast the actual treatment progress of an individual patient and his or her expected treatment response (ETR). Approaches to predict the ETR on the basis of patient intake characteristics and previous treatment progress can be classified into two broad classes: Rationally derived decision rules rely on the judgments of experts, who determine the amount of progress that a patient has to achieve for a given treatment session to be considered “on track.” Empirically derived decision rules are based on expected recovery curves derived from statistical models applied to aggregated psychotherapy outcomes data. Examples of each type of decision rule and of feedback systems based on such rules are presented and reviewed. [ABSTRACT FROM AUTHOR]