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Access and Engagement in Treatment-Aided Addiction Recovery: Differences between Men and Women Open Access


Other title
Social Support
Treatment Engagement
Type of item
Degree grantor
University of Alberta
Author or creator
Gilbert, Meaghan B.
Supervisor and department
Wild, T.C. (Centre for Health Promotion Studies)
Examining committee member and department
Lasiuk, Gerri (Nursing)
Hegadoren, Kathleen (Nursing)
Centre for Health Promotion Studies

Date accepted
Graduation date
Master of Science
Degree level
Background. Addiction treatment research increasingly recognizes the importance of access factors (i.e., systematic barriers and facilitators) and engagement factors (i.e., perceptions of coercion, motivation, and social networks) as determinants of clients’ response to treatment programs. While gender differences in the natural history of drug use are well documented, few studies examined whether access and engagement systematically differ for adult women versus men seeking treatment for addictions. This study is divided into three Research Objectives. Objective 1: To determine whether men and women differ in variables associated with treatment access. Objective 2: To determine whether men and women differ in perceptual variables associated with treatment engagement. Objective 3: To determine whether men and women differ in quality of engagement early in the process of addiction treatment using a regression analysis including coercion, motivation, social support as independent variables and treatment engagement subscales as dependent variables. Methods. Secondary analysis of data collected from a cohort of clients seeking treatment at an Alberta-based residential program. Baseline (N = 328) instruments assessed treatment access variables, including the Social Control Index (SCI), the MacArthur Perceived Coercion Scale (MAPCS), the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), and Perceived Social Support from Friends and from Family (PSS Fa-Fr) (Polcin & Weisner, 1999; Gardner et al., 1993; Miller & Tonigan, 1996; Procidano & Heller, 1983). One month later, follow up surveys (n = 273) assessed treatment engagement (TE) variables using a treatment engagement scale from Simpson and Joe, 2004. Results. Demographic analysis revealed gender difference in treatment and drug history. Objective 1: Men and women differed significantly in treatment access; women were more likely mandated to treatment from a formal referral source. Formal referral sources are agencies or individuals external to the individuals operating at an institutional or organizational level. Objective 2: Men and women differed significantly in their perceptions of coercion and social networks but not motivation; women perceived greater coercion from formal sources and more support from their friends. Objective 3: Among alcohol clients only the TE-commitment subscale was significant and the SCI and the SOCRATES- AMREC subscale were significant. Among the drug clients the main effects were significant for all TE subscales. The SOCRATES - AMREC subscale and the PSS-Fa for TE - confidence and rapport were significant, while the SOCRATES-TS subscale was significant for all three subscales of the TE. Conclusion. Men and women differ in their experiences prior to entering treatment, engagement in treatment, and perceptions of coercion, motivation, and social networks. These differences reflect to varying degrees socially constructed gender roles.
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