Predictors and moderators of aftercare appointment-keeping following brief motivational interviewing among patients with psychiatric disorders or dual diagnosis.

OBJECTIVE: Non-adherence to psychiatric and substance abuse treatment recommendations, especially with regard to aftercare outpatient appointment-keeping following hospitalizations, exacts a high cost on mental health spending and prevents patients from receiving therapeutic doses of treatment. Our primary objective was to evaluate the relationship between potential predictors and moderators of aftercare appointment-keeping among a group of adult patients immediately following hospitalization for severe psychiatric disorders or dual diagnosis. METHODS: Candidate predictors and moderator variables included demographics, psychiatric status, psychiatric symptom severity, and inpatient group adherence, while aftercare appointment-keeping was defined as attendance at the first aftercare appointment. Participants were 121 adult inpatients with a psychiatric disorder or dual diagnosis originally enrolled in an earlier randomized controlled trial comparing standard treatment with standard treatment plus brief motivational interviewing for increasing adherence. RESULTS: RESULTS indicated that, across treatment conditions, those who were female, did not have dual diagnosis, were older (older than 33 years), and were less educated (

Use of the University of Rhode Island Change Assessment to measure motivational readiness to change in psychiatric and dually diagnosed individuals.

In this report, the original 4-factor structure of the University of Rhode Island Change Assessment (URICA; C. C. DiClemente & S. O. Hughes, 1990) was replicated, and the scale's internal consistency was found to be acceptable in a sample of 120 psychiatric and dually diagnosed inpatient participants, who had participated in a randomized clinical trial comparing standard treatment (ST) and ST plus motivational interviewing. Contrary to the authors' hypotheses, participants classified as having low motivational readiness to change, based on their URICA scores, demonstrated greater treatment adherence than high-readiness participants, in that they attended a greater proportion of therapy groups while hospitalized (54% vs. 39%; p < .05) and clinic appointments during their 1st month postdischarge (77% vs. 53%; p < .05). Low-readiness participants were also more likely to attend all of their scheduled clinic appointments (26%) than were high-readiness participants (10%; p < .05).