The relationship of social support and economic self-sufficiency to substance abuse outcomes in a long-term recovery program for women.

A growing literature suggests that women experience chemical dependency in a very different manner than men. Their needs in treatment may also vary. In particular, women with low incomes face greater economic hardship, and may be more subject to the influence of social support in maintaining recovery. Despite evidence for the relationship of both employment and social support in substance abuse treatment outcomes, many programs are reducing services and lengths of stay. The authors explored outcomes for fifty-nine women who attended long-term substance abuse treatment in a womens' facility that emphasized employment and economic self-sufficiency. Reductions in substance use were associated with an increase in economic autonomy. Improvement in other life domains was positively associated with measures of economic self-sufficiency. Women living in drug-free social environments had higher rates of abstinence and better overall functioning. At least among women who participated in our study, economic outcomes, substance use, and general functioning went hand-in-hand. Eliminating services such as employment assistance may, while reducing cost, also negatively impact outcomes among the most vulnerable clientele.     

Perceptions of Substance Abuse on College Campuses: Proximity to the Problem,Stigma, and Health Promotion

For college students recovering from substance addiction, the path to sobriety is fraught with challenges. Many campuses offer recovery support resources, but students indicate stigma associated with recovery prevents them from using these services. This problem could be ameliorated through communication campaigns addressing misperceptions of substance abuse and recovery. The purpose of this study was to understand how students’ perceptions of addiction and recovery vary based on their experience and background. A quantitative survey was employed to examine stigma beliefs among 2 subpopulations of college students at a large Southwestern university. Findings indicate students with exposure to issues surrounding substance abuse and recovery held fewer stigmatized beliefs, emphasizing the importance of identifying and researching a target audience before developing a health promotion campaign.     

Conformity, peer pressure, and adolescent receptivity to treatment for substance abuse: a research note.

To explore the possibility that peer influences not only contribute to adolescent substance abuse but shape feelings about being in treatment for substance abuse, forty adolescent inpatients were surveyed. Misconduct, including substance abuse, was predicted best by perceived peer pressure toward misconduct, low opinions of the value of treatment by disposition to conform to antisocial peers, and sense of stigma associated with being treated by perceived peer pressure toward conformity. Concerns over peer acceptance may be one basis for resistance to substance abuse treatment.     

Self-Sufficiency and Sobriety

Abstract

Substance abuse presents formidable challenges to a welfare reform that has employment as its primary goal. This study reviews the literature on substance abuse and women and reports what substance-abusing women on welfare perceive as unmet needs and barriers to their recovery and ability to join the workforce.     

More Than a Job Club,Sister: Career Intervention for Women Following Incarceration

Following incarceration, women face unique challenges in returning to their communities and seeking employment. This qualitative study used interpretative phenomenological analysis to explore the lived experiences of previously incarcerated women as they participated in It's More Than a Job Club, Sister, a spiritually integrated career intervention, and subsequently sought employment. The following 4 superordinate themes emerged describing this experience: (a) It was more than a job club; (b) God gave me a second chance: the impact of faith on recovery and employment; (c) barriers to employment; and (d) looking ahead. The findings indicate the need for a strengths‐based approach to career intervention that builds upon existing skills and emphasizes identity exploration, uncovering core beliefs and vocational values, bridging the gap between goals and barriers, and leveraging interpersonal skills. The findings also indicate that career counseling with female returning citizens is enhanced by incorporating attention to the role of substance abuse/recovery and by attending to the intersection of calling and vocation.     

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery.     

In college and in recovery: Reasons for joining a Collegiate Recovery Program

ABSTRACT

Objective: Collegiate Recovery Programs (CRPs), a campus-based peer support model for students recovering from substance abuse problems, grew exponentially in the past decade, yet remain unexplored. Methods: This mixed-methods study examines students' reasons for CRP enrollment to guide academic institutions and referral sources. Students (N = 486) from the 29 CRPs nationwide operating in 2012 completed an online survey in 2013. Results: Students were somewhat older than traditional age (mean age = 26). Now sober for 3 years (mean), they had experienced severe dependence on multiple substances. One third reported they would not be in college were it not for a CRP, and 20% would not be at their current institution. Top reasons for joining a CRP were the need for same-age peer recovery support and wanting to “do college sober,” recognizing that college life challenges sobriety. Conclusions: CRPs appear to meet their mission of allowing recovering students to pursue educational goals in “an abstinence hostile environment.” Findings emphasize the need for more institutions to address the support needs of students in recovery.     

"I'Ve had too much done to my heart": the dilemma of addiction and recovery as seen through seven youngsters' lives

Aware of the dearth of in-depth studies on recovering adolescent addict/alcoholics, we conducted a year-long qualitative study of seven formerly-addicted youth committed to recovery. The research question was: how do addicted youth become and remain sober? Bending to social stress, including racism and ethnic prejudice, three participants relapsed. However, personal commitment augmented by familial, community, spiritual, and educational support encouraged four to remain sober. Learning from both those who failed and succeeded, the theoretical concepts of surrender, social stress, and resiliency helped to interpret the participants' patterns of response and better understand adolescent recovery.     

"It Has Made College Possible for Me": Feedback on the Impact of a University-Based Center for Students in Recovery

Objective: The authors aimed to gain information on (1) the challenges for recovering students on a university campus and (2) the most helpful components of a collegiate recovery program.

