Exploring social connectedness, isolation, support, and recovery factors among women seeking substance use treatment.

This cross-sectional study examined the relationship between social variables, recovery orientation, and recovery capital among a sample of n = 30 women actively seeking substance use disorder treatment at a community-based facility in the Midwest United States. Results indicated a positive association between social connectedness, abstinence recovery orientation (p = .048) and social isolation (p = .010). Social isolation was positively associated with abstinence recovery orientation (p = .004) and negatively related to recovery capital (p = .003). Social support was positively correlated with positive expectancy (p = .030) and recovery capital (p = .033). Further, moderate/high alcohol use was related to lower normal living scores (t(28) = 3.10, p = .004), lower recovery capital scores (t(28) = 4.15, p < .000), and higher social isolation scores (t(28) = -2.53, p = .017). Screening at moderate/high risk for cannabis use was related to lower normal living scores (t(28) = 3.01, p = .005), and lower positive expectancy scores (t(28) = 3.03, p = .005). Finally, screening for moderate/high risk for polysubstance use was related to lower normal living orientation (t(28) = 2.52, p = .018) and recovery capital scores (t(28) = 2.79, p = .009). Current findings may inform strategies for examining social connectedness and social isolation variables in future clinical practice, policy, and scholarship.

Residential substance use treatment outcomes for pregnant and postpartum women: Distinct patterns for women enrolled before versus during the COVID-19 pandemic.

INTRODUCTION: Substance use among pregnant and postpartum women (PPW) is a serious public health concern. The COVID-19 pandemic has exacerbated substance use among the general population including pregnant women, and disrupted operations for substance use treatment centers. Little is known about the outcomes of substance use treatment for PPW before and during the COVID-19 pandemic. METHOD: Data from a longitudinal program evaluation were analyzed to examine outcomes among 136 PPW participating in a residential SUD treatment program, and to explore differences in treatment outcomes for women who enrolled in services before versus during the COVID-19 pandemic. Analyses were used to test the significance of change from treatment intake to 6-month post-intake on assessments of substance use, mental health symptoms, and functioning collected to evaluate the Healthy Families Program (HFP), a comprehensive program for PPW located within a gender-specific SUD treatment facility in the United States. RESULTS: Results indicated that from treatment intake to follow-up assessment, clients self-reported statistically significant improvements in family functioning and daily functioning as well as reduced days of substance use. Notably, the rate of treatment intakes declined during the COVID-19 pandemic. In separate analyses by subgroup, mental health indicators showed improvements only for clients engaged in treatment before the COVID-19 pandemic and not for clients served during the COVID-19 pandemic, but substance use decreased significantly for both pre-pandemic and pandemic enrollees. CONCLUSION: Specialized treatment considerations and implications for PPW are discussed, including a need for added emphasis on co-occurring mental health symptoms and family system stress during a pandemic, and the role of nurses in identifying and addressing these concerns. Additionally, potential relapse prevention efforts during COVID-19 for PPW with substance use disorders are examined. CLINICAL RELEVANCE: The present research continues to highlight the importance of specialized treatment programming for PPW with SUDs as well as the potential need for additional recovery support mechanisms to be utilized during the COVID-19 pandemic.

Therapist Adherence to Two Treatments for Adolescent Suicide Risk: Association to Outcomes and Role of Therapeutic Alliance.

In psychotherapy research, adherence refers to the extent to which therapists deliver a treatment as intended. This study examined whether therapist adherence to two different manualized treatments was associated with improved client outcomes and whether the association was moderated by therapeutic alliance. The study sample included 320 video recordings of therapy sessions from 118 cases in a randomized controlled trial (RCT) comparing attachment-based family therapy (ABFT) with family-enhanced nondirective supportive therapy (FE-NST). Recordings were selected from early, middle, and late stages of treatment. The adherence measure consisted of 24 items representing essential therapist interventions from both treatments. Trained raters coded tapes from both therapies. Adolescent self-report of alliance was measured at session 4. Adherence to ABFT was associated with a significant increase in family cohesion at mid-treatment but not at posttreatment. Adherence to FE-NST was significantly associated with an increase in suicide ideation posttreatment. Using therapeutic alliance as a moderator, adherence to ABFT was significantly associated with a reduction in suicide ideation, family conflict, and higher client satisfaction posttreatment. Alliance did not positively affect the association of FE-NST adherence to outcomes. Findings suggest that adherence to ABFT interventions may be better linked to treatment outcomes when adolescents feel a strong alliance with their therapist. Implications for future research and therapist training are explored.

