The Influence of Psychological Problems on Engagement in Drug Court

Matthew L. Hiller, University of Kentucky
J. Matthew Webster, University of Kentucky
Michele Staton, University of Kentucky
Carl G. Leukefeld, University of Kentucky

ABSTRACT
Studies of community-based substance abuse treatment show that mental health problems reduce client engagement in treatment (Joe, Brown, & Simpson, 1995), and that higher levels of treatment engagement lead to improved treatment outcomes (Hubbard, et al., 1999; Simpson et al., 1999). Therefore, it is important for researchers to start examining client engagement in Drug Court programs to learn which factors influence a client's level of personal involvement in the program. As part of the NIDA-funded Enhancing Drug Court Retention in a Rural State project, data were collected during face-to-face interviews by research staff using elements of the Addiction Severity Index and the Brief Symptoms Inventory. Findings showed that psychological problems (i.e., higher levels of depression, higher levels of hostility, and higher levels of anxiety) were related significantly to lower levels of personal engagement during the first 30 days of drug court (including lower ratings of rapport with the case specialist, lower satisfaction with the case specialist and with the drug court program, and poorer self-rated personal progress in treatment), even after statistically controlling for additional factors that could have confounded these relationships. Targeted psychsocial interventions; therefore, may be indicated for individuals who enter Drug Court with higher levels of depression, hostility, and anxiety to improve the probability that they will become personally invested in the drug court treatment process.

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Updated 05/20/2006