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Introduction and Aims: There is increasing interest and evidence for the use of cannabinoid medications in the treatment of cannabis use disorder, but little examination of the correlates of successful treatment. This paper is a secondary analysis of a randomised placebo-controlled trial of nabiximols for the treatment of cannabis use disorder (CUD), aiming to identify which client and treatment characteristics impact treatment engagement and outcomes., Method: Bayesian multiple regression models were used to examine the impact of age, gender, duration of regular cannabis use, daily quantity of cannabis, cannabis use problems, self-efficacy for quitting, sleep, mental health, pain measures, and treatment group upon treatment engagement (retention, medication dose, and counselling participation) and treatment outcomes (achieving end-of-study abstinence, and a 50% or greater reduction in cannabis use days) among the 128 clients participating in the 12-week trial., Results: Among the treatment factors, greater counselling attendance was associated with greater odds of abstinence and ≥ 50% reduction in cannabis use; nabiximols with greater odds of ≥ 50% reduction and attending counselling, and reduced hazard of treatment dropout; and higher dose with lower odds of ≥ 50% reduction. Among the client factors, longer duration of regular use was associated with higher odds of abstinence and 50% reduction, and lower hazard of treatment dropout; greater quantity of cannabis use with reduced hazard of dropout, greater odds of attending counselling, and higher average dose; greater pain at baseline with greater odds of ≥ 50% reduction and higher average dose; and more severe sleep issues with lower odds of ≥ 50% reduction. Males had lower odds of attending counselling., Discussions and Conclusions: These findings suggest that counselling combined with agonist pharmacotherapy may provide the optimal treatment for cannabis use disorder. Younger clients, male clients, and clients with sleep issues could benefit from extra support from treatment services to improve engagement and outcomes., Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au., (© 2022. The Author(s).)

This study examined the association between counselor- and client-rated initial therapeutic alliance and treatment engagement for youths who completed a residential substance abuse treatment program. Group differences between Aboriginal (N = 16) and non-Aboriginal (N = 29) youths were explored. Counselors reported a strong initial therapeutic alliance with all youths; however, Aboriginal youths did not perceive this connection with their counselor to the same extent as non-Aboriginal youths. A difference also emerged between the groups in treatment engagement. Counselors perceived Aboriginal adolescents as engaging in more negative treatment participation. These results provide preliminary data to help inform cross-cultural practice. [ABSTRACT FROM PUBLISHER]

This study explored the predictors, role and effects of motivation in chronic substance users as they began residential treatment, using the Self-Determination Theory (SDT) framework. Testing of the SDT model involved a sample of 350 clients from six therapeutic communities across Australia who completed a battery of standardized measures. It was hypothesized that clients with a more autonomous motivational attitude toward treatment would be more likely to engage in the therapeutic process and would report more psychological well-being in the initial stages of the therapeutic process. It was also anticipated that clients who felt supported in an autonomous fashion by therapeutic staff would be more autonomously motivated with regard to being in treatment. Findings provided support for the hypothesized effects. [ABSTRACT FROM AUTHOR]

Objective: Young people (ages 12-25) experience the highest risk of developing mental disorders; however, their uptake of and engagement with treatment is low. The study explored sociodemographic predictors of attendance and discontinuation of mental health services in a large, population-based sample., Methods: Data were from the minimum data set collected from young people (ages 12-25) who attended headspace, Australia's National Youth Mental Health Foundation, from 2013 to 2017 (N=80,502). Data on key demographic and clinical variables and practitioner ratings of need for ongoing care were analyzed. Cox regression was used to examine the association between sociodemographic factors and rates of discontinuation based on practitioner-rated need for ongoing treatment., Results: The mean±SD number of sessions attended during the first episode of care was 4.6±4.4 sessions (median=3). Session-by-session discontinuation rates ranged from 14% to 19% across 10 sessions. The proportion discontinuing treatment before session 11 was 71.2%. Analysis of a subgroup (N=40,039) showed that 24% of those who discontinued treatment later returned to the same headspace center for a second episode of care. Those who were most at risk of discontinuation were older (ages 18-25), male, heterosexual, Aboriginal or Torres Strait Islander, and living in a rural location., Conclusions: Sociodemographic factors were found to be associated with treatment discontinuation, and some young people followed a pathway in and out of mental health treatment. Further exploration is needed to determine the appropriate length and type of care for specific sociodemographic groups and how best to tailor treatment accordingly.