Likelihood of Asking for Help in Caregivers of Women With Substance Use or Co-Occurring Substance Use and Mental Disorders

Family members are important to the well-being of their relatives with substance use disorders or cooccurring substance use and mental disorders. Many caregivers experience high levels of burden, negatively impacting their capacity to provide support to their ill family member. The Andersen health care utilization model (Andersen & Newman, 1973, 2005) was used to identify the impact of predisposing, enabling, and need factors hypothesized to predict caregivers’ likelihood of asking for help and support with their caregiving role. The sample include 82 women recruited from outpatient or inpatient substance abuse treatment centers and 82 family caregivers nominated by these women. Findings showed that almost half of caregivers were unlikely to ask for help. Multiple regression analysis found that two need variables were statistically significant predictors of caregivers’ likelihood to ask for help. Caregivers who had higher subject burden (worry) and caregivers who provided more assistance with daily living were more likely to ask for help. It is suggested that case managers assess the amount of worried family caregivers’ experience because their worries may provide the motivation to ask for help or to participate in help when it is offered to them

Impact of Dual Disorders, Trauma, and Social Support on Quality of Life Among Women in Treatment for Substance Dependence

Objective Women with dual disorders report lower levels of social support than women with substance dependence alone, and lower levels of social support have been associated with lower quality of life among individuals with substance use disorders. However, little is known about the impact of trauma symptoms and violence exposure on quality of life for women with dual disorders. The purpose of this study was to examine the impact of dual disorders, trauma, and social support related to recovery on various domains of quality of life among women in substance abuse treatment. Methods This study utilized multiple standardized measures and hierarchical ordinary least squares regression to examine quality of life, trauma, and social support in women with dual disorders. Four domains of quality of life were measured (Physical, Psychological, Social, and Environmental Domains). Participants (N=369) were recruited from three inner city women only addiction treatment programs. IRB approval was obtained prior to sample recruitment. Results Presence of a dual disorder was significantly associated with lower quality of life in the Physical and Psychological domains. However, this difference was no longer significant when trauma symptoms were added to the model. Trauma symptoms and Support for Recovery significantly predicted quality of life across all four domains and Friends Support for Abstinence across three domains. Conclusions Findings suggest that the presence of a dual disorder in women may indicate a history of trauma. They also support the importance of both friend’s support for abstinence and recovery support as predictors of quality of life in women with dual disorders. Interventions that focus on social support and quality of life in treatment with women with substance use disorders may potentially enhance treatment outcomes

Intersystem Collaboration: A Statewide Initiative to Support Families

The study described in this paper utilized a qualitative case study method to assess the processes involved in inter-system collaboration in the context of one state\u27s system change initiative. The collaborative experience is described from the perspective of participating service system professionals and family members. The major themes of collaboration that emerged from the study included changes in communication across systems, changes in inter-system relationships, changes in attitudes, changes in interactions with families, and changes in the ways services are delivered. Lessons learned and practice implications of each theme are discussed

Toward a user-centered design of a weather forecasting decision-support tool

Hazard Services is a software toolkit that integrates information management, hazard alerting, and communication functions into a single user interface. When complete, National Weather Service forecasters across the United States will use Hazard Services for operational issuance of weather and hydrologic alerts, making the system an instrumental part of the threat management process. As a new decision-support tool, incorporating an understanding of user requirements and behavior is an important part of building a system that is usable, allowing users to perform work-related tasks efficiently and effectively. This paper discusses the Hazard Services system and findings from a usability evaluation with a sample of end users. Usability evaluations are frequently used to support software and website development and can provide feedback on a system’s efficiency of use, effectiveness, and learnability. In the present study, a user-testing evaluation assessed task performance in terms of error rates, error types, response time, and subjective feedback from a questionnaire. A series of design recommendations was developed based on the evaluation’s findings. The recommendations not only further the design of Hazard Services, but they may also inform the designs of other decision-support tools used in weather and hydrologic forecasting. Incorporating usability evaluation into the iterative design of decision-support tools, such as Hazard Services, can improve system efficiency, effectiveness, and user experience

Support Networks of Primary Caregivers Receiving Family Preservation Services: An Exploratory Study

