Changes in offender motivation during prison-based substance abuse treatment: evaluating individual paths and their relationships to treatment progress

Abstract

Introduction: Although much literature has evidenced the importance of intake motivation levels for substance abuse treatment, considerably less has evaluated treatment motivation longitudinally. The current study modeled motivation change using the well-established Texas Christian University Treatment Motivation scales and evaluated how these changes related to pre-treatment and during treatment factors. Method: A mixed-methods approach was used in which quantitative models of Treatment Motivation change were evaluated in relation to treatment progress measures; semi-structured interviews were used to collect qualitative data which provided context for the quantitative findings. Participants in both portions of the study were male and female, averaged around 35 years of age, and represented diverse races and ethnicities. Results: Quantitative findings showed that motivation change groups did emerge from the data but that these represented only about 5% of the total sample. Whereas available baseline indicators did not tend to predict whether or not an individual's motivation would change, we did find that motivation changes related to certain treatment progress measures (i.e., treatment engagement measures) in expected ways. Qualitative findings showed that motivation changed in both positive and negative directions and for a variety of reasons; these reports supplemented the quantitative findings. We developed a model from these reports illustrating common themes related to motivation change. Discussion: Although these findings provided some additional insights into changes in treatment motivation, we concluded that additional studies are necessary before making definitive conclusions. Clinicians are advised to interpret changes they see with current treatment motivation scales cautiously and couple them with clinical impressions.