Young adults undergoing addiction treatment arrive ready and willing to make the personal changes that bring about recovery, but it's the help and guidance received during treatment that build and sustain those changes, according to a longitudinal study published electronically and in press within the journal Drug and Alcohol Dependence. The study was conducted collaboratively by the Center for Addiction Medicine at Massachusetts General Hospital and Harvard Medical School and the Butler Center for Research at Hazelden.
"This study suggests that strong motivation to change may exist from the get-go among young adults with severe addiction problems entering residential treatment, but the know-how and confidence to change come through the treatment experience," explains John F. Kelly, Ph.D., of the Center for Addiction Medicine who authored the study with Center colleagues Karen Urbanoski, Ph.D., and Bettina Hoeppner, Ph.D., and Valerie Slaymaker, Ph.D., of the Butler Center for Research at Hazelden.
Analysis focused on 303 young adults, age 18-24, attending multidisciplinary, Twelve Step-based residential treatment for alcohol or other drug addiction. The study measured the subjects' levels of change during treatment in key areas, including motivation, psychological distress, coping skills and commitment to participation in mutual support groups such as Alcoholics Anonymous or Narcotics Anonymous. Self-efficacy, or a young person's confidence to stay clean and sober, was also assessed. Assessments were made at treatment intake, mid-treatment, at discharge and three months post-discharge.
When entering treatment, study participants reported high levels of motivation to remain abstinent but lower levels of coping skills, self-efficacy and commitment to mutual support groups. During-treatment increases in these measures predicted abstinence from alcohol or other drug use at three months post-treatment. Self-efficacy or increased confidence in ability to sustain recovery was the strongest predictor of abstinence.
Slaymaker of Hazelden adds, "The young people in our study were quite motivated to do well in treatment but lacked the confidence, coping skills, and commitment to AA that are critical to longer-term success. Treatment appears to work by increasing their confidence and ability to make and sustain healthy, recovery-related efforts."
The findings suggest residential treatment provides the boost that the young people need. By reducing their psychological distress, developing their recovery-focused coping skills, increasing their commitment to AA and other groups, and by enhancing their overall confidence to stay clean and sober, young people make meaningful changes in treatment that position them for improved outcomes. Because self-efficacy was a strong predictor of abstinence, it may serve as a useful clinical summary indicator to monitor change and relapse potential among young adults in treatment.
The study, titled "Ready, Willing, and (Not) Able to Change: Young Adults' Response to Residential Treatment," is published in Drug and Alcohol Dependence.
- J.F. Kelly, K.A. Urbanoski, B.B. Hoeppner, V. Slaymaker. “Ready, willing, and (not) able” to change: Young adults’ response to residential treatment. Drug and Alcohol Dependence, 2011; DOI: 10.1016/j.drugalcdep.2011.09.003
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