Treatment Program Dropouts

Men and Women Have Different Motivations

Woman With Doctor
Why Do People Drop Out of Rehab?. © Getty Images

Men and women who remain in alcohol and drug rehabilitation programs throughout a full year have entirely different motivations for doing so, according to a new study.

Researchers at the Kaiser Permanente Medical Care Program in Oakland, CA separately surveyed 317 women and 599 men who were outpatient alcohol and drug treatment programs that were abstinence-based, "to identify independent predictors of length of stay and program completion." The results were surprising.

The threat of losing their jobs was a main motivator for men to complete the one-year program, while family influences were the main motivation for women to remain a full year, the study found.

"Although prior research has examined predictors of treatment retention in public alcohol and drug treatment programs, little is known about factors that influence treatment retention in an insured outpatient population," wrote authors Jennifer Mertens and Constance Weisner. "Because there is growing evidence that the factors which influence treatment retention may differ by gender, we identified sex-specific predictors."

Men were more likely to remain in treatment if they were there under suggestions or threats from their employers. This finding seems to indicate that intervention that includes participation by employers can be effective in some cases.

For men, having a goal of completely giving up drugs or alcohol also increased their likelihood of remaining in treatment.

In other words, those whose goals were "moderation" or who were not committed to lifelong abstinence were much less likely to remain in the program a full year.

Men older than 40 were more likely to complete treatment than younger men. Shorter stays were more common among men and women who were dependent on stimulants or cocaine and more severe drug problems, the authors said.

Gender Differences

Surprisingly women were not influenced at all by these same factors. Women were more likely to stay in treatment if they were married and living with their spouse according to the researchers. The study also found that African-American women were more likely to drop out than were women of other ethnic categories.

"Among women, retention was predicted by having higher incomes, belonging to ethnic categories other than African American, being unemployed, being married, and having lower levels of psychiatric severity. Among men, predictors of higher retention included being older, receiving employer suggestions to enter treatment, and having abstinence goals," the authors said.

Risk Factors of Dropping Out

"These findings highlight the importance of examining aspects of the course of treatment separately by sex," Mertens and Weisner said. "They also suggest treatment factors that may enhance retention among insured populations, including employer referrals, psychiatric services, and drug-related services."

"People who are entering treatment, as well as their families and friends, may benefit by becoming aware of those 'risk factors' associated with dropping out and plan accordingly," Mertens said.

The study was published in the October 2000 edition of Alcoholism: Clinical and Experimental Research.

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