This study had three primary objectives:
- Evaluate the utility of the Sources of Social Support (SOSS) scale in a sample of alcoholics entering treatment
Test relationships of the SOSS to other variables and constructs as the clients enter treatment
Examine race (African American versus European American) differences in reported support
For this report, which is based on a single treatment facility, the last objective was compromised by the availability of only a small number of African American respondents (n= 13). Despite this, some apparent differences emerge.
Regarding the first objective of this study, the SOSS instrument was shown to possess the favorable psychometric characteristics it manifested in earlier research on diverse, but non-clinical, samples. It showed convergent and discriminant validity by relating to other independent measures reflecting positive interpersonal relationships and support, but not to (or to a lesser extent to) measures not reflective of interpersonal and relevant support meaning. Theoretical construct validity was supported by expected relationships with at least some ‘outcome” measures, such as quality of life, both a scale life satisfaction measure and global items. As found with previous non-clinical samples, the emotional, practical, and overall support measures were normally distributed, and most of the separately rated sources were roughly normally distributed. Emotional and practical support were highly interorrelated, while still capturing about 50% unique meaning. The two scoring systems were also highly correlated and produced similar patterns of relationships with other variables.
Another variation introduced was the administration of the SOSS with its general or standard instructions or with alcohol-specific (AS) directions. In this latter case, the instructions asked for ratings of support specifically to deal with one’s alcohol problem. Higher support was reported with AS instructions for the employer and for friends. Relationship patterns were similar for the two forms, although coefficients were generally larger using the general form. Possibly, the high degree of similarity in the results for the two forms occurred because the respondents’ alcoholism was so central to their lives. The finding of higher support with the AS form for friends and employer targets is important, since these are two sources for which the opposite might have been expected. Friends may have been thought to threaten one’s ability to maintain abstinence, and an employer might be thought to be rejecting of a possibly unreliable worker. Yet, for these sources, more support was reported when the support was directed specifically toward the client’s presenting problem. It may be the case that the SOSS, though designed to tap available support, reflects receipt of support in these cases. That is, clients may be especially likely to have received support from sympathetic friends and employers.
Racial differences cannot be well tested until a larger number of African-American respondents are available. Nonetheless, the expectation of greater importance of the extended family in the black subculture (Allen, Markovitz, Jacobs, & Knox, 2001; Brome, Owens, Allen, & Vevaina, 2000) was supported by the finding of higher support scores for relatives, and a higher practical support score across sources. In addition, the known importance of the church in African American communities was reflected in higher support from clergy and church members. The differences were statistically reliable despite the low power imparted by the small number of black respondents (n= 12). Beyond the importance of the church as a community entity, it was also the case that African-American respondents scored higher on two religiosity/spirituality dimensions and showed greater acceptance of the AA philosophy. They also were lower in depression and endorsement of positive statements about alcohol and drugs. Future study of follow-up data will enable determination if any of these racial differences relate to quality of outcome, i.e., achieving abstinence. The possibility of finding a racial difference in outcome is interesting, though it may be difficult to interpret given African Americans are rare clients in this particular treatment setting. An attempt is underway to involve black clients from other settings.
Descriptive findings for the entire sample revealed the clients in general felt between “a fair amount” and a “great deal” of support, and somewhat more emotional than practical support. These amounts are within the range, but slightly lower, than reported by non-clinical samples. The highest available support was reported for therapist/counselor/case manager, AA sponsor, children, and parents. Support from one’s spouse or partner was high, but about one-half unit lower on the 5-step scale than for the four highest sources. Although parental support was rated above average overall, it was not related to any of the other study variables. Clearly the most consistent correlate of social support was religiosity and spirituality, reflected in positive correlations for the dimensions of Closeness to God and Practice of religion, and for acceptance of a 12-step philosophy. It is important to note that the linkage between social support and religious belief, experience, and practice was not limited to the two religion-based sources, clergy and church members.
These sources were important for available support, but so were several others outside of a church context. Thus, in a general sense, those who were more religious and spiritual reported a higher sense of support available to them from their social network. The religiosity dimension that seemed to tap a splitting off from God was not significantly related to social support. A higher feeling a quality of life or life satisfaction was also associated with higher SOSS scores, but it is important to note that depression and reports of more severe impairment due to poor health were not related to SOSS scores. Therefore, it is not credible that high religiosity or social support scores are attributable to social desirability response bias. The discriminant validity of the SOSS is particularly apparent.
To what extent social support and other variables studied will predict later abstinence will be a topic of later investigation. These later questions can be addressed with assurance that the SOSS is a valid reflection of social support for these respondents in this setting. The current cross-sectional results also provide further direction for the study of predictors and relationships. Social support and religiosity are clearly two domains of interest. In addition, we can examine if each of these factors, especially important for African American clients, provide them a resource for achieving treatment goals.