Addiction Problems,Addiction Services,and Social Work in the Republic of Ireland

SUMMARY

The aim of this paper is to review policy and practice in relation to the management of alcohol and drug problems in Ireland, with a specific focus on the role of professional social work. There is a high prevalence of alcohol and drug problems in the caseloads of social workers that work within the statutory childcare and criminal justice services. Professional social work in Ireland is of comparatively recent origin and there are few social workers employed in specialist addiction posts or settings in Ireland. The profession as a whole, moreover, has not actively lobbied for a greater role in specialist services. While formal social policy on addictions has shifted in recent decades towards broad public health strategies, which reflect a pragmatic European perspective, the disease model from the United States of America continues to have popular appeal.     

Substance Use and Abuse and the Role of Social Workers in Germany

SUMMARY

The paper outlines major trends in consumption patterns of alcohol and other drugs in Germany with special focus on the use of cannabis among young people. It discusses primary prevention efforts and describes the current treatment system with its two branches: one for people with alcohol problems and the other for those with drug problems. It highlights the developing role of social work and identifies the research topics that are influenced by social workers and that will influence the debate regarding the future role of the profession.     

Counseling for the Family: The Neglected Aspect of Addiction Treatment in Canada

ABSTRACT

There has been a historic neglect of both research and practice in the area of counselling for the family members of alcohol or other drug abusers by the addiction field in Canada. As a result, treatment for individual family members affected by alcoholism and other drug addiction remains a neglected component of the majority of Canadian addiction programs. When family involvement is incorporated, the tendency has been to concentrate on orientation and education rather than on the provision of counseling for the family members. This dearth of programming exists despite the knowledge that an active alcohol or drug abuser's behaviour disrupts the entire family system, including the functioning and development of children. Each family member is uniquely affected with negative outcomes ranging from economic hardship to violence being perpetrated against them to an increased risk among children of becoming alcohol or drug abusers themselves. Thus, treating only the active alcohol or other drug abuser is limiting and an overly narrow orientation for the enhancement of both family and community health.     

The Role of Social Workers in the Treatment of Addictions

Abstract

This article describes the history of social workers' involvement in the treatment of addictions in the United States. Beginning with Mary Richmond, the “mother of social casework,” social workers have played an increasingly important role in the treatment of individuals with alcohol and other drug problems and of their family members. Today, social workers are important players not only in program development, administration, and treatment of chemical addictions, but also in “process” addictions, such as eating disorders and gambling. Moreover, social workers are increasingly involved in addictions research and policy arenas.     

Systemic Barriers to the Employment of Social Workers in Alcohol and Other Drug Treatment Agencies

Abstract

Literature suggests a low number of social workers employed in the field of alcohol and other drug (AOD) treatment. This study shows that social workers with undergraduate degrees (BSWs) have higher rates of employment in AOD than bachelor's degree holders from other disciplines. Master's level social workers (MSWs), however, have a much lower involvement than their counterparts with counseling degrees. Six factors are inferred to partially explain MSWs' low involvement in the field: (1) low education requirements; (2) low pay; (3) absence of “social worker” positions; (4) competition among different disciplines; (5) lack of MSW interns; and (6) state certification requirement. Suggestions to increase the employment of social workers in the AOD field are offered.     

A Preliminary Exploration of Immigrant Substance Abusers from the Former Soviet Union Living in Israel,Germany and the United States: A Multi-National Perspective

SUMMARY

The Former Soviet Union (FSU) has historically been seen as having an unusually large population of individuals with alcohol problems. Since the fall of the communist regime, a growing drug abusing population has become visible. With the large migration of its residents to western countries and to Israel, the rates of alcohol and drug problems among these immigrants appear to be disproportionally high, although reliable data are lacking. The purpose of this article is to summarize exploratory data regarding alcohol and other drug use among immigrants from the Former Soviet Union living in Israel, Germany and the United States, and to identify further research needs and implications for treatment and policy.     

Cocaine Abusing Women Who Report Sexual Abuse: Implications for Treatment

ABSTRACT

Four hundred seventy-three substance-abusing women were assessed for histories of sexual abuse. The results of bivariate analysis indicated that Sexual Abuse Survivors (SAS) had higher levels of depression, anxiety, and psychological distress. A greater number of SAS reported histories of emotional and physical abuse. They also had greater severity on ASI scales of alcohol, drug, medical, and family/social difficulty. Logistic regression analysis indicated that women who were survivors of sexual abuse were more likely to have histories of emotional and physical abuse, higher levels of addiction severity, and more family members who used drugs. Implications for research and treatment are discussed.     

