Exploring low-cost, low-resource ways to increase attendance in addiction treatment

8 Nov 2022

Attendance in addiction treatment settings is often met with challenges, with client non-attendance frequently compromising clinical outcomes and strategies for retaining clients often difficult to implement or expensive.

increase attendance in addiction treatment

A recent literature review led by Turning Point clinical psychologist, Dr Adam Rubenis , explored low-cost and low-resource ways to increase client attendance in counselling for addiction treatment and found practical strategies clinicians can use in their current practice. Such strategies include role induction; pre-treatment written or verbal contact; short message service and telephone reminders; and contracting, prompting, and reinforcement.

Dr Rubenis said there were good benefits from text and phone reminders, as well as social reinforcement.

"The review showed text and phone reminders had a consistent positive impact on early attendance, although that did tend to weaken over time and for individuals with more complex needs."

Contracting, prompting and reinforcement, which involves getting the client to sign a contract stating they will attend sessions; sending reminders throughout treatment (prompting) and providing social reinforcement through things such as certificates, also proved effective.

“We found that although this was a protracted method for increasing attendance, it was found to be low-cost and effective,” said Dr Rubenis.

Another useful method, role induction, requires clinicians to talk to clients about what to expect from treatment before starting, the trajectory of their treatment and success rates.

Completion rates for addiction treatment vary between substances and care settings. In 2019–2020, planned completion of treatment was 57 per cent for outpatient counselling, and 47 per cent for inpatient/rehabilitation settings. Having low attendance and retention rates compromise the effectiveness of treatment in clinical settings.

To improve clinical outcomes for clients, effective low-cost strategies for increasing engagement need to be prioritised. While there is no consensus on which retention strategies are most effective, a broad range of strategies should be considered to increase the likelihood of attendance in the early stages of addiction treatment.

**As part of the project, Dr Rubenis conducted interviews with clinicians, consumers and other experts to develop a helpful checklist for clinicians based on some of these strategies. To access the checklist please click here .