The Importance of Treatment Motivation
In 2015, only about 11 percent of the approximately 22 million people who needed addiction treatment received it. And though increased access to treatment is necessary, it’s not enough to close this treatment gap. While barriers to accessing treatment – like the high cost of treatment and the limited number of treatment facilities and providers – may explain why many people who need treatment don’t receive it, the reality is that many experiencing addiction do not feel motivated to seek help.
The problem of motivation is a fundamental part of the disease of addiction and is often closely related to “denial.” People with severe addiction have difficulty with the insight, motivation, judgment, and self-care skills needed to initiate help on their own. Part of the reason for this is that drugs cause severe impairment in the brain’s ability to accurately perceive problems and make healthy decisions. This brain impairment is often misinterpreted by the addicted person, their family, and the general public as being a problem of willpower or not caring.
Why is motivation so important?
Addiction is a chronic relapsing condition, and even those who enter treatment may not be successful in reducing or stopping their substance use. A recent study estimates that around 35 to 48 percent of people who enter addiction treatment will not complete it. For those with addiction, substance use becomes part of daily life, and can be a coping mechanism for other physical and psychological symptoms, such as chronic pain, depression, or anxiety.
Many people who complete treatment will relapse. Often, people with addiction face an uphill battle of cravings and urges to use during and after treatment. Individuals with addiction also need to sort through problems that they may have been avoiding when using or problems which are consequences of their use.
Those entering recovery are faced with the challenge of learning to reengage in daily life activities that may have gone by the wayside while they were using addictive substances. That takes ongoing support and attention from health professionals, family, and friends, and requires motivation to forge ahead, even when facing inevitable setbacks or obstacles. Those suffering from addiction will not just wake up with a happy, problem-free life once they stop using or leave a treatment program.
In fact, relapse rates are estimated to be between 40 to 60 percent for those who are treated. This doesn’t mean that people aren’t trying to recover, or that they don’t want to. Changing addictive behavior is extremely challenging, and people need help to do so.
How can someone become motivated to change behavior?
Entering and remaining in addiction treatment asks a lot of people. For many people, doing this alone seems impossible. However, there are evidence-based practices that increase motivation for changing behavior, including Motivational Interviewing (MI) and Motivational Enhancement Therapy (MET).
These motivational interventions help individuals recognize that uncertainty about behavior change is normal, while also helping them harness their strengths to do so. Motivation is made up of three critical components working together to influence behavior, each of which is addressed through motivational interventions:
- Willing – Desire to change
- Does the person see change as something they want?
- Able – Confidence
- Even if they want to change, does it feel possible?
- Ready – Priority
- Even with willingness and ability, is it a priority right now?
We need more than improved treatment access
Motivation for treatment and for a continued recovery is essential for success. Without being willing, able, and ready, a lack of motivation can be an obstacle to successful treatment and recovery. And even if treatment were available for everyone who needed it, there would still be people who were not motivated to start and those who wouldn’t be motivated to stay in treatment. Yet building and maintaining motivation for recovery can’t be done alone. People with addiction are more likely to be motivated to seek treatment if they can openly share their goals and challenges with family and friends and be confident that they will receive the social support needed to stay on the path to recovery.
Addressing the challenge of motivating individuals to seek and complete treatment and sustain recovery also requires a concerted effort to (1) train health professionals and treatment providers in the necessary skills of engaging people in motivational interventions, (2) research and implement the most effective means of doing so, and (3) provide adequate funding so that these tools are used broadly enough to have an impact on the 22 million people in dire need of addiction care.
Amy Schreiner, MS, PhD
Amy is an Associate Research Scientist and Project Director at Center on Addiction