A mixed research design study compared patients who consented to treatment randomization with patients who opted for usual care.
Methods:
Patients in substance abuse rehabilitation who consented to randomization (that is, consenting group [CG]) were compared with those unwilling to undergo randomization (that is, nonconsenting group [NG]) but who, nevertheless, underwent the experimental assessment sessions, which spanned from intake to 6-month follow-up.
Results:
Patients in the CG exhibited a longer history of drug abuse, less occupational stability at intake, and following intensive treatment, tended not to do as well in terms of recovery, compared with those in the NG.
Conclusion:
Inclusion of data from partial participants in research protocols may offer a viable strategy to better appraise data generalizability.
WellsKB. Treatment research at the crossroads: The scientific interface of clinical trials and effectiveness research. Am J Psychiatry1999;156:5–10.
2.
Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: Project Match post treatment drinking outcomes. J Stud Alcohol1997;58:7–29.
3.
HumphreysKWeisnerW.Use of exclusion criteria in selecting research subjects and its effect on the generalizability of alcohol treatment outcome studies. Am J Psychiatry2000;157:588–94.
4.
SladeMPriebeS.Are randomized controlled trials the only gold that glitters?Br J Psychiatry2001;179:286–7.
5.
BrownTGSeraganianPTremblayJAnnisH.Matching substance abuse after-care treatments to client characteristics. Addict Behav2002;26:585–604.
6.
MillerWRBennettME. Treating alcohol problems in the context of other drug abuse. Alcohol Res Health1996;20:118–23.
AnnisHMDavisCS. Relapse prevention. In: HesterRKMillerWR, editors. Handbook of alcoholism treatment approaches. New York: Pergamon Press; 1989. p 170–82.
9.
NowinskiJBakerS.The twelve-step facilitation handbook. New York: Jossey Bass; 1992.
10.
SobellLCMaistoSASobellMBCooperAM. Reliability of alcohol abusers' self-reports of drinking behavior. Behav Res Ther1979;17:157–60.
11.
BaborTFBrownJDel BocaFK. Validity of self-reports in applied research on addictive behaviors: Fact or fiction?Behav Assess1990;12:5–31.
12.
McLellanATLuborskyLWoodyGEO'BrienCP. An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. J Nerv Ment Dis1980;168:26–33.
13.
McLellanATWoodyGELuborskyLO'BrienCPDruleyKA. Increased effectiveness of substance abuse treatment: A prospective study of patient–treatment “matching.”J Nerv Ment Dis1983;171:597–605.
14.
SpitzerRLWilliamsJBGibbonMFirstMB. User's Guide for the Structured Clinical Interview for DSM-III-R. Washington (DC): American Psychiatric Association Press; 1990.
15.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-III- R). Washington (DC): APA Press; 1987.
16.
DerogatisLRLipmanRSCoviL.The SCL-90: An outpatient psychiatric rating scale. Psychopharmacol Bull1973;9:13–28.
17.
TabachnickBGFidellLS. Using multivariate statistics. 4th ed.Boston: Allyn and Bacon; 2001.
18.
RychtarikRGMcGillicuddyNBConnorsGJWhitneyRB. Participant selection biases in a randomized clinical trial of alcoholism treatment settings and intensities. Alcohol Clin Exp Res1998;22:969–73.
19.
McKayJRAltermanAIMcLellanATBoardmanCRMulvaneyFDO'BrienCP. Random versus nonrandom assignment in the evaluation of treatment of cocaine abusers. J Consult Clin Psychol1998;66:697–701.
20.
StrohmetzDBAltermanAIWalterD.Subject selection bias in alcoholics volunteering for a treatment study. Alcohol Clin Exp Res1990;14:736–8.
21.
SmithL.Help seeking in alcohol-dependent females. Alcohol Alcohol1992;7:3–9.
22.
Health Canada. Best practices treatment and rehabilitation for women with substance use problems. Ottawa: Health Canada; 2001.
23.
DeLeonG.Commentary: Reconsidering the self-selection factor in addiction treatment research. Psychol Addict Behav1998;12:71–7.
24.
CaetanoR.Editorial: Non-response in alcohol and drug surveys: A research topic in need of further attention. Addiction2001;96:1541–5.
