Determinants of relapse and re-admission among alcohol abusers after intensive residential treatment

Little information is available in Belgium on the number and characteristics of alcohol abusers who contact treatment agencies and on the effectiveness of these services. International research has identified some determinants of relapse and recovery after treatment, but additional research is needed in order to better tailor services to the needs of service users. This study aimed at measuring abstinence and relapse among alcohol abusers (n=249) after intensive, residential treatment in specialized units in five Belgian psychiatric hospitals. Six month outcomes concerning substance use, psychological health, social support and integration were studied using the EuropASI. Logistic regression analyses were performed to identify predictors of relapse and readmission. Significant reductions in the severity of alcohol and psychological problems were observed, but six months after the initial treatment episode more than half of all respondents (54%) had been using alcohol regularly. The domains ‘psychiatric problems’ and ‘patients’ personal perspectives’ were the best predictors of relapse and readmission. Also, ‘patients’ living situations’ predicted relapse. Specific variables that independently predicted relapse were ‘satisfaction with day activities’ and ‘number of days with problems due to alcohol’. Less severe psychiatric problems at the start of treatment and more severe psychiatric problems and negative feelings of wellbeing at the time of follow-up were independent predictors of readmission. We conclude that treatment agencies need to recognize the relapsing nature of alcohol abuse and have to organize their services from a continuing care perspective, including specific attention for individuals’ psychological needs and day/leisure activities.