Research That Matters (January 17 - 20, 2008)

Purpose: Substance abuse by pregnant women can lead to a range of short and long-term consequences for both the mother and fetus. Offering substance abuse treatment to pregnant, drug-dependent women has been associated with benefits including less substance use (Svikis et al., 1997) and reduced risk of poorer birth outcomes (Fiocchi & Kingree, 2001). The first step for pregnant women in discontinuing substance use is often entering a short-term treatment program (i.e., detoxification). By itself, short-term treatment is rarely successful at achieving abstinence (Franken & Hendriks, 1999; Howell & Chasnoff, 1999); thus, long-term treatment is emphasized and encouraged. However, there has been limited research examining pregnant women in short-term treatment to understand motivations and barriers to long-term treatment participation. Methods: Eighty-six pregnant women admitted to a short-term inpatient substance abuse treatment program participated in a face-to-face interview. Motivations for long-term treatment were quantitatively measured through the Treatment Attitude Profile (TAP; Neff & Zule, 2000). Motivations and barriers to long-term treatment were also qualitatively explored through open-ended questions to better understand these constructs. Quantitative data analysis was conducted using the Statistical Package for the Social Sciences (SPSS). NVivo was used to code qualitative data from women's responses into themes. After thematic coding, qualitative data was entered in SPSS for analyses. Results: Pregnant women were 25 years old (M = 25.47). The majority were Caucasian (94.2%) and had on average one (M=1.31) child. Motivation scores for long-term treatment were high, with an average score of 74 out of the 100 possible. Women most commonly reported being motivated for treatment because of their current pregnancy (76.7%). A substantial minority also reported being motivated for treatment because they needed help (27.9%; e.g., withdrawal) or because they just wanted to change their lifestyles (23.3%; e.g., tired of drug-using life). Despite having high levels of motivation, the majority (79.1%) of pregnant women discussed experiencing barriers to entering and/or remaining in long-term treatment involving both personal (40.7%) and interpersonal/environmental (61.6%) demands. The most common personal barriers mentioned were: self/denial - not wanting to admit a problem existed (18.6%) and insurance/money for treatment (10.5%). The most commonly reported interpersonal and/or environmental barriers were: not wanting to be away from their children (22.1%), treatment waiting list, paperwork, and referrals (16.3%), and stigma/not wanting others to know (15.1%). Implications: Previous research suggests that motivation for (De Leon et al., 2001) and barriers to (Ashley et. al., 2003) treatment are important influences on treatment-seeking behavior, as well as for retention and success. Findings from this study underscore the importance of the dual focus in social work on both the person and environment (Greene, 1999) for maximizing pregnant women's substance abuse treatment success. Results suggest that it is a combination of both personal and environmental factors which are important influences on treatment motivation, as well as barriers to treatment. Given the innumerable benefits of substance abuse treatment for pregnant women, facilitating motivation to participate in long-term treatment as well as helping these women overcome any barriers are both critical issues for social workers.