Motivation and emotion/Book/2024/Treatment motivation in juvenile delinquency

Treatment motivation in juvenile delinquency:
What is the role of treatment motivation for juvenile delinquency and how can it be enhanced?

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Overview

Scenario

Alex is a 17-year-old male from a small neighborhood and has been struggling with drug use for the past two years. It initially started as occasional experimentation, but quickly spiraled into regular use. This lead to frequent absences from school, declining health, and strained relationships with family and friends where he often lashed out. Despite several warnings from his parents and teachers, Alex didn’t see a reason to change his behavior. He felt invincible and was convinced that he had everything under control.

Juvenile delinquency and offence is a significant social issue whereby researchers are contently evaluating what contributes to negative juvenile behaviour, and the best treatment practices (Carl et al., 2020). Premature treatment termination is one of the most significant concerns that is linked to re-offending, as well as negative social and psychological outcomes for the individual (Carl et al., 2020) It must be noted, that juvenile offenders differ greatly from adult or mature offenders, meaning it is important to tailor treatment to the specific needs of young people reduce repetition of negative or antisocial behaviours (Richards, 2011). Treatment motivation is vital to this process as it sets up for positive treatment engagement, commitment and outcomes. However, justice involved youth often lack motivation to engage with treatment, often not seeing a their behaviour as problematic or severe enough to seek help and believing that they are able to take control on their own. This makes it extremely important to tailor treatment in a way that works to increase motivation and help the individual understand the importance of engaging with treatment.

Focus questions:

What is treatment motivation?
What is the role of treatment motivation for juvenile delinquents?
What are the factors that act as barriers to treatment motivation?
How can treatment motivation be enhanced for justice involved youth?

Understanding treatment motivation in juvenile delinquency

Treatment motivation is a significant factor that interacts with external catalysts (such as treatment) and environmental factors to influence readiness to change. Having a level treatment motivation is often necessary to turn potential treatment effects into actual behavioural change.

Defining Treatment Motivation

Treatment motivation can be defined as an individual’s readiness and willingness to change their behaviour.

Treatment readiness encompasses the state of an individual or the therapeutic context, and whether there are characteristics present that are likely to promote engagement in therapeutic intervention and bring about behavioural change (Sturgess et al., 2016)

Treatment motivation or readiness is often the result of different internal and external influences such as individual and environmental factors (Sturgess et al., 2016), which will be explored later in the chapter.

Importance and role of treatment motivation in juvenile justice

Motivation is considered a significant influencer of successful treatment outcomes (Sturgess et al., 2016)

Often, justice involved juveniles display poor treatment motivation as they are typically not personally seeking change, and may often believe that there is no reason for change (van der Helm et al., 2014).

Treatment motivation is however crucial for engaging and retaining juveniles in treatment programs, particularly in settings like youth correctional facilities (van der Helm et al., 2018).

What makes juvenile offenders different from adult offenders?

Table 1.
Brain development	Developmental differences mean that children and adolescents are less capable of making well-reasoned decisions and controlling impulses compared to adults (Queensland Government Statistician’s Office & Queensland Treasury, 2021)
Peer pressure/influence	Again, due to things factors such as maturity and being more reward-driven, juveniles are more susceptible to peer pressure and are likely to engage in risky behaviours despite understanding the potential consequences (Richards, 2011)
Moral Understanding	While adolescents can make moral decisions, they may not fully understand the long-term consequences of their behaviour, especially if it appears that they may get away with it in the moment (Queensland Government Statistician’s Office & Queensland Treasury, 2021)

Note: Different factors which differentiate juvenile offenders from adult offenders.

Theoretical perspectives on treatment motivation

There are many motivational theories which work to explain and deepen our understanding of what drives human behaviour. When it comes to treatment motivation, the Transtheoretical Model of Change (TTM) and Self-Determination Theory (SDT) seem to be the most prominent in research and literature (Hashemzadeh et al., 2019; Kennedy & Gregoire, 2009).

