Table 3 Treatment barriers identified by youth

Youth interest

“Really I just feel like it [treatment] doesn’t help because they just try to educate it…I feel like you can only change for yourself and not somebody else.”

“the more I kept going to interviews [treatment sessions] I kind of lost interest in it because it felt like it was more being forced on me."

“For me, to be honest, I don’t know what can help me because I don’t like talking about my problems. I don’t really want to solve them. I just want to lock them up and leave them over here. Like, basically, just get rid of them.”

“No, not really [not interested in treatment], because no matter what anybody’s telling, I’m going to do what I want to do at the end of the day. My head will tell me about training technique, this is not going to help, this is what will help in real life. If I try to think about something, -read a book and color, but in real life, ain’t nobody likely to tell me, “no. Wrong move. Read a book. It was just her telling me to think like that and I can’t just think like that”

“I just thought it was stupid. Other kids that do cocaine, heroin, speed, meth, and all that stuff. I’m just here smoking Mary Jane, ain’t nothing wrong with that. It’s legal in the States. Why can’t it be legal everywhere?”

Negative JJ experience

“But if anything, it [JJ experience] did push me to do it [use substances] more because of the stress of being arrested and the stress of all of these new issues that I’m facing and the worry of drug tests and everything else. It was a lot of stress on me at once, and I’m going to be bluntly honest with you. The day after I got arrested, I was like I’m just having consistent panic attacks. I’m like I need to smoke.”

“They don’t help you at all. They basically just want you put in the system. They don’t really try to help you as much as you think they’re going to help.”

Scheduling/time

“I work a lot, so I don’t have really a lot of free time to do stuff like that [participate in treatment].”

“I don’t go there [treatment] because I feel like I don’t have time. I have so much to do. I have a job. I go to school. I have all my friends. I don’t see how I would get that in there for real.”

Type of treatment available

“But like, everybody there in that class I had [previous treatment experience] was there for weed. Like a marijuana charge or whatever…me and all those people were there for the same thing, it’s kind of easier to talk about because they all understand where you’re coming from. But like, if you got a crack head in the corner, and you got someone that’s addicted to alcohol, and then someone who just smokes a blunt every now and then, I mean it’s a little difficult to understand their insight because we don’t really know what they’re going through or anything. So like, sometimes people don’t really want to talk about that to just anybody. It’s like, with those programs, they expect you to talk and I don’t just … I don’t know, like share extra. But sometimes people aren’t really comfortable with that.”

“Less talking [would have made treatment participation easier]. I feel like I write more, like they need to figure out how people communicate.”

Trust

“I don’t talk about the things that I need to talk about, because that’s just not something I share with anybody. I share that with people I trust and I don’t trust very easily.”

“I’d say the most difficult part was kind of gaining the trust for my therapist.”