Predicting Attrition in the Treatment of Substance Use Disorders

One of the notions of substance abuse treatment is that people must hit “rock bottom” before they are ready for recovery. So pervasive is the notion that, sometimes when people fail to achieve total abstinence from substances during treatment, they are told to leave and come back when they are “ready.” Althoughtherapists would not expel an anxious client from treatment for having a panic attack, or a depressed client for being sad, proponents of the rock bottom theory may be quick to assume that clients who relapse in substance abuse treatment need to hit rock bottom before they can begin to recover. 

Another variation of this notion is that people who have hit rock bottom have nowhere to go but up, so they are more likely to show improvement simply by regression to the mean. But although these views may have some conventional wisdom to support them, the research is mixed as to whether they are valid. At this point, it is unclear that the data support either side of this debate. Read more>>>>>>>>>>>>>>