Social Network Ties and Goal Formation: Correlates of Treatment Entry and Reduced Alcohol use Following Treatment Completion.

Abstract

While effective treatment for alcohol use disorders (AUDs) exists, only about 28% of individuals suffering from AUDs seek help for problems (Cohen, Feinn, Arias, & Kranzler, 2007). The National Institute of Health strategic initiative of systems-thinking approaches to health (USDHHS, 2010b) suggests that social network ties may reveal important keys to how persons experiencing health problems, including AUDs, seek treatment. Additionally, approximately 60% of individuals in treatment for AUDs will relapse within the first year following alcohol treatment (Maisto, Pollock, Cornelius, Lynch, & Martin, 2003; Whitford, Widner, Mellick, & Elkins, 2009). One mechanism of change that could reduce relapse of alcohol use may be the goals individuals adopt upon entry to treatment. The objectives of this dissertation are 1) identify the characteristics of social network ties among persons with experiencing AUDs, 2) examine how social network ties influence treatment use for alcohol dependence, and 3) to examine whether goals individuals adopt concerning drinking in early treatment influence subsequent alcohol use following treatment completion. Objectives 1 and 2 examine wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Objective 3, examines the Life-Transitions Study (LTS) (Robinson et al., 2011). Results suggest that social networks of individuals with AUDs are smaller in size and less diverse. Additionally, social network ties of individuals with AUD play a moderating role in seeking treatment such that individuals with high level of alcohol consumption and more social ties are more likely to seek treatment than individuals with high levels of alcohol consumption and few network ties. Finally, controlling for differences in who adopts a goal of abstinence from alcohol, individuals who adopt a goal of abstinence at treatment entry are likely to have more percent days abstinence and more days since last consuming alcohol compared to individuals who adopt a non-abstinence goal. These findings offer several implications for social work practice including the utilization of social networks as a resource among individuals with AUDs, the identification of high risk AUD groups least likely to seek treatment, and risk factors associated with higher levels of alcohol use following treatment for AUDs.