Motivation for change and psychological distress in homeless substance abusers

This study explores the treatment needs of homeless individuals participati ng in a large urban day shelter program. Alcohol and drug use, psychologica l distress, and stage of change were assessed in 100 participants presentin g for services. The associations among substance use, risk perception, and readiness to change were examined for alcohol and drugs separately. Partici pants had high levels of psychological distress compared to "non-patient" s amples. Eighty percent had used alcohol in the past 6 months, with 65% of t hose drinking at higher-risk levels; 60% had used drugs, with 82% in the hi gher-risk levels. While the majority felt that they drank and/or used drugs "too much," most were in precontemplation or contemplation stages of chang e. Intervention efforts for this population should focus on motivation, fac ilitation through the stages, and the associations between psychiatric symp toms and substance use. (C) 2001 Elsevier Science Inc. All rights reserved.