Client/Clinician Discrepancies in Perceived Problem Improvement and the Potential Influence on Dropout Response



This paper examines the possibility that clinicians working in an alcohol and other drug (AOD) treatment service may lack appreciation of problem improvement in clients who choose to dropout against clinical advice. Underlying this investigation is the belief that if clinicians are indeed unperceptive of problem improvement amongst this population then this may explain why retention based responses to client dropout continue to be promoted, despite evidence to suggest that they are ineffective and/or unnecessary. Outcome data obtained from a sample of 75 AOD treatment clients and their respective clinicians at baseline and 2-month follow-up are reported. Analysis of these data suggest a client/clinician discrepancy in perceived problem improvement was evident in the study setting: clinicians reported significantly less problem improvement in the first 2 months of service attendance as compared to their clients and this discrepancy was most pronounced if the client had dropped out of treatment.


Dropout Retention Treatment fit Treatment outcome 



This study was undertaken with financial assistance from the Waitemata District Health Board and the John Dobson memorial scholarship. The authors would like to thank participating clients and staff of the AOD treatment service for their cooperation. The authors would also like to acknowledge Jenny Wolf and Robert Steenhuisen for their support of the project and Amanda Wheeler (Director, Clinical Research and Resource Centre) for her input over the course of the study.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.School of Population Health, Faculty of Medical & Health SciencesUniversity of AucklandAucklandNew Zealand
  2. 2.School of Pharmacy, Faculty of Medical & Health SciencesUniversity of AucklandAucklandNew Zealand
  3. 3.Clinical Research & Resource Centre (CRRC)HendersonNew Zealand

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