Pathways to treatment retention for individuals legally coerced to substance use treatment: The interaction of hope and treatment motivation

Although several states have adopted policies diverting individuals convicted of non-violent drug offenses to substance use treatment, in lieu of incarceration or as a condition of probation, previous research has produced inconsistent findings on the effectiveness of such programs when comparing outcomes for legally coerced individuals to more voluntary entrants. Less studied in these populations is within group variation in treatment expectations and motivation influences, which have been shown to affect retention as well. As motivation has traditionally been viewed as contributing to treatment retention and higher levels of hope (the perception that goals can be met) are viewed as an asset in treatment, the role of these factors in predicting better retention between legally coerced and more voluntary clients were examined in a sample of 289 treatment admissions in California. Results found that motivation mediates the relationship between hope and retention for participants in general. Although the differences in mediation between the legally coerced and the non-legally coerced were not significant, when examining the groups separately, there was a significant mediation of the relationship between hope and retention by motivation only for those individuals who were not legally coerced into treatment (p\u3c.05). The findings imply that while being legally coerced may lead to different pathways to treatment retention, for individuals who were not legally coerced, higher levels of hope may play an important role in determining treatment retentio

Pathways to treatment retention for individuals legally coerced to substance use treatment: The interaction of hope and treatment motivation

Although several states have adopted policies diverting individuals convicted of non-violent drug offenses to substance use treatment, in lieu of incarceration or as a condition of probation, previous research has produced inconsistent findings on the effectiveness of such programs when comparing outcomes for legally coerced individuals to more voluntary entrants. Less studied in these populations is within group variation in treatment expectations and motivation influences, which have been shown to affect retention as well. As motivation has traditionally been viewed as contributing to treatment retention and higher levels of hope (the perception that goals can be met) are viewed as an asset in treatment, the role of these factors in predicting better retention between legally coerced and more voluntary clients were examined in a sample of 289 treatment admissions in California. Results found that motivation mediates the relationship between hope and retention for participants in general. Although the differences in mediation between the legally coerced and the non-legally coerced were not significant, when examining the groups separately, there was a significant mediation of the relationship between hope and retention by motivation only for those individuals who were not legally coerced into treatment (p\u3c.05). The findings imply that while being legally coerced may lead to different pathways to treatment retention, for individuals who were not legally coerced, higher levels of hope may play an important role in determining treatment retentio

Developmental Considerations for Substance Use Interventions From Middle School Through College

This article summarizes a symposium organized by Dr. Elizabeth D’Amico and presented at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, Canada. The four presentations illustrate the importance of creating substance use interventions that are developmentally appropriate for youth. They represent innovative approaches to working with preteens, teenagers, and young adults. Dr. D’Amico’s paper describes her research on the development of a voluntary brief intervention targeting alcohol use among middle school students. Findings indicated that by using school and community input, she was able to obtain a diverse a sample of youth across grades, sex, ethnicity, and substance use status. Dr. Ellickson’s paper describes her research on Project ALERT, a school-based prevention program for middle school youth. Her findings indicate that Project ALERT worked for students at all levels of risk (low, moderate, and high) and for all students combined. Dr. Wagner’s Teen Intervention Project was a ran-domized clinical trial to test the efficacy of a standardized Student Assistance Program for treating middle and high school students with alcohol and other drug problems. The study provided a unique opportunity to begin to examine how development may impact response to an alcohol or other drug intervention. Dr. Turrisi’s paper examined processes underlying the nature of the effects of a parent intervention on college student drinking tendencies. Findings suggested that the parent intervention seems to have its impact on student drinking by reducing the influence of negative communications and decreasing the susceptibility of influences from closest friends. Dr. Kim Fromme provided concluding remarks

Habit, Intention, and Drug Use as Interactive Predictors of Condom Use Among Drug Abusers

This three-wave study explored the prospective effects of habit (previous condom use), intentions to use condoms, past and proximal (before sex) drug use (alcohol, marijuana, cigarette, and hard drug use), and interactions among these variables on condom use among 211 men and women intravenous drug users. Several theoretical alternatives were evaluated. In one alternative, habit is thought to have preeminence over intentions and other variables in the prediction of behavior. In another alternative, drug use is thought to interact in its effects on condom use, by making individuals susceptible to not adhering to their previous intentions regarding safe sex practices. The results showed that condom use habit was a consistent and strong predictor of future condom use, whereas intention was a weak and inconsistent predictor. Neither past (long-term) nor proximal (before sex) drug use moderated (interacted with) the effects of either intention or habit on later condom use. The preeminence of habit in the prediction of condom use is similar to findings from other areas of health behavior, underscoring the need for more focused research on the underpinnings of health habit effects

Motivation to stop substance use and psychological and environmental characteristics of homeless women.

Characteristics associated with wanting to permanently quit their alcohol, cocaine or heroine use were examined in 748 homeless women. Only a third of Latinas wanted to stop using alcohol; they were also at relatively high risk for continued heroine use. Recognition that their substance use was an extremely serious problem was a consistent predictor of wanting to quit substance use. Other important predictors of desiring to quit two substances included not hanging out with other drug users, lifetime hospitalization for drug use and recent substance use treatment. Findings from this study may be helpful for selecting relative good candidates for the limited number of substance abuse treatment slots available for homeless women and providing supplementary assistance to those already in treatment

Motivation to stop substance use and psychological and environmental characteristics of homeless women.

Characteristics associated with wanting to permanently quit their alcohol, cocaine or heroine use were examined in 748 homeless women. Only a third of Latinas wanted to stop using alcohol; they were also at relatively high risk for continued heroine use. Recognition that their substance use was an extremely serious problem was a consistent predictor of wanting to quit substance use. Other important predictors of desiring to quit two substances included not hanging out with other drug users, lifetime hospitalization for drug use and recent substance use treatment. Findings from this study may be helpful for selecting relative good candidates for the limited number of substance abuse treatment slots available for homeless women and providing supplementary assistance to those already in treatment