Implications of Family and Peer Relations for Treatment Engagement and Follow-Up Outcomes: An Integrative Model

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An integrative analytic model was proposed to explain deviance in terms of the family of origin, perceived peer and family relations, psychosocial functioning, motivation for treatment, and treatment engagement. The model was tested by using data from opioid-addicted persons who completed methadone treatment and were interviewed 1 year after discharge. The hypothesized model was shown to fit the data for outcomes at follow-up. A history of poor family relations was related to perceived family dysfunction and peer deviance at treatment entry; these 2 factors in turn predicted poor psychosocial functioning, which was related to higher levels of motivation. Higher motivation was associated with greater treatment engagement, which was associated with reduced opioid use and criminality. The importance of examining associations between family and peer relations and posttreatment outcomes within the context of treatment engagement is discussed.

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