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Disclosure, Stigma, and Social Support Among Young People Receiving Treatment for Substance Use Disorders and Their Caregivers: a Qualitative Analysis

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Abstract

Relational processes (i.e., disclosure, stigma, social support) experienced by youth with substance use disorders (SUDs) and their caregivers may act as barriers to, or facilitators of, recovery but are understudied. Single-session qualitative semi-structured interviews were conducted with 19 patients and 15 caregivers recruited by clinicians from a SUD program. There was variability in disclosure experiences, including how many people knew about patients’ SUD diagnosis and treatment, whether patients or caregivers primarily disclosed to others, and feelings about others knowing about one’s or one’s child’s SUD treatment. After disclosing, patients and caregivers experienced stigmatizing (e.g., social rejection) and supportive (e.g., understanding, advice) reactions from others. Disclosures may have important implications for relationship and recovery-related outcomes. Moreover, some child-caregiver pairs have significant disagreements regarding disclosure of SUD treatment. Addressing relational processes within treatment by encouraging patients and caregivers to share the disclosure decision-making process may support the recovery of youth with SUDs.

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Acknowledgements

The authors thank the participants, as well as the care providers and program staff, for their support of and contributions toward this work.

Role of Funding Source

This work was supported by the Agency for Healthcare Research and Quality (AHRQ; K12HS022986, VAE), National Institute on Drug Abuse (NIDA; K01DA042881, VAE), and UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS; P30MH58107, LMB). Funders were not involved in the study design; collection, analysis, or interpretation of the data; write up of the report; or decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of its funders.

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Authors and Affiliations

  1. University of Delaware, 111 Alison Hall West, Newark, DE, 19716, USA

    Valerie A. Earnshaw & Natalie M. Reed

  2. Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA

    Valerie A. Earnshaw & Sharon Levy

  3. Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA

    Valerie A. Earnshaw, David D. Menino & Sharon Levy

  4. RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA

    Laura M. Bogart

  5. Recovery Research Institute, Massachussetts General Hospital and Harvard Medical School, 151 Merrimac St. 6th Floor, Boston, MA, 02114, USA

    John F. Kelly

  6. College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA

    Stephenie R. Chaudoir

Authors
  1. Valerie A. Earnshaw
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  2. Laura M. Bogart
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  3. David D. Menino
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  4. John F. Kelly
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  5. Stephenie R. Chaudoir
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  6. Natalie M. Reed
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  7. Sharon Levy
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Correspondence to Valerie A. Earnshaw.

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The authors declare that they have no conflicts of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients included in the study.

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Earnshaw, V.A., Bogart, L.M., Menino, D.D. et al. Disclosure, Stigma, and Social Support Among Young People Receiving Treatment for Substance Use Disorders and Their Caregivers: a Qualitative Analysis. Int J Ment Health Addiction 17, 1535–1549 (2019). https://doi.org/10.1007/s11469-018-9930-8

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  • DOI: https://doi.org/10.1007/s11469-018-9930-8

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