Community Corrections Report Volume: 11 Issue: 2 Dated: January/February 2004 Pages: 5-6,19,20
This first part of a three-part series addresses the issues involved in moving coerced drug-treatment clients from external motivation for treatment to internal motivation for change through the use of a cognitive tool called the Addiction/Offender Cycle.
DiClemente (1999) has noted that although drug abusers have been found to respond positively to external incentives for treatment, such as monetary rewards and avoidance of punishment, these incentives generally produce only short-term positive results, such as temporary abstinence or better participation. He notes that although court-mandated treatment can provide powerful incentives and elicit motivation to attend treatment, attendance at treatment does not mean that the individual is motivated to change the substance-abusing behavior. Motivation for change is a dynamic state that is subject to fluctuation and is amenable to the influence of contextual factors. Further, there is a significant difference between external motivation for treatment and internal motivation for change. Studies have shown that upon entering treatment, clients are more often motivated by external or imposed factors, rather than by an internal desire for change. Treatment providers, on the other hand, focus on a change agenda that encourages either reactance or compliance for the sake of "getting by." This results in clients not only failing to move from external motivation for treatment to internal motivation for change, but may even reduce the client's interest in the external motivating factors. The client may move toward an internal state of silent resistance to change. An important aspect of treatment is to guide the client toward a waning of external motivations for treatment to be replaced by more internal motivation, such that incentives for change are "owned by the individual" and "become integrated into the life of the individual." The remaining two articles in this series will explain how this can be done. 7 references
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