Existential isolation’s associations with psychological distress and treatment engagement among justice-involved individuals in substance use treatment

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Background Justice-involved individuals experience high rates of substance use disorders and psychological distress. Less is known about how subjective experiences of social disconnection, such as existential isolation (EI), may be associated with engagement in correctional substance use treatment. Existential isolation, the feeling that one’s experiences are not understood by others, has been linked to poorer mental health outcomes (e.g., anxiety, depression). This study examined the relationship between EI, psychological distress, and treatment engagement.Method Participants were 127 individuals enrolled in a correctional substance use treatment program in the southwestern United States. Participants completed measures of EI, anxiety, depression, counseling rapport, peer support, and treatment participation.Results Higher levels of EI were associated with greater anxiety and depression and lower levels of counseling rapport, peer support, and treatment participation while controlling for covariates. An exploratory analysis found that individuals reporting greater levels of EI reported weaker counseling rapport, and diminished counseling rapport was associated with lower levels of treatment participation.Conclusions Feeling misunderstood by others may be relevant to treatment engagement, underscoring the importance of fostering supportive therapeutic relationships within correctional treatment settings.