Barriers to Treatment Inventory

The BTI is an instrument that can be used by substance abusers and assessment staff as a useful tool for helping identify barriers to treatment entry. It contains items drawn from the extensive literature on barriers to treatment and from items found in the Allen Barriers to Treatment Instrument (ABTI), as well as other barrier lists. Approximately 100 items from these sources were considered for inclusion in the BTI. Items were reviewed by senior clinical staff for relevance to the current population and setting. Fifty-nine items were selected for inclusion in the instrument, including 25 items that load on one or more of 7 different factors: Absence of Problem, Negative Social Support, Fear of Treatment, Privacy Concerns, Time Conflict, Poor Treatment Availability, and Admission Difficulty. The BTI has practical implications for settings that conduct substance abuse assessments, most notably CIUs like the one where this study was conducted. The average of 15 minutes spent completing the BTI could provide benefits to both individual substance abusers and assessment programs. For the individual, a discussion of BTI results may improve the likelihood that barriers are successfully resolved and that linkage occurs. By increasing linkage rates, programs conduct fewer assessments that do not result in successful follow-through. The BTI could also provide programs with aggregate information about the clients they assess. By identifying the barriers that could impact treatment entry, assessment programs are better able to develop effective interventions to facilitate treatment entry. For example, motivational interviewing has shown value in helping clients manage the ambivalence that often surrounds substance use and the decisions to seek treatment. Treatment mentors could be engaged to help prospective clients deal with their fears about treatment and their reticence about revealing personal information to others.