PERCEIVED COERCION AMONG CLIENTS ENTERING SUBSTANCE-ABUSE TREATMENT -STRUCTURAL AND PSYCHOLOGICAL DETERMINANTS

Little is known about the extent to which admission to alcohol and oth er drug treatment programs is perceived as a coercive imposition. This is because coercion is typically inferred from referral source rather than measured. In this study, clients (N = 300) entering substance ab use treatment were assessed on structural variables (sociodemographic background, criminal history, current legal status, referral source), psychological variables (personal beliefs about substance abuse, perce ived interpersonal pressures), alcohol/drug use, and perceived coercio n. Mandated treatment status predicted perceived coercion; however, ma ny mandated clients did not, and many self-referrals did, report being coerced into treatment. Psychological factors accounted for additiona l variance in perceived coercion, controlling for referral source. Sub stance dependence did not add to the predictability of perceived coerc ion beyond structural and psychological variables. These findings are inconsistent with the notion that coercion can be inferred from referr al source. Instead, results support self-determination theory (Deci & Ryan, 1985), which proposes that multiple social and psychological eve nts promote perceived coercion by undermining personal autonomy. (C) 1 998 Elsevier Science Ltd.