Women's motivators for seeking treatment for alcohol use disorders

Grosso, Justine A.; Epstein, Elizabeth E.; McCrady, Barbara S.; Gaba, Ayorkor; Cook, Sharon; Backer-Fulghum, Lindsey M.; Graff, Fiona S.

doi:10.1016/j.addbeh.2013.02.004

Cited by 33 publications

(31 citation statements)

References 36 publications

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“…These findings suggest that women who were more proactively working toward abstinence at the start of treatment had experienced more consequences from their drinking (but were not necessarily drinking more frequently than other women) and were more likely to use a variety of coping behaviors to deal with alcohol-related situations at baseline. These findings support the idea that perceived negative consequences may be a significant motivator prompting actions toward becoming abstinent from alcohol, and are in line with previous findings on motivation to seek treatment (Tucker, Vuchinich, & Gladsjo, 1994; Grosso et al, 2013). Women who were in the maintaining abstinence category reported taking more steps toward quitting at baseline than the other two groups, but they also reported more ambivalence, which in the SOCRATES (Miller & Tonigan, 1996) indicates heightened “wondering” about the negative consequences of continued alcohol use and about the possibility of having an alcohol problem.…”

Section: Discussionsupporting

confidence: 91%

Heterogeneity in pathways to abstinence among women in treatment for alcohol use disorder

Holzhauer

Epstein

Cohn

et al. 2017

Journal of Substance Abuse Treatment

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Background Although many providers recommend alcohol abstinence as an initial step in the treatment of alcohol use disorders (AUD), there is a scarcity of research on specific behavioral strategies to achieve this step. The current study examined efficacy of a unique abstinence planning intervention for alcohol in a cognitive behavioral therapy (CBT) outpatient protocol. Design 128 women enrolled in a randomized controlled trial of CBT for AUD at a university-based clinic comprised the sample. Measurements Session 1 manual-guided interventions included an abstinence planning discussion in which each woman chose a specific plan for achieving initial abstinence in collaboration with her therapist. Drinking data were collected via participant logs during the 16 week within-treatment period and via Timeline Follow-Back interview at 12 month follow-up. Findings For 32.8% (n=42) of women who stopped drinking during the pre-treatment assessment period, their abstinence plan was to maintain abstinence (MA). 18.0% (n=23) of women chose a “cold turkey” approach (CT, abrupt cessation without medical assistance), and 46.1% (n=59) chose a “winding down” approach (WD, systematic reduction of drinking toward a specified quit date). Generalized Estimating Equations (GEE) analyses showed that type of abstinence plan chosen was differentially associated with percent days drinking (PDD) in later treatment (weeks 7–16) (p < .01) and during 12 month follow-up (p < .01). Women in the WD group had the highest PDD for both time frames and women in the CT group drank more frequently during later treatment compared to those in the MA group. The association between plan and PDD during follow-up was moderated by early treatment PDD (weeks 1–7; p < .01), such that women in the MA and WD groups had lower follow-up PDD if they were able to decrease their drinking during early treatment. Conclusions Women who were maintaining abstinence at treatment entry or had planned to stop using alcohol abruptly (i.e., “cold turkey”) after starting treatment had better overall drinking outcomes than those who chose to wind down. A plan to wind-down drinking appeared to be the most appealing option to women in the study and, among those who were able to successfully execute this winding down approach, was related to positive long-term drinking outcomes.

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Section: Discussionsupporting

confidence: 91%

Heterogeneity in pathways to abstinence among women in treatment for alcohol use disorder

Holzhauer

Epstein

Cohn

et al. 2017

Journal of Substance Abuse Treatment

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“…Such autonomy could foster the motivation needed to improve health (Grosso et al, 2013). The SEM further contextualizes lives impacted by poverty, racism, and gender discrimination beyond what can be treated in the current rewards and punitive sanctions model (Stokols, 1996).…”

Section: Discussionmentioning

confidence: 99%

Meeting health and psychological needs of women in drug treatment court

Morse

Cerulli

Bedell

et al. 2014

Journal of Substance Abuse Treatment

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We explored healthcare-related experiences of women drug court participants through combining context from the Socio-Ecological Model with motivation needs for health behavior as indicated by self-determination theory. Five focus groups with 8 women drug court participants, 8 court staff, and 9 community service providers were examined using qualitative framework analysis. Themes emerged across the Socio-Ecological Model and were cross-mapped with self-determination theory-defined motivation needs for autonomy, relatedness, and competence. Socio-Ecological levels contained experiences either supporting or eroding women’s motivation needs: 1) intrapersonal challenges participants termed an “evil cycle” of relapse, recidivism, trauma, and life challenges; 2) interpersonal context of parenting and stigma involving features of this “evil cycle”; 3) institutions with logistical barriers to legal and medical assistance; 4) community resources inadequate to support living and employment needs. Self-determination theory helps explain motivation required to address the women’s healthcare needs and multiple demands at all levels of the Socio-Ecological Model.

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“…Much of the extant research has examined the relative risk for specific alcohol-related diseases for women compared to men (e.g., cardiovascular disease, Ikehara et al, 2008; see Kay et al, 2010 for review). Women often cite health concerns as a reason for seeking alcohol treatment (Grosso et al, 2013), so understanding the constellation of health problems in a population of women seeking alcohol treatment may suggest opportunities to target and engage at-risk women in treatment for other health issues.…”

Section: Introductionmentioning

confidence: 99%

Baseline health status and quality of life after alcohol treatment for women with alcohol dependence

Bold

Epstein

McCrady

2017

Addictive Behaviors

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Background Research suggests that women with alcohol use disorders (AUDs) experience more severe medical and social consequences from alcohol use compared to men, but little is known about health improvements following alcohol treatment. Methods This study sought to characterize the pre-treatment health status of 138 alcohol dependent women enrolled in 12 sessions of female-specific group or individual outpatient treatment and examine the degree to which alcohol treatment might promote positive quality of life changes. Quality of life was assessed using the World Health Organization Quality of Life measure at baseline and 3 months later at the end of treatment. Results The most common health problems at baseline were: smoking cigarettes (34.1%), hypertension (31.2%), obesity (27.5%), arthritis (21.0%), high cholesterol (17.4%), heart problems (8.7%), and a history of cancer (7.2%). Significant improvements across physical, t(117)=4.67, p<.001, d=.42; psychological, t(117)=7.31, p<.001, d=.62; social, t(117)=3.18, p=.002, d=.28; and environmental, t(117)=2.39, p=.018, d=.17; quality of life domains were seen after treatment. Percent days abstinent during treatment was positively associated with overall health satisfaction and psychological health at the end of treatment. Conclusions Women presenting for outpatient treatment for alcohol use disorders report many comorbid negative health problems. Thus, it is important for both substance use and health care providers to consider the overlap of alcohol use problems and health domains. Furthermore, female-specific cognitive behavioral treatment for alcohol use disorders positively impacted multiple health domains for women, suggesting a potential transdiagnostic intervention to target co-occurring health and substance use problems.

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Women's motivators for seeking treatment for alcohol use disorders

Cited by 33 publications

References 36 publications

Heterogeneity in pathways to abstinence among women in treatment for alcohol use disorder

Heterogeneity in pathways to abstinence among women in treatment for alcohol use disorder

Meeting health and psychological needs of women in drug treatment court

Baseline health status and quality of life after alcohol treatment for women with alcohol dependence

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