En la investigación sobre psicoterapia, la adhesión se refiere al grado en el cual los terapeutas brindan un tratamiento según lo previsto. Este estudio analizó si la adhesión del terapeuta a dos tratamientos estandarizados diferentes estuvo asociada con mejores resultados en los pacientes y si la asociación estuvo moderada por la alianza terapéutica. La muestra del estudio incluyó 320 videograbaciones de sesiones de terapia de 118 casos en un ensayo aleatorizado controlado donde se comparó la terapia familiar basada en el apego (TFBA) con la terapia de apoyo no directiva optimizada por la familia (TAND-OF). Se eligieron grabaciones de las etapas iniciales, intermedias y finales del tratamiento. El instrumento de medición de la adhesión consistió en 24 ítems que representaban intervenciones esenciales del terapeuta de ambos tratamientos. Un grupo de calificadores capacitados codificaron las grabaciones de ambas terapias. El autoinforme de alianza de los adolescentes se midió en la cuarta sesión. La adhesión a la TFBA estuvo asociada con un aumento considerable de la cohesión familiar en la mitad del tratamiento, pero no después del tratamiento. La adhesión a la TAND-OF estuvo asociada considerablemente con un aumento de la ideación suicida después del tratamiento. Utilizando la alianza terapéutica como moderadora, la adhesión a la TFBA estuvo asociada considerablemente con una reducción de la ideación suicida, el conflicto familiar y una mayor satisfacción del paciente después del tratamiento. La alianza no afectó positivamente la asociación de la adhesión a la TAND-OF con los resultados. Los resultados sugieren que la adhesión a las intervenciones de TFBA puede asociarse mejor con los resultados del tratamiento cuando los adolescentes sienten una alianza fuerte con su terapeuta. Se analizan las implicancias para futuras investigaciones y para la capacitación de los terapeutas.

An Exploration of Mothers' Successful Completion of Family-Centered Residential Substance Use Treatment.

Behavioral health and substance use centers have started focusing efforts on creating, adopting, and implementing evidence-based practices and programs that effectively address the needs of women and, particularly, mothers entering treatment with children. However, women with substance use disorders (SUDs) remain an underserved and understudied population; even less studied are the complexities and unique SUD treatment needs of women who have children. Family therapists' systemic training is a valued approach in conceptualizing and implementing treatment for mothers with SUDs and their families. This study explored the construct of mothering children during family-centered substance use treatment using a transcendental phenomenological approach. Analysis revealed themes related to motherhood, parenting, and support for mothers and children. Two themes emerged from the data: (a) grappling with motherhood and addiction leading to the decision for treatment and (b) specific aspects of the treatment program conducive to motherhood. Results indicated the positive impact of mothers' experiences in family-centered substance use treatment, aligning with previous literature that suggests mothers are more engaged in treatment when their children remain in their care. The insights gleaned from the participants in this study provide suggestions for further improving programming that supports mothers and their children during the recovery process. Treatment considerations are offered for family therapists working with mothers with SUDs and their families.

Los centros para la salud conductual y el consumo de sustancias han comenzado a centrar sus esfuerzos en la creación, la adopción y la implementación de prácticas y programas factuales que aborden eficazmente las necesidades de las mujeres y, particularmente, de las madres que ingresan en un tratamiento con hijos. Sin embargo, las mujeres con trastorno por consumo de sustancias siguen siendo una población marginada y poco estudiada; y aun menos estudiadas son las complejidades y las necesidades exclusivas de tratamiento para los trastornos por consumo de sustancias de las mujeres que tienen hijos. La capacitación sistémica de los terapeutas familiares es un enfoque valioso a la hora de conceptualizar e implementar el tratamiento para las madres con trastornos por consumo de sustancias y sus familias. Este estudio analizó el constructo de la maternidad durante el tratamiento para el consumo de sustancias centrado en la familia utilizando un enfoque fenomenológico trascendental. El análisis reveló temas relacionados con la maternidad, la paternidad y el apoyo para las madres y los hijos. De los datos surgieron dos temas: (a) la lucha con la maternidad y la adicción conducente a la decisión de recibir tratamiento y (b) aspectos específicos del programa de tratamiento favorables para la maternidad. Los resultados indicaron el efecto positivo de las experiencias de las madres en el tratamiento para el consumo de sustancias centrado en la familia en consonancia con bibliografía anterior que sugiere que las madres se comprometen más con el tratamiento cuando sus hijos quedan a su cuidado. Las apreciaciones recogidas de los participantes de este estudio ofrecen sugerencias para mejorar más las programaciones que apoyen a las madres y a sus hijos durante el proceso de recuperación. Se ofrecen consideraciones sobre el tratamiento para los terapeutas familiares que trabajan con madres con trastornos por abuso de sustancias y sus familias.

Social Support, Family Empowerment, Substance Use, and Perceived Parenting Competency during Pregnancy for Women with Substance Use Disorders.

