Research That Matters (January 17 - 20, 2008)

The community attachment (CA) model of addiction is an ecologically-based social process model that suggests social context referents (peers, family, neighbors) will influence a client's attachment to addiction or recovery communities, via cognitive, affective and behavioral commitments. Of interest to social work practitioners and researchers is how to validly measure addiction and recovery attachment, via these transactional processes. Thus, this study had two specific aims: 1) to examine the influence of social context referents on clients' intention to change drug using behavior, using a new assessment tool; and 2) to examine the moderating effects of contextual indicators (labor market attachment, educational attainment, and family poverty status) on these relationships.

Method

The Ecological Assessment of Substance Abuse Experiences (EASE) is a new instrument, developed from a community attachment model of addiction and the Theory of Reasoned Action, designed to measure the relative importance of social context referents on addiction and recovery attachment processes. Specifically, the EASE measures social identity, social norms, outcome beliefs and social network attitudinal favorability to drug use and recovery. A growing number of instrument validation studies show the EASE to possess good psychometric properties. This study sample consisted of 302 adult clients seeking inpatient and outpatient substance abuse treatment services in two large metropolitan areas; clients completed a set of instruments that included the EASE. Reliability estimates for EASE subscales were moderate to high (á = .831 to .919).

Results

To test for moderating effects, three sets of hierarchical models were estimated for each of the three contextual indicators: labor force attachment, post secondary educational attainment, and family poverty status. Results showed all three contextual indicators moderated relationships between social context referenced attitudes, drug use concern, and intention to change drug using behaviors. Increased labor force attachment strengthened the relationship between drug-related social identity and intention to change drug using behaviors (â = .299; p<.01), and strengthened the relationship between recovery-related outcome beliefs and intention to change (â = .305; p<.01). Lower family poverty rates were associated with a greater impact of drug-related social identity on intention to change (â = -.189; p<.05). Higher levels of educational attainment strengthened the impact of social network drug use favorability on drug use concern (â = .230; p<.05). However, lower levels of educational attainment were associated with a stronger impact of outcome beliefs (both drug and recovery related) on drug use concern (â = -.228 and -.401; p<.05).

Implications

The community attachment model holds promise in offering the field of addiction a new way of understanding addiction processes from a person-environment transactional framework, and the EASE offers practitioners a new tool to assess these transactions. In addition, this study's results suggest, specifically, that social workers and other substance abuse practitioners should include in their assessments attention to both micro level orientations to social context (e.g., a client's perception of social network favorability towards drug use) and understanding of macro level contextual dimensions (e.g., labor force attachment), as both may influence behavioral change opportunities when clients transition back into the community.