A Qualitative Analysis of Family Dynamics and Motivation in Sessions With 15 Women in Drug Treatment Court

Abstract

Women with substance use disorders (SUDs) often experience inadequate health care, mental and physical health problems, trauma, lack of social support, and undermining of support for psychological needs of autonomy, competence, and relatedness needed for motivation and well-being. For women with SUD trying to reclaim sobriety and a healthy life, family can present both barriers and support. The aim of this study is to gain a deeper understanding of the intersection of family relationships with motivation of women in Drug Treatment Court (DTC) to attain their health goals. Data consist of transcribed intervention sessions between trained peer interventionists and 15 DTC participants from The Women’s Initiative Supporting Health DTC Intervention Study. This analysis uses a qualitative framework approach to analyze the data. The Self-determination Theory of human motivation and Family Systems Theory provide the conceptual framework to understand how participants’ expressions of motivation-related basic needs of autonomy, competence, and relatedness and change-related behaviors interfaced with family support. Analysis revealed more mentions of family in motivation-supportive contexts than in motivation-thwarting contexts, but highlighted complex roles families can play in health of women in recovery from SUD. Providers may be able to incorporate this knowledge to address the needs of this challenging population.

The Impact of Traumatic Stress, Social Support, and Substance Problems on Graduation Among Female Offenders in a Prescription Drug Court Program

“…The present findings showed that tangible social support was a significant negative predictor of graduation, an indicator contrary to our hypotheses and to past research on the prevalence of social networks (Goldberg et al, 2019;Laudet et al, 2004;Warren et al, 2007;Watkins et al, 1999) but consistent with some literature on the quality of social networks (Dannerbeck et al, 2006;Falkin & Strauss, 2003). We observed that participants with higher levels of tangible support were 6% less likely to graduate compared to those with lower levels of support.…”

“…Next, considering findings that mental health symptoms (e.g., depression) are negatively correlated with drug court completion (Mendoza et al, 2013) and that a high rate of female drug court participants endorse a history of trauma exposure (Sartor et al, 2012), we hypothesized that depression and posttraumatic stress symptoms (PTSS) would be negatively associated with drug court graduation. Finally, given the impact of positive social support systems on decreases in mental health symptoms and substance use and an increased likelihood of drug court graduation (Goldberg et al, 2019;Laudet et al, 2004;Warren et al, 2007;Watkins et al, 1999), we hypothesized that higher levels of social support would be positively associated with the likelihood of graduation in the present sample.…”

“…Although limited in scope, some existing research has determined that connections between drug court participants' outcomes and their selfefficacy are contingent upon access to sustainable social support. This work has linked positive social relationships to improved mental health and substance use outcomes, successful completion of treatment, and drug court graduation (Goldberg et al, 2019;Laudet et al, 2004;Warren et al, 2007;Watkins et al, 1999). Positive social support is especially imperative during the beginning stages of treatment, when individuals are most likely to exhibit deficits in motivation for change, which can result in difficulty adhering to their treatment plan or abstaining from substances (Laudet et al, 2004).…”

“…Overall, female offenders are more likely than male offenders to meet the diagnostic criteria for psychiatric disorders and report housing issues, parenting stress, and a history of trauma exposure (Messina et al, 2007(Messina et al, , 2008Tossone & Baughman, 2020). Women who are in treatment for substance use often lack strong positive social support (Goldberg et al, 2019) and, instead, may possess strong social networks that actually enable their substance use behaviors (Falkin & Strauss, 2003). Further, women also experience unique barriers to treatment due to their roles as primary caregivers, often fearing they will be reported to the child welfare system and have their children removed because of their substance use (National Resource Center on Justice Involved Women, 2016).…”

“I was 15 when I started doing drugs with my dad”: Victimization, Social Determinants of Health, and Criminogenic Risk Among Women Opioid Intervention Court Participants

“…Journal of Interpersonal Violence 37 (21)(22) successes and lessons learned from the use of drug treatment courts (DTC) and the urgent need to address rapidly rising opioid overdose deaths, various sites across the U.S. have recently implemented OCs (Watson, 2018). Given the differences in needs and outcomes between female and male DTC participants, and what little is known of OC outcomes, it is important to develop sound gender-responsive, trauma-informed, and trauma-specific strategies to inform legal practices and public health approaches (Goldberg et al, 2019;Tripodi & Pettus-Davis, 2013).…”