Drug abuse treatment entry and engagement: Report of a meeting on treatment readiness

Abstract

Although the effectiveness of drug abuse treatment has been demonstrated repeatedly, many drug abusers do not enter treatment, many who do enter leave prematurely, and relapse following treatment is common. To further research treatment entry and engagement, the National Institute on Drug Abuse convened scientists representing diverse research traditions in December 1996. This article summarizes meeting presentations and recommendations. Presentations focused on treatment readiness/motivation for change, ethnographic reports of drug abusers' perceptions of and attitudes toward treatment, and reports on alternative treatments for high‐risk drug abusers. Recommendations focused on the potential contribution of qualitative research, integration of qualitative and quantitative research approaches, development of flexible treatment approaches that are cognizant of patients' life circumstances, and services research to improve the organization and delivery of drug abuse treatment. © 1999 John Wiley & Sons, Inc.; J Clin Psychol 55: 643–657, 1999.

The Relationship of Social Support to Treatment Entry and Engagement: The Community Assessment Inventory

“…This finding is consistent with previous research illustrating that greater levels of support from family and friends are associated with treatment motivation (12,4,36,13,37,14). Further, 31% of all out-of-treatment participants responded that they lived with someone who used drugs even once in a while, versus only 19% of all in-treatment participants, and nearly half of out-of-treatment participants responded that they had at least one friend who used drugs, compared with a little over a third of in-treatment participants.…”

“…Support from a relative or significant other at treatment entry has specifically been associated with lower heroin and alcohol use (9). Additional research has shown family support to be related to positive treatment outcomes (10,11), and that such support can influence recovery through motivation to change (12,13,14). Individuals may also experience fewer and less serious episodes of relapse when family is involved in treatment (2,3).…”

A Qualitative Exploration of Individuals’ Motivators for Seeking Substance User Treatment

“…During times when consumers in treatment appear unmotivated or ambivalent, the modes of entry and the focus on autonomy may help in targeting motivators that will offer more impact on recovery. Through a review of treatment entry recommendations, Battjes, Onken, and Delany (1999) found that both individuals entering treatment and clinicians will benefit from a better understanding of clients' motivations for seeking treatment rather than simply trying to meet the treatment program goals. These benefits may include an easier transition into services and a clearer understanding of long-term goals.…”

Predictors of motivation for abstinence at the end of outpatient substance abuse treatment

“…The stages of change theory provided the theoretical basis for Motivational Interviewing (Miller & Rollnick, 1991; Miller & Rollnick, 2002) and its manualized brief version, Motivation Enhancement Therapy (Miller, Zweben, DiClemente, & Rychtarik, 1992), both widely used and generally effective at fostering reductions in substance use (Babor & Del Boca, 2003; UKATT Research Team, 2005). A focused subset of models conceptually related to RTC have examined motivation for treatment more specifically and its relationship to treatment retention, engagement, and outcomes (Battjes, Onken, & Delany, 1999). These models include the TCU Treatment Motivation model that centers on stages of treatment readiness (Simpson & Joe, 1993) and the Circumstances, Motivation, Readiness, and Suitability model (CMRS; De Leon & Jainchill, 1986; De Leon, Melnick, & Kressel, 1997).…”