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COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG CONFERENCE BROCHURE.pdf - Drexel University College ... COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

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COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 What were our results? What was our clinical sample? Other 7 Exclude 23 IQ

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 What did we find? •Intent-to-treat model: Patients who were randomized to the intervention, or TAU, were included in the analysis even if treatment was incomplete. •Most FASST patients who did not complete sessions had at least 2 sessions and no more than 4. •Patients for whom we could not obtain follow-up data were treated as a “no show.” • Nearly 64% of patients receiving the experimental intervention attended the first scheduled post-hospitalization outpatient appointment. •Nearly 36% of control patients attended the first scheduled appointment. •Likelihood Ratio (Fischer’s Exact chi – square) = 12.890; p < 0.001. % Attendance x Intervention 70 60 50 40 30 20 10 0 FASST TAU Intervention Other findings of import… • Reported monthly income < $341 per month. • Nearly 78% reported no employment in the past 30 days. • Male patients engaged in high risk sexual behavior: • 28% report giving drugs for sex. • 10% report paying someone money to have sex. • Female patients engage in high risk sexual behavior: • 34% report on having sex to get drugs. • 26% report being paid money or drugs to have sex • 3% report on having unprotected sex with someone they know to have HIV/AIDS. • About 20% of males and females report being worried (moderately or greater) about getting HIV/AIDS. • 13% report they may have already been exposed to HIV/AIDS. Some qualitative session data… • Antecedents (Triggers) most frequently cited: • Boredom • Alone/lonely • Argument with significant other • Behavior (with mood): • Anger/argument. • Drug use/hallucinations • Consequences: • Feel good “real” (cocaine use). • Worsening relationship with C/SO. Some more qualitative session data… Impediments-potential disincentives • Availability • Hard for me to get there • Long wait to get appointment • Continuity • Therapist left • Different person all the time • Relevance • Doesn’t help • Just talk • Ambience • Dirty • Wait too long What have been our challenges? • Follow-up extremely difficult. • Recruiting family member or significant other, FSOCs, has been difficult: • 27 consented. • 5 attended at least 1 session • 32 phone calls from family member, significant other or caregiver (FSOC). • Alternatives: • Community Mentor. • Treatment in home (MST and FFT). • Phone treatment. • Train case mangers and staff at boarding homes etc. Concluding remarks… Social capital • Relationship between interpersonal trust, social reinforcement and social engagement. • Related to income inequality, health outcomes, medical compliance and civic engagement. • Determined by network of interacting formal, informal norms and behavior of institutions, community and individuals. Our patients live in communities with diminished social capital. 7

<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006<br />

What were our results?<br />

What was our clinical sample?<br />

Other<br />

7<br />

Exclude<br />

23<br />

IQ

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