Network Support treatment for alcohol dependence: gender differences in treatment mechanisms and outcomes

Network Support treatment was intended to help alcohol dependent patients alter their close social support networks to be more supportive of sobriety and less supportive of drinking. The purpose of the present study was to examine the differential influences of Network Support treatment on men and women.

Alcohol dependent men (n=122) and women (n=88) recruited from the community were randomly assigned to 1 of 3 12-week outpatient treatment conditions: Network Support (NS), Network Support+Contingency Management (NS+CM), or Case Management (CaseM; a control condition). Patients were then followed for a period of 27 months. Multilevel modeling was used to evaluate Sex×Treatment interaction effects on outcome variables over time. Tests of mediation were used to determine what factors might account for differential effectiveness for men or women in the NS conditions.

Analyses of drinking-related outcome measures over the 27 months indicated that women fared less well overall, and particularly poorly in the Network Support conditions, relative to men. Tests of mediation indicated that self-efficacy change and change in the number of non-drinking close associates partially mediated the effect of NS treatments on outcome.

It was concluded that the NS conditions failed to alter women's social networks, and may have had the effect of undermining women's self-efficacy. Network Support treatment might be applicable for women and more effective generally if particular attention is paid to understanding preexisting social support networks.