Do Motivational Incentives Facilitate Drug Addiction Therapy?

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Abstract

Objectives:

Motivation to change behavior is an important therapeutic factor that affects treatment outcomes in patients with substance-use disorders. The motivation level influences treatment engagement, retention, and outcomes. Assessment of motivation is an important aspect of management of these patients.

Methods:

A total of 26 patients admitted in Kasr Al-Ainy Addiction Unit fulfilling Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria of one or more substance dependence disorder were included. Patients were assessed using the Stage of change readiness and the treatment-eagerness scale (SOCRATES) and Addiction Severity Index before attending 4 motivation-incentives group psychotherapy sessions: 1 session/week. Patients were reassessed using SOCRATES after the sessions.

Results:

SOCRATES increased 3 scales after the motivation-incentives groups; however, recognition and ambivalence scales showed significant increase (P=0.005 and 0.012, respectively), whereas the increase in the taking steps scale was not statistically significant, with P=0.125. A best-fit model of regression was calculated for factors that may predict SOCRATES before the group. Age of the patient, education years, main substance of abuse (either tramadol or other substances), history of suicide, previous treatment trial, positive or negative medical history, history of alcohol use, history of legal problems, presence of family issues, and psychiatric complications were predictors of the recognition, ambivalence, and taking steps components of motivation.

Conclusions:

Short-motivation incentives group therapy may improve the readiness to change in patients with polysubstance dependence.

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