Views of Social Support: Perspectives of women in substance abuse treatment

Purpose

Few studies have examined social network resources of women with substance use disorders, with even fewer studies exploring the non-supportive network members that make recovery more difficult. This study sought to understand how women in substance abuse treatment describe their network members' support and non-support for recovery. Typically social support is viewed as consisting of emotional, tangible and informational support. Our study aimed to further social support research by building understanding of how “social support” is defined and viewed from the perspective of women in treatment. Further specificity can help treatment programs design and match network interventions to sustain recovery.

Methods

As part of a larger NIDA funded study, eighty-six women, predominantly African American (81%), were recruited from residential (n=41) and outpatient (n=45) treatment programs. Mean age was 33.9 years. 45% had a high school diploma. Utilizing the Computerized Diagnostic Interview Schedule, we found that 56% of the women had co-existing substance use and mental disorders. Social network measures included structure, types of support provided and network functioning. Women responded to open-ended questions regarding both positive and negative aspects of their support network. Responses were transcribed and entered into Atlas Ti. Analysis was guided by grounded theory methodology using three coders.

Results

Many network members are described as both helpful and harmful to recovery at the same time. For example, network members both “took care of children” while mothers used and “helped care for children” while mothers attended treatment programs. Further, “offering a place to stay” was perceived as something that may help get someone “off the streets” or give them a “place to use”. Moms and boyfriends who still use substances were often described as supportive, even though these network members may have introduced the women to drugs. Emotional support was frequently described as “talking to me”, “being there for me”, “does for and with me “and “makes sure” I do what I need to do. Women commented on the importance of network members who were “happy” they were in treatment, “proud of them” or who “wanted them to get better.” Several forms of tangible support while in treatment are notable: “help with kids”, “brings me things”, “place to live” and money to help. Responses also focus on informational and cognitive support, including advice giving, criticism, teaching, and educating. Nearly all women describe networks which contain features harmful to recovery: “still uses”, “having a place to use”, “money to use” and child care to use.

Conclusions and Implications

These findings highlight the positive and negative aspects of networks of women in treatment and the potential roles network members can play in recovery. Practitioners need to be aware that substance abusing women are often embedded in networks that help and harm at the same time. Reducing contact with network members, even substance users, is viewed as difficult to achieve in the context of recovery. The role of professionals in helping women re-build supportive networks will be discussed.