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Tuesday, December 9, 2008

Treatment Center Drop Out Rate

At the Center, you have recently conducted an audit of treatment outcomes as part of the continuing quality improvement effort implemented 18 months ago. You note that the treatment drop out rate has gone up significantly since last December. You decide to investigate.
Identify factors that you would hypothesize are responsible for the increased drop out rate. Describe factors that relate to patient characteristics, counselor characteristics, reimbursement system characteristics, and any other potential reasons that would explain this change. Limit the total number of

1. Overall mediocre quality care. Patients will notice in the short or long run how the Center is being run from treatment by counselors to facilities. Quality improvement should be a priority, and principles and methods of improving quality should be adopted.

2. Cultural Incompetence. Diversity and ethnic education should be part counselors agenda when handling patient on a daily basis.

Racial and ethnic minorities frequently lack access to culturally appropriate care. In the effort to create smaller and more efficient provider networks, there is a risk of eliminating providers and groups who have special expertise with different cultures and different healing practices (e.g., Afrocentric counseling and Spanish-speaking services, sweat lodges for Native Americans, and American Sign Language services for individuals who are deaf). Often, the reason given for exclusion of cultural practices is that accepted evidence of effectiveness does not exist. The committee observes, however, that controlled trials or other outcomes assessments have not been done for many, if not most, medical treatments (Institute of Medicine Staff, 1997).

3. Underestimating the scope of the issues. When client or patient approaches a counselors, it should not be taken lightly nor ignore other possibilities of the problem.

Although the stigma associated with seeking treatment for mental or addictive disorders is a significant factor in masking the scope of these problems by keeping them “in the closet,” the unusual fragmentation of these sectors of care is also part of the problem. A first factor is that, unlike most other health conditions, separate publicly managed health care systems are maintained for mental illness and substance abuse treatment (Institute of Medicine Staff, 1997).

4. Lack of Knowledge. Many counselors may stop learning when they reach their level of "in"competence. Counselor should be open to learning and accept the fact that not all information can be limited.

One major consequence of this limitation is the lack of the more enduring, intensive relationship of treatment personnel and patients, which can be an important source of data about the older person as well as a check on one’s evaluation of him or her (Butler, 1998)

Butler, R., Lewis, M., & Sunderland, T. (1998). Aging and Mental Health: Positive Psychosocial and Biomedical Approaches. Austin, TX: Pro-Ed.

Institute of Medicine Staff (1997). Managing Managed Care: Quality Improvement in Behavioral Health. Washington, DC, USA: National Academies Press, 1997. Retrieved on 14 November 2008 at:
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