Examination of the Role of Therapeutic Alliance,Treatment Dose,and Treatment Completion in the Effectiveness of The Seven Challenges

Adolescent alcohol and illicit drug (AOD) use is a major public health concern. This longitudinal study examines the effectiveness of The Seven Challenges in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Participants were 89 adolescents (72 male, 17 female) enrolled in a 3 month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using AOD, reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Despite a small sample and other limitations, findings add to existing literature that suggests that The Seven Challenges is an effective substance abuse treatment for adolescents. Furthermore, findings suggest that adolescent substance abuse treatment should focus on clients meeting pre-determined program goals as well as on dose.     

News coverage of alcohol and other drugs in U.S. college newspapers

This study investigated the substance use-related content of a sample of student-run college newspapers. Two independent coders examined 157 news stories, features, editorials, commentaries, letters, photographs, and cartoons. Items about alcohol appeared in one out of every two issues, while items about other drugs appeared in one out of every five issues. Basic information about alcohol and other drug (AOD) use was reported in about one-fifth of the items, while three-fourths dealt with social, legal, safety, or health problems associated with AOD use, especially alcohol consumption. Just over half referred to some type of control policy, most often an enforcement action. Around one-fourth mentioned educational efforts to promote AOD prevention. Very few dealt with detection, intervention, or treatment. Most college newspapers are missing good opportunities for more extensive coverage of AOD issues that would better inform their readers, especially about factors contributing to campus AOD problems and specific program and policy options.     

A qualitative study of exodus graduates: family-focused residential substance abuse treatment as an option for mothers to retain or regain custody and sobriety in Los Angeles, California

In this article, 21 long-term, poly-substance abusing mothers describe how they successfully completed an 18-month family-focused residential substance abuse treatment program in southern California that helped them retain or regain custody of their children. Their stories and experiences with specific program characteristics and approaches of this rare treatment option are described, in their own voices. Policy implications for child welfare and parental substance abuse treatment are examined in light of these success stories.     

Using child welfare assessments and latent class analysis to identify prevalence and comorbidity of parent service needs

Data collected through Illinois's Integrated Assessment (IA) program—an assessment and service coordination program incorporating clinical assessments of both parents following a child's placement in foster care—offers a unique opportunity to examine the service needs of parents within a family context. Between January 2007 and June 2010, integrated assessments were completed with 4089 families in which at least one parent participated in the assessment. Utilizing these data, this study employs a Latent Class Analysis approach to identify the patterns of service needs of parents with children entering foster care. Latent class models were generated for mothers and fathers who participated in comprehensive family assessments based on identified service needs. Models revealed “low need” and “high need” classes among both mothers and fathers. A distinct class characterized by substance abuse needs emerged among fathers and a similar class among mothers was characterized by both substance abuse and mental health needs. A mental health needs class was identified among fathers while a similar class among mothers was characterized by both mental health needs as well as trauma symptoms. In examining the distribution of classes among families where both parents were present, the largest groups of families were those in which both parents fell into the “low need” classes, those in which the father fell into the “low need” class and the mother fell into the “substance abuse and mental health” class, and those in which both the mother and the father fell into the “substance abuse” classes. Implications for case assignment practices, father engagement, and addressing comorbid service needs are discussed.     

A Computer-Assisted Self-Interview (CASI) Assignment in the MSW Classroom

ABSTRACT

This article reviews the research regarding computer-assisted self-interviews and describes a specific program, the Addiction Severity Index-Multimedia Version (ASI-MV), a self-administered audio assessment of substance use as well as concurrent psychosocial problems. This program was integrated into a graduate substance abuse course through a simulated exercise intended to introduce students to computer-based assessments. Students (N = 21) later evaluated the exercise and their reactions to computerized assessment at the end of the semester. Overall, students reported increased assessment skills, more comfort with the use of computers to assess clients, and willingness to incorporate computers into social work practice.     

Services for substance abuse-affected families: The project connect experience

With more families entering the child welfare system with problems of substance abuse, there is an increasing need for programs that can respond effectively to these families' needs. This article describes one community-based program designed to support and strengthen families with an identified problem of substance abuse. parents' progress in addressing their problems with substance abuse, reduction of risk in Project families. children's placement experiences, and client satisfaction are discussed. The article concludes with implications for practice with substance abuse-affected families.Project Connect is funded by a grant from the National Center on Child Abuse and Neglect, U. S. Department of health and Human Services. It is administered by the Rhode Island Center for Children-at-Risk, which is a program of Children's Friend and Service, Providence, Rhode Island. Project Connect is operated under contract from the Rhode Island Department of Children, Youth, and Families. The author wishes to acknowledge the staff of Project Connect and the Rhode Island Department of Children, Youth, and Families without whose contributions this work would not have been possible.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

Women in Substance Use Treatment

Abstract

The objective of this study was to examine the differences between women with children in substance use treatment who are involved in Child Protective Services (CPS+) and those who are not involved (CPS-). Using a sample of all alcohol and other drug (AOD) clients (N = 6,023) receiving substance use treatment over a three-year period (1997-99), the study found that CPS+ women were more likely to be younger, have more children, have been arrested less often, be mandated to receive treatment, to have an unsatisfactory exit status or be transferred to another treatment program at discharge. CPS+ women were also more likely to have attended outpatient or day treatment for the AOD treatment. This study points out that there may be specific risk factors in place for a subgroup of women with children in AOD treatment.     

