Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change

Abstract

Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (Time 1) and 35 days after admission (Time 2). The design consisted of a comparison sample (n = 281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n = 238). Repeated measures ANCOVAs were conducted using each Time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation.

The Effectiveness of the Treatment Readiness and Induction Program (TRIP) for Improving During-Treatment Outcomes

“…Dependent measures were assessed at Time 2 and include scales that have been used in previous studies (e.g., Becan et al, 2015; Knight et al, 2015). Engagement scales from the adolescent version of the Client Evaluation of Self and Treatment (CEST; Knight et al, 2014) measured youth's perceptions of their treatment participation (11 items, coefficient alpha = .92), treatment satisfaction (6 items, coefficient alpha = .82), rapport with counselors (counselor rapport; 12 items, coefficient alpha = .94), and support received from peers in treatment (peer support; 5 items, coefficient alpha = .82).…”

“…Compared to youth in residential settings who received standard operating practice, youth in TRIP reported greater gains in decision making competence (Knight et al, 2015). In addition, TRIP has been found to promote treatment motivation among adolescents, especially for those who have a low tendency to behave rashly when experiencing positive emotions (Becan, Knight, Crawley, Joe, & Flynn, 2015). While TRIP appears to be successful in promoting targeted skills, the degree to which it also promotes active participation and development of productive therapeutic relationships is unknown.…”

A structural model of treatment program and individual counselor leadership in innovation transfer

“…The project was structured as 2 phases. Effectiveness was examined in Phase 1 [29, 30]. Phase 2 examined implementation of TRIP in multiple juvenile-justice and community-based sites in the United States.…”

Mental Health and Substance-Related Treatment Utilization, Dropout, and Continuity of Care among Detained Adolescents: A 14-Year Longitudinal Study

“…(Becan, Knight, Crawley, Joe, & Flynn, 2014), the delayed timing for treatment utilization may reflect the longer time it takes youth to become ready and willing to participate in substance-related treatment. Alternatively, findings may be explained by the fact that effective mental health treatments (e.g.…”

“…Additionally, providers in the system and in the community may be more motivated to help DAs who are stuck in the revolving door of the juvenile justice via recidivism and/or re-detentions by getting them engaged in treatment services (Becan et al, 2014).…”