Exploring the impact of coercion and voluntary entry on dropout rates in a therapeutic community for substance abuse rehabilitation: A survival analysis and logistic regression study

Abstract

High dropout rates challenge drug rehabilitation programs. Both therapists and academics aim to pinpoint predictors of retention, with individual motivation, both external and internal, being a key factor. This study compares the retention period for residents who joined the Hartuv residential therapeutic community as an alternative to imprisonment (i.e. due to external motivation) and residents who joined the community voluntarily. In this study, residents of the Hartuv residential therapeutic community between 2010 and 2015, were examined. The analysis of the data used both logistic regression and survival analysis. The logistic regression evaluated the predictors for completing or dropping out of the program. The survival analysis examined the retention time, measured over a 12-month follow-up period, which represents the completion of the program. Residents who entered the program as an alternative to imprisonment were significantly more likely to retain in treatment than those who arrived voluntarily. Retention in treatment is influenced by external motivation. Strengthening familial, social, and occupational relationships may increase external motivation among residents who enter the program voluntarily and therefore lack significant external motivation.