Why people enter treatment for alcohol problems: Findings from UK Alcohol Treatment Trial pre‐treatment interviews

Orford, Jim; Kerr, Cicely; Copello, Alex; Hodgson, Ray; Alwyn, Tina; Black, Rachel; Smith, Michael; Thistlethwaite, Gill; Westwood, Alison; Slegg, Gary

doi:10.1080/14659890500246540

Cited by 42 publications

(41 citation statements)

References 32 publications

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“…In addition, significant decreases in alcohol consumption are also noted several weeks before the phone call, suggesting that decision-making after seeing an advertisement for treatment may lead to successful behavior change (Sobell, 2011). Moreover, work by Orford and his colleagues (2006a;2006b) has identified several pretreatment change elements derived from qualitative interviews with clients, including thinking differently about the problem (e.g., weighing pros and cons), receiving encouragement for change from family and friends, a catalyst or clearly identified factor responsible for initiating change (e.g., negative alcohol-related event), the initial phone call, and finally, the baseline assessment. All of these elements are capable of promoting pretreatment changes in alcohol use and several are suggestive of a more natural or selfguided change process.…”

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confidence: 99%

Pretreatment Changes in Drinking: Relationship to Treatment Outcomes

Stasiewicz¹,

Schlauch²,

Bradizza³

et al. 2013

PsycEXTRA Dataset

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Pretreatment changes in alcohol use challenges the assumption that the major portion of the change process occurs after treatment entry. Greater understanding of the behavior change process prior to treatment has the potential to improve our understanding of behavioral changes during treatment. In this study, participants (N = 45) were recruited for a clinical trial examining multiple mechanisms of change in cognitive-behavioral treatment for alcohol dependence. Using data from both baseline and end of treatment assessments, several pretreatment intervals were created (e.g., a two-week pre-phone call interval, phone call to baseline assessment, baseline assessment to first treatment). To examine pretreatment changes in drinking, percent days abstinent and drinks per drinking day were analyzed using multi-level growth curve modeling and repeated measures ANOVAs. Initial examination of the data revealed significant increases in percent days abstinent and decreases in drinks per drinking day during the pretreatment intervals. Follow-up analyses also suggested that the majority of change in drinking occurs between the phone call and baseline assessment. Further examination of the data revealed two distinct patterns of pretreatment change: a) rapid changers who maintained changes during the course of treatment, and b) gradual changers who changed more gradually during the course of treatment. Analyses revealed that rapid changers had significantly higher rates of abstinence and lower drinks per drinking day at 90 days post-treatment compared to gradual changers. Overall, the data suggest that a more systematic investigation of pretreatment changes in alcohol use is warranted. Future studies may yield insights resulting in more efficient treatment delivery and adaptations to treatment based on an individual's pretreatment change status. Changes in addictive behavior frequently take place without professional treatment (Sobell et al., 1991). Indeed, unaided change may be more common than professionally-aided change in the case of alcohol problems (Sobell et al., 1996). Even among those who enter treatment, there is much in their accounts to suggest that a large component of the change process is self-directed (Orford et al., 2006a), with a few studies showing that significant changes in drinking occur prior to the first formal treatment session (e.g., Epstein et al., 2005; Sobell, 2011). As Orford (2006a) notes, these findings suggest that formal treatments are embedded within a much larger system of change-promoting elements occurring before, during, and after formal treatment. Furthermore, these data challenge the assumption that the majority of change occurs after treatment entry and suggests that behavior change must be examined through a broader lens (Willenbring, 2007). Although there is a wealth of research on behavioral change during and after treatment for alcohol use disorders, few studies have focused on pretreatment change, or change that occurs prior to the first formal treatment session. The aim o...

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confidence: 99%

Pretreatment Changes in Drinking: Relationship to Treatment Outcomes

Stasiewicz¹,

Schlauch²,

Bradizza³

et al. 2013

PsycEXTRA Dataset

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“…Among individuals with problematic substance use, stigma [50], and lack of willingness to change [51] have been suggested as barriers to substance abuse treatment whereas having hit the rock bottom [52] and formal and informal pressures [53] have been recognized as turning points to treatment, or treatment facilitators. Thus, both H-and L-participants of this study appear to be similar to other individuals with problematic substance use with regard to certain treatment perceptions.…”

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confidence: 99%

Perceptions of treatment among offenders with mental health problems and problematic substance use: The possible relevance of psychopathic personality traits

Durbeej¹,

Alm²,

Gumpert³

2014

OJPsych

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Substance abuse is related to re-offending, and substance abuse treatment may be effective in reducing criminal recidivism. Psychopathy, however, another factor that strongly correlates with re-offending, may be negatively associated with treatment utilization. This qualitative study explored perceptions of substance abuse treatment among offenders with mental health problems, problematic substance use, and various degrees of psychopathic personality traits. An Interpretative Phenomenological Analysis (IPA) revealed that some treatment perceptions may vary with degree of psychopathic traits. For instance, participants with low and high degrees of psychopathic personality traits had different views on treatment requirements imposed upon them. Many treatment perceptions were also similar between the two participant groups. Thus, treatment perceptions may not be explained by degree of psychopathic personality traits alone, but the presence of some particular psychopathic traits may be relevant in explaining certain treatment perceptions. The results highlight the complex relationship between the individual and the treatment system, and may give input to future studies on rehabilitation of offenders with multiple treatment needs.

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“…A variety of variables influence whether individuals seek help for substance abuse problems (Grant, 1997;Orford et al, 2006;Tsogia, Copello, & Orford, 2001;Tucker & King, 1999). First, there may be differences in availability and access to treatment due to geographical differences and personal resources (e.g., insurance, income).…”

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confidence: 98%

“…In the Rosen et al (2004) study of low-income women, a simple barrier index (i.e., no insurance, no car or license, no childcare, and less than GED education) predicted service utilization. Orford et al (2006) formulated a parsimonious model of help-seeking for alcohol problems in which growing problem recognition based on accumulating life/health problems combines with an acute triggering event or circumstance and/or external social influences.…”

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confidence: 99%