Family Support and Social Exclusion In a Family-Centered Context: Evidence from Mandated Addiction Treatment In Taiwan

Background and Purpose: Social exclusion has received relatively limited attention in research on mandated addiction treatment, despite its relevance to reintegration. This gap is particularly important in family-centered contexts such as Taiwan, where family relationships remain central to everyday support, supervision, and social belonging. Since 2018, Taiwan has further institutionalized a family-centered approach through the expansion of the Social Safety Net policy, which emphasizes cross-sector collaboration, community-based services, and family-inclusive support for individuals with complex needs. Within this policy context, family support may shape reintegration in ways that are not fully captured by individual-level or generalized recovery resources. This study focuses on whether family support is associated with social exclusion among individuals receiving deferred prosecution with mandated addiction treatment in Taiwan, and considers its role as a relational dimension of reintegration.

Methods: A cross-sectional survey was conducted with 288 adults receiving deferred prosecution with mandated addiction treatment in Taiwan. Participants were recruited through purposive sampling from treatment settings affiliated with 10 district prosecutors’ offices. Social exclusion was measured using a 22-item scale, and family support was assessed using the Family APGAR. Hierarchical multiple regression was used to examine whether family support remained associated with social exclusion after adjustment for sociodemographic and treatment-related characteristics, internalized stigma, and recovery capital. Analyses involving treatment duration were based on 238 cases with available data.

Results: Family support was significantly associated with lower social exclusion at the bivariate level (r = −.386, p < .001). In the regression models, family support remained significantly associated with lower social exclusion after adjustment for control variables and internalized stigma (β = −.337, p < .001) and continued to be significant after recovery capital was added to the model (β = −.217, p < .001). The persistence of this association suggests that family support was not fully captured by broader recovery-supporting resources and instead represented an independent relational dimension of reintegration.

Conclusions and Implications: These findings suggest that family support should not be treated merely as a background characteristic or subsidiary resource in addiction recovery research. Rather, in family-centered policy contexts, it may constitute a distinct relational dimension through which reintegration is shaped. This highlights the need to conceptualize social exclusion as a relationally embedded outcome, not only an individual or structural condition. For practice and policy, the findings support greater attention to family-centered and culturally responsive approaches within addiction treatment and diversion systems, particularly where reintegration is an explicit goal.