Policy on reintegration of women with histories of substance abuse: A mixed methods study of predictors of relapse and facilitators of recovery

<p>Abstract</p> <p>Background</p> <p>The predominant U.S. policy approach toward individuals with substance abuse problems has relied on stigma and punishment by withholding access to education, cash assistance, housing, social support, and normal social roles. In contrast to this approach, the theory of reintegrative shaming asserts that providing individuals with the opportunity to reconnect with society is more effective in reducing potential to relapse to crime and drug abuse. Strategies that promote such reconnection include expanding access to basic needs and supportive relationships along with increasing opportunities to fully participate in mainstream social roles.</p> <p>Methods</p> <p>The present cross-sectional study examined the predictors of relapse and the facilitators of recovery in a sample of 325 women with histories of substance abuse. Analysis of secondary data, collected as part of a national cross-site study, employed a mixed methods approach conducting (1) logistic regression to examine the predictors of relapse and (2) an inductive qualitative analysis of responses from open-ended items to explore the women's perceptions of barriers to and facilitators of recovery.</p> <p>Results</p> <p>Results suggest that lower levels of instrumental support, affective support, and participation in normal roles (such as parent, employee, student, and citizen) are significant predictors of relapse to drug use and criminal behaviors. Qualitative findings support the quantitative results, revealing that participating women perceived the variables of support and role participation as critical in facilitating their recovery. They also noted the importance of individual characteristics such as optimism and strength and emphasized the significance of their relationship with their children in motivating them to avoid relapse. Findings suggest that punitive policies toward women with substance abuse histories may be ineffective.</p> <p>Conclusion</p> <p>The author concludes that current policies designed to withhold access to basic needs such as housing, education, cash assistance, and positive relationships may deprive women with histories of substance abuse of the means to reconnect with society. Policies that promote access to basic needs and offer avenues for women to participate in normal societal roles should be more fully explored.</p

An exploratory study of engagement in a technology-supported substance abuse intervention

BACKGROUND: The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings. METHODS: This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed. RESULTS: The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community. CONCLUSIONS: The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions. Additional investigation into ways technology may be useful to enhance treatment access for certain subgroups is needed

The Relationship between Mother’s Child Abuse Potential and Current Mental Health Symptoms: Implications for Screening and Referral

This analysis examined data from mothers at 2 of the 9 sites participating in Substance Abuse and Mental Health Services Administration\u27s (SAMHSA\u27s) national Women Co-occurring Disorders and Violence Study (WCDVS). According to previous literature, it was hypothesized that women in the WCDVS would be at high risk of perpetrating child abuse. This research examined mothers\u27 potential for physical child abuse and assessed the association between child abuse potential, current mental health symptoms, alcohol and drug use severity, and trauma. Results revealed that participants had significant potential for child abuse. Hierarchical regression analyses revealed that current mental health symptoms were the strongest predictor of mothers\u27 scores on the Child Abuse Potential (CAP) Inventory. This study highlights the important relationships between commonly used instruments across the mental health, substance, and child welfare fields and the potential dual use of these instruments. Implications for policy and practice are discussed