Treatment seeking in cannabis dependence: The role of social cognition

•Cannabis-related cognitions should affect motivation to seek treatment.•We compared treatment-seeking and non-seeking cannabis dependent individuals.•Treatment seekers had higher negative expectancies and lower emotional relief self-efficacy.•Treatment seekers had poorer psychosocial functioning and higher self-perceived cannabis dependence.

Background and aimsRelatively few cannabis dependent individuals seek treatment and little is known about the determinants of treatment seeking. Social Cognitive Theory (SCT) provides a useful framework for examining human behaviour and motivation which may be helpful in explaining treatment seeking. This study examined the differences in cannabis outcome expectancies and cannabis refusal self-efficacy between treatment seekers and non-treatment seekers with cannabis dependence.DesignNon-treatment seekers were referred to an illicit drug diversion program. Treatment seekers commenced an outpatient cannabis treatment program and completed a comprehensive assessment that included measures of cannabis outcome expectancies and refusal self-efficacy.SettingA public hospital alcohol and drug outpatient clinic.Participants269 non-treatment seekers and 195 individuals commencing cannabis dependence treatment.MeasurementsThe Cannabis Expectancy Questionnaire (CEQ), Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), Severity of Dependence Scale - Cannabis (SDS-C), General Health Questionnaire (GHQ-28) and Readiness to Change Questionnaire (RTC) were completed.FindingsTreatment seekers had significantly higher levels of negative cannabis outcome expectancies and significantly lower levels of emotional relief refusal self-efficacy (belief in ability to resist using cannabis when experiencing negative affect) (ps < 0.001). Treatment seekers had significantly higher levels of psychological distress and self-perceived cannabis dependence compared to non-treatment seekers (ps < 0.001).ConclusionsHigh negative cannabis outcome expectancies and low emotional relief refusal self-efficacy may play a key role in motivation to seek treatment.