Factors Predicting Retention Among Hispanic Clients Mandated to Drug Treatment

Background: Social workers are charged with investigating and addressing issues surrounding the disproportionate rates of incarceration for individuals belonging to ethnic minority groups and to assure culturally competent treatment and interventions for drug offending individuals in need of substance abuse services (NASW, 2009). Over 5 million individuals in the United States are being supervised in the community by the criminal justice system and one third are under supervision for a drug offense (Glaze& Bonczar, 2009). 2.2 million adults were discharged from probation and parole in 2006, only 57% and 44% respectively without violation (PEW, 2009). Individuals convicted of drug law violations are less likely to successfully complete and drug treatment and treatment is available to only a few (FDC, 2009). Current statistics reflect 11% of the community supervision population are Hispanic and one in 54 Hispanic males is incarcerated; 37% as a result of drug offenses (Glaze& Bonczar, 2009; Lopez & Light 2009; Warren, 2008). Few studies document the effect of acculturation during substance abuse treatment (Youtz, Arroyo, Miller, Tonigan, 2002; Arroyo, Westerburg, & Tonigan, 1998) or examine the differences between clients of heterogeneous Hispanic descent.

Purpose: This research project was to assess the roles of motivational factors, the therapeutic relationship, and acculturation experiences in predicting treatment retention among Hispanic males mandated to drug treatment in South Florida. Distinguishing factors related to Hispanic clients retained in treatment from those who terminate prematurely. . Method: 243 Hispanic clients mandated to drug treatment by the criminal justice system were assessed at intake using the Addiction Severity Index and further assessments were conducted with those admitted to residential treatment. The measures used in this study were the number of days a participant remained in treatment, the Addiction Severity Index (ASI), Acculturation Rating Scale for Mexican Americans-II (ARSMA), Stages of Change Readiness Model and Treatment Eagerness Scale (SOCRATES), the Working Alliance Inventory (WAI). Hierarchical multiple regression analysis and ANOVA was conducted testing six hypotheses: (a) motivation to change at the time of entry will result in greater retention, (b) acculturation is related to retention, (c) differences in problem recognition and readiness for treatment exist between Hispanics of diverse descent, (d) a stronger therapeutic alliance will retain clients in treatment longer, (e) motivation to change will be positively related to the therapeutic alliance, and (f) during the course of treatment variation in motivation to change will be predicted by the therapeutic alliance. Results: Retention related to motivation to change R2 = .34 for Step1:DR2= .08 (ps<.005) and level of acculturation R2 = .27 for Step1:DR2= .14 (ps<.005). Problem recognition and readiness for treatment differ depending on the ethnic descent F(2,232)5. 03, p<. 01. Motivation to change is related to the therapeutic alliance R2 = .39 for Step1:DR2= .29 (ps<.005). Conclusions and Implications: This research identifies factors that may improve retention which include the use of evidence based motivation enhancement and treatment readiness techniques that have been adapted for cultural relevancy in order to retain Hispanic clients in the treatment.