Relationship and institutional pressure to enter treatment: Differences by demographics, problem severity, and motivation
Relationship and institutional pressure to enter treatment: Differences by demographics, problem severity, and motivation
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DOI：
10.15288/jsad.2007.68.428
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发表时间：
2007-05-01
影响因子：
3.4
通讯作者：
Beattie, Martha
中科院分区：
文献类型：
--
作者：
Polcin, Douglas L.;Beattie, Martha
目的：研究表明，有物质使用问题的个人经常受到进入治疗的压力。压力可能来自机构（如刑事司法或福利）或关系（如家庭或朋友）。研究还表明，压力可以促进治疗进入。然而，很少有研究评估不同来源的压力是如何变化的。方法：698名因酒精或药物问题进入住院或门诊治疗的患者在入院后不久完成了面对面的访谈。通过询问参与者是否有其他人建议他们接受治疗，包括家人、朋友和机构内的专业人员，来评估压力。其他评估包括成瘾严重程度指数和改变的准备程度。结果：大多数参与者（73%）报告了某种形式的压力：29%来自个人关系，30%来自机构，14%来自两者。其余27%的人报告没有进入治疗的压力。对基线数据进行多项逻辑回归分析显示，假释或缓刑、非全职工作、法律问题更严重的人预示着来自机构的压力。相反，基线的关系压力是由酒精问题的严重程度来预测的。与只接受关系压力的参与者相比，那些只接受制度压力的参与者有更低的酒精、药物、家庭、精神和医疗严重程度。此外，制度压力与较低的动机相关，而关系压力与动机完全无关。当控制问题严重程度时，基线压力与12个月的结果无关。结论：来自机构的个人进入治疗的压力的相关因素与来自个人关系的进入治疗的压力的相关因素不同。讨论了这些发现对公共政策、治疗和进一步研究的意义。
Objective: Studies have shown that individuals with substance-use problems frequently receive pressure to enter treatment. Pressure can come from institutions (e.g., criminal justice or welfare) or relationships (e.g., family or friends). Research has also shown that pressure can facilitate treatment entry. However, few studies have assessed how pressure from different sources varies. Method: Six hundred ninety-eight individuals entering residential or outpatient treatment for alcohol or drug problems completed face-to-face interviews soon after admission. Pressure was assessed by asking participants if others had suggested they enter treatment, including family, friends, and professionals within institutions. Additional assessments included the Addiction Severity Index and readiness to change. Results: Most of the participants (73%) reported some type of pressure: 29% from personal relationships, 30% from institutions, and 14% from both. The remaining 27% reported no pressure to enter treatment. Multinomial logistic regression of baseline data showed being on parole or probation, not being employed full time, and having more severe legal problems predicted pressure from institutions. In contrast, relationship pressure at baseline was predicted by severity of alcohol problems. Compared with participants receiving only relationship pressure, those receiving only institutional pressure had lower alcohol, drug, family, psychiatric, and medical severity. In addition, institutional pressure was associated with lower motivation at baseline, whereas relationship pressure was not related to motivation at all. When controlling for problem severity, baseline pressure was not associated with 12-month outcome. Conclusions: Correlates of pressure from institutions for individuals to enter treatment differ from those associated with pressure from personal relationships to enter treatment. Implications of these findings for public policy, treatment, and further research are discussed.