Evaluation of the Cape Town Drug Counselling Centre: a theory and outcomes-based approach
Master Thesis
2013
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University of Cape Town
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Abstract
This study examined treatment response and participant characteristics amongst substance misusing clients of a Cape Town low-cost out-patient treatment programme.A theory-based approach to the evaluation was used and substance use outcomes of participants were measured over the three time periods of admission, 6- weeks postadmission (immediately after the intervention) and 10-weeks post-admission as were elements of the Centre's causal chain mechanism: Relationships between the domains of motivation (comprising the three sub-scales of Recognition, Taking Steps and Ambivalence), drug-taking confidence (self-efficacy), Alcoholics/Narcotics Anonymous affiliation and previous clean time against levels of substance use and severity of dependence at each time point were measured. Substance use and levels of severity of dependence should decline over time. As Self-Efficacy, Taking Steps and NA/AA Affiliation scores increase, so substance use levels and levels of severity of dependence should decrease. Higher scores of Recognition and Ambivalence should be associated with higher levels of substance use and severity of dependence. Forty seven percent of participants reported abstinence of all substances at 10-week follow-up and a further 13% abstained from all substances with the exception of alcohol which they had used only once or twice. Reductions in use of individual substances were high: 95% of participants who, on admission, reported use of methaquolone (mandrax), 89% of heroin users, 84% of cocaine users and 73% of methamphetamine users reported abstinence of those drugs at 10-week follow-up. Self-Efficacy and Taking Steps scores significantly increased over time and were also significantly associated with reduction in substance use and severity of dependence. Higher Recognition scores were significantly associated with higher levels of substance use at admission and 10-week follow-up. There was an inverse association between amount of exposure to the treatment programme and levels of substance abuse and severity of dependence. NA/AA affiliation was low at all time points and did not appear to be associated with reductions in substance use. As substance use and substance dependence significantly decreased and as measurable elements in the chain of causal mechanisms changed over time consistent with programme causal theory, and as the change in those elements impacted on levels of substance use in a significant way, it can be tentatively suggested that there was a treatment programme effect.
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Duffett, L. 2013. Evaluation of the Cape Town Drug Counselling Centre: a theory and outcomes-based approach. University of Cape Town.