Continuing Care and Trauma in Women Offenders’ Substance Use, Psychiatric Status, and Self-Efficacy Outcomes

Abstract

Using secondary data analysis of 3 separate trauma-informed treatment programs for women offenders, we examine outcomes between those who received both prison and community-based substance abuse treatment (i.e., continuing care; n = 85) and those who received either prison or community aftercare treatment (n = 108). We further account for differences in trauma exposure to examine whether continuing care moderates this effect on substance use, psychiatric severity, and self-efficacy outcomes at follow-up. The main effect models of continuing care showed a significant association with high psychiatric status and did not yield significant associations with substance use or self-efficacy. However, the interaction between trauma history and continuing care showed significant effects on all 3 outcomes. Findings support the importance of a continuing care treatment model for women offenders exposed to multiple forms of traumatic events, and provide evidence of the effectiveness of integrating trauma-informed treatment into women's substance abuse treatment.

Keywords:

• continuing care
• self-efficacy
• substance-use
• trauma
• women offenders

Notes

“Other” traumatic events included parental neglect, stalked by anyone, and so on.

Robust models use iteratively reweighted least squares in which the regression is run multiple times and outliers are repeatedly given less weight until the solution stabilizes.

Covariates used to generate the propensity score included race, age, marital status, education, employment, presence of children, child custody loss, residence prior to incarceration, mental health treatment experience, age of first arrest, offense type, number of convictions, primary substance, prior substance abuse treatment, and exposure to physical/sexual abuse.

In the substance use and psychiatric severity models, an OR/IRR <1 is evidence of a negative association, and an OR/IRR >1 is evidence of a positive relationship .

The self-efficacy model had fewer cases because of missing data (n = 13) at follow-up.

The “one” category in Figures 1, 2, and 3 includes participants who reported zero trauma events (n = 2).

The outcome abstinence yes/no was not used in order to avoid reducing variation and because the baseline measure for substances used was standardized because of differences in timelines across studies (past 1 year vs. past 30 days).