Interventions to Strengthen Noncustodial Father Involvement in the Lives of Their Children

Abstract

This paper describes quantitative evaluation of a program designed to increase noncustodial fathers' visitation frequency and financial assistance to their children. The initial program objectives were to enhance parental skills and work opportunities for fathers. Discussion group data revealed that additional obstacles to father involvement included conflicts between parents and substance misuse and abuse. Communication skills, anger management, alternative methods of coping with stress and increased activities for families were added to the program components in response to these needs. Future plans for strengthening community connections to expand educational, training and employment opportunities as well as increased outreach to families were based on additional assessment of interventions needed for successful co-parenthood.     

Engaging substance-affected families in child welfare: parent perspectives of a parenting intervention at program initiation and completion

Families affected by substance abuse are at an increased risk of child welfare involvement and poor child welfare outcomes. One strategy to improve outcomes among these families is evidence-based parenting interventions. While these interventions show the potential for advancing the child welfare field, they have not been widely and rigorously evaluated with birth parents, especially those affected by substance abuse, who face marked vulnerability and marginalization. We sought to draw on parents’ expertise and to understand their first and changing impressions throughout involvement in a parenting intervention, as well as overall impressions at program completion. Semi-structured interviews were conducted with a purposive sample of 10 parents who were involved in child welfare and a family drug treatment court. All parents were affected by parental substance use and had recently completed the Strengthening Families Program. Interviews were transcribed verbatim and analyzed for prominent themes. The study’s findings showed that parents described four key themes that influenced their perspectives of the parenting intervention: program reputation as communicated by peers, relevance and applicability of the program, children’s involvement and enjoyment of the program, and program structure issues that pointed to the need for high-quality group facilitation. Implications for practice and research are discussed.     

FOLLOW-UP SURVEY OF GRADUATES FROM ACCREDITED DEGREE-GRANTING MARRIAGE AND FAMILY THERAPY TRAINING PROGRAMS

This article reports the results of a mailed survey of 1980, 1983, and 1986 graduates (n = 205) from degree-granting marriage and family therapy training programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education. The graduates considered themselves (a) sufficiently to quite well prepared in marital/couple therapy, family therapy, and individual therapy with adults and (b) minimally to moderately well prepared in individual therapy with children and adolescents, individual diagnosis, and individual psychological assessment. The presenting problems for which graduates most strongly recommended increased emphasis in their MFT training program were alcoholism, other substance/drug abuse, incest/sexual abuse, and domestic violence.     

Young Fathers: An Analysis of Risk Behaviors and Service Needs

One hundred and twenty eight young fathers participated in an assessment of risk behaviors and service needs prior to entering a program for young fathers. Of this group, 73% were unemployed, 69% were school drop-outs, almost 40% had substance abuse problems, close to 30% had committed a felony, and less than half had declared paternity for their children. The majority of these young fathers desired employment services and educational/vocational training. Despite their risk behaviors, young fathers did not want substance abuse counseling, child support services, or help in obtaining a GED. There appears to be a discrepancy between the problems and needs, and the services which these young fathers requested. Many young fathers believed employment would be a panacea to all their problems. These findings suggest that more attention should be given to examining these issues in programs targeting young fathers. Services such as preventive health and mental health should be considered prior to the final goals of employment and establishment of paternity.     

Attitudes of Social Work Students About Substance Abuse: Can a Brief Educational Program Make a Difference?

ABSTRACT

This study examined whether a brief educational program could modify attitudes of master's level social work students about substance abuse. Study methodology involved a two-group pre-test and post-test quasi-experimental design. The Substance Abuse Attitude Survey, a standardized assessment instrument, was used to measure attitudes based on five distinct factors. No significant changes in student attitudes were found after participating in the educational session. Recommendations are offered for how social work schools may enhance their efforts to prepare students to effectively work with substance abusing clients and their families.     

An evaluation of substance abuse aftercare program for homeless women with children using confounding variable-control design

An outcome evaluation of a substance abuse aftercare program for homeless women with children was conducted using confounding variable-control evaluation design. The confounding variables are chosen from pre-treatment and other contextual variables of the clients that are known to have significant influence on the program outcome, but those that could not have been influenced a priori by the client involvement in in-treatment program activity at Transition House (TH). The latter is the independent variable of this evaluation design. The pre-treatment variables are measured by severity of alcohol and other drug (AOD) problems of the clients, their mental health status, age, and their job status before enrollment in the program. The contextual confounding variables are composed of family and social support available to the clients before and during recovery. While applying multiple regression analysis, we were able to explain 50.8% of the total variance in program outcome by four pre-treatment variables. By adding two contextual variables of family and social support, the total variance in program outcome explained is increased to 64.1%. Finally, by adding the degree of client involvement in in-treatment program activity, we were able to augment the total variance of the program outcome to 69.7%. By estimating the changed variance of program outcome by the in-treatment program activity during the final step, controlling for all other variables previously entered, we were able to establish that client involvement in in-treatment program had unique and positive impact on the program outcome distinct from those explained by the confounding variables. The additional variance uniquely added by in-treatment program activity is 5.6% (p < .001). It has been determined that the degree of client involvement in in-treatment program had positive and systematic impact on the program outcome.     

