Pretreatment for substance-abusing people with intellectual disabilities: intervening on autonomous motivation for treatment entry.

Background Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non-disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a crucia...

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Published in:Journal of Intellectual Disability Research Vol. 59; no. 12; pp. 1168 - 1183
Main Authors: Frielink, N., Schuengel, C., Kroon, A., Embregts, P. J. C. M.
Format: pictorial research tables/charts Journal Article
Published: Wiley-Blackwell Dec2015
Online Access:View this record in EBSCOhost
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      dt: Dec2015
      vid: 59
      iid: 12
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Pretreatment for substance-abusing people with intellectual disabilities: intervening on autonomous motivation for treatment entry.
      aug:
        au:
          Frielink, N.
          Schuengel, C.
          Kroon, A.
          Embregts, P. J. C. M.
        affil: Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
      sug:
        subj:
          Intellectual Disability
          Substance Abuse Rehabilitation
          Motivational Interviewing Methods
          Motivation Classification
          Human
          Experimental Studies
          Netherlands
          Descriptive Statistics
          Female
          Male
          Psychological Theory
          Questionnaires
          Adult
          Young Adult
          Summated Rating Scaling
          Friedman Test
          Post Hoc Analysis
          Wilcoxon Signed Rank Test
          Chi Square Test
          Effect Size
          Adult: 19-44 years
          Female
          Male
      ab: Background Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non-disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a crucial problem among substance-abusing people with ID. This study tested a motivational intervention to facilitate autonomous motivation (i.e. wanting to change substance abuse because of a sense of free choice and volition) for engaging with a subsequent addiction treatment. Method A multiple-case experimental design (N=6) was conducted to measure day-to-day motivation to change substance abuse among individuals with mild ID (N=3) and borderline level of intellectual functioning (N=3) in the Netherlands. The participants (five men, one woman) lived in the community (except one, he lived in a residential facility) and abused cannabis, alcohol or hashish. During the intervention phase, the 10-session treatment programme 'Beat the kick' was delivered by an experienced psychologist, based on motivational interviewing techniques adapted for people with mild to borderline ID. Participants completed an adaptive self-reported inventory based on selfdetermination theory (SDT) two to three times a week during baseline, intervention and 1-month follow-up. Results The results of five of the six participants (one dropped out) showed that the type of motivation changed from more controlled types of motivation (i.e. external motivation and introjected motivation) at baseline to more autonomous types of motivation after completion of the intervention. In addition, the participants reported a significant increase in overall need satisfaction and autonomy satisfaction and a significant decrease of overall need frustration. Conclusions The implementation of SDT and motivational interviewing principles in the treatment programme 'Beat the kick' reliably changed the type of motivation. In addition, the experimental effects provide initial proof of the use and applicability of SDT among people with ID.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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