Abstract

Clients are less likely to drop out of residential drug treatment programs prematurely when they are either internally motivated (i.e., having a high level of treatment readiness) or externally pressured by the legal system to enter, participate, and remain in treatment. However, little is known about the combined impact these factors have on treatment engagement and retention. This study focused on a national sample of 2,194 clients admitted to 18 long-term residential facilities. Although there was no significant interaction effect, findings indicated that clients with higher levels of treatment readiness at intake stayed in treatment at least 90 days, regardless of legal pressure. Likewise, those under legal pressure (defined by legal status and supervisory pressures) remained in treatment longer, regardless of treatment readiness. However, motivational readiness for treatment accounted for the greatest improvements in retention and, unlike legal pressure, was related to indicators of therapeutic engagement.

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