Doctor of Philosophy

Abstract

dissertationSubstance abuse treatment agencies increasingly work with clients who are mandated to treatment by the criminal justice system. This trend has necessitated a better understanding of the impact of clients' subjective perceptions of coercion on motivation for treatment and recovery. The present study utilized a mixed methods approach to understand the impact of both perceived coercion and empowerment on motivational processes for adults ordered by the criminal justice system to attend substance abuse treatment. Data were collected from 98 adults ordered to undergo assessment and treatment for substance abuse problems as the result of a drug-related offense. It was hypothesized that perceived coercion and empowerment would be negatively correlated. While these variables were negatively correlated, they value of the correlation was not significant. It was also hypothesized that perceived coercion and empowerment would predict motivational processes, including motivational readiness-to-change levels and whether or not motivation was internalized. Multiple and logistic regression analyses indicated that, as hypothesized, perceived coercion was a significant predictor of these processes: Higher perceived coercion predicted lower motivation levels and noninternalized motivation. Contrary to this hypothesis, however, empowerment was not a significant predictor of motivational processes. A grounded theory analysis of 11 participant interviews (from the original sample of 98 participants) resulted in the emergence of 6 themes that further developed the relationship among perceived coercion, empowerment, and motivation. The grounded theory model provided good validation of the statistical findings, suggesting that when participants spoke of feeling coerced into treatment, they spoke of a negative impact on motivation. However, the majority of interviewees, regardless of their feelings about the court order, had high expectations for treatment and anticipated addressing mental health issues and other "tools" of treatment. In further support of the statistical findings, interview participants also had a difficult time describing empowerment as impacting motivation. Instead, many participants suggested that as they worked toward recovery, which reflected a foundation of motivation, they often felt more empowered as a result

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