How Important is Motivation Alcohol Treatment Outcomes?
Motivation is the general term for an inner drive or urge to do such things as meet a goal, make plans for the future and set limits on one’s behavior. Addiction specialists commonly note the importance of motivation as a factor in achieving successful outcomes while in recovery for drug- or alcohol-related issues. In a study published in March/April 2014 in the Journal of Addiction Medicine, a group of Swiss researchers used a questionnaire called the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) to assess the importance of initial motivation in the drinking-related outcomes of alcohol-dependent people who receive treatment in a residential setting.
Some people affected by serious problems with drugs or alcohol recognize the severity of those problems and express a self-generated desire to enter recovery and change. However, other people have mixed feelings about entering recovery or only consider seeking treatment because outside forces compel them to do so. Since motivation is typically viewed as a critical component in successful treatment, doctors and other treatment specialists often make efforts to improve their clients’/patients’ perspective on the recovery process. In fact, a psychotherapeutic technique called motivation enhancement therapy is specifically geared toward helping people affected by alcohol, cocaine or opioid addiction overcome their internal conflicts about entering treatment and engage more actively in the recovery process. During this therapy, clients/patients express their concerns, participate in motivation-building discussions and learn to cope with highly stressful situations that may tax their ability to stay motivated.
The Stages of Change Readiness and Treatment Eagerness Scale is specifically designed to help health professionals measure a person with serious drug or alcohol problems readiness to start altering his or her normal routine and participate in some sort of treatment. The questionnaire gathers information on three topics: the individual’s level of self-recognition about his or her dangerous substance intake, the individual’s level of ambivalence or uncertainty about entering treatment and the individual’s willingness to actively take steps and engage in the treatment process. The original version of SOCRATES used 32 questions to probe these issues; a shorter version of the questionnaire contains only 19 questions. In addition, there are gender-specific versions of SOCRATES.
Impact of Motivation
In the study published in the Journal of Addiction Medicine, the Swiss research team used the Stages of Change Readiness and Treatment Eagerness Scale to measure the level of treatment motivation in a group of 415 Swiss adults receiving treatment for alcohol dependence (i.e., alcoholism) in 12 separate residential programs. In addition, the researchers assessed the potential impact of a number of other factors, including the relative intensity of each participant’s alcoholism, level of alcohol intake prior to seeking treatment, the presence and relative intensity of any additional serious mental health concerns, gender, employment status and level of belief in the ability to abstain from alcohol use at the end of treatment.
One year after each participant completed residential treatment, the researchers used three measurements to assess the success of that treatment: the ability to abstain from consuming alcohol, the amount of alcohol consumed by those who did not completely abstain and the amount of time it took for any given participant to lapse back into alcohol use. After analyzing all of the relevant factors, the researchers concluded that those motivated individuals who initially expressed a willingness to take active steps in the recovery process experienced a relatively modest but meaningful improvement in their treatment outcomes. In addition, they concluded that those individuals who believe they can control their drinking behaviors at the end of treatment also have greater success in maintaining their long-term recovery.
Significance and Considerations
The authors of the study published in the Journal of Addiction Medicine note that two specific aspects of alcoholism recovery are impacted by strong initial motivation and a belief in self-control over alcohol intake: the ability to completely avoid alcohol use and the ability to limit the number of drinks consumed when abstinence is not maintained. All told, the authors emphasize the importance of the gains produced by active treatment motivation. They believe that treatment outcomes for people dealing with alcoholism or other substance addictions may be substantially improved by efforts to strengthen the particular aspect of motivation that leads people to take action on their own behalf.
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