Young adulthood represents a key developmental period for the onset of substance use disorder SUD. While the number of young adults entering treatment has increased, little is known about the mechanisms of change and early recovery processes in this important clinical population. Repeated-measures and regression analyses modeled during-treatment change in process variables and impact on outcome. Statistically significant medium to large effect sizes were observed for changes in most processes during treatment, with the exception of motivation, which was high at treatment intake and underwent smaller, but still significant, change. In turn, these during-treatment changes all individually predicted 3-month abstinence to varying degrees, with self-efficacy emerging as the sole predictor in a simultaneous regression. Findings help to clarify the mechanisms through which treatment confers recovery-related benefit among young adults. Treatment appears to work, in part, by helping to maintain motivation while conferring greater ability and confidence to enact such change.
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