Client's Perceived Need for Treatment and Its Impact on Outcome.

Objectives. Based on the concept of "stage of change," this study examines the relationship between patients' motivation for substance abuse treatment and their posttreatment improvements in the areas measured by the Addiction Severity Index (ASI; alcohol, drug, medical, psychiatric). We attempt to answer the following questions: Do clients' perceptions of "need for drug, alcohol, psychiatric, and medical treatment" at admission predict their improvements on these problems at 6-month follow-up? How do clients' perceived needs contribute to their use of treatment and their reported change? Methods. Clinical interview data (N = 696) collected using the ASI from the Target Cities Project in the city of Philadelphia in 1993 and 1995. Results. Clients' motivation made a substantial difference in their improvement following treatment in all problem areas. Clients who said treatment was even slightly important on the ASI at admission made more changes than clients who reported that treatment was "not at all" important. Even when the motivation groups were approximately equated for lifetime problem severity there was still a significant effect of recent motivation as expressed on the ASI. Conclusions. These data are consistent with other findings from the "stage of change" literature suggesting that treatment is only important for patients who are ready or at least somewhat motivated to receive it. These findings underscore the importance of efforts to increase patients' readiness for treatment in order to achieve better treatment effects.