Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers
Abstract Background Retention in substance use treatment is one of the strongest predictors of improved outcomes among adolescents, making retention an important goal of treatment. We examined treatment providers’ perspectives on barriers and facilitators to treatment retention among adolescents, an...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13011-020-00284-4 |
| _version_ | 1818027724979044352 |
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| author | Andrea Acevedo Nellie Harvey Maureen Kamanu Shalini Tendulkar Sasha Fleary |
| author_facet | Andrea Acevedo Nellie Harvey Maureen Kamanu Shalini Tendulkar Sasha Fleary |
| author_sort | Andrea Acevedo |
| collection | DOAJ |
| description | Abstract Background Retention in substance use treatment is one of the strongest predictors of improved outcomes among adolescents, making retention an important goal of treatment. We examined treatment providers’ perspectives on barriers and facilitators to treatment retention among adolescents, and their views on contributors to racial/ethnic disparities in retention including ways to address disparities. Methods Semi-structured interviews were conducted with 19 providers at state-licensed detoxification, residential, and outpatient facilities serving adolescents for substance use disorders in Massachusetts. Interviews were coded by at least two independent coders. Results Providers identified barriers and facilitators at the policy/systems, facility, family, and client levels. Some of the barriers included insurance limits on sessions/length of stay and low reimbursement (policy/systems), staff turnover (facility), low family engagement (family), and low internal motivation (client). Some facilitators mentioned were support from state’s substance use agency (policy/systems), flexibility with meeting location (facility), family participation (family), and high internal motivation and presence of external motivators (client). Barriers that contributed to racial/ethnic disparities included lower socio-economic status, language barriers, and mistrust. Having bilingual/bicultural staff and multi-lingual materials, and facilitating transportation were identified as strategies for reducing disparities in treatment retention. Conclusions It is critical that adolescents who access substance use services remain and complete treatment and that there is equity in treatment retention. Provider perspectives in factors associated with retention can inform the development of comprehensive interventions and policies to help improve retention and reduce disparities. |
| first_indexed | 2024-12-10T04:52:27Z |
| format | Article |
| id | doaj.art-9d37ae079f134ec4a04fd3090120bb10 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-12-10T04:52:27Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-9d37ae079f134ec4a04fd3090120bb102022-12-22T02:01:35ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2020-06-0115111310.1186/s13011-020-00284-4Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providersAndrea Acevedo0Nellie Harvey1Maureen Kamanu2Shalini Tendulkar3Sasha Fleary4Department of Community Health, Tufts UniversityDepartment of Community Health, Tufts UniversityDepartment of Community Health, Tufts UniversityDepartment of Community Health, Tufts UniversityEliot-Pearson Department of Child Study and Human Development, Tufts UniversityAbstract Background Retention in substance use treatment is one of the strongest predictors of improved outcomes among adolescents, making retention an important goal of treatment. We examined treatment providers’ perspectives on barriers and facilitators to treatment retention among adolescents, and their views on contributors to racial/ethnic disparities in retention including ways to address disparities. Methods Semi-structured interviews were conducted with 19 providers at state-licensed detoxification, residential, and outpatient facilities serving adolescents for substance use disorders in Massachusetts. Interviews were coded by at least two independent coders. Results Providers identified barriers and facilitators at the policy/systems, facility, family, and client levels. Some of the barriers included insurance limits on sessions/length of stay and low reimbursement (policy/systems), staff turnover (facility), low family engagement (family), and low internal motivation (client). Some facilitators mentioned were support from state’s substance use agency (policy/systems), flexibility with meeting location (facility), family participation (family), and high internal motivation and presence of external motivators (client). Barriers that contributed to racial/ethnic disparities included lower socio-economic status, language barriers, and mistrust. Having bilingual/bicultural staff and multi-lingual materials, and facilitating transportation were identified as strategies for reducing disparities in treatment retention. Conclusions It is critical that adolescents who access substance use services remain and complete treatment and that there is equity in treatment retention. Provider perspectives in factors associated with retention can inform the development of comprehensive interventions and policies to help improve retention and reduce disparities.http://link.springer.com/article/10.1186/s13011-020-00284-4Substance use treatmentAdolescentsRetentionDisparities |
| spellingShingle | Andrea Acevedo Nellie Harvey Maureen Kamanu Shalini Tendulkar Sasha Fleary Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers Substance Abuse Treatment, Prevention, and Policy Substance use treatment Adolescents Retention Disparities |
| title | Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers |
| title_full | Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers |
| title_fullStr | Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers |
| title_full_unstemmed | Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers |
| title_short | Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers |
| title_sort | barriers facilitators and disparities in retention for adolescents in treatment for substance use disorders a qualitative study with treatment providers |
| topic | Substance use treatment Adolescents Retention Disparities |
| url | http://link.springer.com/article/10.1186/s13011-020-00284-4 |
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