Predicting Incentives to Change Among Adolescents with Substance Abuse Disorder

Abstract

While interest in understanding the incentives to change amongindividuals with substance abuse disorders is growing, little is knownabout incentives among adolescents with substance abuse disorders whoare participating in formal services. The present research assesses thedegree and nature of motivation and treatment readiness amongadolescents admitted to substance abuse services, and whether suchfactors vary across significant subgroups of youth based on their social,legal, or clinical profiles. Data are based on interviews with 249 youthbetween 12 and 18 years of age who have been admitted to eitherinpatient, residential, or outpatient substance abuse treatment. Measuresare adapted from an instrument developed to assess multiple domains ofmotivation to change (e.g., intrinsic and extrinsic motivation, treatmentreadiness). Results suggest that the incentive to change amongadolescents with substance‐abusing behavior is modest at best,regardless of dimension. Nonetheless, ethnicity, type of substance use,and psychopathology significantly predict incentives to change, thoughthe predictors depend on which dimension is considered. The mostrobust predictor of incentives is the severity of negative consequencesassociated with youth's substance use—the greater the severity, thegreater the incentives. Findings underscore the need to examine theutility and dimensionality of incentive for treatment planning, while atthe same time, they identify factors that treatment planners can consideras they seek ways to enhance incentives and help adolescents withsubstance use disorders attain positive outcomes.