Matching treatment focus to patient social investment and support: 18-month follow-up results.

Abstract

Patients were randomly assigned to 1 of 3 treatments: brief broad-spectrum (BBS), extended relationship enhancement (ERE), or extended cognitive-behavioral (ECB). A hierarchical latent growth model was used to analyze the data of 188 patients (82%) followed for 18 months. ERE treatment was significantly more effective in increasing abstinence of patients entering treatment with a network unsupportive of abstinence or with a low level of investment in their network, whereas BBS treatment was more effective for patients with either (a) both a social network unsupportive of abstinence and a low level of network investment or (b) high investment in a network supportive of abstinence. ECB outcomes were neither as good as those matched nor as bad as those mismatched to the different exposures of relationship enhancement. This suggests that dose of relationship enhancement should be determined after assessing patient relationships.

Sex Differences in Social Support and Self-Efficacy Within a Recovery Community

“…Analyses revealed that for both women and men, longer lengths of residency in OH were significantly related to decreased social support for alcohol/drug use. This finding is an important one given the impact that such support has been found to have on drinking behaviors (Longabaugh et al, , 1995(Longabaugh et al, , 1998. That this relationship was stronger for women than men suggests the possibility that the process of recovery and the impact of variables such as social support may differ for women and men.…”

“…Research in the area of addiction and recovery similarly highlights the important impact of social support networks on both individuals' substance use and abstinence (e.g., see Beattie & Longabaugh, 1997;Humphreys, Mankowski, Moos, & Finney, 1999;Longabaugh, Beattie, Noel, Stout, & Malloy, 1993;Longabaugh, Wirtz, Beattie, Noel, & Stout, 1995;Longabaugh, Wirtz, Zweben, & Stout, 1998). With respect to recovery, this research has found that specific social support for abstinence (vs. general social support) is directly and positively related to maintaining abstinence (Longabaugh et al, , 1998Mohr, Averna, Kenny, & Del Boca, 2001;Rice, Longabaugh, & Stout, 1997) and that this effect is strongest when the individuals are highly invested in these supportive networks (Longabaugh et al, , 1998.…”

“…Several of the indices are reversed scored so that all indices have the same direction, with larger scores representing more support for drinking/drug use. Longabaugh et al (1993Longabaugh et al ( , 1995 have demonstrated strong construct validity across IPA subscale indices (.80), as well as a test-retest reliability over a 2-3-day period of .95 (Longabaugh et al, 1998;Del Boca, McRee, & Babor, 1995). Beattie et al (1993) have also reported acceptable overall item and subscale alphas for this instrument (i.e., for both subscales and total items, Cronbach's alpha was .66-.67).…”

“…Following the initial analyses, analyses were conducted to test the proposed model derived from that described by Longabaugh et al (1993Longabaugh et al ( , 1995Longabaugh et al ( , 1998 in which substance use outcomes are a function of social support for alcohol/drug use, moderated by social investment. In this study, Longabaugh's model was modified to include length of residency in OH as a predictor of support for alcohol/drug use and abstinence self-efficacy such that time spent as a resident in an OH would be associated with decreased support for substance use and increased network investment and self-efficacy.…”

A systematic review of emergency care brief alcohol interventions for injury patients

“…These patients tend to be younger than the general population, which could make it possible to detect risky drinking practices in the early stages (Antti-Poika & Karaharju, 1988). In addition, an injury is believed to increase receptivity of patients toward alcohol counseling, thus providing a "teachable moment" in which the aversive experience naturally produces a period where the individual is contemplating behavior change (Longabaugh, Wirtz, Beattie, Noel, & Stout, 1995;Gentilello et al, 1999). However, it has also been suggested that the traumatic experience of the injury and the subsequent emergency department visit and/or hospitalization could themselves yield a decrease in drinking independent of any interventions (Bombardier, Dawn, & Kilmer, 1997;Bombardier & Rimmele, 1998).…”