title: Structural Ecosystems Therapy for HIV+ African-American women and drug abuse relapse.
abstract: This report examines the effect of Structural Ecosystems Therapy (SET) for (n=143) HIV+ African-American women on rate of relapse to substance use relative to both a person-centered approach (PCA) to therapy and a community control (CC) group. A prior report has shown SET to decrease psychological distress and family hassles relative to these 2 comparison groups. In new analyses, SET and CC had a significant protective effect against relapse as compared with PCA. There is evidence that SET's protective effect on relapse was related to reductions in family hassles, whereas there was not a direct impact of change in psychological distress on rates of relapse. Lower retention in PCA, perhaps caused by the lack of a directive component to PCA, may have put these women at greater risk for relapse. Whereas SET did not specifically address substance abuse, SET indirectly protected at-risk women from relapse through reductions in family hassles.
authors.affiliation: Leonard M. Miller School of Medicine, Department of Epidemiology and Public Health, University of Miami, FL 33136, USA. dfeaster@med.miami.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Burns
authors.forename: Ahnalee M
authors.initials: AM
authors.lastname: Brincks
authors.forename: Guillermo
authors.initials: G
authors.lastname: Prado
authors.forename: Victoria B
authors.initials: VB
authors.lastname: Mitrani
authors.forename: Megaly H
authors.initials: MH
authors.lastname: Mauer
authors.forename: Jose
authors.initials: J
authors.lastname: Szapocznik
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D017753:Ecosystem; D005196:Family Therapy / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D009035:Mothers / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013315:Stress, Psychological / Q000517:prevention & control*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D014481:United States