title: Pathways to treatment retention for individuals legally coerced to substance use treatment: the interaction of hope and treatment motivation.
abstract: BACKGROUND
  Although several states have adopted policies diverting individuals convicted of non-violent drug offenses to substance use treatment, in lieu of incarceration or as a condition of probation, previous research has produced inconsistent findings on the effectiveness of such programs when comparing outcomes for legally coerced individuals to more voluntary entrants. Less studied in these populations is within group variation in treatment expectations and motivation influences, which have been shown to affect retention as well.
  
  
  METHODS
  As motivation has traditionally been viewed as contributing to treatment retention and higher levels of hope (the perception that goals can be met) are viewed as an asset in treatment, the role of these factors in predicting better retention between legally coerced and more voluntary clients were examined in a sample of 289 treatment admissions in California.
  
  
  RESULTS
  Results found that motivation mediates the relationship between hope and retention for participants in general. Although the differences in mediation between the legally coerced and the non-legally coerced were not significant, when examining the groups separately, there was a significant mediation of the relationship between hope and retention by motivation only for those individuals who were not legally coerced into treatment (p<.05).
  
  
  CONCLUSIONS
  The findings imply that while being legally coerced may lead to different pathways to treatment retention, for individuals who were not legally coerced, higher levels of hope may play an important role in determining treatment retention.
authors.affiliation: Temple University, Department of Psychology, Weiss Hall, 1701 North 13th St., Philadelphia, PA 19122, USA. ashleyhampton@temple.edu
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Hampton
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Conner
authors.forename: Dustin
authors.initials: D
authors.lastname: Albert
authors.forename: M Douglas
authors.initials: MD
authors.lastname: Anglin
authors.forename: Darren
authors.initials: D
authors.lastname: Urada
authors.forename: Douglas
authors.initials: D
authors.lastname: Longshore
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome