Poster 11: Increasing substance use disorder treatment compliance for persons with traumatic brain injury

Objective: To compare the effectiveness of 3 interventions for increasing compliance during the initial phase of substance use disorder treatment. Design: Randomized controlled trial. Setting: 2 community-based programs for persons diagnosed with traumatic brain injury (TBI) and substance use disorder. Participants: 195 new clients (n=124, n=71) of 2 programs. Participants were randomly assigned to 1 of 4 treatment conditions, and stratified by race, gender, facility, and interviewer. Interventions: Reduction of logistical barriers to attending appointments; brief motivational interviewing to increase motivation for treatment; provision of financial incentives to participate in treatment; and attention control. Main Outcome Measures: Signed Individualized Service Plan (ISP) within 30 days of intake. Secondary outcomes included days to signing the ISP, premature termination, and missed appointments. Results: The sample was comprised of 70% men, and 31% of participants were of minority status. TBI onset occurred an average of 8 years before study entry. The barrier reduction and financial incentive interventions resulted in higher rates of signing the ISP within 30 days (P<.001). Significant differences between conditions were also found for days to signing ISP and premature termination. Conclusions: Initial participation in treatment can be improved by reducing barriers to participation or by providing financial incentives.