CHARACTERIZING MULTISYSTEM STIGMA: EXAMINING ITS ADVERSE IMPACT ON MOTHERS' ENGAGEMENT AND RETENTION IN RESIDENTIAL SUD TREATMENT
Conference
Rivera, D, Guerrero, E, Cortes, D et al. (2024). CHARACTERIZING MULTISYSTEM STIGMA: EXAMINING ITS ADVERSE IMPACT ON MOTHERS' ENGAGEMENT AND RETENTION IN RESIDENTIAL SUD TREATMENT
. DRUG AND ALCOHOL DEPENDENCE, 261 10.1016/j.drugalcdep.2024.111234
Rivera, D, Guerrero, E, Cortes, D et al. (2024). CHARACTERIZING MULTISYSTEM STIGMA: EXAMINING ITS ADVERSE IMPACT ON MOTHERS' ENGAGEMENT AND RETENTION IN RESIDENTIAL SUD TREATMENT
. DRUG AND ALCOHOL DEPENDENCE, 261 10.1016/j.drugalcdep.2024.111234
Background: Mothers who have a substance use disorder (SUD) have historically faced increased multisystem stigma when concurrently involved with the problem-solving court (PSC) and chil welfare (CW) systems while in residential SUD treatment. However, how increased exposure to multisystem stigma associated with being concurrently involved with the PSC and CW systems adversely affects the residential treatment engagement and retention of mothers remains largely unexplored. Our study’s aims were to examine how increased exposure to stigma from the PSC and CW systems negatively affects residential treatment engagement and retention. Methods: We used purposive sampling to recruit 24 SUD treatment clinicians (n = 18) and directors (n = 6) from four women's residential SUD treatment programs in Los Angeles County. Participants were involved in administering SUD treatment to mothers concurrently involved with the CJC and CW systems. For each participant, sociodemographic and program characteristics data were collected, and a thematic analysis framework was used to analyze the semi-structured interviews. Results: All 24 participants were women with a mean age of 47.3 years, with 54.2% identifying as Hispanic, 33.3% as White nonHispanic, and 12.5% as Black. Five main themes emerged, demonstrating how increased exposure to multisystem stigma (PSC and CW) negatively affects residential SUD treatment engagement and retention. They include (1) fear and distrust of disclosure; (2) induced distress and despair; (3) diminished treatment incentive and motivation; (4) lost trust, anxiety, and powerlessness; and (5) demeaning/disempowering verbiage and fear-based approaches. Conclusions: This study characterizes the nuanced ways in which multisystem stigma operates within the PSC, CW, and SUD treatment context, offering a fuller understanding of treatment engagement and retention adversities faced by mothers and their treatment providers. Given the multisystem exposure to stigma, there is a clear need for comprehensive anti-stigma intervention training that addresses the increased and intensified stigma faced by women in residential SUD treatment. Future research should consider exploring the viewpoints of mothers and CW and CJ staff members to triangulate findings that will increase understanding of historically embedded cross-system practices (PSC and CW) that contribute to stigma-related risks and their impact on treatment engagement and retention.
