Transcript Efficacy of Drug and Alcohol Treatment

Efficacy of Drug and Alcohol Treatment Programs on
Women:
The Effect of Proposition 36
presented at the
University of California, Irvine
by
Taline Kizirian
California’s Substance Abuse and
Crime Prevention Act: Prop. 36
• State-mandated program
• Alternative to incarceration
• 3 different levels of treatment: 6,9,12
months
• Must be addicted to drug or alcohol and
have pled or been found guilty for
possession of drugs
Pertinent Issues in Drug and Alcohol
Treatment
1.
Court discretion in deciding necessary time in recovery
2.
Male-oriented approaches vs. gender-specific modalities
that would improve the quality of treatment
3.
Interaction between treatment participants and providers
4.
Severity of drugs used
5.
Physiological, emotional, and familial differences special to
women
Theoretical Background
 Falkin et al.
-Gender specific programs create a setting that empowers, improves
coping skills and helps women “develop functional support networks
and greater life stability”
 Murphy, S. & Rosenbaum, M.
-While cessation of drug abuse is viewed as the ultimate goal of
treatment, complete abstinence is difficult to achieve and even harder
to maintain
 Bride
- psychiatric symptoms than men, more depression and anxiety, lower
self-esteem, and higher rates of childhood sexual abuse
 Paltrow
-relationship to drugs is often affected by experiences with domestic
violence and their responsibilities for family and children
 Acharyya et al.
- women tend to report a higher problem severity then men
Interpersonal Factors Hypothesized to
Affect the Process of Recovery
• Relationships (H1):
– Participants in a relationship with a significant other who
uses drugs while she is in treatment find it more challenging
to complete treatment
• Support (H2):
– Successful recovery is reliant upon familial and spousal
support offered to the individual undergoing treatment
Situational Factors Hypothesized to Affect the
Process of Recovery
• Setting (H3):
– Residential treatment facilities rather then outpatient
recovery programs provide more access to treatment
providers and professional help during all times of the
day
• Staff (H4):
– Successful recovery is positively related to the
institutional rules and protocols that can inadvertently
hinder and obstruct rather then foster relief for female
addicts.
Research Site and Sources of Data
•
•
Residential Treatment Sites: Orange County, CA
– State-certified and court-approved drug and
alcohol treatment facilities
– Court-mandated and voluntary clientele
– Proximity to researcher
Data
– Case studies by drug treatment experts
– Interviews with residents in drug and alcohol
treatment
– Interviews with counselors and treatment
providers
Methodology I
Interpretive Ethnographic Tradition
• Interviews
-15-20 minutes
• Clients
-History
-Expectations
-Relationships
•
Counselors
- History
- Methods
(Anspach 1993)
Methodology II
• Sampling Method
-Snowball/Convenience Sample
-15 Female Treatment Clients
-2 Female Treatment Providers
• Sample Characteristics
-18-60 years old
-4 cognitively challenged
-8 pregnant
-14 with children
-low SES
-low academic achievment
Perspective
• Generalizability
-small sample size
-non-representative sample
• Validity
-inability to study outcomes of treatment participants
-lack of knowing depth of participants mental and health
problems that would affect recovery
RESULTS 1
VARIABLE
1
PRIOR
TREATMENT
DESCRIPTION
Participant’s history of drug
and/or alcohol treatment
The extent to which residents
2
3
RULE
agree and adhere to their
AGREEMENT program rules
SETTING
Residential vs. outpatient
treatment
FINDING
Participants who received
prior treatment did not
demonstrate a decrease in
the likelihood of relapse
Participants who adhere to
program rules are more
likely to successfully
overcome drug addiction
then those who do not
There was no significant
difference in successful
program recovery for
patients in residential
versus outpatient programs
RESULTS 2
VARIABLE
4
5
STAFF
WORK
DESCRIPTION
Treatment providers, counselors and
therapists who play a role in
strengthening participants’ capability
to overcome addiction
FINDING
Participants indicated that
institutionalized challenges
led to incompletion of
recovery
Participants required to
Whether or not the program requires
work during treatment
participants to maintain a part time or
indicated difficulty
full time job during the course of the
attending scheduled events
program
due to job-related stress
RESULTS 3
VARIABLE
6
SUPPORT
DESCRIPTION
Emotional and spousal support
provided by family members and
friends
FINDING
Participants receiving support from
their spouses and loved ones in the
form of visitation during treatment
and verbal affirmation of support are
less likely to relapse then those who
do not see or speak with their
significant others and/or family
members including children.
General Finding
The efficacy of Proposition 36 for
women may be determined by
considering the substantial
improvements in treatment methods
and the acknowledgment of a diverse
set of barriers that need to be addressed
in order to promote the recovery of
women drug users.
Acknowledgments
•
•
•
•
Professor John Dombrink
Dr. Valerie Jenness
Glenda Kelmes, doctoral student
University of California, Irvine Undergraduate
Research Opportunities Program
• The Treatment Participants and Counselors who
Participated
• The Department of Criminology, Law and Society
For more information contact me at:
Taline Kizirian
Department of Criminology, Law and Society
University of California, Irvine
[email protected]