“This Treatment Can Really Help Me”—A Longitudinal Analysis of Treatment Readiness and Its Predictors in Patients Undergoing Alcohol and Drug Rehabilitation Treatment
Abstract
Background
There is evidence that patients entering alcohol or drug treatment have different levels of treatment readiness and change their motivation differently over time. Nonetheless, existing studies mainly use single measures of motivation and do not consider individual differences. This study addresses 2 questions: (i) How does treatment readiness change in patients with alcohol and drug use dependence over the course of an inpatient rehabilitation treatment?; and (ii) Can changes in treatment readiness be explained by sociodemographic and substance use-related characteristics?
Methods
Data from 177 alcohol-dependent patients and 152 drug-dependent patients were collected in 2 inpatient rehabilitation centers in Germany. Three single-item indicators of treatment readiness were assessed weekly over the course of the treatment. Sociodemographic and substance use-related characteristics were assessed at baseline. To model developments of treatment readiness that may be different for each patient, multilevel analyses for longitudinal data were used.
Results
The overall effect of time on treatment readiness was not significant, indicating that average motivation across all patients did not change over the course of the treatment. However, individuals showed different initial states and different rates of change. School education, employment status, earlier substance use treatments, and craving predicted treatment readiness. Interactions with time were found for craving and marital status.
Conclusions
The results suggest that it is necessary to consider individual differences when evaluating treatment motivation in alcohol- and drug-dependent patients. The identification of variables predicting motivation may help to improve substance abuse treatment contents and outcomes.
Graphical Abstract
The present study assessed treatment readiness in the course of an in-patient rehabilitation program for alcohol- and drug-dependent clients. It became evident that most of the variance in treatment readiness was between individuals, whereas a smaller part was variance between measurement occasions. Temporal changes thus only played a subordinate role, whereas differences between individuals were more important. An important factor showing both main and interaction effects on treatment readiness was craving.
