Prediction of outcome in coerced and voluntarily treated alcoholics

The study concerns multivariate prediction of the short-term outcome of alcoholism in a coercive treatment setting in Sweden. One hundred and twenty-one patients (87 men, 34 women) with a mean age of 41 (range 26–63) years attended a 5-week program. They were for the most part severely alcohol-dependent and socially unstable. Compulsorily committed patients ( n -32) were less socially stable but did not differ from the voluntary patients ( n =89) in the type of drugs abused. Nine months (mean) after treatment, a follow-up was performed by mailing questionnaires to the patients and to the referring social workers. The improvement data in the questionnaires were checked with other data. Data on alcohol abuse were available for 116 (96%) of the patients; 55% improved. Of these, 13% had remained entirely abstinent. Using multivariate logistic regression, participation in a self-help group and first-time admission were found to be significant factors for overall improvement, while having a family and more than primary education were significant for abstinence. Compulsory commitment to treatment was not related to the short-term drinking outcome. Undergoing voluntary treatment and having previous treatment experience were significant factors for participation in self-help groups.     

On the significance of social control: Treatment‐entry pressures,self‐choice and alcohol and drug dependence criteria one year after treatment

Storbjörk J. On the significance of social control: treatment‐entry pressures, self‐choice and alcohol and drug dependence criteria one year after treatment This article explores how self‐choice and treatment‐entry pressures are associated with one‐year treatment outcome (dependence symptoms, 0–6, 12 months) among alcohol and drug misusers, respectively. Informal pressures (from family and friends), formal pressures (related to work, healthcare, social services, social allowances, child custody) and legal pressures (related to the police, criminal justice system, compulsory treatment) were analysed. A sample (N= 1,210) representative of the addiction treatment system of Stockholm County was interviewed when starting a new treatment episode and after one year. Regression analyses indicated that self‐choice and pressures are associated with outcome among alcohol misusers but not among drug misusers when controlling for background factors and severity. Self‐choice (without pressures) correlated with a good outcome (a lower number of dependence criteria). Pressures were generally associated with poorer outcome. Alcohol misusers who had experienced threats regarding child custody did better in comparison with those not experiencing such pressure. The difference in results by drug type and implications were discussed.     

The social work services in screening process of compulsory treatment interventions in addicts in Iran: A content analysis study

Compulsory treatment has had a detrimental impact on drug abuse treatment policies and programs in Iran. Physicians are currently required to conduct initial treatment screening. Social workers are a part of the treatment team but have no authority to initiate a compulsory drug treatment plan. For this reason, the present article investigates social work service participation in the process of compulsory drug treatment. The study methodology is content analysis. Nine social workers participated in seven focus group discussions. Overall, 110 codes were extracted from the sessions and were categorized into five main themes: interview and initial assessment; referral; investigation of ineligibility criteria; report to judicial authority; and follow‐up and advocacy. The results of this research suggest amending executive bylaws based on a social work approach to the screening process for compulsory drug treatment.     

Psychological distress among women who were sexually abused as children

One of the aims of the study was to investigate how participants in self‐help groups (SHG) for women (n = 87) who had been sexually abused in childhood rated their mental health and to what extent they were at risk of developing posttraumatic stress disorder (PTSD). A further aim was to investigate the relationship between the ratings of mental health, occurrence of PTSD, women's interpersonal relationships, reasons for participating in an SHG and characteristics of the childhood sexual abuse (CSA). The participants completed questionnaires regarding their personal relationships, reasons for joining a group, abuse characteristics, mental health (Symptom Checklist‐90‐Revised) and PTSD (Impact of Event Scale‐Revised). The women showed poor mental health, and more than half of them were at risk of developing PTSD. Lack of social support and feelings of shame correlated with poor mental health, whereas guilt did not. Relationships with female friends had a positive association. Further research is needed to determine whether participating in an SHG could provide adequate social support and reduce feelings of shame, thereby contributing to the healing process in the aftermath of CSA. Key Practitioner Message: ? Child abuse is a significant component of the global burden of disease; ? Both social workers and public health care providers meet sexually abused girls and it is important that they have knowledge about the subject; ? An important clinical implication for adequate treatment would be to assess and recognise childhood sexual abuse and to link diagnosis to trauma.     

The Substance Abuse Treatment Self-Efficacy Scale

Abstract

Evaluating substance abuse services in ordinary treatment environments requires the use of instruments to measure various dimensions of the intervention process in order to link those processes with client outcomes. This paper reports on the further validation of the Alcohol and other Drug Self-Efficacy Scale (AODSES), designed to measure social workers' perceived self-efficacy with regard to the implementation of substance abuse services. In the first validation study, Kranz (2003) employed exploratory factor analysis to reduce the original 98 items to six factors (43 items) that accounted for 76% of the variance, and demonstrated excellent internal consistency. The current study is a reanalysis of the same data using confirmatory factor analysis, a more stringent test of construct validity. Results were strongly supportive of a 5-factor model with seven of eight indices showing excellent fit of the observed data to the model, and high internal consistency for all subscales. Potential practical applications for clinical evaluation in substance abuse environments and limitations of the study are discussed.     

