title: Barriers and facilitators to successful transition from long-term residential substance abuse treatment.
abstract: Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals' basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment.
authors.affiliation: New York University Silver School of Social Work, 1 Washington Square North, New York, NY 10003, United States. Electronic address: jennifer.manuel@nyu.edu.
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Manuel
authors.affiliation: New York University Silver School of Social Work, 1 Washington Square North, New York, NY 10003, United States. Electronic address: yeqing.yuan@nyu.edu.
authors.forename: Yeqing
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Silberman School of Social Work at Hunter College, 2180 Third Avenue @ 119th St., New York, NY 10035, United States. Electronic address: dhe0014@hunter.cuny.edu.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Herman
authors.affiliation: Virginal Commonwealth University Department of Psychology, 806 West Franklin Street, Richmond, Virginia 23284-2018, United States. Electronic address: dssvikis@vcu.edu.
authors.forename: Dace S
authors.initials: DS
authors.lastname: Svikis
authors.affiliation: Services for the UnderServed, Inc., 305 Seventh Avenue, 10th Floor, New York, NY 10001, United States. Electronic address: onichols@sus.org.
authors.forename: Obie
authors.initials: O
authors.lastname: Nichols
authors.affiliation: Services for the UnderServed, Inc., 305 Seventh Avenue, 10th Floor, New York, NY 10001, United States. Electronic address: EPalmer@sus.org.
authors.forename: Erin
authors.initials: E
authors.lastname: Palmer
authors.affiliation: New York University Rory Meyers College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, United States. Electronic address: sherry.deren@nyu.edu.
authors.forename: Sherry
authors.initials: S
authors.lastname: Deren
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000592:standards*; D004651:Employment / Q000592:standards*; D005260:Female; D006798:Housing / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D036301:Qualitative Research; D012114:Residential Treatment / Q000592:standards*; D019966:Substance-Related Disorders / Q000534:rehabilitation / Q000628:therapy*
keywords: Care transitions; Continuing care; Residential treatment; Socio-ecological model; Substance abuse