Correlates of motivation to change in adolescents completing residential substance use treatment

Wei, Christina; Heckman, Bernadette Davantes; Gay, Joe; Weeks, Justin W.

doi:10.1016/j.jsat.2010.11.014

Cited by 15 publications

(15 citation statements)

References 39 publications

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“…These results are broadly consistent with prior research in older adult and adolescent samples (Kelly et al, 2005; Morgenstern et al, 1996; Wei et al, 2011). However, while all therapeutic processes improved significantly during treatment, there was broad variation in the magnitude of these changes.…”

Section: Discussionsupporting

confidence: 91%

“…Placing these magnitude increases in the context of other clinical findings, it is notable that motivation to change at admission seems higher in our sample than in the Wei et al, (2011) adolescent residential SUD sample (where the mean was 9.6 [SD=2.8] on a scale from −2 to +14) but the effect size for during-treatment change was similarly small in magnitude (i.e., 0.22 for Wei et al, and.17 in our sample). Also, effects sizes were smaller in that study ranging from 0.15–0.40 across the subscales assessing coping skills.…”

Section: Discussionsupporting

confidence: 49%

“…One recent study of during-treatment changes among adolescents attending a residential treatment program showed significant improvements in coping skills, while motivation remained fairly stable from admission to discharge (Wei et al, 2011). In general, however, there is little available evidence on the mechanisms of treatment and early recovery processes in adolescents and emerging adults with SUD, which may well differ from older adults as has been shown with mechanisms of behavior change within mutual-help groups, such as AA/NA.…”

Section: Introductionmentioning

confidence: 99%

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“Ready, willing, and (not) able” to change: Young adults’ response to residential treatment

Kelly

Urbanoski

Hoeppner

et al. 2012

Drug and Alcohol Dependence

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Background Young adulthood represents a key developmental period for the onset of substance use disorder (SUD). While the number of young adults entering treatment has increased, little is known about the mechanisms of change and early recovery processes in this important clinical population. This study investigated during-treatment change in key therapeutic processes (psychological distress, motivation, self-efficacy, coping skills, and commitment to AA/NA), and tested their relation to outcome at 3 months post-treatment. Methods Young adults undergoing residential treatment (N=303; age 18–24; 26% female; 95% Caucasian) were enrolled in a naturalistic prospective study and assessed at intake, mid-treatment, discharge, and 3 months following discharge. Repeated-measures and regression analyses modeled during-treatment change in process variables and impact on outcome. Results Statistically significant medium to large effect sizes were observed for changes in most processes during treatment, with the exception of motivation, which was high at treatment intake and underwent smaller, but still significant, change. In turn, these during-treatment changes all individually predicted 3-month abstinence to varying degrees, with self-efficacy emerging as the sole predictor in a simultaneous regression. Conclusions Findings help to clarify the mechanisms through which treatment confers recovery-related benefit among young adults. At treatment intake, high levels of abstinence motivation but lower coping, self-efficacy, and commitment to AA/NA, suggests many entering treatment may be “ready and willing” to change, but “unable” to do so without help. Treatment appears to work, in part, by helping to maintain motivation while conferring greater ability and confidence to enact such change.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

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“Ready, willing, and (not) able” to change: Young adults’ response to residential treatment

Kelly

Urbanoski

Hoeppner

et al. 2012

Drug and Alcohol Dependence

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“…Living in an environment with diminished employment and educational opportunities could be a hindrance to treatment completion, and could also shape peer group influences on youth within the treatment system. [32] We found that racial/ethnic composition of the metro area was a strong predictor of treatment completion differences, particularly for Hispanic youth. Although co-residence with members of one’s own racial/ethnic group can have a protective effect against risk behaviors,[33] it can also indicate higher rates of exclusion and socio-economic disadvantage not otherwise captured by other indicators such as the unemployment rate.…”

Section: Discussionmentioning

confidence: 94%

Explaining Racial/Ethnic Differences in Adolescent Substance Abuse Treatment Completion in the United States: A Decomposition Analysis

Saloner

Carson

Cook

2014

Journal of Adolescent Health

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Purpose To identify contributors to racial/ethnic differences in completion of alcohol and marijuana treatment among adolescents at publicly-funded providers. Methods The 2007 Treatment Episode Data Set (TEDS) provided substance use history, treatment setting, and treatment outcomes for youth aged 12-17 from five racial/ethnic groups (N=67,060). Individual-level records were linked to variables measuring the social context and service system characteristics of the metropolitan area. We implemented non-linear regression decomposition to identify variables that explained minority-white differences. Results Black and Hispanic youth were significantly less likely than whites to complete treatment for both alcohol and marijuana. Completion rates were similar for whites, Native Americans, and Asian Americans, however. Differences in predictor variables explained 12.7% of the black-white alcohol treatment gap and 7.6% of the marijuana treatment gap. By contrast, predictors explained 57.4% of the Hispanic-white alcohol treatment gap and 19.8% of the marijuana treatment gap. While differences in the distribution of individual-level variables explained little of the completion gaps, metropolitan-level variables substantially contributed to Hispanic-white gaps. For example, racial/ethnic composition of the metropolitan area explained 41.0% of the Hispanic-white alcohol completion gap and 23.2% of the marijuana completion gap. Regional differences in addiction treatment financing (particularly use of Medicaid funding) explained 13.7% of the Hispanic-white alcohol completion gap and 9.8% of the Hispanic-white marijuana treatment completion gap. Conclusions Factors related to social context are likely to be important contributors to white-minority differences in addiction treatment completion, particularly for Hispanic youth. Increased Medicaid funding, coupled with culturally tailored services, could be particularly beneficial.

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“…In terms of death, a review of the adolescent suicidal literature shows that rates of any alcohol and other drug use disorder (AOD) were found to range from 27% to 50% among adolescents who died by suicide (Esposito-Smythers & Spirito, 2004). Comorbidity has also been linked to adolescent substance use where adolescents with substance use disorders are more likely to have co-occurring psychiatric diagnoses compared without substance use disorders (Wei et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Examining the relationship between self-control and adolescent TC treatment completion

Abdel-Salam

2013

Journal of Substance Use

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A type of treatment intervention that is widely regarded in terms of treating adolescents with issues of substance use is the therapeutic community (TC). Despite their effectiveness, empirical studies of drug treatment are mostly atheoretical, even though treatment programming is based on theory. In this study, an attempt was made to apply concepts related to a Gottfredson and Hirschi's General Theory of Crime to predict treatment completion. Using data collected as part of the Drug Abuse Treatment Outcomes Studies Adolescents (DATOS-A), a multisite prospective study of adolescent drug abuse treatment effectiveness, this study examined whether characteristics associated with low self-control predicted treatment completion. The primary finding was that motivation for treatment was significantly related to treatment completion. Although the characteristics associated with low self-control did not predict treatment completion in the hierarchical linear modeling (HLM) models that included the demographics and risk and protective factors, there were several significant bivariate relationships between pretreatment behaviors and the characteristics associated with low self-control. Because of these relationships, it is important that TC practitioners are aware of how these characteristics might interplay with treatment completion and how TC strategies may help the adolescent to overcome them.

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Correlates of motivation to change in adolescents completing residential substance use treatment

Cited by 15 publications

References 39 publications

“Ready, willing, and (not) able” to change: Young adults’ response to residential treatment

“Ready, willing, and (not) able” to change: Young adults’ response to residential treatment

Explaining Racial/Ethnic Differences in Adolescent Substance Abuse Treatment Completion in the United States: A Decomposition Analysis

Examining the relationship between self-control and adolescent TC treatment completion

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