Psychosocial correlates of treatment fears among young psychotropic substance abusers in Hong Kong

Abstract

The study examined the psychosocial correlates of treatment fears among young psychotropic substance abusers receiving residential drug treatment in Hong Kong. The study investigated the relationships between treatment fears and several psychosocial correlates on both the personal (personal competence) and the family (family functioning, parental communication, parental support, parent-child conflict and parental drug use) levels. The ecological systems theory was adopted as the theoretical framework because of its wide applicability and practicability. The study covered two phases. The first phase focused on the development and validation of two new instruments (the Early Treatment Fears Scale and the Anticipated Discharge Fears Scale), which were indigenously developed and employed in this study. The second phase was the main study. A total of 303 young male psychotropic substance abusers with a mean age of 20.3 joined the study on a voluntary basis. Based on a post-positivistic paradigm, a cross-sectional survey design using validated instruments was employed. In the first phase, the Early Treatment Fears Scale and the Anticipated Discharge Fears Scale were developed and validated. Both measures showed good content validity. They also showed good internal consistency and convergent validity in the main study. There are several important findings from the second phase of the study. First, family functioning was significantly associated with early treatment fears (ETF) and anticipated discharge fears (ADF) in drug abusers. Second, significant correlations were found between the dyadic parent-child relationship qualities (i.e., mutuality, parental concern, parental behavior control, parent-child communication, and parent-child conflicts and harmony) and treatment fears (ETF and ADF). Third, young psychotropic substance abusers' early treatment fears (ETF) and anticipated discharge fears (ADF) were negatively associated with personal competence. Fourth, the mediating effects of family functioning in the influence of personal competence on treatment fears of young psychotropic substance abusers were identified. Fifth, stronger endorsement of positive Chinese cultural beliefs about adversity was found to be associated with a lower level of treatment fears. Sixth, hopelessness was positively related to treatment fears. Finally, life satisfaction was negatively related to treatment fears. The study provides important theoretical and practical contributions. Theoretically, it clarifies the conceptualization of treatment fears by differentiating "early treatment fears" and "anticipated discharge fears" among young psychotropic substance abusers in Hong Kong, leading to the development of indigenous measurement tools. The study employed the ecological systems theory to highlight the importance of addressing personal competence and family functioning in the rehabilitation of young psychotropic substance abusers. Furthermore, the study indicates how personal competence and family functioning are related to the treatment fears of young psychotropic substance abusers. Practically, the study provides implications for social work intervention and policy formulation to nurture positive youth development and to enhance the quality of family functioning, both of which are necessary for the development of youth. With these methodological advances of a holistic perspective and validated indigenous instruments, the research is pioneering in that it examines the treatment-fears correlates (personal competence and family competence) of young psychotropic substance abusers in a Chinese context.