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Background Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. Aims The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. Design, setting and participants Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake ( n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). Findings Hierarchical regression analyses showed that client-perceived social support ( F1,198 = 10.9, P = 0.001) and treatment motivation and readiness ( F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable ‘significant others’ participation in network intervention’ (network involvement) in the model, the fit clearly improved ( F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased ( F1,197 = 2.9; P = 0.091). Conclusions Participation in the social network intervention was associated with improved treatment retention controlling for other client characteristics. This suggests that the intervention may be of benefit in the treatment of addicted individuals. [ABSTRACT FROM AUTHOR]

Transition to re-entry (aftercare) is a stressful event for therapeutic community residents. While several authors agree on the importance of social support during reintegration, few studies have focused on the experiences of re-entry clients themselves and their significant others during this period. Using a case-study design, the present study examines the re-entry process of four TC-residents and three of their social network members during a six-month period, starting at the time of their transfer to the halfway house. Clients and their significant others have mixed feelings about the reintegration period, although both are mainly positive. Clients report difficulties in leaving behind the TC-mentality and building up a stable social network; they are surprised about the frequent contacts with substance (ab)use in mainstream society. Significant others misjudge clients’ feelings about transition and relapse. Many significant others have a positive attitude towards the use of substances. The tendency in mainstream society to increasingly accept the use of substances intensifies clients’ need for early guidance in building up stable supportive networks. Significant others need well-grounded information on the reintegration process and on relapse. [ABSTRACT FROM AUTHOR]

Transition to re-entry (aftercare) is a stressful event for therapeutic community residents. While several authors agree on the importance of social support during reintegration, few studies have focused on the experiences of re-entry clients themselves and their significant others during this period. Using a case-study design, the present study examines the re-entry process of four TC-residents and three of their social network members during a six-month period, starting at the time of their transfer to the halfway house. Clients and their significant others have mixed feelings about the reintegration period, although both are mainly positive. Clients report difficulties in leaving behind the TC-mentality and building up a stable social network; they are surprised about the frequent contacts with substance (ab)use in mainstream society. Significant others misjudge clients’ feelings about transition and relapse. Many significant others have a positive attitude towards the use of substances. The tendency in mainstream society to increasingly accept the use of substances intensifies clients’ need for early guidance in building up stable supportive networks. Significant others need well-grounded information on the reintegration process and on relapse. [ABSTRACT FROM AUTHOR]

By statistical analysis of client data it is shown how past or current network information together with other knowledge assesses treatment needs. The main findings are as follows. The client’s previous exposure to addicts in the family has almost no influence on his or her present contacts with addicts in daily life. About 30% of the clients have experienced addicts both in family and among friends, about 30% have only family exposure, about 20% have neither kind of exposure, and about 20% have no family exposure but have current exposure to addicts. Exposure to addicts in family implies a higher risk of severe need for professional intervention than no such exposure. For the clients with no family exposure but with current exposure to addicts there is, somewhat surprisingly, a lower risk than for the other three categories of clients. This effect seems to be mainly because the psychiatric status of these clients is somewhat better than for those in the other three categories. The effect disappears if we look solely for drug addiction intervention needs; then there is a clear increase in relative treatment needs for the categories with previous or present addiction exposure compared to those without. [ABSTRACT FROM AUTHOR]