Childhood maltreatment among Norwegian drug abusers in treatment

This article reports on the investigation of the correlation between the European Addiction Severity Index (EuropASI) and the Childhood Trauma Questionnaire (CTQ) among 102 Norwegian drug abusers admitted to treatment. The aim of the study is to explore how different types and levels of childhood trauma and social and psychiatric factors, medical situation and experienced family history are interrelated. The study addresses three main questions: 1) What is the prevalence of different kinds of childhood trauma among drug abusers in treatment? 2) Does type or level of maltreatment in childhood predict specific substance abuse problems as adults and/or specific social, psychiatric and medical problems as adults? 3) Do substance abuse problems and mental health problems in the primary family predict different types and levels of childhood maltreatment? Twenty‐five per cent of the total sample was included in the high‐level trauma group and 54% in the intermediate‐level group. Females had significantly higher scores than males in all types of childhood trauma. The strongest correlations were found between childhood trauma and lifetime psychiatric problems and psychiatric status during the last 30 days before admission for treatment. More research, and especially prospective studies, is needed to clarify the importance of parents' substance abuse and psychiatric problems in childhood/adolescent compared with trauma in the client's childhood and the client's current psychiatric status.     

Poor Hemodialysis Outcome Identifying Social Risk Factors in Elderly and Non-elderly Patients in Singapore

Little is known about the social determinants that predispose hemodialysis patients to poor treatment outcome. Using a clinical data mining method, this study aims to identify differences in social risk factors for hospitalization between elderly and non-elderly patients. The sample consists of 100 elderly and 219 non-elderly patients who started hemodialysis at the National Kidney Foundation from October 2007 to September 2008 and were followed through up to one year of hemodialysis to examine their hospitalization status then. Bivariate analysis revealed differences in the risk profiles between the two groups. The study has implications for funding policy and also draws attention to how clinical interventions ought to be tailored between the two age groups.     

Development of Social Health Insurance in Mongolia: Successes, Challenges and Lessons

This paper examines the process of developing social health insurance in Mongolia, and its successes, challenges and lessons. The government of Mongolia introduced social health insurance in 1994, which is compulsory for all public and private sector employees and low-income and vulnerable population groups. The scheme also provided voluntary insurance for unemployed people of working age. About 95 per cent of the population was covered by health insurance within the first two years thanks to a high level of government subsidy for vulnerable population groups. The insurance benefit initially covered nearly all inpatient services except the treatment of some specified chronic and infectious diseases, which were directly funded by the government. The scheme not only had many successes but also faced challenges in maintaining universal coverage. The new financing arrangement has provided little financial incentive for healthcare providers to contain health expenditure, contributing to rapid health cost inflation. In addition to reforming the payment system for providers, there has been an increasing need to expand benefits into ambulatory care. The development of compulsory health insurance in Mongolia shows that a prepaid health insurance mechanism based on risk sharing and fund pooling is feasible in low-income countries given political commitment and government financial support for vulnerable population groups.     

Elder Abuse in Turkey and Associated Risk Factors

Abstract

Elder abuse is one of the most important problems encountered by the elderly. Health, economical and psychological dimensions of the experience of aging also pose risk for elder abuse. This study aims to determine the abuse to which elder people are exposed based upon their own evaluations and to investigate the risk factors associated with elder abuse. This is a cross-sectional study among quantitative designs. Population of the study comprises 309 outpatient elders over the age of 65 referring to Ayd?n Do?an Geriatrics Clinic of Ankara University, Turkey. Collected data were analyzed by chi-square test and logistic regression. In total, 70.9% of the elderly participating in this study experienced abuse more than once. Majority of the participants were victims of emotional abuse (64.1%), followed by neglect and abandonment (26.9%) and economic abuse (12.6%). There was significant relation between sex, marital status, health status of the elderly and being abused (p?p?相似文献   

An exploratory study of substance abuse among Latino older adults

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

Whether Professional Training Matters: Attitudinal Antecedents to the Turnover Intentions of Social Workers in Guangzhou,China

This study aims to identify whether the professional training of social workers has an effect on the attitudinal antecedents of turnover intention. This study investigated 395 trained and 353 non-trained social workers from the Integrated Family Service Centers in Guangzhou, China. It was found that professional education did not significantly alter the attitudinal antecedents to turnover intention. In both groups, a higher feeling of burnout or a lower level of organizational commitment produced a higher intention of turnover. Furthermore, the significant influences of burnout and organizational commitment were found to be respectively mediated by job satisfaction with professional association or job satisfaction with organizational environment. This study not only provides insights into the stabilization of the emerging workforce of Chinese social workers, but also poses serious questions about social work education.     

