Sung Hung-En, Belenko Steven, Feng Li, Tabachnick Carrie
The National Center on Addiction and Substance Abuse at Columbia University, 633 Third Avenue, New York, NY 10017-6706, USA.
J Subst Abuse Treat. 2004 Jan;26(1):315-28. doi: 10.1016/s0740-5472(03)00144-2.
Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.
遵守治疗方案是治疗参与的一个重要但很少被研究的前提条件,也是成功治疗的必要条件。本研究基于近期的治疗过程研究,对治疗依从性进行了理论驱动的分析。提出了五个假设来预测刑事司法强制要求的客户的治疗不依从情况。这些假设涉及治疗进展的不同决定因素,包括身体状态、支持性社会网络、传统社会参与、治疗动机和冒险倾向。对150名参与转处计划的成瘾重罪罪犯的数据进行了分析,以检验这些假设。与这些假设相关的预测因素正确识别出58%的完全依从客户和55 - 88%的不依从客户。大多数假设至少得到了部分证实,并且在各项分析中出现了一些强相关因素。发现身体状态处于最佳时期的客户、社会支持较差的客户以及缺乏内在改变愿望的客户尤其有可能违反治疗计划规则。讨论了临床意义。