Participants: The 15 students in the study were all in recovery from substance abuse. They entered the university and also entered the campus recovery program either in fall 2002 or fall 2003.

Methods: Semistructured interviews were conducted with students multiple times during their first academic year.

Results: Participants identified several challenges on the university campus. Many believed they would have dropped out of school or relapsed without the support of the recovery program, and they described aspects of the program that were particularly important to them.

Conclusions: Support from a campus recovery program is essential for many recovering students. There are a variety of recovery program components that can foster the sense of community that was so important to the students in this study.     

Substance abuse and child welfare: clear linkages and promising responses

Parental substance abuse is a significant factor in many of the families served in the child welfare system. This article examines: (1) the prevalence of substance abuse among families involved with the child welfare system; (2) the impact of substance abuse on child welfare practice; (3) how both the Adoption and Safe Families Act of 1997 and welfare reform legislation intensify the need to address parental substance abuse effectively; and (4) promising strategies for addressing these families' needs.     

Review of outcome research on marital and family therapy in treatment for alcoholism

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.     

Economic evaluation of continuing care interventions in the treatment of substance abuse: recommendations for future research

The chronic and relapsing nature of substance abuse points to the need for continuing care after a primary phase of treatment. This article reviews the economic studies of continuing care, discusses research gaps, highlights some of the challenges of conducting rigorous economic evaluations of continuing care, and offers research guidelines and recommendations for future economic studies in this emerging field. Rigorous economic evaluations are needed by health care providers and policy makers to justify the allocation of scarce resources to continuing care interventions. The adoption of cost-effective continuing care services can reduce long-term consequences of addiction, thereby potentially increasing overall social welfare.     

Mental Health and Substance Abuse Screening in Primary Care

ABSTRACT

An automated screening system for substance abuse and mental health problems was developed and implemented in a rural primary care clinic. Eighty-nine patients were assessed with this system. The incidence of identified problems, 35% in total, was consistent with that found in previous studies of patients in general and medical settings. Additionally, over half of the patients assessed felt at least some need for mental health or substance abuse treatment. Nonetheless, because of the staff's concerns over patient privacy, impeding patient flow, and the physician's perceived ability to adequately identify these problems without assistance, the system was not adopted.     

Substance Abuse,Homelessness, Developmental Decision-Making and Spirituality: A Women's Health Issue

ABSTRACT

A qualitative methodology was used to examine the relationship between homeless women's spirituality, substance abuse, moral reasoning and developmental decision-making. Findings indicated that a lack of development in spirituality and the ability to make decisions in childhood is related to homeless, addicted women's inability to maintain abstinence and achieve social independence. Spirituality impacted decisions to abstain from substance abuse and increased the women's social independence. Findings suggest that treatment needs to incorporate spirituality, family of origin, and the development of skills for independent decision-making. The authors propose that childhood maltreatment, homelessness and substance abuse impede spiritual development. Therefore, substance abuse treatment needs to include a focus on spirituality and moral reasoning in the recovery process.     

Pathways to recovery after substance abuse treatment: leaving a life of crime behind

Changes in criminal activity following substance abuse treatment were examined among 941 individuals. The estimated cost to society of crimes committed in the 6 months prior to intake was used to classify participants into three groups: no-, low-, and high-cost. Logistic regression was used to predict criminal activity at 6 and 24 months following intake as a function of (a) intake status, (b) treatment, and (c) outcome status and changes. The three groups varied significantly at intake and what predicted subsequent criminal activity. Treatment effects on criminal activity were mediated by the extent to which treatment reduced substance use. Outcomes were also predicted by other factors (e.g. housing, employment, medical problems, psychological distress, and social support). The results support the need for multidimensional assessments for predicting the risk of illegal activity, the need for reassessments following treatment, and the value of addressing other problems in reducing subsequent criminal activity.     

Trying to come home: Substance exposed infants, mothers, and family reunification

Substance abusing mothers comprise a significant proportion of caregivers in public child welfare, and achieve low reunification rates. Unfortunately little is known about treatment options intended to facilitate recovery and increase reunification. This study focuses particular attention on the relationship between specific treatment modalities (e.g., residential and outpatient), recovery from substance abuse and family reunification. Analyzing a sample of 160 mothers and their substance exposed infants, the findings clearly identify the benefits of residential treatment in terms of both treatment progress (directly) and family reunification (indirectly), but only when residential services are delivered in combination with transitional services.     

Substance abuse by men in partner abuse intervention programs: current issues and promising trends

This article discusses key studies linking intervention for co-occurring substance abuse and partner abuse. Findings are grouped into three areas: (a) the effect of addictions treatment on partner violence; (b) application of transtheoretical, motivational, and culturally focused approaches to improve engagement and prevent attrition; and (c) assessment-based matching of services. Finally, the relative value of serial, coordinated, and integrated substance abuse programs and partner abuse intervention programs are considered. We reached three primary conclusions: (a) Addiction treatment alone reduces the risk for future domestic violence in a subset of men who batter, (b) screening and assessment for substance abuse by all men in partner abuse intervention programs is a standard of practice but needs to extend beyond "intake" and occur periodically, and (c) coordinated and integrated substance abuse and domestic violence programs probably offer more safety than traditional serial substance abuse treatment followed by partner abuse intervention.