Young adults with severe addiction problems genuinely want to become clean and sober. They just don’t know how to do it, says a new study by the Center for Addiction Medicine at Massachusetts General Hospital and Harvard Medical School and the Minnesota-based Butler Center for Research at Hazelden.
Researchers say they were surprised by the high degree of motivation reported by 18 to 24-year-olds in the study at the time they entered a multidisciplinary 12-step-based residential treatment program. But the subjects had low coping skills, self-confidence and low commitment to support groups like Alcoholics Anonymous or Narcotics Anonymous, according to “Ready, willing and (not) able to change: Young adults’ response to residential treatment,” published in the journal Drug and Alcohol Dependence.
Subjects were assessed at mid-treatment, discharge and three months post-discharge. Researchers observed significant declines in subjects’ psychological distress and increases in self-confidence, abstinence-focused coping skills and commitment to AA/NA – all linked to abstinence from alcohol and other drug use three months after discharge.
“It really supports the notion that treatment works by increasing coping skills and confidence to helping maintain or enhance motivation. When people feel confident that they can enact change, they’re more likely to do it,” says John F. Kelly, Ph.D., who designed the study with colleagues Karen Urbanoski, Ph.D., Bettina Hoeppner, Ph.D., and Valerie Slaymaker, Ph.D.
The study analyzed 303 young adults seeking treatment at the Hazelden Center for Child, Youth, and Families in Plymouth, Minn., where Slaymaker is chief academic officer and provost. Patients at the center receive seven hours of daily individual and group therapy, lectures, educational sessions and mental health counseling and their television watching is monitored by center staff.
Asked to rate their motivation on a scale of 1-10 at intake, subjects reported an average of 9.1. Slaymaker had expected the average to fall in the middle of the scale. “As a society we have this idea that they’ve been coerced by external forces … family members, employers or legal circumstances,” she says. “The more I thought about it, the more it made conceptual sense to me. They clearly understood that things weren’t going well and you can see how they had a very high degree of psychological distress.”
About 75 percent of the subjects were male, but Kelly and Slaymaker say no gender differences were observed in the acquisition of skills during treatment.
Young adulthood is a key developmental period for the onset of substance abuse problems, yet most addiction studies focus on subjects with an average age in their 40s.
The next step will be to look at post-treatment outcomes up to one year after discharge to determine the factors associated with helping young adults engage in continued treatment and stay in programs like AA, Kelly says.
By Janine Weisman