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David P. Rentler


Dual-diagnosed female offenders (DDFOs) present direct care providers with complex psychosocial needs and challenges that result in a serious lack of motivation to attain, sustain, and continue treatment after release from prison. Unsuccessful treatment of DDFOs represents a significant public health and safety risk including continuing criminal acts, increased health care costs, accidents related to substance abuse, and poor reintegration. Through in-depth semistructured interviews with direct care providers, this phenomenological study's focus was on examining the motivational facilitators associated with treatment adherence, barriers to treatment adherence, and approaches for enhancing treatment motivation. Nine major themes emerged from this research, including the importance of an empathetic approach and a strong therapeutic alliance as motivational facilitators; lack of insight and acceptance of the need for treatment, lack of resiliency, and the role of external system factors in barriers to treatment adherence; and using an empathetic approach, building rapport, instilling hope, and avoiding confrontation as approaches for enhancing treatment motivation. These findings may inform theory and practice related to the treatment of DDFOs in U.S. prisons. These findings contribute to social change by identifying outcomes related to treatment attendance, continuity of care, and completion and may help reduce recidivism associated with DDFOs, decrease costs of care, and lower public risks such as accidents related to substance use. The study provides reference points that may inform recommendations to state correctional departments regarding effective programming strategies for DDFOs.

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