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.

As part of a larger initiative to promote active learning at Case Western Reserve University, three faculty members (one field and two academic) participated in a yearlong fellowship focusing on active instruction and academic technologies. The use of interactive technology and technology-based peer-to-peer active learning was considered a natural fit to the teaching of social work clinical practice skills; these techniques were designed to recognize students' diverse learning styles and to promote hands-on application of practice skills in classroom and field settings. The following innovations were implemented. First, a foundation methods practice course was ''flipped''-students viewed online lectures and instructional videos at their own pace prior to class, allowing classroom time to be reserved for collaborative work and case study exercises designed to engage students and deepen their understanding. Second, the Google Application Suite was used in both foundation and advanced masters courses to (a) help bridge the gap between field and classroom through case study dialogues with community practitioners using Google Hangouts video conferencing capability, (b) create an online and in-class learning community using Google?, and (c) promote student collaboration using Google Drive, Documents and Presentation. Third, the integration of newly designed interactive classroom learning spaces and collaborative technology was used to promote a pedagogical shift toward active learning. Implementation and evaluation of these approaches to teaching social work practice are presented.

Introduction Women with substance use disorders enter treatment with limited personal network resources and reduced recovery support. This study examined the impact of personal networks on substance use by 12 months post treatment intake. Methods Data were collected from 284 women who received substance abuse treatment. At six month follow up, composition, support availability and structure of personal networks were examined. Substance use was measured by women’s report of any use of alcohol or drugs. Hierarchical multivariate logistic regression was conducted to examine the contribution of personal network characteristics on substance use by 12 months post treatment intake. Results Higher numbers of substance using alters (network members) and more densely connected networks at six month follow-up were associated with an increased likelihood of substance use by 12 months post treatment intake. A greater number of isolates in women’s networks was associated with decreased odds of substance use. Women who did not use substances by 12 months post treatment intake had more non-users among their isolates at six months compared to those who used substances. No association was found between support availability and likelihood of substance use. Conclusions Both network composition and structure could be relevant foci for network interventions e.g. helping women change network composition by reducing substance users as well as increasing network connections. Isolates who are not substance users may be a particular strength to help women cultivate within their network to promote sustained sobriety post treatment.

We explored tobacco use across federally qualified health centers (FQHCs) and compared data on state-level tobacco use between FQHC patients and the general population. We used data from the Uniform Data System (UDS) and the Behavioral Risk Factor Surveillance System (BRFSS) to generate estimates of 2013 prevalence of tobacco use among adults aged 18 years or older. According to UDS data, the overall prevalence of tobacco use was 25.8% in FQHCs compared with 20.6% in the general population represented by BRFSS data, an average of 5.2 percentage points (range, −4.9 to 20.9) higher among FQHCs. Among FQHCs, the burden of tobacco use and the opportunity for offering cessation assistance is substantial.

Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment.

Background Interpersonal trauma poses challenges and complications to the development and maintenance of personal networks of substance using women. Few studies have examined its effects on personal network support availability and quality of relationships, limiting our understanding of the social context in which substance using women with a history of trauma are embedded. Methods Women with substance use disorders (SUD) who received treatment at three county-funded, women-only intensive treatment programs (N = 375) were interviewed at intake and at follow ups 1, 6, and 12 months later. A network software program, Ego Net, elicited 25 network members per respondent, social support availability, and the quality of network relationship at each assessment. Trauma symptomatology was assessed with Trauma Symptom Checklist-40 at intake. Results Findings from longitudinal mixed model analyses indicated that higher levels of trauma symptomatology were associated with both a negative, critical quality and less closeness in network relationships over the 12 month study period. However, trauma symptoms were not related to the number of network members reported as providing emotional, concrete, or sobriety support. Effects of trauma symptoms on the support availability in the network and the quality of network relationships were consistent over the follow-up period. Conclusions Findings highlight the potential role of trauma symptoms in determining the quality of relationships within personal networks among women with SUD, suggesting the need for routine mapping of network relationships throughout treatment.

This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t-tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.

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