Self-determination theory

Self-determination theory (SDT) focuses on intrinsic versus extrinsic motivation. Intrinsic motivation relates to personal satisfaction and internal rewards, while extrinsic motivation is linked to external rewards or avoiding negative consequences (Gillison et al., 2019). Intrinsic motivation is driven by personal satisfaction and internal rewards and is effective in fostering long-term engagement in treatment (van der Helm et al., 2018). Extrinsic motivation is linked to external rewards or avoiding negative consequences (van der Helm et al., 2018). Interventions that target intrinsic reasons for change, such as personal benefits, are more effective in increasing readiness to change and treatment commitment, particularly in justice-involved youths (O'Grady et al., 2022). However, intrinsic motivation may not always be applicable to high-risk offenders who are mandated to treatment, where extrinsic factors play a more significant role (Polaschek, 2009).

Transtheoretical model of change

The Transtheoretical Model of Change (TTM) suggests that during behavioural change, individuals move through a number of stages which correspond to their willingness to take action (see figure 1). The TTM is used in treatment by providing a structured framework for understanding and supporting behaviour change, as well as assessing an individual’s readiness and commitment to change (Hashemzadeh et al., 2019). Critiques of the TTM: originally developed for use in understanding and treating addictive behaviour, so it may not be entirely relevant to criminal or antisocial behaviour (Casey et al., 2010). Human behaviour is also extremely complex and too multifaceted to be categorized into just a few stages (Casey et al., 2010). Regardless, research suggests that acknowledging an individual’s stage of change can be useful in predicting treatment outcomes and that different treatment strategies are effective at different stages of the TTM, allowing for tailored treatment (Hashemzadeh et al., 2019).

Factors influencing treatment motivation

Treatment motivation a crucial factor in turning treatment potential into actual change (van der Stouwe et al., 2018). Research suggests that readiness to change can be influenced by various factors including individual factors (e.g., personality, beliefs), catalyst events (e.g., treatment), and context (e.g., social environment) (van der Stouwe et al., 2018).

Individual factors

Self-Efficacy: The belief in one’s own ability to successfully change their negative behaviour. High self-efficacy is associated with a higher likelihood of engaging in treatment (Tavakoli Ghouchani et al., 2016).

Threats: Perceived threats or consequences of continued negative behaviour, such as the risk of losing a job, health issues, legal difficulties, and family problems can motivate individuals to pursue treatment (Tavakoli Ghouchani et al., 2016).

Environmental factors

Family Factors: Support and encouragement from family members play a significant role in motivating individuals to seek treatment. The presence of family support can lead to a higher likelihood of engaging in and continuing treatment (Tavakoli Ghouchani et al., 2016).

Friends' Factors: Social support from friends can be a significant factor in treatment retention (Tavakoli Ghouchani et al., 2016).

Therapeutic alliance

It is also suggested that the relationship between an individual and their clinician is strongly related to treatment motivation and positive treatment outcomes (Papalia et al., 2022). This will be explored further as a barrier to treatment motivation.

Barriers to treatment motivation

There are various barriers to treatment motivation for justice involved youth, which can arise from the from the individual themselves, their environment and community, and the individuals directly involved in their treatment (McBrayer et al., 2024).

Negative staff perception

Lack of trust

Young offenders are have been found hold the belief that they are being judged by staff, expecting disrespect due to their crimes, which discourgaes[spelling?] them from engaging in treatment (Sturgess et al., 2016).
Staff encompasses anyone directly involved in treatment and change and can include clinicians, mentors, correctional and legal representatives.
On the other hand, positive interactions with staff encourage youths to open up, accept treatment, and manage negative emotions (Sturgess et al., 2016)

Denial

Denial or minimization of ones crimes is a significant barrier for young delinquents to being motivation for treatment.
Those in denial of their negative behaviour are more likely to refuse treatment, especially if the feel it was forced upon them or offered in an offensive or belittling manner or they were not provided with much information and education about the treatment process (Sturgess et al., 2016).

Poor treatment perception

Disinterest in Treatment: Youths often believe they can handle problems on their own, making treatment seem unnecessary (McBrayer et al., 2024).
Scepticism: young people can often doubt that treatment is relevant to real-life challenges, reducing motivation (McBrayer et al., 2024).
Program Mismatch: When the program does not align with the individual’s learning style or cognitive capacity, it can lead to disengagement (Carl et al., 2020).

