Increasing motivation and raising retention rates are considerable challenges for providers

Increasing motivation and raising retention rates are considerable challenges for providers of adolescent substance abuse treatment. to treatment attrition and Vorinostat (SAHA) retention. Qualitative data analysis revealed five themes affecting retention either positively or negatively. Themes included associations (with family peers and counselors) responsibility (degree to which clients embrace jobs functions and rules) emotional regulation (ability Vorinostat (SAHA) to express feelings appropriately) thinking (identifying behavior patterns and recognizing consequences) and self-efficacy (feelings of empowerment). Implications for future research and for developing strategies aimed at increasing motivation and retention are discussed. Keywords: Motivation for treatment Retention Adolescents Substance abuse treatment Qualitative analysis According to a report published by the Substance Abuse Vorinostat (SAHA) and Mental Health Services Administration (SAMHSA 2011 over 10 percent of adolescents aged 12 to 17 were using illicit substances and nearly 1.8 million adolescents needed treatment. Yet for several reasons (e.g. not wanting to stop using unaffordable cost perceived negativity by others) over 90 percent did not receive treatment. Facilitating access to treatment and promoting retention among adolescents is urgent as those who complete treatment are two to three times more likely to have positive outcomes (Winters 1999 Yet retention rates among youth have historically been low (Etheridge Smith Rounds-Bryant & Hubbard 2001 Pompi & Resnick Vorinostat (SAHA) 1987 When clients drop out within the first few weeks counselors have limited opportunities to promote change with their clients. Understanding the factors that impact motivation to stay in treatment may help to improve retention and address substance abuse problems in the United States. Research examining attrition among adolescent treatment admissions has identified VHL specific barriers to engagement including low motivation and readiness (e.g. Melnick De Leon Hawke Jainchill & Kressel 1997 lack of bonding with treatment staff (Battjes Gordon O’Grady & Kinlock 2004 dysfunctional family and peer associations (e.g. Broome Simpson & Joe 2002 Gutman Eccles Peck & Malanchuk 2011 and juvenile justice involvement (e.g. Battjes Gordon O’Grady Kinlock & Carswell Vorinostat (SAHA) 2003 Pagey Deering & Sellman 2010 The purpose of this study is usually to further explore these associations by soliciting information from counselors parents and adolescents regarding their experiences in the early days of residential treatment-in particular their reflections on what promotes client retention or what incites them to leave prematurely. Qualitative analytical techniques are used to explore how experiences and perceptions of the treatment process impact retention. Input from three primary constituent groups may offer suggestions for future research and inform the development of interventions aimed at increasing retention among youth. Motivation and Readiness Perhaps the most commonly cited barrier to treatment retention (for both adults and youth) is lack of motivation (De Leon Melnick & Kressel 1997 Melnick et al. 1997 Mensinger Diamond Kaminer & Wintersteen 2006 Orlando Chan & Morral Vorinostat (SAHA) 2003 According to the Texas Christian University (TCU) Treatment Process Model (Joe Simpson & Broome 1999 Simpson 2004 motivation for treatment is usually a precursor to therapeutic engagement. Past research has shown that adult clients who are motivated for treatment are twice as likely to engage in treatment and engaged clients are more than twice as likely to remain in treatment long enough to experience psychological and behavioral changes (Simpson & Joe 2004 Comparable associations among treatment factors and improved outcomes have been found for adolescent populations (Joe Knight Becan & Flynn 2012 But motivation to stay in treatment is highly complex and often erratic. It can be influenced or grow out of internal sources external pressures or a combination of the two (Battjes et al. 2004 The literature examining factors associated with retention of adolescents in substance abuse treatment has identified personal characteristics and external pressures including family and peer influences which can promote or hinder engagement. Specifically adolescents with externalizing problems (Winters Stinchfield Latimer Stone 2008 including deviant behavior (Hawke.