Barriers and Facilitators to Treatment Engagement Among Clients in Inpatient Substance Abuse Treatment

There is a call for drawing on client voice to provide a rich, nuanced understanding of factors influencing substance treatment engagement as to maximizing treatment benefits. We interviewed 60 clients in a short-term inpatient substance treatment program and examined facilitators and barriers to treatment engagement. Thematic analysis yielded four themes, including perceived treatment needs, trust and counselor rapport, peer inspiration, and organizational factors. Perceived treatment needs serve as both a facilitator and a barrier wherein the acknowledgment of needs led to greater treatment engagement whereas a lack of perceived needs hindered treatment engagement. The establishment of trust and counselor rapport and peer inspiration facilitated treatment engagement. Clients rated several organizational factors including a lack of treatment provision, gender-responsive treatment and infrastructure, and ineffective communication with nonclinical staff as barriers to treatment engagement. Clinical implications include enhancing treatment motivation and counselor rapport, establishing gender-responsive treatment programs, and providing trainings for staff.

Download Full-text

Gender Differences in Treatment Engagement Among a Sample of Incarcerated Substance Abusers

Criminal Justice and Behavior ◽

10.1177/0093854807304347 ◽

2007 ◽

Vol 34 (9) ◽

pp. 1143-1156 ◽

Cited By ~ 30

Author(s):

Michele Staton-Tindall ◽

Bryan R. Garner ◽

Janis T. Morey ◽

Carl Leukefeld ◽

Jennifer Krietemeyer ◽

...

Keyword(s):

Gender Differences ◽

Drug Abuse ◽

Substance Abusers ◽

Negative Relationship ◽

Treatment Engagement ◽

Treatment Programs ◽

Psychosocial Variables ◽

Criminal Thinking ◽

Psychosocial Dysfunction ◽

Abuse Treatment

This article examines gender differences in treatment engagement, psychosocial variables, and criminal thinking among a sample of male and female substance abusers ( N = 2,774) enrolled in 20 prison-based treatment programs in five different states as part of the National Institute on Drug Abuse—funded Criminal Justice Drug Abuse Treatment Studies cooperative agreement. Results indicate that inmates in female treatment programs report more psychosocial dysfunction, less criminal thinking, and higher engagement than in male facilities, and there is a more negative relationship between psychosocial variables and treatment engagement (compared to male programs). Only one subscale of criminal thinking had a significant gender interaction, with males having a significantly stronger relationship between cold-heartedness and low treatment engagement. Implications for treatment interventions with a gender-specific focus are discussed.

Download Full-text

Findings from a Process Evaluation of a Statewide Residential Substance Abuse Treatment Program for Youthful Offenders

The Prison Journal ◽

10.1177/0032885501081002006 ◽

2001 ◽

Vol 81 (2) ◽

pp. 246-270 ◽

Cited By ~ 6

Author(s):

DANIEL P. MEARS ◽

WILLIAM R. KELLY ◽

EMILY D. DURDEN

Keyword(s):

Process Evaluation ◽

Treatment Program ◽

Chemical Dependency ◽

Treatment Programs ◽

Treatment Needs ◽

Substance Abuse Treatment Program ◽

Chemical Dependency Treatment ◽

Youthful Offenders ◽

Abuse Treatment ◽

Process Evaluations

Despite the critical importance of process evaluations to enhancing the efficiency and long-term effectiveness of chemical dependency treatment programs, attention to process-related dimensions of treatment programming has been largely neglected. Using data collected on youthful offenders with chemical dependency treatment needs in the Texas Youth Commission, this article provides a systematic and empirical process evaluation of factors associated with successful program progress in the Texas Youth Commission's Chemical Dependency Treatment Program. Analyses focus on appropriate program placement and whether and to what extent risk, dynamic or criminogenic need, behavioral, and treatment amenability factors are related to several key measures of program progress—including completion or expulsion, days to completion or expulsion, and performance—as well as to variation among these outcomes across treatment sites. Policy and research implications of these analyses and of process evaluations are discussed.

Download Full-text

Tempest in a TC

Criminal Justice and Behavior ◽

10.1177/0093854807304349 ◽

2007 ◽

Vol 34 (9) ◽

pp. 1168-1178 ◽

Cited By ~ 11

Author(s):

Christine A. Saum ◽

Daniel J. O'Connell ◽

Steven S. Martin ◽

Matthew L. Hiller ◽

Grant A. Bacon ◽

...

Keyword(s):

Transition Planning ◽

Treatment Programs ◽

State Agencies ◽

Treatment Motivation ◽

Treatment Readiness ◽

Treatment Providers ◽

Treatment Facilities ◽

New Treatment ◽

Using Data ◽

Abuse Treatment

Corrections officials frequently use private contractors to operate in-prison, therapeutic community (TC) treatment programs. However, the recurrent competitive bidding process inherent in state agencies contracting for services sometimes results in a treatment-provider change. Few studies have focused on whether this change leads to better or worse treatment motivation and engagement for clients and how it might be evaluated. Using data collected during the larger Criminal Justice Drug Abuse Treatment Studies Performance Indicators for Corrections study, quantitative assessments of client functioning were made at two points in time. Changing to new treatment providers in three in-prison TC treatment facilities caused significant disruptions, leading to decreased client—counselor rapport and peer support as well as lower levels of treatment readiness, participation, and satisfaction of clients. Qualitative client and staff interviews provided further insight relevant for correctional administrators and treatment providers who may be considering similar changes. General recommendations for provider transition planning are offered.

Download Full-text

Substance-Involved Women Inmates: Challenges to Providing Effective Treatment

The Prison Journal ◽

10.1177/0032885599079001003 ◽

1999 ◽

Vol 79 (1) ◽

pp. 23-44 ◽

Cited By ~ 44

Author(s):

JORDON PEUGH ◽

STEVEN BELENKO

Keyword(s):

Substance Abuse ◽

Women Inmates ◽

Recovery Process ◽

Treatment Programs ◽

Treatment Needs ◽

Family Responsibilities ◽

Sexually Transmitted ◽

And Gender ◽

State Prisons ◽

Abuse Treatment

This article describes the substance involvement and treatment needs of women in state prisons. Women are a rapidly growing portion of the inmate population, largely due to drug law violations and substance abuse problems. However, few receive comprehensive substance abuse treatment while incarcerated. When treatment is available, it is often not adequate to meet the manifold needs of this population: Poor health, risk of sexually transmitted diseases (STDs) and HIV, psychological problems, histories of victimization, family responsibilities, and a lack of marketable employment skills greatly complicate their recovery process. Treatment programs for women inmates should be greatly expanded and need to be intensive, comprehensive, and gender specific. Such intensive treatment, especially when combined with aftercare, can reduce recidivism and assist women in becoming contributing members of their families and communities.

Download Full-text