Pressure and Expectation

Pressure and Expectation

Research shows anyone can respond to addiction treatment, even people who enter a treatment program due to a court order or family influence. For a person who is internally motivated to make treatment a success, the outcomes may be even better.[1]

Motivation During Addiction Treatment

It takes a step-by-step process to treat addiction. Just as treatments change over time, it’s likely a person’s attitudes about himself and others change as well. Feelings of pressure from inside and out will reflect where a person is on his treatment trajectory toward recovery. Since addiction is a brain disease, the changes brought by treatment indicate a person’s brain is changing along with his behavior. Researchers don’t understand the full impact of the various ways addiction treatments change the brain, but they are learning more about the process through brain scans and other research studies.[2]

Researchers still debate the full impact of forcing a person to enter addiction treatment through various measures, including to a court mandate, fear of losing custody of children or pressure from family members. Many studies show patients respond to treatment even when forced—they stay in treatment longer and reduce substance use. One reason a person may benefit from coerced treatment is his ability to internalize the treatment process once he reaches a treatment facility.[3]

Changing attitudes during treatment also are a normal part of the therapeutic approach. Addiction treatment first addresses the physical aspects of the disease, initially treating any withdrawal symptoms and ensuring a person’s body is free of toxic substances. After the detoxification phase, behavioral treatments are the most common next step. These treatments include psychological counseling, which guides a person through the next stages of treatment and teaches ways to identify negative-thinking patterns that are destructive to one’s self and others. Counseling is offered in groups or on an individual basis. To be completely effective, the counseling must give a person the skills needed to manage stressful situations after active treatment and build a toolkit of resources to manage the temptations to use substances.[4]

Stages of Change

Addiction clinicians know treatment must evolve over time to match a person’s internal pressure on himself. While some people believe a person must “hit bottom” to be ready to transform, there’s no reason a person can’t see the need for change before destroying his life with opiate addiction or other substance use. Researchers identify the following catalysts as reasons that may propel a person to seek and participate in addiction treatment:

  • Experiencing distress: an episode of severe depression or anxiety may encourage a person to seek help
  • Extraordinary life event: a loved one’s death, pregnancy, job loss or other dramatic life event may stimulate a person to change
  • Self-appraisal: looking at the pros and cons of drug use at the individual level encourages 30% to 60% of change reported in recovery studies
  • Recognizing negative consequences: seeing the harm on an individual level or harm to others may prompt change
  • External voices: encouragement from positive friends or even a court mandate may encourage a change of heart

People who have a positive attitude toward making a change reduce their substance intake, have higher abstinence rates, are better able to adjust socially and stay in treatment longer. Many clinicians think about a person’s readiness for change as going through one of five stages: pre-contemplation, contemplation, preparation, action and maintenance. A person doesn’t see the need for change until the preparation phase, when the benefits of getting off substances outweigh the negatives. After this stage, the commitment to make a change becomes stronger. Combined with the skills and tools gained during psychological therapies, a person is then set for maintenance during the recovery period.[5]

Need Help Finding Addiction Treatment?

It can be a difficult first step to make the decision to seek help for opiate addiction. When it’s clear a family member or friend needs help, there are many options for achieving and living in recovery. If you or a loved one is struggling with a substance use problem, please call our toll-free number.

Our admissions coordinators are trained to offer expert advice and provide guidance about the best possible treatment options. We help individuals overcome addictions with a philosophy that addresses the whole person—mentally, physical and spiritually. Call our toll-free helpline 24 hours a day for advice. Don’t struggle alone; call us today.


[1] Ondersma, S. J., Winhusen, T., & Lewis, D. F. (2010). External Pressure, Motivation, and Treatment Outcome among Pregnant Substance-Using Women. Drug and Alcohol Dependence. Retrieved Mar. 13, 2016 from

[2] Fowler, J. S., Volkow, N. D., Kassed, C. A., & Chang, L. (2007). Imaging the Addicted Human Brain. Science & Practice Perspectives, 3(2), 4–16. Retrieved Mar. 13, 2016 from

[3] Conner, B. T., Longshore, D., & Anglin, M. D. (2009). Modeling Attitude towards Drug Treament: The Role of Internal Motivation, External Pressure, and Dramatic Relief. The Journal of Behavioral Health Services & Research. Retrieved Mar. 13, 2016 from

[4] National Institute on Drug Abuse. (2014). Treatment and Recovery. Drugs, Brains, and Behavior: The Science of Addiction. Retrieved Mar. 13, 2016 from

[5] Center for Substance Abuse Treatment. (1999). Enhancing Motivation for Change in Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 35. Substance Abuse and Mental Health Services Administration. Retrieved Mar. 13, 2016 from