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Martin, Toby C.The Effect of Social Networks and Co-occurring Mental Disorders on Barriers to Treatment and Treatment Motivation among Women with Substance Use Disorders
Doctor of Philosophy, Case Western Reserve University, 2007, Social Welfare
This study examined the predictive role of social networks and substance use and mental health disorders on perceived barriers to treatment services and treatment motivation. The research objectives of this study were to identify and to gain a further understanding of the barriers and motivators women experience in accessing services in substance abuse treatment and/or mental health disorders treatment programs. The sample consisted of 245 women: 86 recruited from community based substance abuse treatment facilities and 159 recruited from an ongoing study of cocaine exposed infants and their mothers. The measures included: the Diagnostic Interview Schedule to determine substance use and mental health disorders, Allen Barriers Scale to measure perceived barriers to substance use and mental health disorders treatment, Treatment Motivation Scale to measure Problem Recognition, Desire for Help and Treatment Readiness and Social Network Map to collect information on the composition of and support provided by the social network. Multiple regressions examined the contributions of social network characteristics, substance use and mental health disorders, current participation in treatment, age of women, and the number of children to barriers to treatment and treatment motivation. Overall, few social network variables accounted for barriers to treatment. Informational support and lack of sobriety support from friends were statistically significant predictors of treatment barriers. Several social network variables were found to be predictive of treatment motivation, although not always in the direction expected. Informational support was the only positive support predictive in the expected direction. Dual disorder status was a significant predictor of both treatment barriers and treatment motivation. The study did not show the age of the woman as a significant predictor of barriers but did show age as a significant predictor for treatment motivation. The number of children was not found to be a significant predictor for barriers; however, it was a significant predictor for Desire for Help. The treatment status of the women proved to be a significant predictor of barriers as well as for Problem Recognition and Desire for Help. Clinicians should attend to the personal social networks of clients to help address barriers to treatment and treatment motivation.


Elizabeth Tracy (Advisor)


Social Work


substance use disorders; social networks; barriers to treatment; treatment motivation; women with substance use disorders

Stevenson, Lauren DeMarcoThe Influence of Treatment Motivation, Treatment Status and Social Networks on Perceived Social Support of Women with Substance Use or Co-Occurring Disorders
Doctor of Philosophy, Case Western Reserve University, 2009, Social Welfare

This study examined predictors of perceived social support and support forrecovery of women with substance use disorders or co-occurring substance use and mental disorders. The sample consisted of 136 adult women; 86 women were engaged in inpatient and outpatient substance abuse treatment programs, and 50 women were recruited from a study of mothers with cocaine exposed infants.

The women in the study were predominantly African American (82.4%) and of low income status with 80% of the women reporting an annual family income below $15,000. All of the women had a current substance use disorder and 77 (56.6%) of the women also had a co-occurring mental disorder including: Major Depression, Post Traumatic Stress Disorder, Mania, Generalized Anxiety Disorder, Hypomania, and Dysthymia. On average, women reported having a social network comprised of 10.73 members.

A significant relationship was found between critical members (those who provide negative support) within women’s social networks and perceived social support, with a higher percent of critical network members predicting lower perceived social support. Perceived social support scores were also significantly lower for women with a co-occurring mental disorder. Indirect relationships were found for women’s perceived social support. The percent of professionals within women’s social networks moderated the relationships between women’s treatment motivation and treatment status with perceived social support. The percent of substance users in women’s networks moderated the relationship between treatment motivation and perceived social support.

A sub sample analysis of 86 women in substance abuse treatment explored predictors of support for recovery. A significant relationship was found between the percent of members who support sobriety and support for recovery. This finding provides construct validity for the support for recovery measure.

Practice implications as well as directions for future research are included in this study. Findings suggest that clinicians should work with social network members and clients on improving communication and eliminating critical support to improve social support. Future research should focus on the impact of social relationships on treatment outcomes.


Elizabeth Tracy, PhD (Committee Chair); David Biegel, PhD (Committee Member); Kathryn Adams, PhD (Committee Member); Sonia Minnes, PhD (Committee Member)


Social Research; Social Work


Social Support Networks; Social Support; Substance Use Disorders; Dual Disorders; Co-Occurring Disorders; Treatment Motivation; Social Networks; Substance Abuse; Women