It was hypothesized that positive external incentives like supportive and empathic friends,

rewards, or coercion of various types may stimulate and can influence motivation for change.

This was based on theoretical assumption of Maslow's theory which suggests that the most basic

level of needs must be met before the individual will strongly desire (or focus motivation upon)

the secondary or higher level needs. However, this research revealed that the quality of life

satisfaction in a residential treatment facility had no significant relationship with the level of

motivation to change. This notion supports the proposition of Herzbergs hygiene-motivation

theory which explains that living condition, security, benefits, insurance, and other maintenance

factors do not directly influence positive satisfaction or affect motivation, though lacking and

scarcity results dissatisfaction. These are called hygiene factors which are extrinsic in nature and

include aspect such as physical environment, health care accessibility, mobility, and social

support. Data analysis revealed that hygiene factors; physical environment, the food they eat,

medical and psychological services do not increase nor decrease their motivation and readiness

to change. Extrinsic influences like coercion which entails legal system involvement and self-

referral were also found insignificantly related to levels of motivation (Siegal, 2003). This also

expounds that Hygiene factors were not a major source of satisfaction and contentment among

inpatients. The research finding is in lined with the study conducted by Kacel et. al., (2005)

which highlights that the highest satisfaction scores were all intrinsic factors and the lowest

satisfaction scores were all extrinsic factors.

Better motivation was consistently associated with severity of substance use. This

research proved that higher motivation for treatment scores were associated with greater levels of

problem severity. Various researches presented the relationship of motivation and severity of
drug addiction. One is the study of Hiller et. al (2009) which suggested that individuals with

more drug-use related life problems may recognize the need and desire help for treatment. The

significant relationship of drug addiction severity with the facets of CMR scales implies that

problem recognition, recent drug use, physical health problems, and desire for help, would likely

influence the treatment readiness, adherence to treatment, and recognition to change.

To further understand the process of drug addiction treatment, the influence of individual

characteristics on treatment readiness was explored. Predisposing characteristics such as drug

treatment history and educational attainment were found to have slight influence with addiction

severity index but defined insignificant. The link between the fixed characteristics was found

weak and inconsistent. Individuals with prior substance abuse treatment were also more likely to

re-enter treatment (Rapp, et. al 2007). Other studies also state that there was no association found

between prior treatment history and readiness to change.

Among the domains of WHO-QOL BREF, Social Relationship scores yielded significant

relationship with the respondents age. Older adults report higher satisfaction within the facets of

social relationship such as social support and personal relationship. The present research

approved with the 2011 study of Luong and Fingerman entitled Better With Age: Social

Relationships Across Adulthood. The study agreed with the idea that social role changes may

provide advantages for adults in navigating personal relationships. Specifically, adults engaged

more in strategies that enhance social relationship skills and exert effort to avoid conflicts.

Oftentimes, adults are more positively reciprocating forgiveness and altruism than younger

individuals.
Recommendation
A thorough understanding of quality of life is important in exploring the complexity of

substance use disorder to help in developing treatment suitable for individual needs in a

therapeutic community. Recognizing an individuals source of internal motivation can assist

practitioners in exploring areas like psychotherapy, treatment program and mental health.

Intrinsic motivation may be incorporated into aspects of group-centered intervention and may

facilitate change the individuals perceived perceptions of self and help them into changing their

behavior. This present research will provide useful information to drug treatment and

rehabilitation regarding interventions in treating addiction and structure of program operation.

While this study does provide some insights, our knowledge of the long term consequences is at

present limited.