Inside-Out Health: An Integrative Program for Substance Abuse Treatment Clients

Background: This presentation will focus on how women in treatment for substance use disorders have been identified as at risk for developing co-occurring addictions (e.g., eating disorders) during and following treatment (Cohen, Greenfield, Gordon, Killeen, & Jiang, 2010). Health-related concerns (e.g., inadequate nutrition, weight gain, sedentary lifestyle) (Greenfield, & Grella, 2009) has been commonly found as female clients begin treatment. Body dissatisfaction has also been reported by clients during substance abuse treatment as they begin to gain necessary weight which may contribute to disordered eating behaviors (Jackson, & Grilo, 2002). Current research (Emerson, Glovsky, Amaro, & Nieves, 2009; Weinstock, Barry, & Petry, 2008) supports the need to incorporate health education (e.g., nutrition, physical activity, body image) during treatment to improve recovery rates and overall health. Methods: Two evidence-based programs, Full of Ourselves (Steiner-Adair & Sjostrom, 2006) and Healthy Steps to Freedom (Lindsay, Valasquez, & Warren, 2009), inspired the development of an integrative health education program (i.e., Inside-Out Health) designed to promote physical activity, healthy nutrition and positive body image. This 6-week program was piloted with 49 participants aged 18-59 (M=30.61, SD=6.90) during a regularly held group therapy session at an all-female substance abuse treatment facility. Seventy-four percent of the participants attended 4 or more sessions out of 6 and 22% had perfect attendance. Nutrition, physical activity and body image were evaluated at pre- and post- and exploratory questions and interviews were included to assess program satisfaction. Results: While statistical analyses did not reveal significant changes in body esteem and physical activity, the Food Choice Questionnaire responses on two subscales (i.e., FCQ-weight control, FCQ-nutrition) approached significance. FCQ-weight control scores increased from pretest (M=.2.24, SD=1.0) to posttest (M=2.55, SD=.74) and FCQ-nutrition scores increased from pretest (M=2.70, SD=.67) to posttest (M=2.82, SD=.68). Thematic analyses did reveal preliminary successes with this health education program in addressing physical activity, nutrition, and body image to supplement the recovery process for these participants. Discussion: Participants will learn how this integrative program is an initial attempt to incorporate health education and eating disorder prevention efforts into an existing substance abuse treatment program. This study confirms the feasibility of promoting physical activity, nutrition and positive body image among female substance abuse clients. Future programs would benefit through continuing an integrative approach during treatment as well as extending the length of the program to ensure adequate time to address these health-related topics. Keywords: substance abuse, eating disorder, comorbidity, women