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Factors Associated With Readiness For Treatment In A Sample Of Substance-Dependent, Trauma-Exposed Incarcerated Women

Hrouda, Debra R.
http://rave.ohiolink.edu/etdc/view?acc_num=case1401824178

Abstract Details

2014, Doctor of Philosophy, Case Western Reserve University, Social Welfare.
Substance use and posttraumatic stress disorder are significant factors in criminal-justice-involved women. While mandated treatment may help engage some in treatment, there remains a significant proportion of offenders who do not respond, relapse, and end up back in the criminal justice system - especially for people who are ambivalent and/or do not recognize a need for treatment. The Transtheoretical Model of Change (TTM) recognizes that people are at different levels of readiness to change behaviors related to substance misuse. Studies have shown that following the stage-based approach leads to greater engagement and retention in treatment ultimately leading to better outcomes overall. If mandated treatment approaches followed the TTM, it is likely offenders at all stages of readiness will be engaged and stay in treatment leading to improved criminal justice outcomes. Methods: This is a secondary data analysis of a sample of 187 incarcerated women who met criteria for at least one substance dependence disorder and were trauma-exposed. Subjects were interviewed while incarcerated to determine SOCRATES scores; PTSD and Cocaine diagnoses; criminal justice; and demographic characteristics. It employed ordinal logistic regression to explore the relationship between demographic, criminal justice, and behavioral health-related factors and the newly-developed SOCRATES variable: Ambivalence in the context of Recognition Findings: Results supported the use of the SOCRATES in this population; offered a framework for examining Ambivalence in the context of Recognition (heretofore missing); and reinforced the contention that factors previously found to be associated with mandated treatment outcomes (and traditionally used to determine criminal justice sanctions) do not adequately predict stage of change readiness. Similarly, trauma-related factors were not significantly associated with Ambivalence in the context of Recognition - perhaps indicating that trauma factors may not inhibit readiness. Implications: Ambivalence in the context of Recognition was not related to any of the factors previously shown to predict success with criminal justice sanctions (e.g. mandated treatment). Policy-makers, those who make recommendations to the courts, as well as treatment providers might consider adding the direct assessment of readiness, ambivalence, and recognition to provide a more complete picture of potential targets and approaches.
Kathleen Farkas, PhD (Committee Chair)
Elizabeth Tracy, PhD (Committee Member)
David Hussey, PhD (Committee Member)
Christina Delos Reyes, MD (Committee Member)
205 p.
Behavioral Sciences; Clinical Psychology; Criminology; Gender; Gender Studies; Legal Studies; Management; Mental Health; Public Policy; Social Work; Womens Studies
women; jail; Transtheoretical Model; behavior change; ambivalence; problem recognition; substance dependence or abuse; trauma exposed; PTSD; engagement; mandated treatment; SOCRATES; motivation; cocaine; criminal justice; sanctions; offender; TTM

Recommended Citations

Citations

  • Hrouda, D. R. (2014). Factors Associated With Readiness For Treatment In A Sample Of Substance-Dependent, Trauma-Exposed Incarcerated Women [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1401824178

    APA Style (7th edition)

  • Hrouda, Debra. Factors Associated With Readiness For Treatment In A Sample Of Substance-Dependent, Trauma-Exposed Incarcerated Women . 2014. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1401824178.

    MLA Style (8th edition)

  • Hrouda, Debra. "Factors Associated With Readiness For Treatment In A Sample Of Substance-Dependent, Trauma-Exposed Incarcerated Women ." Doctoral dissertation, Case Western Reserve University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1401824178

    Chicago Manual of Style (17th edition)

case1401824178
586
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This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.