"It Has Made College Possible for Me": Feedback on the Impact of a University-Based Center for Students in Recovery

Objective: The authors aimed to gain information on (1) the challenges for recovering students on a university campus and (2) the most helpful components of a collegiate recovery program.

Participants: The 15 students in the study were all in recovery from substance abuse. They entered the university and also entered the campus recovery program either in fall 2002 or fall 2003.

Methods: Semistructured interviews were conducted with students multiple times during their first academic year.

Results: Participants identified several challenges on the university campus. Many believed they would have dropped out of school or relapsed without the support of the recovery program, and they described aspects of the program that were particularly important to them.

Conclusions: Support from a campus recovery program is essential for many recovering students. There are a variety of recovery program components that can foster the sense of community that was so important to the students in this study.     

Applying an Ecological Framework to Understanding Drug Addiction and Recovery

ABSTRACT

A new conceptual model of drug addiction and recovery, the Acculturation Model, is presented, with “addiction” and “recovery” understood as distinct sociocultural phenomena with their unique prescribed behaviors, rituals, symbols, and language that serve to construct and consolidate a cultural identity. The model suggests that individuals in recovery from drug addiction will need to make a cultural transformation in order to maintain sobriety. Examples of specific rituals that may help facilitate movement from addiction to recovery are detailed.     

Cognitive Processes: Their Influence on Varying Pathways to Recovery

ABSTRACT

Cognitive processes have been known to have a significant impact on recovery from alcohol and other drugs. From a study of self-changers (natural recoverers) without treatment or self-help groups, analysis of the data has identified beliefs that influenced the change experience–from the evaluation of reasons for drinking and the consequences that instigated the motivation and determination to take action, to the individually-conceived strategies to implement and maintain abstinence, and the perceived consequences of abstaining. Belief systems and strategies of recovery are compared across three pathways to recovery–self-change, cognitively-oriented treatment, and Alcoholics Anonymous.     

Latinas in Treatment

Abstract

This study analyzed secondary data collected from a recovery home specifically for Hispanic female substance abusers, and from four other recovery homes. Demographics, drug use history, and length of stay were compared to determine if participants of the culturally specific home remained in the program longer, and the reasons why. Results indicated that the women in the Hispanic recovery home stayed over a month longer and were more likely to be poor, unemployed, and methamphetamine or heroin addicts. Regression analysis was used to determine how these and other characteristics predicted length of stay, a variable that has been found to correlate with successful outcomes. Length of stay was associated with the culturally specific program, prior arrests, and years of problem drug usage. Implications for program design and treatment are discussed.     

Posttreatment 12-Step Program Affiliation and Dropout: Theoretical Model and Qualitative Exploration

ABSTRACT

Treatment outcome research has repeatedly demonstrated that involvement in twelve-step (TS) programs (e.g., Alcoholics Anonymous or Narcotics Anonymous) following treatment is associated with improved substance use outcomes. Treatment providers widely encourage TS program attendance during treatment and for aftercare; yet, evidence suggests that minimal and sporadic attendance or complete dropout is the more common occurrence. Providers would benefit from knowledge that would contribute to a greater understanding of factors that influence posttreatment TS program affiliation or dropout to guide treatment strategies. This article reviews the literature on TS affiliation, advances theory and a model to explain affiliation, and reports findings from a qualitative research study focused on understanding what people in TS facilitative treatment report as good (the pros) and not so good (the cons) about TS program involvement. Results suggest that unresolved ambivalence as well as socio-cultural barriers to support contribute to poor TS program utilization.     

Serving families with child maltreatment and substance use disorders: A decade of learning

ABSTRACT

An increase in parental substance use disorders (SUD) and the number of infants and toddlers entering foster care has prompted federal and state efforts to change the treatment paradigm toward more integrated and family-centered strategies. The Regional Partnership Grant (RPG) program demonstrated that family-centered strategies can improve child and parent outcomes. The current challenge is to bring effective strategies to scale. This conceptual article highlights the lessons learned from 10 years of implementing and evaluating programs to meet the needs of families affected by parental SUD and child maltreatment. Effective family-centered strategies identified by the RPG program are illustrated with specifics from the Sobriety Treatment and Recovery Team program. These effective strategies could be implemented in any jurisdiction and include (1) collaboration toward integrated services between child welfare and SUD treatment, (2) timely access to SUDS treatment, (3) recovery management and support, (4) tailored family services, and (5) adaptation to local jurisdiction needs. When these strategies are operational, children are more likely to be safe and remain in parent custody, and parents are more likely to achieve sobriety and improve their parental capacity. Future research might examine the unique impact of each of the five strategies independently.     

Comparative Analysis of State Statutes

Abstract

The purposes of this study were to analyze statutory requirements regarding prenatal substance abuse reporting, related healthcare assessments, and state interventions with reported women and their families. The author conducted a legal search of the statutes of ten states, which were identified as having “specific gestational abuse statutes” in previous literature (Lieb & Sterk-Elifson, 1995).

The findings revealed that seven of the ten states included a specific reporting requirement. Even in these seven states, neither assessment procedures nor treatment provisions were well-delineated. Only three states had specific provisions on therapeutic intervention with reported women. Based on the findings, three principles for a model statute are recommended for balancing the rights of infants and mothers.     

