Factors that Affect Treatment Expectations of Outpatients with Substance Use Problems

Abstract

The study assessed treatment expectations (TE) of outpatients with substance use problems as well as factors that affect their TE. Participants were 200 outpatients presenting at three community based substance abuse treatment services. Results of general linear modelling analyses showed that outpatients with substance use problems have higher expectations about their personal contribution to the counseling process (i.e., expected to be motivated, open and responsible in counseling) and the facilitative conditions that exist in the counseling environment. In comparison, they had significantly lower expectations about clinicians’ expertise (m diff = .75 and .58, p < .001 compared to personal contribution and facilitative conditions, respectively) and clinicians’ nurturance (warmth and comfort) levels (m diff = .73 and .57, p < .001 compared to personal contribution and facilitative conditions, respectively). Females had significantly higher TE in relation to personal contribution, F(1,184) = 20.76, p < .001 and facilitative conditions, F(1,184) = 7.76, p < .01 than males. Males, individuals reporting more than one substance of concern, younger clients and individuals reporting no previous substance abuse treatment tend to underestimate level of motivation needed to contribute to counseling outcome. Individuals with extremely severe stress levels had higher clinician related expectations which include clinician expertise, genuineness, and warmth than those without such stress levels. These findings identify groups of clients that may need to be educated about specific aspects of the process of counseling early in the therapy process.