Date of Award


Degree Type


Degree Name

Doctor of Philosophy in Psychology



First Advisor

Nichea Spillane


Research continues to suggest that substance use treatment retention and completion presents an ongoing problem, especially among marginalized groups. In particular, African American women have the lowest rates of treatment retention and completion across all substance using groups. While gender and ethnoracial identities continue to be examined in their relation to substance use treatment, these identities are often studied in isolation offering limited information about how intersecting identities impact substance use treatment for African American women. Researchers have commented on the immediate need for research aimed at describing, understanding, and improving treatment for this population. Research using the voices of African American women to better understand treatment experiences is critically necessary to understand how their intersecting identities interact with treatment retention and completion. Understanding their perceptions of culturally competent care could also be used to address their unique treatment needs. The purpose of this study is to describe and examine the substance use treatment experiences of African American women, and qualitatively explore the treatment process for this sample with special attention to the role of cultural competency. This study will address the following research questions: 1) How do African American women describe their experiences in substance use treatment? 2) What is the nature of the relationship African American women have had with their substance use treatment provider(s)? 3) What are the perceptions of a culturally competent provider and to what extent is this valued by African American women receiving substance use treatment?

Participants included six African American adult women ages 30-63 years old, who were currently engaged in formal substance use treatment or have been engaged in treatment within the last year. Participants were recruited from community-based treatment settings including residential, intensive outpatient, and outpatient. Due to the descriptive nature of this study, one to two semi-structured, open-ended interviews were conducted, lasting approximately 60 to 90 minutes each. Data analysis utilized a combined and layered approach that was divided into three steps: observational notes, theoretical notes, and methodological notes. Data analysis focused on developing common descriptions across participants' stories in relation to the above-mentioned research questions. Results and implications are further discussed regarding efforts to improve substance use treatment for African American women.



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