Early Motivation, Well-being, and Treatment Engagement of Chronic Substance Users Undergoing Treatment in a Therapeutic Community Setting

Abstract

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.

Client engagement in psychotherapeutic treatment and associations with client characteristics, therapist characteristics, and treatment factors

“…'Say yes' appears to relate to commitment, motivation, or intentions for treatment (e.g. Dowling & Cosic, 2011;Klag et al, 2010). 'Be A C C E P T E D M A N U S C R I P T…”

“…Motivation (Dingle et al, 2008), intentions (Klag et al, 2010) or commitment (Joe et al 1999) to participate, rather than the acts of participation, have been employed as proxies for engagement. Motivation can predict behavior (Chatzisarantis, Hagger, Smith, & Sage, 2006) and has thus been conceptualized by some researchers (e.g.…”

“…Participation was also assessed by the three measures of engagement (discussed below). Involvement was incorporated within operational definitions of engagement in six studies (Baydar et al, 2003;Boardman et al, 2006;Joe et al, 1999;Klag et al, 2010; or disengagement (Frankel & Levitt, 2009). …”

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

“…Individuals who dropped out were significantly more likely to have a criminal history (consistent with the findings of Darke et al, 2012 (Cardoso, Chan, Berven, & Thomas, 2003), spirituality (Dermatis et al, 2010), and engagement and motivation (Klag, Creed, & O'Callaghan, 2010). Five studies included two time points with the gap between measured points varying in length from 4 -15 months post program completion, and were in pre and post format (Bankston et al, 2009;Dekel et al, 2004;López-Goñi et al, 2010;Messina et al, 2000;Zoccali et al, 2007).…”

“…One study (Klag et al, 2010) tested the self-determination theory in relation to the Therapeutic Community and found that, as hypothesized, higher levels of autonomy led to higher reports of psychological well-being during the early stages of rehabilitation, and higher levels of engagement in the rehabilitation process. Dermatis, Salke, Galanter, and Bunt (2001) investigated social affiliation (a feature of the community-as-method approach), and depression.…”