Social pressure, coercion, and client engagement at treatment entry: A self-determination theory perspective

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.01.002 Byline: T. Cameron Wild (a), John A. Cunningham (b)(c), Richard M. Ryan (d) Keywords: Treatment; Coercion; Motivation; Self-determination theory Abstract: Research on coercion in addiction treatment typically investigates objective sources of social pressure among legally mandated clients. Little research has examined the impact of clients' perceptions of social pressures in generalist addiction services. Clients seeking substance abuse treatment (N =300; 221 males and 79 females; M age=36.6 years) rated the extent to which treatment was being sought because of coercive social pressures (external motivation; [alpha] =.89), guilt about continued substance abuse (introjected motivation; [alpha] =.84), or a personal choice and commitment to the goals of the program (identified motivation; [alpha] =.85). External treatment motivation was positively correlated with legal referral, social network pressures to enter treatment, and was inversely related to problem severity. In contrast, identified treatment motivation was positively correlated with self-referral and problem severity, and was inversely related to perceived coercion (ps Author Affiliation: (a) Centre for Addiction and Mental Health Research Laboratory, University of Alberta, 13-133 Clinical Sciences Building, Edmonton, Alberta, Canada T6G 2T3 (b) Centre for Addiction and Mental Health, Canada (c) University of Toronto, Canada (d) University of Rochester, United States