Legal Mandates and Perceived Coercion in Residential Alcohol and Other Drug Treatment

Rourke, Poppy; Howard, John; Martire, Kristy A.

doi:10.1080/13218719.2014.986839

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…Regarding the success of forced treatments, " Rourke et al (2015)" examined the effect of family and legal coercion on permanence in treatment in patients addicted to alcohol and other drugs. This study found that none of the sources of coercion had an effect on the patient's willingness to participate or remain in treatment.…”

Section: Discussionmentioning

confidence: 99%

“…This study found that none of the sources of coercion had an effect on the patient's willingness to participate or remain in treatment. Rourke, Howard and Martir (2015), speculate that family pressure may in some cases be interpreted by addicts as positive (supportive, inspiring) and in others as negative (lack of understanding, high expectations). The negative effect of social support is similar to what is referred to in the literature as codependency.…”

Section: Discussionmentioning

confidence: 99%

“…Unaware of their own problems, addicts may suffer from lack of motivation to initiate treatment, fail to use recommended compensatory strategies, establish unrealistic goals, or experience problems of social readjustment (Verdejo, et al, 2002). Nevertheless, there is some evidence suggesting that forced treatment can be effective in promoting acceptance of responsibility for improving life habits and increasing the likelihood of remaining in treatment (Inciardi et al, 2004;Rourke et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Perceived social support as predictor of treatment completion in methamphetamine dependent individuals

Arreola

Vargas

Domínguez

et al. 2019

RIIAD

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Introduction: perceived social support (PSS) is considered an important factor to lessen the negative effects of stressful events. Likewise, the literature suggests a beneficial impact on the evolution of different diseases. However, little is known about the relationship between PSS and treatment completion in methamphetamine-dependent individuals who receive help in a forced manner. Objective: to evaluate the effect of perceived social support (PSS) on treatment completion in methamphetamine-dependent individuals. Methods: prospective study with a cohort of 67 men on whom PSS, addiction severity, anxiety, and depression were assessed. Results: analysis of variance of prospectively obtained data showed that age, years of drug use, and PSS differed between those who completed the treatment and those who did not. Logistic regression analysis showed that increases in PSS (Odds Ratio, OR = .970, Confidence Interval - CI 95 % = .943 - .999) were predictive of a decrease in the probability of completing the treatment, while age had the opposite effect (OR = 1.117, CI 95 % = .1.027 - 1.215). Discussion and conclusion: these results show that the role of social support in the treatment of chronic conditions is complex and suggest the need to study the nature and quality of the social interactions that lead to therapeutic success.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perceived social support as predictor of treatment completion in methamphetamine dependent individuals

Arreola

Vargas

Domínguez

et al. 2019

RIIAD

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“…The role of having a referral from the criminal justice system appears to have mixed results in the literature, as Mutter et al (2015) found this type of referral to be associated with higher odds of completing treatment. Interestingly, Rourke et al (2015) found that treatment engagement was related to motivation, self-efficacy, and peer support, suggesting that an interaction may exist between contextual variables and various treatment outcomes.…”

Section: Contextual Factorsmentioning

confidence: 99%

Recovery Within a Community-based Residential Treatment for Substance Use Problems: Program Theory Development and the Impact of COVID-19

Mutschler

2024

Preprint

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<p>Community-based residential treatment for substance use disorders (SUDs) has mixed effectiveness in reducing substance use and substance-related problems, which has been hypothesized to be due to the variability of program offerings across treatments. Further, due to the recent COVID-19 pandemic, community-based residential treatment centres have had to adapt their programming in order to follow necessary infection control mandates, leading to considerable changes in programming. The purpose of the present dissertation was twofold: 1) to develop a realist program theory of a community-based residential treatment centre in order to understand what components of treatment are most effective, who benefits from treatment, and why; and 2) to document and synthesize the experiences of stakeholders at a treatment centre during COVID-19. The present dissertation was completed in collaboration with Renascent, a community-based residential treatment program located in Toronto, Canada. In order to meet the first purpose, a realist evaluation was conducted using qualitative interviews (N=27) with program stakeholders. The results of the thematic analysis identified four overarching organizational contexts and 11 Context-Mechanism-Outcome (CMO) configurations that comprise the program theory. The CMOs were grouped into three themes (i.e., relational, psychological, and diversity), underscoring the multiple pathways in which recovery is achieved for individuals with SUDs. Study two involved a qualitative investigation of the experiences of key stakeholders at the treatment centre during COVID-19 using an inductive approach. Interviews were conducted with stakeholders (N=13) and analyzed using thematic analysis. The interviews and subsequent analysis identified a number of themes (i.e., service accessibility, difficulties with interpersonal connection, and increased stress experienced by frontline staff). Across the two studies, the importance of building peer recovery relationships, creating structure, and inter-agency collaborations was highlighted. The results of both studies provide a template as to how implementation of novel practices can occur and how tensions can be overcome through collaboration. The results of the present dissertation offer a significant contribution to the literature in understanding how, why, and for whom community-based residential treatment for SUDs is effective, while also providing timely data on the experiences of attending and implementing treatment during a pandemic.</p>

