Impact of Online Patient Feedback (OQ) to Therapist

Dropout represents one of the largest problems in substance abuse treatment. International and Nordic research show that only 20 - 40 % of substance abusers complete treatment as intended. At the same time, one of the most consistent factors of favourable post-treatment outcome is treatment completion. In spite of the serious and continuous challenge dropout represents the phenomena is not well understood and there is a need to explore more of the factors that influence dropout and how it can be counteracted. As also stated: "…effective methods for reducing the problem of dropouts from treatment is one more area in need of further research" (NOU 2003:4, s 77). For the general field of mental health one of the most important innovations involves providing therapists with patient feedback about their progress. The most well-established and widely researched feedback system is the Outcome Questionnaire (OQ-45.2). The system has been shown to improve treatment outcomes, including reduced treatment dropout and length of treatment, but the system is yet to be utilized with a substance abusing patient group. The aim of the present study is to examine the usefulness of OQ-45.2 with substance abusing patients.

Hypotheses and research questions 1. The OQ-45.2 feedback will be effective in identifying patients at risk of dropout of substance abuse treatment. 1a. The condition were feedback is withheld from the therapist, will correctly identify patients who will dropout. Research Question: Is there variation in the accuracy of dropout prediction as a function of age, gender differences or type of substance abuse? 2. The OQ-45.2 feedback will be effective in reducing dropout in outpatient substance abuse treatment. 2a. The feedback condition will result in less dropout than the no-feedback condition. Research Question: Is there a variation in the OQ-45.2 preventive dropout effect due to age, gender or type of substance abuse? 3. The OQ-45.2 feedback will shorten length of inpatient substance abuse treatment. 3a. The feedback condition will identify patients who are ready to terminate therapy. Research Question: Is there variation in identification of patients ready to terminate as a function of age, gender differences or type of substance abuse?

Patients randomized to this condition completes the OQ-45.2 weekly, but the reports are withheld from therapists and patients.

Patients and therapists uses the feedback-system as intended, with real-time feedback to the therapist and full use of the suggested interventions

Completion of the OQ-45.2 with real-time feedback to the therapist and full use of the suggested interventions every week of the treatment program

The main goal of the present study is to examine the usefulness of OQ-45.2 with regard to reducing dropout from substance abuse treatment.

Inclusion Criteria: Primary diagnosis of addiction, F10-19, using the International Classification of Diseases, admitted in 2011-2014 for treatment at the department of addiction treatment - youth, Oslo University Hospital Exclusion Criteria: Ongoing psychoses, severe language difficulties