Motivation for Participation in Rehabilitation among Individuals with Substance Use Disorder: A Thematic Analysis
Objective: This study aimed to identify the components shaping motivation for participation in rehabilitation among individuals with substance use disorder. Methods and Materials: This applied qualitative study used thematic analysis based on Braun and Clarke’s approach. Participants included 19 specialists and therapists from addiction treatment centers in Tehran and 16 clients undergoing rehabilitation. Expert participants had at least 10 years of clinical or therapeutic experience, and clients had participated in rehabilitation programs for at least six months. Data were collected through semi-structured interviews using snowball sampling. Interviews continued until theoretical saturation was reached after 35 interviews. Data were analyzed through open, axial, and selective coding using MAXQDA software. Intercoder reliability was assessed using Holsti’s coefficient. Findings: Thematic analysis identified 8 overarching themes and 32 main themes shaping motivation for rehabilitation participation. The overarching themes were internal reconstruction and personal transformation; social and environmental support; therapeutic awareness and self-knowledge; coping skills and emotion regulation; cognitive and emotional deterrents; social and identity reconstruction; individual and meaning-related growth after treatment; and quality of services and the treatment process. Coding reliability was acceptable, with Holsti coefficients of 0.76, 0.73, and 0.77 across three selected interviews. The findings showed that rehabilitation motivation is formed through the interaction of internal decision-making, hope, self-efficacy, family and peer support, therapeutic alliance, craving control, emotional regulation, identity reconstruction, and humane treatment services. Conclusion: Motivation for participation in substance use rehabilitation is a multidimensional, interactive, and process-oriented phenomenon that begins within the individual and is stabilized through relationships, treatment structures, and the social environment.