To Stay or Not To Stay: Adolescent Client, Parent, and Counselor Perspectives on Leaving Substance Abuse Treatment Early.

Increasing motivation and raising retention rates are considerable challenges for providers of adolescent substance abuse treatment. Research has shown that motivation for treatment, social influences (peers, family, counselors), and for some clients external pressure from the juvenile justice system, can serve as key factors in successful retention. To further understand influences on motivation and retention, focus groups were conducted in two residential treatment facilities. Adolescent clients, parents, and treatment staff were asked to describe their experiences with the treatment process focusing specifically on factors related to treatment attrition and retention. Qualitative data analysis revealed five themes affecting retention either positively or negatively. Themes included relationships (with family, peers, and counselors), responsibility (degree to which clients embrace jobs, roles, and rules), emotional regulation (ability 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.