Multidimensional assessment of perceived treatment-entry pressures among substance abusers.

Abstract

Motivational assessment instruments typically measure clients' attributions about their readiness to change problem behaviors. They do not indicate why a client may be motivated to change, or provide guidance on how to retain an unmotivated client in treatment. The authors interviewed 415 substance abuse clients about their reasons for entering treatment and scored their responses along the dimensions of (a) negative versus positive treatment-entry pressures, (b) internal versus external sources of those pressures, and (c) the life domain from which the pressures emanated. Exploratory cluster analysis yielded 5 types of clients characterized by different profiles of perceived treatment-entry pressures. Cluster membership was predictive of treatment outcomes, and the clusters differed by demographic variables. These data support the discriminative and predictive utility of performing a multidimensional assessment of pressures to enter treatment.

Avaliação multidimensional do usuário de drogas e a Escala de Gravidade de Dependência

“…A maioria dos estudos, entretanto, refere-se a populações específi cas, não abordando a questão de forma mais ampla, didática e sistematizada [57][58][59][60][61][62][63][64][65][66][67] . A seguir são descritos os achados referentes aos elementos essenciais da avaliação do usuário de SPA, ilustrados pela apresentação de um caso clínico.…”

Compulsory Substance Abuse Treatment: An Overview of Recent Findings and Issues

“…While this substantive focus is certainly warranted, given the expansion of compulsory treatment policies in the USA, we suggest that additional research is required on formal (agency) and informal mandates. This is especially important, given emerging evidence that informal mandates play a very significant role in treatment entry for most individuals, including legally mandated clients [38][39][40][41].…”

“…They demonstrated that self-reported reasons for entering treatment can be reliably coded with regard to reinforcement schedule, social mediation and psychosocial domain. A later cluster-analytic study [39] provided suggestive evidence that treatment entry is associated with different coercion profiles across individuals and that these profiles may exhibit different relations with treatment response and outcome. Polcin and Weisner [40] developed an index of coercion by summing over questions asking participants to indicate whether any of 14 social control agents (spanning legal, formal and informal mandates) had given them an ultimatum to enter treatment.…”

Participation in treatment and Alcoholics Anonymous: A 16‐year follow‐up of initially untreated individuals

“…With respect to AA, providers can introduce patients to an AA sponsor or recovery guide, address potential barriers such as lack of transportation and childcare services, and maintain contact to enhance continuing attendance (Johnson & Chappel, 1994). More detailed assessments of clients' motivations and readiness for change in specific life domains may help to target high-risk individuals for these interventions (Brown, Melchior, Panter, Slaughter, & Huba, 2000;Marlowe et al, 2001). …”