Does Mandated Treatment Benefit Youth? A Prospective Investigation of Adolescent Justice System Involvement, Treatment Motivation, and Substance Use Outcomes.
Does Mandated Treatment Benefit Youth? A Prospective Investigation of Adolescent Justice System Involvement, Treatment Motivation, and Substance Use Outcomes.
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DOI：
10.1080/07347324.2013.831671
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发表时间：
2013-01-01
影响因子：
0.9
通讯作者：
Kelly JF
中科院分区：
文献类型：
--
作者：
Yeterian JD;Greene MC;Bergman BG;Kelly JF
在美国，大多数接受药物使用障碍（SUD）治疗的青少年现在都被刑事司法系统转介。然而，鲜为人知的是，关于如何司法系统的参与与青少年社区治疗的结果。司法系统的参与在多大程度上反映了缺乏治疗的内在动机，这一点也存在争议。本研究探讨了司法系统转介和报告的治疗进入的原因之间的关系，并测试在何种程度上预测治疗反应和结果。青少年门诊患者（N = 127; M年龄= 16.7，24%为女性），司法系统参与程度不同（即，无司法系统参与[No-JSI; n = 63]，司法系统参与[JSI; n = 40]，司法系统参与-授权[JSI-M; n = 24]）和动机水平（即，自我激励[n = 40]，外部激励[n = 87]）进行了比较。多水平混合模型测试了这些组在12个月内对戒酒天数百分比（PDA）和酗酒几率（HD）的影响。与No-JSI或JSI相比，JSI-M不太可能自我激励（p = 0.009）。相对于无JSI，JSI-M总体上具有更高的PDA，但随着时间的推移显著下降。自我激励的患者与PDA或HD的外部激励患者没有差异。强制青少年门诊患者报告自我激励治疗条目的可能性大大降低。尽管自我激励的治疗进入可能会产生更好的结果的概念，司法授权似乎预测一开始更强的治疗反应，虽然这随着时间的推移而减少。持续监测和/或治疗可能是必要的，以帮助维持对参与司法系统的青少年的治疗成果。
The majority of adolescents treated for substance use disorder (SUD) in the United States are now referred by the criminal justice system. Little is known, however, regarding how justice-system involvement relates to adolescent community treatment outcomes. Controversy exists, also, over the extent to which justice system involvement reflects a lack of intrinsic motivation for treatment. This study examined the relation between justice system referral and reported reason for treatment entry and tested the extent to which each predicted treatment response and outcome. Adolescent outpatients (N = 127; M age = 16.7, 24% female) with varying levels of justice-system involvement (i.e., no justice system involvement [No-JSI; n = 63], justice-system involved [JSI; n = 40], justice system involved-mandated [JSI-M; n = 24]) and motivation levels (i.e., self-motivated [n = 40], externally-motivated [n = 87]) were compared at treatment intake. Multilevel mixed models tested these groups’ effects on percent days abstinent (PDA) and odds of heavy drinking (HD) over 12 months. JSI-M were less likely to be self-motivated compared to No-JSI or JSI (p = 0.009). JSI-M had higher PDA overall, but with significant declines over time, relative to no-JSI. Self-motivated patients did not differ from externally-motivated patients on PDA or HD. Mandated adolescent outpatients were substantially less likely to report self-motivated treatment entry. Despite the notion that self-motivated treatment entry would be likely to produce better outcomes, a judicial mandate appears to predict an initially stronger treatment response, although this diminishes over time. Ongoing monitoring and/or treatment may be necessary to help maintain treatment gains for justice system-involved adolescents.