Copyright 1994 Families International, Inc.The authors describe network characteristics and support resources from a clinical sample of 40 families. Data were obtained by family workers during the first two weeks of intervention. Case vignettes illustrate the multiple uses to which this information was put. Implications for future research and practice are discussed

Personal Network Recovery Enablers and Relapse Risks for Women With Substance Dependence

We examined the experiences of women in treatment for substance dependence and their treatment providers about personal networks and recovery. We conducted six focus groups at three women’s intensive substance abuse treatment programs. Four coders used thematic analysis to guide the data coding and an iterative process to identify major themes. Coders identified social network characteristics that enabled and impeded recovery and a reciprocal relationship between internal states, relationship management, and recovery. Although women described adding individuals to their networks, they also described managing existing relationships through distancing from or isolating some members to diminish their negative impact on recovery. Treatment providers identified similar themes, but focused more on contextual barriers than the women. The focus of interventions with this population should be on both internal barriers to personal network change such as mistrust and fear, and helping women develop skills for managing enduring network relationships

Predictors of Depressive Symptomatology in Family Caregivers of Wom-en With Substance Use Disorders or Co-Occurring Substance Use and Mental Disorders

This study utilized a stress-process model to examine the impact of having a female family member with substance use or co-occurring substance use and mental disorders on family caregivers\u27 depressive symptomatology. Participants were 82 women receiving substance abuse treatment and the family member providing the most social support for each woman. Greater caregiver depressive symptomatology was predicted by greater care recipient emotional problems, less care recipient social support, and poor caregiver health. Implications of findings for treatment and future research are discusse

Substance Abuse Treatment Stage and Personal Networks of Women in Substance Abuse Treatment

This study examines the relationship among 4 treatment stages (i.e., engagement, persuasion, active treatment, relapse prevention) and the composition, social support, and structural characteristics of personal networks. The study sample includes 242 women diagnosed with substance dependence who were interviewed within their first month of intensive outpatient treatment. Using EgoNet software, the women reported on their 25 alter personal networks and the characteristics of each alter. With one exception, few differences were found in the network compositions at different stages of substance abuse treatment. The exception was the network composition of women in the active treatment stage, which included more network members from treatment programs or 12-Step meetings. Although neither the type nor amount of social support differed across treatment stages, reciprocity differed between women in active treatment and those in the engagement stage. Networks of women in active treatment were less connected, as indicated by a higher number of components, whereas networks of women in the persuasion stage had a higher degree of centralization, as indicated by networks dominated by people with the most ties. Overall, we find social network structural variables to relate to the stage of treatment, whereas network composition, type of social support, and sociodemographic variables (with a few exceptions) do not relate to treatment stage. Results suggest that social context, particularly how social contacts are arranged around clients, should be incorporated into treatment programs, regardless of demographic background

Prospective Patterns and Correlates of Quality of Life among Women in Substance Abuse Treatment

Background Quality of life (QOL) is increasingly recognized as central to the broad construct of recovery in sub- stance abuse services. QOL measures can supplement more objective symptom measures, identify specific service needs and document changes in functioning that are associated with substance use patterns. To date however, QOL remains an under investigated area in the addictions field, especially in the United States. Methods This study examines patterns and predictors of QOL at 1 and 6 months post treatment intake among 240 women enrolled in substance abuse treatment in Cleveland, Ohio. The World Health Organization Quality of Life (WHOQOL-BREF) measure was used to assess physical, psychological, social and environmental domains. Hierarchical multiple regressions were conducted to identify correlates of QOL at 6 months post treatment intake. Results All QOL domains across the follow up time points improved significantly. However, QOL scores across domains remained below those of healthy population norms. Trauma symptoms significantly predicted Phys- ical and Psychological QOL. Among treatment process variables, alcohol use was the sole significant factor associ- ated with QOL and only for Environmental QOL. Recovery support and friends support for abstinence were consist- ently associated with QOL across all four domains. Implications This study suggests the usefulness of the WHOQOL measure as an indicator of functioning in sub- stance abusing populations. Findings underline the importance of helping women deal with trauma symptoms and develop support for recovery. Further research is needed on the longitudinal relationship between QOL and sub- stance use patterns