INITIAL MOTIVATIONS FOR ALCOHOL TREATMENT - RELATIONS WITH PATIENT CHARACTERISTICS, TREATMENT INVOLVEMENT, AND DROPOUT

This study examines (a) the relation of initial treatment motivations to alcoholics' involvement in outpatient treatment and dropout and (b) the relations among patient characteristics, severity, alcohol expect ancies, motivation, and treatment retention. A treatment motivation qu estionnaire (TMQ) was developed to assess both internalized and extern al motivations for treatment, as well as confidence in the treatment a nd orientation towards interpersonal help seeking. In Study 1, the TMQ was administered to 109 outpatients entering an alcoholism clinic. Ba sed on these data the scale was revised and was administered to a subs equent sample of 98 subjects seeking treatment. Information about demo graphic variables, measures of substance use, alcohol expectancies, an d psychiatric severity was also gathered. Eight weeks after intake, ou tcome was evaluated through attendance records and clinician ratings. Results revealed that internalized motivation was associated with grea ter patient involvement and retention in treatment. Subjects high in b oth internalized and external motivation demonstrated the best attenda nce and treatment retention while those low in internalized motivation showed the poorest treatment response, regardless of the level of ext ernal motivation. Problem severity was also related to a greater degre e of internalized motivation. The importance of initial motivations in understanding treatment response and dropout is discussed.