Strategies to enhance treatment motivation

When it comes to enhancing treatment motivation, motivational interviewing is the most prominent is research literature. Along with motivational interviewing, some other strategies include increasing treatment satisfaction by tailoring treatment approaches to the individuals cognitive and social needs, as well nurturing social support and involving family in the recovery process where feasible (Coviello et al., 2013; Creaney, 2014; Pederson et al., 2021; van der Helm et al., 2014).

Motivational Interviewing

Initially designed to treat substance use disorders.
Motivational Interviewing (MI) is a collaborative communication method which focuses on identifying and drawing out an individual's personal goals and motivations for change (see Goals and emotion 2024) within a supportive and compassionate setting (Pederson et al., 2021).
This is done by encouraging clients to express their reasons for considering behaviour changes, a concept known as "change talk”. (Pederson et al., 2021).
The core principles of MI include showing empathy, exploring and identifying reasons for change, addressing resistance, and promoting self-efficacy (Pederson et al., 2021).

Control and tailored approaches (treatment satisfaction)

Another factor often found among literature which is said to be related to poor treatment retention and engagement is a perceived lack of choice, control and autonomy in the treatment process (Sturgess et al., 2016).
By involving individuals in decision-making around their treatment process and treating them with respect, it is more likely that they will engage with interventions and develop the motivation to change (Creaney, 2014; Sturgess et al., 2016).
This enhances self-esteem and motivation to change as autonomy fosters a feeling of ownership, nurturing individuals to be more invested in the outcomes (Creaney, 2014)

Family and Community Involvement

Those who have a higher degree of social support from peers and family have been found to have better treatment outcomes (Coviello et al., 2013)
Positive relationships with family, mentors, and friends can be protective (Zwecker et al., 2018).
Having the capacity to obtain social support from one’s environment has been linked to better coping, and therefore motivation to engage (van der Helm et al., 2014)

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Emphasises the theoretical underpinning of juvenile treatment motivation
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References

Carl, L. C., Schmucker, M., & Lösel, F. (2020). Predicting Attrition and Engagement in the Treatment of Young Offenders. International Journal of Offender Therapy and Comparative Criminology, 64(4), 355-374. https://doi.org/10.1177/0306624x19877593

Casey, S., Day, A., & Howells, K. (2010). The application of the transtheoretical model to offender populations: Some critical issues. Legal and Criminological Psychology, 10(2), 157-171. https://doi.org/https://doi.org/10.1348/135532505X36714

Coviello, D. M., Zanis, D. A., Wesnoski, S. A., Palman, N., Gur, A., Lynch, K. G., & McKay, J. R. (2013). Does mandating offenders to treatment improve completion rates? Journal of Substance Abuse Treatment, 44(4), 417-425. https://doi.org/https://doi.org/10.1016/j.jsat.2012.10.003

Creaney, S. (2014). The benefits of participation for young offenders. Safer Communities, 13(3), 126-132. https://doi.org/https://doi.org/10.1108/SC-02-2014-0003

Gillison, F. B., Rouse, P., Standage, M., Sebire, S. J., & Ryan, R. M. (2019). A meta-analysis of techniques to promote motivation for health behaviour change from a self-determination theory perspective. Health Psychology Review, 13(1), 110-130. https://doi.org/10.1080/17437199.2018.1534071

Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A. M., & Daei, A. (2019). Transtheoretical Model of Health Behavioral Change: A Systematic Review. Iran J Nurs Midwifery Res, 24(2), 83-90. https://doi.org/10.4103/ijnmr.IJNMR_94_17

Kennedy, K., & Gregoire, T. K. (2009). Theories of Motivation in Addiction Treatment: Testing the Relationship of the Transtheoretical Model of Change and Self-Determination Theory. Journal of Social Work Practice in the Addictions, 9(2), 163-183. https://doi.org/10.1080/15332560902852052

