More than a million US women are detained in jails each year; many have alcohol use disorders (AUDs). AUD intervention with pretrial jail detainees presents a logistical challenge due to limited jail stays and lack of resources for postrelease treatment. The availability, no-cost entry, and promise of anonymity of Alcoholics Anonymous (AA) make it a highly accessible resource for underserved populations. However, the outreach of AA volunteers into jails (as opposed to prisons) has been limited, and incarcerated women are unlikely to seek out strangers for help after release. This study pilot tested an enhanced referral approach introducing a 12-step volunteer to a woman in jail who would attend a meeting with her after release.
Participants were 14 unsentenced female pretrial jail detainees with AUD. Intervention consisted of introducing participants detained in jail to female AA volunteers who could accompany them to an AA meeting after release. Assessments took place at baseline and 1 month after release. This uncontrolled pilot study evaluated the feasibility and acceptability of this enhanced referral approach. Pre-post alcohol use, drug use, alcohol problems, and AA attendance are also reported.
Enhanced referral was feasible and acceptable. Many (57%) of the 14 participants who met with AA volunteers in jail were in contact with those volunteers after release from jail. Participants had significantly fewer drinking days, heavy drinking days, alcohol problems, and drug-using days during the postrelease follow-up than they did before jail detention.
Providing linkage between women in jail and female AA volunteers who can accompany them to a postrelease meeting is achievable, and may be a disseminable and low-cost method to improve alcohol outcomes in this vulnerable population.
[Show abstract][Hide abstract] ABSTRACT: Objective and method:
In this article, I review my research applying interpersonal treatments and interpersonal principles from psychotherapy for major depression and substance use to broader public health goals for incarcerated women and other vulnerable populations.
A public health focus has led me to expand the boundaries of psychotherapy research to include partners such as prisons, parole officers, and bachelor's level providers; behaviors like risky sex; service delivery challenges; and ultimately to research with an eye toward informing policy and advocacy.
A public health perspective provides context and rationale for conducting sound psychotherapy research; the combination of public health and psychotherapy-specific perspectives can lead to novel research.
Psychotherapy Research 11/2013; 24(2). DOI:10.1080/10503307.2013.838656 · 1.75 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose ‐ The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use and major depressive disorders (MDDs) as they return to the community from prison. Design/methodology/approach ‐ The paper used qualitative methods to evaluate the perspectives of 15 women with co-occurring substance use and MDDs on the circumstances surrounding their relapse and recovery episodes following release from a US prison. Women were recruited in prison; qualitative data were collected using semi-structured interviews conducted after prison release and were analyzed using grounded theory analysis. Survey data from 39 participants supplemented qualitative findings. Findings ‐ Results indicated that relationship, emotion, and mental health factors influenced women's first post-prison substance use. Women attributed episodes of recovery to sober and social support, treatment, and building on recovery work done in prison. However, they described a need for comprehensive pre-release planning and post-release treatment that would address mental health, family, and housing/employment and more actively assist them in overcoming barriers to care. Practical implications ‐ In-prison and aftercare treatment should help depressed, substance using women prisoners reduce or manage negative affect, improve relationships, and obtain active and comprehensive transitional support. Originality/value ‐ Women with co-occurring mental health and substance use disorders are a high-risk population for negative post-release outcomes, but limited information exists regarding the processes by which they relapse or retain recovery after release from prison. Findings inform treatment and aftercare development efforts.
International Journal of Prisoner Health 11/2013; 9(4). DOI:10.1108/IJPH-02-2013-0009
[Show abstract][Hide abstract] ABSTRACT: Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.
The Journal of Behavioral Health Services & Research 03/2014; 42(4). DOI:10.1007/s11414-014-9397-8 · 1.37 Impact Factor
Note: This list is based on the publications in our database and might not be exhaustive.
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