Treatment motivation among caregivers and adolescents with substance use disorders

Abstract

Substance use disorders (SUDs) in adolescence have negative long-term health effects, which can be mitigated through successful treatment. Caregivers play a central role in adolescent treatment involvement; however, studies have not examined treatment motivation and pressures to enter treatment in caregiver/adolescent dyads. Research suggests that internally motivated treatment (in contrast to coerced treatment) tends to lead to better outcomes. We used Self-Determination Theory (SDT) to examine intersecting motivational narratives among caregivers and adolescents in SUD treatment. Relationships between motivation, interpretation of caregiver pressures, adolescent autonomy, and relatedness were also explored. Adolescents in SUD treatment and their caregivers (NDyads = 15) were interviewed about treatment experiences. Interviews were coded for treatment motivation, including extrinsic (e.g., motivated by punishment), introjected (e.g., motivated by guilt), and identified/integrated motivation (e.g., seeing a behavior as integral to the self). Internalization of treatment motivation, autonomy support/competence (e.g., caregiver support for adolescent decisions), and relatedness (e.g., acceptance and support) were also coded. Four dyadic categories were identified: agreement that treatment was motivated by the adolescent (intrinsic); agreement that treatment was motivated by the caregiver (extrinsic); agreement that treatment was motivated by both, or a shift towards adolescent control (mixed/transitional); and disagreement (adolescents and caregivers each claimed they motivated treatment; conflicting). Autonomy support and relatedness were most prominent in intrinsic dyads, and least prominent in extrinsic dyads. The mixed/transitional group was also high in autonomy support and relatedness. The extrinsic group characterized caregiver rules as an unwelcome mechanism for behavioral control; caregivers in the other groups saw rules as a way to build adolescent competence and repair relationships, and adolescents saw rules as indicating care rather than control. Adolescents with intrinsic motivations were the most engaged in treatment. Results suggest the importance of intrinsically motivated treatment, and highlight autonomy support and relatedness as mechanisms that might facilitate treatment engagement.

Parenting Styles and Aggressive Adolescents: Relationships with Self-esteem and Personal Maladjustment

“…Future studies should examine mechanisms that may be involved in this process. Additionally, campaigns aimed at training parents as psychosocial protective agents against adolescent aggressiveness, such as, for example media campaigns or family programs, should be informative (Cornelius, Earnshaw, Menino, Bogart, & Levy, 2017;Rinaldi & Farr, 2018). Specifically, interventions with aggressive adolescents and their parents should be focused on fostering a warmth relationship within the family, based on dialogue and affection, helping the aggressive adolescents to improve their family perceptions, as valued and appreciated members in home.…”

Redemption from plight: a qualitative study on reasons behind treatment decisions among Iranian male opioid users

“…A growing body of literature emphasizes the motives of treatment-seeking are of high importance in the treatment process [26,[28][29][30][31]. This matter has led to discussions about motive-based interventions [21,30,32].…”

Predictors of five-year relapse rates of youths with substance abuse who underwent a family-oriented therapy program

“…Having developed a rapport with the participants, the psychologists were able to learn how illicit drugs fitted into their lives. Feedback was the main counseling technique used during the meeting, in which the psychologists asked questions and the participants reflected their past in the hope to prompt the latter's self-motivational statements [18]. The focus of the treatment program was to identify the situations which had put the young participants at high risk for drug abuse, to enhance their motivation to abstain from substance abuse and to develop coping strategies to prevent relapse.…”

“…Substance abuse among young people has become a serious public health problem for years [1]. In the United States alone, 75.6% of young people under the age of 18 have admitted to use addictive substances (such as cigarettes, alcohol, marijuana and/or cocaine) at least once [2,3]. Recently, drug abuse among Taiwanese adolescents has also been on the rise [4,5], with ketamine, ecstasy and methamphetamine being the most popular illicit drugs [6][7][8].…”