McBrayer, C., Turner, A., Whitener, M., Adams, Z. W., Hulvershorn, L., Zapolski, T. C. B., & Aalsma, M. C. (2024). "Just as expensive as sending him to college:" barriers and perceptions of treatment in justice-involved youth. Health Justice, 12(1), 33. https://doi.org/10.1186/s40352-024-00289-2

O'Grady, M. A., Tross, S., Cohall, A., Wilson, P., Cohall, R., Campos, S., Lee, S., Dolezal, C., & Elkington, K. S. (2022). Readiness to change among justice-involved young adults in an alternative sentencing program who screened positive for alcohol or drug risk. Addict Behav Rep, 16, 100456. https://doi.org/10.1016/j.abrep.2022.100456

Papalia, N., Dunne, A., Maharaj, N., Fortunato, E., Luebbers, S., & Ogloff, J. R. P. (2022). Determinants and Outcomes of the Therapeutic Alliance in Treating Justice-Involved Youth: A Systematic Review of Quantitative and Qualitative Research. Clin Child Fam Psychol Rev, 25(4), 658-680. https://doi.org/10.1007/s10567-022-00407-2

Pederson, S. D., Curley, E. J., & Collins, C. J. (2021). A Systematic Review of Motivational Interviewing to Address Substance Use with Justice-Involved Adults. Substance use & misuse, 56(5), 639-649. https://doi.org/10.1080/10826084.2021.1887247

Polaschek, D. L. (2009). Rehabilitating high-risk offenders: Pre-treatment motivation, therapeutic responsivity, and change. Journal of the New Zealand College of Clinical Psychologists, Spring, 39-47.

Queensland Government Statistician’s Office & Queensland Treasury. (2021). Youth offending. In Research Brief. https://www.qgso.qld.gov.au/issues/10321/youth-offending-april-2021-edn.pdf

Richards, K. (2011). What makes juvenile offenders different from adult offenders? Trends and issues in crime and criminal justice(409), 1-8.

Sturgess, D., Woodhams, J., & Tonkin, M. (2016). Treatment Engagement From the Perspective of the Offender:Reasons for Noncompletion and Completion of Treatment—A Systematic Review. International Journal of Offender Therapy and Comparative Criminology, 60(16), 1873-1896. https://doi.org/10.1177/0306624x15586038

Tavakoli Ghouchani, H., Niknami, S., Aminshokravi, F., & Hojjat, S. K. (2016). Factors Related to Addiction Treatment Motivations; Validity and Reliability of an Instrument. J Res Health Sci, 16(3), 147-152.

van der Helm, G. H. P., Kuiper, C. H. Z., & Stams, G. J. J. M. (2018). Group climate and treatment motivation in secure residential and forensic youth care from the perspective of self determination theory. Children and Youth Services Review, 93, 339-344. https://doi.org/https://doi.org/10.1016/j.childyouth.2018.07.028

van der Helm, P., Beunk, L., Stams, G.-J., & van der Laan, P. (2014). The Relationship Between Detention Length, Living Group Climate, Coping, and Treatment Motivation Among Juvenile Delinquents in a Youth Correctional Facility. The Prison Journal, 94(2), 260-275. https://doi.org/10.1177/0032885514524884

van der Stouwe, T., Asscher, J. J., Hoeve, M., van der Laan, P. H., & Stams, G. (2018). The Influence of Treatment Motivation on Outcomes of Social Skills Training for Juvenile Delinquents. Int J Offender Ther Comp Criminol, 62(1), 108-128. https://doi.org/10.1177/0306624x16648130

Zwecker, N. A., Harrison, A. J., Welty, L. J., Teplin, L. A., & Abram, K. M. (2018). Social Support Networks among Delinquent Youth: An 8-Year Follow-up Study. J Offender Rehabil, 57(7), 459-480. https://doi.org/10.1080/10509674.2018.1523821

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External links

How to increase voluntary participation in justice programs (NSW government behavioural insights unit)
Motivational interviewing implementation and practice manual (Juvenile Court Judges’ Commission)

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Motivation and emotion/Book/2024/Treatment motivation in juvenile delinquency

Contents

Overview