Mental Health Recovery

Abstract

Strengths-based approaches that emphasize culturally competent services and naturally occurring community support may be more appropriate than traditional mental health services for African American adults with psychiatric disabilities. An examination of the literature on service utilization and treatment needs for this population highlights the paucity of empirical studies in these areas, while an exploration of the literature related to psychiatric recovery, a prominent strengths-based framework, reveals insufficient application of the approach to the specific interests of African American service recipients. We suggest that recovery is in fact highly compatible with such culturally relevant approaches as the Afrocentric model, and argue that the concept of recovery may therefore provide a resonant and particularly useful framework for practice with this population. Implications for research, practice and policy are discussed.     

Best Practices in the Treatment of Substance-Abusing Women in the Child Welfare System

ABSTRACT

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e.g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

The Impact of Methamphetamine Use on Parenting

SUMMARY

Children whose parents abuse substances are often exposed to chaotic and neglectful lifestyles. Because of the increase in methamphetamine abuse, especially by females of child-bearing age, it is important to understand how the use of this drug impacts parenting. In this qualitative study, ten parents being treated for methamphetamine abuse were interviewed. Results indicated that while using, parents utilized a polarized style of parenting and specific drug management strategies, allowed exposure to violence, created upheaval in their children's daily living structure, and felt ambivalence when discussing these effects on children. Implications for social work practice include early intervention focusing on strengthening parenting skills.     

A Family Perspective for Substance Abuse: Implications from the Literature

SUMMARY

This paper calls for researchers and treatment providers to increase their recognition of the role that family and family functioning has for understanding the incidence and impact of substance abuse. Substance abuse is identified as a family problem by exploring its occurrence within families as well as its impact on marital relationship, family violence, and child abuse and neglect. The impact of substance abuse on the roles of spouses and parents are examined, as is the impact of substance abuse on children at various developmental stages. The role of the family as participant in active substance abuse as well as a valuable treatment resource is also explored. Finally, the authors present recommendations for increasing the focus on family in substance abuse research.     

Recovery Processes in a Treatment Program for Women

ABSTRACT

Recovery processes of 32 women were explored in six focus groups following completion of treatment in a community based women-specific substance abuse group program. Grounded theory analysis yielded an over-arching theme of Building a House of Recovery and several sub-themes describing women's perceptions of the processes that were central to their recovery.     

The Role of Shame in Women's Recovery from Alcoholism

Abstract

This study compares the recovery experience of female members of Alcoholics Anonymous (AA) who reported a history of childhood sexual abuse (68%) with those who did not report experiencing childhood sexual abuse. A sample of 53 women was obtained from AA. A significant relationship was found between shame and two measures of difficulties in recovery-problems in social adjustment and relapse. Though the hypothesis that experiences of child sexual abuse predicted difficulty in recovery was not supported, these data suggest that shame may be an important variable in both the etiology and treatment of alcoholism in women.     

A Qualitative Examination of the Juvenile Drug Court Treatment Process

ABSTRACT

Drug treatment courts have proliferated at a remarkable rate, to over 1,000 drug court programs by May 2001. Literature has developed which shows drug courts to be generally effective for reducing recidivism and drug use. However, research on juvenile drug court treatment has lagged behind its adult predecessor. Recent research efforts emphasize the need to understand the process components of drug court so this treatment model can be described and modified to improve effectiveness. The current paper has three related objectives: (1) to describe how focus groups can be effectively used to study juvenile drug court treatment processes; (2) to present findings from a juvenile drug court in which this method was used; and (3) to interpret these findings through an empirically validated conceptual model that has been used to examine the treatment process components of community-based drug abuse treatment. Implications for evaluation and treatment professionals are discussed.     

Physical Activity as a Helpful Adjunct to Substance Abuse Treatment

ABSTRACT

While limited research exists on the topic of physical activity as an adjunct to substance abuse treatment, a review of relevant multidisciplinary literature indicates a logical rationale for its potential benefits to recovery from addiction. This article provides an overview of common variables that contribute to addictive disease and summarizes the relationship of regular physical activity to improvements on many of these variables. The stages of change from the Transtheoretical Model (TTM, Prochaska & DiClemente, 1982; Prochaska & Velicer, 1997) are described in the context of effectively matching clients in substance abuse therapy to interventions that may include physical activity. Finally, important practical suggestions for implementing physical activity as a useful adjunct to substance abuse treatment are provided.     

The Psychology of the Psychopharmacology Triangle

Abstract

The psychopharmacological triangle generated by recent changes in mental health practices requires social workers to deepen their understanding of the psychological meanings of such treatment. Many clients receive concurrent psychotherapeutic and psychopharmacological interventions from different providers, creating a triangular treatment relationship. To facilitate a successful outcome, social workers will need to understand how meaning, transference and countertransference are stimulated by this arrangement. The literature on these issues as well as clinical experience will highlight specific issues requiring attention. By attending to these dynamics, the social worker can maximize the chances for a successful treatment outcome.     

Substance Abuse Treatment with Adolescent African American Males

Abstract

The use of substances by adolescent African American males is of particular concern because of the damaging effect that drug abuse has not only on the individual and his family but also on the African American community. The literature is scant regarding treatment services and few therapeutic interventions have been specifically designed to holistically meet the needs of these youth. This article proposes the use of Afrocentricity and Reality Therapy as therapeutic bases for substance abuse treatment with this population.