BACKGROUND: Parenting self-efficacy has been linked to positive parent and child outcomes however, little research exists on factors that influence parenting self-efficacy among pregnant women with substance use disorders. OBJECTIVES: This study explored substance use severity, social support, and family empowerment as predictors of parenting self-efficacy among pregnant women (N = 71) entering SUD treatment. METHODS: The study used a quantitative cross-sectional design. RESULTS: Statistically significant positive correlations emerged between social support and parenting self-efficacy as well as family empowerment and parenting self-efficacy. Family empowerment and social support were also correlated. A backward elimination regression analysis revealed family empowerment to be the strongest predictor of parenting self-efficacy. No relationships were found among substance use severity and the study variables. CONCLUSIONS: When promoting parenting self-efficacy, both social support and family empowerment are important domains to consider for treatment planning and resource development among pregnant women with substance use disorders.

Home telehealth for chronic disease management: selected findings of a narrative synthesis.

BACKGROUND: Chronic disease has become an increasingly important issue for individuals and healthcare organizations across Canada. Home telehealth may have the potential to alleviate the economic and social challenges associated with rising rates of chronic disease. An aim of this review was to gather and synthesize the evidence on the effectiveness of home telehealth in chronic disease management. MATERIALS AND METHODS: We searched the Medline, EMBASE, Web of Science, CINAHL, and PAIS databases for studies published in English from January 1, 2005, and December 31, 2010. Academic publications, white papers, and gray literature were all considered eligible for inclusion, provided an original research element was present. Articles were screened for relevance. RESULTS: One hundred one articles on quantitative or mixed-methods studies reported the effects of home telehealth on disease state, symptoms, and quality of life in chronic disease patients. Studies were consistent in finding that home telehealth was equivalent or superior to usual care. CONCLUSIONS: The literature strongly supports the use of home telehealth as an equally effective alternative to usual care. The circumstances under which home telehealth emerges as significantly better than usual care have not been extensively researched. Further research into factors affecting the effectiveness of home telehealth would support more widespread realization of telehealth's potential benefits.

Understanding families impacted by opioid use: Outcomes of a therapist training program.

INTRODUCTION: Increasing the substance use workforce is vital in addressing the many complexities of opioid use among families. The purpose of the present research was to examine 6-month outcomes of a training program focusing on opioid use among families, for master-level family therapy (MFT) and community mental health counseling (CMHC) students. METHOD: In total, 58 students participated in self-reported survey assessments at baseline and 6-month follow-up across the following domains: attitudes about substance use, interpersonal professional collaboration, trainee confidence, professional quality of life, and cross-cultural counseling competence. RESULTS: The study results indicated a significant improvement between scores on attitudes of working with families impacted by substance use disorders from baseline to follow-up. There was a significant positive change in cross-cultural competency, interprofessional competency, and trainee confidence from baseline to follow-up. DISCUSSION: The findings contribute to extant literature by examining the potential role of participating in substance use training for graduate-level MFT and CMHC trainees and considerations for implementing specific substance use training components among graduate-level trainees. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parenting self-efficacy and empowerment among expectant mothers with substance use disorders.

OBJECTIVE: to describe parenting self-efficacy and family empowerment among expectant mothers with substance use disorders. DESIGN: the study employed a quantitative cross-sectional design. PARTICIPANTS: participants were 71 pregnant women with substance use disorders entering a gender-specific, substance use disorder, residential treatment facility. MEASUREMENTS: measurement tools included: the demographic data form, the Parenting Sense of Competence Scale, the Addiction Severity Index, and the Family Empowerment Scale. FINDINGS: women in their third trimester reported statistically significant higher levels of both parenting self-efficacy and family empowerment than women in their first trimester. KEY CONCLUSIONS: interventions that promote parenting self-efficacy and family empowerment need to target women in their first trimester. IMPLICATIONS FOR PRACTICE: midwives with specialized training in substance abuse disorders are in a unique position to bolster expectant mothers' parenting capabilities during the addiction recovery process.

A two year longitudinal outcome study of addicted health care professionals: an investigation of the role of personality variables.

The co-morbidity of personality disorders (PDs) and other dysregulatory personality patterns with addiction have been well-established, although few studies have examined this interplay on long-term sobriety outcome. In addition, health care professionals suffering from addiction have both a significant public health impact and a unique set of treatment and recovery challenges. The aim of this study was to investigate if personality variables differentiated sobriety outcome in this population over a two year interval. A clinical sample of health care professionals participated in a substance abuse hospital treatment program individually tailored with respect to personality. Participants took the Temperament and Character Inventory and the Millon Clinical Multiaxial Inventory at intake, and were tracked two years post-discharge to determine sobriety status. Univariate analyses showed antisocial personality, female gender, and alcohol dependence were independent predictors of relapse, however a significant relationship between personality and substance use did not exist in multivariate analysis when controlling for demographic variables The lack of multivariate relationships demonstrates the heterogeneity in self-report measures of personality, which suggests the interplay of personality and addiction is complex and individualized.