Accelerated Intake’s Impact on Overall Attrition Rates

Many substance abuse therapists feel that patients need to prove their level of motivation to enter treatment by being put on wait lists. By having clients meet certain requirements while on these lists, providers feel they are able to weed out those who are not sufficiently motivated to enter treatment. The research on accelerated intake refutes this theory.

Accelerated intake does not negatively affect treatment attrition rates. Alterman et al (1994) found no difference in the attrition rates of patients entering their substance abuse facility though a special accelerated intake pilot program and those beginning treatment through normal intake procedures.

In a study examining retention rates at an intensive outpatient cocaine treatment facility, Gotthel et al (1999) found very little difference in retention rates between patients who attended their first treatment session, walk-ins and those needing extra outreach to bring them in after missing their initial intake appointment. The study looked at retention rates of patients who stayed in treatment less than 4 weeks, less then 8 weeks, less than 12 weeks and successfully completed the 12 week program. In all 4 areas there was very little difference in attrition between the groups.

Festinger et al (1996) suggests this implies that patients who normally wouldn’t have entered treatment but for accelerated intake, do just as well as patients entering under normal circumstances. The goal is to engage a larger number of clients in treatment that would normally not have made it to the initial intake. But they make clear that a successful accelerated intake program should not be confused with treatment efficacy (Festinger et al 2002).

Addenbrooke & Rathod (1990) also found no difference between normal intake attrition rates and accelerated intake attrition rates. They saw this as a negative as their initial assumption was that accelerated intake would help overall attrition rates. They concluded that waiting to get initial treatment is not necessarily a bad thing. Since the goal of accelerated intake is to expose a greater number of patients to treatment then through normal procedures, Addenbrooke’s conclusions seem to be incorrect. Overall attrition rates are not affected negatively or positively by accelerated intake. So, we can conclude that through accelerated intake a larger number of people enter treatment and therefore a larger number of people successfully complete treatment.

In many ways the first request for service appears to be one of the most important of the nine paths set forth by NIATx. First request presents organizations with a great opportunity to engage and motivate clients while getting them enrolled in proper treatment. If done successfully, a positive first impression will have a greater chance of transferring over to the other paths. A major part of this success is based on accelerated intake. And the success of accelerated intake is based on many factors including the proper staffing of the facility to handle increased assessments, the standardization and reduction of paperwork and the engagement of the client to motivate them to further their treatment. All of these issues are important and will be addressed in later stages of this project.