Harford R J, Ungerer J C, Kinsella J K
Am J Psychiatry. 1976 Dec;133(12):1399-1404. doi: 10.1176/ajp.133.12.1399.
The authors found that four measures of legal pressure were either unrelated or negatively related to retention and outcome in five drug abuse treatment modalities. This suggests that nonvolunteer clients are likely to be insufficiently motivated to benefit fully from treatment and their presence may adversely affect staff morale and prognosis of volunteer clients. The authors recommend that legal pressure not be used as a basis for assigning applicants to treatment modalities and suggest that treatment outcome might be improved by procedures that 1) deal clinically with motivational differences between volunteers and nonvolunteers, 2) establish stricter motivational criteria for admitting nonvolunteers, or 3) encourage enforcement of existing sanctions against violations of stipulations to treatment.
作者发现,在五种药物滥用治疗模式中,四种法律强制手段与留存率及治疗效果要么无关,要么呈负相关。这表明非自愿接受治疗的患者可能动力不足,无法充分从治疗中受益,而且他们的存在可能会对工作人员的士气以及自愿接受治疗患者的预后产生不利影响。作者建议,法律强制手段不应作为将申请者分配到治疗模式的依据,并指出通过以下程序或许可以改善治疗效果:1)从临床角度处理自愿接受治疗者与非自愿接受治疗者之间在动力方面的差异;2)为接纳非自愿接受治疗者制定更严格的动力标准;或者3)鼓励对违反治疗规定的行为执行现有制裁措施。