Enhancing Drug Treatment Program Staff's Self-Efficacy to Support Patients' HCV Needs

To increase HCV-related support for patients in substance abuse treatment programs, we implemented an on-site staff training in 16 programs throughout the United States. It aimed to increase participants' self-efficacy in assisting patients with their HCV-related needs. Findings indicate that participants' self-efficacy increased both 1- and 3-months post-training, resulting in providers' perceptions that they were better able to support patients regarding HCV. Implementing an engaging and interactive HCV training for social workers and other substance abuse treatment program staff has the potential to increase their HCV knowledge, self-efficacy, and the HCV-related assistance provided to patients both in the short- and longer-term.     

Evaluating the effectiveness of a school drug and alcohol prevention curriculum: a new look at "Here's Looking at You, Two"

The article reports on the results of an evaluation of a school drug and alcohol prevention curriculum marketed under the title, "Here's Looking at You, Two." Previous evaluations, unreported in the literature and having unresolved methodological problems, have found that while the program appears effective at transmitting information regarding drug and alcohol abuse, it has not been effective at changing the underlying attitudes and behaviors that, in part, explain substance abuse. Employing a more rigorous methodology, our examination of a relatively large sample across five school districts provides support for previous findings. Over the short-term of one year, the program was particularly effective at transmitting substance information to primary and middle school students. The program, however, produced very little of the expected effect on the underlying attitudes that are critical to changing substance abuse behaviors.     

Gender differences in psychosocial complexity for a cohort of adolescents attending youth-specific substance abuse services

This study examines gender differences in the characteristics of young people (N = 1000) attending alcohol and other drug (AOD) services in the state of Victoria, Australia. Females demonstrate levels of substance use that are at least as high, and perhaps more harmful than that of males. Our data add to a growing base of evidence that young women attending youth AOD services experience additional psychosocial problems at higher rates than their male counterparts. This evidence is now fairly consistent in regard to mental health problems, self-injury, suicide attempts, and homelessness. Findings from this study further suggest that the gender imbalance may extend to child protection involvement, family conflict and disconnection, access to social support, and exposure to neglect and abuse.     

Evaluation of the In Touch training program for the management of alcohol and other drug use issues in schools

In Touch is a professional training program designed to develop staff skills and support structures so as to enable schools to manage alcohol and other drug (AOD) matters in a coordinated manner that maximizes beneficial outcomes for at-risk students, while at the same time maintaining school discipline and community relationships. This study is an evaluation of the impact of the program on alcohol and other drug (AOD) related knowledge, attitudes and activity of participating school staff, and on AOD management practice in their schools. Data from 53 intervention participants and 21 controls were compared at pre- and post-intervention. These data indicated a 46% increase in AOD knowledge among those who participated in In Touch training. Attitudes favorable to integrated, supportive management of AOD issues also increased significantly in this group, as did desirable practice. However, change in school practice was limited. Significantly more schools whose staff participated in In Touch training had a written drug policy at post-intervention, but schools' usual responses to AOD-related incidents were substantially the same. These findings indicate that professional training on the management of AOD matters can change the understanding and practice of individual staff, but if school structures and practice are to be substantially influenced, a broader program is required.     

Programa shortstop: a culturally focused juvenile intervention for Hispanic youth

Culturally sensitive juvenile delinquency and substance abuse interventions are relatively limited and unavailable to many first-time Hispanic juvenile offenders. The purpose of this study was to test the effectiveness of a culturally focused juvenile and substance abuse intervention program for first time Hispanic youth offenders. The intent of the program was to decrease juvenile recidivism and increase substance abuse resistance. Programa Shortstop is a family based intervention designed for Hispanic youth ages 9-17. The intervention was delivered to 352 youth and at least one parent/caregiver over the 5-year study period. For intervention youth, the results of the recidivism study (n = 321) indicated that 89% of youth participating in Programa Shortstop between 1995 to 1997 were not rearrested within one year of completing Programa Shortstop. Additionally, statistical paired t-test analysis found that the intervention model had a positive effect on legal knowledge and school related factors associated with substance abuse and delinquency. Parent participants demonstrated significant increases in knowledge related to substance abuse and the legal system.     

Multiple Family Group Therapy in a Drug and Alcohol Rehabilitation Centre

In the last decade there has been increasing interest in working systemically with groups of families. Multiple family groups (MFGs) have been used in mental health settings with schizophrenia, eating disorders and drug and substance abuse. This article describes the MFG program used in Higher Ground Alcohol and Drug Rehabilitation Trust, a rehabilitation centre in Auckland, (New Zealand). Higher Ground provides an 18‐week residential therapeutic program for people with a severe substance abuse disorder. The MFG in Higher Ground focuses on developing better communication patterns and better boundaries between family members, fostering mutual support, and promoting self‐responsibility.