Motivation for treatment preceding and following a substance abuse program

Background: Motivation for treatment is generally considered a powerful predictor of treatment seeking and success in patients with alcohol and drug dependence disorders. Objective measures have seldom been used, however, to assess how motivation is altered during treatment, or the impact of depression/anxiety on motivation. Methods: We assessed motivation using the Treatment Motivation Questionnaire (TMQ) in 78 male alcohol- and drug-dependent veterans immediately preceding and following an intensive, 2-week residential substance abuse program. The TMQ assesses four domains of motivation: internal motivation, external motivation, interpersonal help-seeking, and nonconfidence in treatment. Results: Following treatment, only external motivation changed (decreased), whereas the other dimensions of motivation retained the high levels observed pretreatment. Depression (as measured by the Beck Depression Inventory, BDI) was highly correlated with three of the four domains of motivation, while anxiety (as measured by the Spielberger State-Trait Anxiety Inventory, STAI) was highly correlated solely with internal motivation. Conclusions: Our findings suggest that depression and anxiety may differentially effect motivation and that external motivation may be quite transient; treatment implications of these findings are discussed. The usefulness of the TMQ in a residential population was also explored. (C) 2002 Elsevier Science Ltd. All rights reserved.