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“…Now that therapies that break addictions are being developed, what is the subjective experience of freedom of those who are compelled to "get clean"? Poppy Rourke et al 11 found that addicts sent to treatment by the court were no different in their engagement with their recovery than those who went voluntarily, and the experience of "drug courts" mandating treatment suggests that they are effective in reducing drug use and recidivism. 12 As Arthur Caplan 13 concludes, "Mandatory treatment which relieves the coercive effects of addiction and permits the recreation or re-emergence of true autonomy in the patient can be the right thing to do.…”

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confidence: 99%

Commentary: Freedom Means Self-Awareness and Self-Control: Bioenhancement Can Help

Hughes¹

2017

Camb Q Healthc Ethics

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There are three basic forms of power in society: overt coercion, remuneration, and persuasion. Overt coercion, when our goals and interests are clear to ourselves and we are forced to other ends, is the most obvious affront to free will. Remuneration changes our behavior by offering us something we want more. Persuasion is the most opaque form of power, because we are convinced that we are acting freely but actually are pursuing others' ends. It is only the unconscious manipulation of persuasion that undermines our sense of free will. The gun or the pile of cash may force us to act against our desires, but we still know what they are. Freedom from persuasion requires becoming aware of our own minds, and strengthening the mental faculties that contribute to the useful illusion of free will. The question posed by this commentary is whether people in general can be coerced toward this subjective freedom by force, cash, or persuasion. Society is more interested in encouraging conformity than self-awareness, but when we encourage one another to become more self-aware and self-governed, we support one another toward freedom from automaticity. Raising a child is an exercise of coercion that inevitably involves encouraging conformity and automaticity, as well as mature self-awareness and decisionmaking. Distinguishing the social pressures that encourage self-awareness from those that discourage it will become even more important in the era of moral enhancement. Raki ć and I agree that voluntary moral enhancement is desirable, and that involuntary moral enhancement contributes to the subjective freedom of mentally ill adults. However, in arguing that moral enhancement must be voluntary for everyone else, Raki ć is attempting to defend a reifi ed conception of free will that, in my view, is at odds with both material and political reality. Raki ć even concedes that his threshold conception of free will is an illusion, but insists that it is a necessary illusion, and one so fragile that it evaporates whenever externally encouraged. Although I agree that he is correct that we appear to be enabled by the myth of free will, we are enabled by degrees, and not across a binary threshold. Nor are any of us ever free of the pressures to be more subjectively automatic or free; we are always surrounded by guns, money, and opinions. Raki ć points to the research of Davide Rigoni et al., 1 Kathleen Vohs and Jonathan Schooler, 2 and Roy Baumeister et al., 3 which suggests that belief in free will enables self-control and moral behavior. But these free will researchers were precisely not looking for a binary, threshold effect. Both the Rigoni et al. and the Vohs and Schooler

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Legal Mandates and Perceived Coercion in Residential Alcohol and Other Drug Treatment

Cited by 5 publications

References 41 publications

Perceived social support as predictor of treatment completion in methamphetamine dependent individuals

Perceived social support as predictor of treatment completion in methamphetamine dependent individuals

Recovery Within a Community-based Residential Treatment for Substance Use Problems: Program Theory Development and the Impact of COVID-19

Commentary: Freedom Means Self-Awareness and Self-Control: Bioenhancement Can Help

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