An Exploratory Study of Substance Abuse Among Latino Older Adults

ABSTRACT

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

普通高中家庭经济困难学生资助问题探析

高中教育处于义务教育与大学教育的中间阶段,既不属于法定的义务教育,也不属于国家大力扶持的高等教育。当前,高中生既无法免交学杂费,又没能享受各项助学优惠政策,对一些困难家庭而言,供孩子上高中仍是一项无力承受的负担。造成普通高中家庭经济困难学生资助乏力的原因主要有政府救助缺位,资助的责任主体界定不合理,社会关注度低等,解决这些问题需要政府、家庭、社会的共同努力。     

Soviet Review Readers' Questionnaire

The editors of THE SOVIET REVIEW want to thank all those who sent us their completed questionnaires. The response was excellent. By the end of October we had received 644 replies, representing about 10 per cent of our subscribers, and more are still coming in. The replies proved to be both interesting and informative, and will serve as a useful guide to the editors in selecting material for future translations.     

Well-Being and Affective Commitment among Ambulance Volunteers: A Mediational Model of Job Burnout

ABSTRACT

Burnout represents a relevant risk for ambulance volunteers. According to the Job Demands-Resources model, role conflict and social support can be considered as antecedents of burnout which, in turn, may lower affective commitment. This study aims to investigate the relationship between social support, role conflict, and affective commitment, as mediated by job burnout. Survey data were collected from 352 Italian volunteers and analyzed using structural equation modeling methods. Social support was confirmed as a protective factor, and role conflict as an antecedent of burnout which, in turn, decreases affective commitment. The relationship between role conflict and affective commitment is mediated by burnout which, on the contrary, does not mediate the effect of social support on affective commitment. Social support may protect against burnout. Because of its positive effects on a personal and an organizational level, affective commitment may be increased raising levels of supervisor support and reshaping role expectations. It could be useful to carry out future longitudinal studies, in order to confirm the antecedents and effects of job burnout; furthermore, this research should be extended to other ambulance organizations, in order to generalize the results; finally, multi-group analyses would allow to bring out possible differences between paid-staff and volunteers.     

FACTORS INFLUENCING LEGAL DISPOSITION IN CHILD ABUSE INVESTIGATIONS

The study used an experimental design to investigate factors that influence a child protective service worker's decisions to recommend court action in cases of child abuse involving physical injury. The focus was decisions that are made early in an investigation. Seriousness of injury, whether or not there was a previous child abuse report, the consistency of the explanation regarding nature and location of injury, and parental reaction toward the worker were all found to significantly affect case disposition decisions. Although there was a general tendency among workers not to recommend court action, there was substantial disagreement regarding the appropriateness of court action in particular child abuse cases. The findings substantiate the need for clarification of decision-making criteria in child abuse cases.     

Civil Commitment for Drug Dependency

In recent proposals for new legislation in New South Wales for dealing with drug-dependent persons, opinion has been sharply divided over the issues for and against civil commitment for drug abuse per se. This paper examines the situation as seen from a legal point of view.     

GROUP WORK WITH ALCOHOLIC,POLY DRUG-INVOLVED ADOLESCENTS WITH DEVIANT BEHAVIOR SYNDROME

Trail-blazing efforts are now underway in social work treatment with adolescents who are involved with both alcohol and other drug abuse and who have been arrested for antisocial acts. These are young people who are caught in a pathological system which is spiraling them deeper and deeper into self-destruction, either by their antisocial acts leading to continuing conflict with the law and often incarceration, and/or to the breakdown of their physical system by the substance abuse. Traditional forms of social casework or psychotherapies are of little use since the young person is likely to deny vigorously that he has a problem and shrink from contact with the helping resources that are available. Whereas a psychodynamic orientation is necessary in order for the worker to provide the degree of understanding of the internal turmoil of these young persons, the focus of treatment must be upon problem solving and a peer support system that can sustain the faltering ego through the social hazards of adolescence and young adulthood. To understand the professional demands of this practice, we will describe the general characteristics of this special segment of today's youthful population, the social-psychodynamic factors involved, and the diagnostic issues raised. Several concepts for clinical practice with these young people will be discussed: enforced treatment, age-related differential planning, and group work as the optimal treatment modality. An actual group work practice situation will illustrate theorerical and technical issues raised in the treatment process.     

ASSESSING MANAGEMENT IN THE CHILD ABUSE FIELD

In order to identify essential elements of quality case management in the child abuse field and determine the relationships between case management and treatment outcome, 354 child abuse cases were studied using audit techniques developed in the medical field. It was found that the variables identified as contributing to quality case management do not necessarily directly affect treatment outcome: however the variables identified serve as important guidelines for future studies in this area.     

论民间法的社会权力基础

民间法以社会权力为基础,国家法以国家权力为保障。民间法与国家法共同起源于原始习惯,二者的互动与互补既符合历史的逻辑,又符合事物发展的内在规律。社会权力是指以特定范围内的社会主体的同意为基础、以契约为表现形式,并受到一定程度程序控制的社会强制力,具有“同意性”、“契约性”和“多元性”特点。社会权力视角的民间法具有权利与权力的双重属性,具有“冷暴力”、“文化性”和“族性”特征。社会权力的变迁必然引发民间法的发展,社会权力是民间法实效的重要基础,应为民间法与国家法沟通的理性平台。