Willingness for treatment as a predictor of retention and outcomes.

Retention in drug treatment is important to successful outcomes. The purpose of this study was to test assumptions made in the development and implementation of the ASSET project. The three assumptions were that living conditions of the homeless adult drug user influence willingness for treatment; willingness relates to treatment tenure; and, conditions, willingness and time in treatment influence treatment outcomes. Data on alcohol use, drug use, employment and housing as well as motivation, readiness and suitability of treatment were collected from 494 homeless adults at baseline and at follow-up. Data were subjected to multivariate causal analysis using factor analytic structural equations modeling. Practical fit indices were acceptable. The measurement model confirmed a higher order construct labelled willingness encompassing motivation, readiness and suitability. The structural model demonstrated that willingness positively related to treatment tenure; willingness positively influenced change in drug use and housing; and, tenure related positively to change in housing.