The Survey of Treatment Entry Pressures (STEP): identifying client's reasons for entering substance abuse treatment.
OBJECTIVE
Systematically identifying reasons that clients enter substance abuse treatment may allow clinicians to immediately focus on issues of greatest relevance to the individual and enhance treatment engagement. We developed the Survey of Treatment Entry Pressures (STEP) to identify the specific factors that precipitated an individual's treatment entry. The instrument contains 121 items from 6 psychosocial domains (i.e., family, financial, social, medical, psychiatric, legal). The current study examined the STEP's psychometric properties.


METHODS
A total of 761 participants from various treatment settings and modalities completed the STEP prior to treatment admission and 4-7 days later. Analyses were performed to examine the instrument's psychometric properties including item response rates, test-retest reliability, internal consistency, and factor structure.


RESULTS
The items displayed adequate test-retest reliability and internal consistency within each psychosocial domain. Generally, results from exploratory and confirmatory factor analyses support a 2-factor structure reflecting type of reinforcement schedule.


CONCLUSIONS
The study provides preliminary support for the psychometric properties of the STEP. The STEP may provide a reliable way for clinicians to characterize and capitalize on a client's treatment motivation early on which may serve to improve treatment retention and therapeutic outcomes.
Treatment Research Institute.
Karen Leggett
KL
Dugosh
David S
DS
Festinger
Kevin G
KG
Lynch
Douglas B
DB
Marlowe
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D011594:Psychometrics / Q000295:instrumentation*; D019966:Substance-Related Disorders / Q000628:therapy*; D011795:Surveys and Questionnaires / Q000592:standards*
coercion; drug abuse; engagement; psychometrics; substance abuse treatment