Treatment Engagement As a Predictor of Premature Treatment Termination and Treatment Outcome in a Correctional Outpatient Sample

Background: It is widely assumed that the outcome of correctional treatment largely depends on the patient's treatment engagement; however, evidence for this notion is scarce.

Aim: In this study, the Treatment Engagement Rating scale (TER) was used to investigate the relationship of a patient's treatment engagement with premature treatment termination and treatment outcome, defined as reduction of the risk of reoffending.

Method: Employing a prospective design, this study addressed the relationship of the behavioural treatment engagement of correctional outpatients (N = 138) with treatment non-completion and treatment outcome, respectively.

Results: Treatment engagement as measured by the TER emerged as an accurate predictor of treatment non-completion (area under the curve = 0.76; odds ratio = 4.1) and was also significantly correlated with treatment outcome (rho = 0.41). The prediction was more accurate for sex offenders than for violent offenders, for expulsion from the treatment than for dropout, and when treatment engagement was assessed closer to the end of the treatment.

Conclusions: The study provides evidence that the outcome of correctional treatment depends to a substantial degree on the behavioural efforts that the patients make for the treatment. Periodic assessment of treatment engagement in correctional treatment facilities would be useful, and the TER seems to be a practical, reliable and valid instrument for this purpose.