Transitions between Social Network Profiles for Women in Early Recovery

Background: The first 6 months after treatment entry may be a critical time of transition between levels of social network recovery support for women with substance use disorders. Previous research identified 3 latent profiles of recovery-specific social network variables at treatment entry that predicted abstinence outcomes at 12 months after treatment entry. The Highly-Connected profile had interconnected networks with higher levels of recovery support; the Treatment-Related profile had more loosely-knit networks with more network members from treatment; the At-Risk profile had loosely-connected networks, less recovery support, and more people with whom they used. Previous analyses identified that lower levels of traumatic symptomatology, having a co-occurring mental health disorder, and participation in residential treatment were associated with greater ability to maintain abstinence. It was theorized that women in the At-Risk profile would be most likely to transition between profiles over the first 6 months after entering treatment, and that lower levels of trauma, having a co-occurring disorder, and participating in residential treatment would be associated with lower likelihood of transitioning.

Methods: We used Latent Transition Analysis (LTA) to track how 377 women moved between the 3 previously-identified profiles between treatment entry (T1) and 6 months thereafter (T3). Mover-stayer LTA and logistic regression analysis determined the probabilities of moving for each profile  and whether TSC-40 score, co-occurring diagnosis, or treatment modality (outpatient vs. residential) predicted which women transitioned between profiles.

Results: Mover-stayer LTA showed that 25.7% of the women transitioned. Those in the At-Risk profile had the highest probability of transitioning (P=.55), and those in the Highly-Connected profile had the highest probability of remaining in their profile (P=.51). Roughly 30% of those in the At-Risk (N=171) and Treatment-Related (N=56) profiles, and 14% in the Highly-Connected profile transitioned between T1 and T3. Most of those in the At-Risk profile who transitioned (N=55) moved to the Highly-Connected profile (N =39, 70.9%). Women in the Treatment-Related profile at T1 who transitioned (N=18) were evenly split between the Highly-Connected and At-Risk profiles at T3. Of those in the Highly-Connected profile at T1 who transitioned (N=18), 14 moved to the At-Risk profile at T3. Level of trauma and dual diagnosis did not significantly predict whether individuals moved between profiles. Participating in outpatient treatment reduced the odds of staying in the same profile by .44 (B=-0.814, p=.06).

Implications: This study shows that the majority of women in early recovery maintain their network style over the first 6 months after entering treatment. However, particularly for those with less recovery-supportive networks, some women are able to build more stable, recovery-supportive networks during early recovery. Surprisingly, women’s level of trauma did not affect the odds of moving between profiles. This may indicate that women with trauma histories may become more resilient as they move through treatment. Participation in residential treatment may also help women build more recovery-supportive networks. Further research is needed to fully understand the mechanisms of moving between social network types.