Exploring the Nature of the Relationship Between Poverty and Substance Abuse

Abstract

Poverty and substance abuse are two serious social problems that are often assumed to be interrelated. This article explores what is currently known about the relationship between these two problems. Four possible models for describing the interrelationship are identified: causal, risk factor, exacerbation, and spurious. The theoretical explanations from both the substance and poverty literature are discussed in light of their implications for these types of models. The public health perspective is selected from the substance abuse theoretical literature as the model that best subsumes and directs thinking about the relationship between poverty and substance abuse, because its focus on agent, host, and environment draws attention to the range of factors that can influence both problems, as well as the ways in which they come together. Findings from the research literature are then discussed within the framework of the public health model. The article concludes by outlining the gaps in knowledge and an agenda for future research.     

Social Service Research and Religion

Abstract

Development of accountability standards to demonstrate cause and effect relationships are gaining rapid advancement in the field of social sciences. Many governmental agencies, foundations, and other funders have developed approaches that require organizations to utilize science-based programs and incorporate evaluative methods to show improved outcomes and cost benefits to society. This article will examine the need for increased accountability in developing effective interventions by faith-based organizations in the delivery of social service interventions. Recently, there has been a strong movement toward governmental funding for faith-based institutions to provide social services, although there has been inadequate scientific data to demonstrate that approaches implemented are effective in meeting needs or yielding favorable outcomes. Similarly, many faith-based organizations provide innovative and effective programs that could serve as model programs if there was appropriate empirical evidence. This article will discuss how rigorous evaluative approaches such as randomized clinical control trials can produce scientific data on program effectiveness. We will use a case example in the field of drug and alcohol treatment to illustrate these points.     

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.     

Factors Associated With Substance Use Disorders Among Traumatized Homeless Youth

This study aimed to identify homeless youths’ lifestyle and trauma-related risk factors as well as protective factors associated with alcohol use disorder or no disorder and drug use disorder or no disorder. Youth receiving homeless services in Denver (n = 201), Austin (n = 200), and Los Angeles (n = 200; N = 601) completed quantitative interviews assessing demographic information, alcohol and drug use, homeless lifestyle risk factors, trauma-related risk factors, and protective factors. Findings showed differences in trauma-related risk factors between alcohol and drug use disorders, but not homeless lifestyle risks. Protective factors predicted substance use disorders beyond risk factors. Understanding trauma-related risk and protective factors associated with substance use disorders could improve interventions.     

Substance Use and Disabilities: Experiences of Adults' Social Care Professionals and the Implications for Education and Training

This paper draws on data from a national survey of social workers and social care practitioners in England undertaken in 2010–2011. It focuses on practitioners working in services for adults with either learning or physical disabilities and, in particular, their experiences of responding to alcohol and other drug use among their service users. Based on secondary analysis of survey and focus group data from the earlier study, the paper outlines the extent to which workers in these areas of practice encounter alcohol and drug problems and discusses the key challenges this poses for them. The findings show that between 4% and 10% of adults' practitioners' service users have alcohol and drug problems depending on the nature of the disability. Regardless of the type of disability, practitioners reported difficulties in talking about substance use with their service users as well as identifying tensions around life-style choice and risk management. They also reported the need for education and training in a number of areas. Social work education and subsequent training in working with substance use problems needs to be available to adults' practitioners and it needs to address the specific issues and needs in different areas of social work practice.     

Natural Recovery from Substance Dependency

Abstract

The literature on cessation of drug and alcohol dependency without benefit of treatment or participation in self-help groups spans nearly forty years. While this literature is substantial and analyses of the processes of natural recovery well-developed, discussions directed at treatment providers around the value of these analyses for practice has been sparse. Drawing on our study as well as the research of others, this paper explores two dimensions of natural recovery that hold important implications for treatment providers who work with substance dependent clients. These include the common strategies used by remitters and the concept of recovery capital as a way to capture the embeddedness of these natural recovery strategies within a unique structural context of personal attributes and social environments.     

Investigating feasibility and fidelity of the Parenting Young Children program in Sweden

Specific aimsThis study explored feasibility and fidelity of an education program for parents with intellectual disability. The Australian Parenting Young Children intervention was translated and adapted for support workers in the Swedish social services.MethodFidelity was examined using implementation diaries tracking frequency of implementation of program activities and teaching approaches ((over 14 months, completed by 27 support workers from 15 municipalities). Eighteen of these support workers and their managers (n = 12) completed questionnaires examining feasibility using Roger’s concepts of program compatibility and complexity.FindingsResults showed that implementation of Parenting Young Children was feasible, with overall positive attitudes to Evidence Based Practice, good program compatibility, low perceived program complexity, and high satisfaction with implementation support. The fidelity measures suggest problems in how the program is used by some support workers: parents received less than the recommended number of sessions and activities such as observation of parents and follow up, were infrequently used by support workers.DiscussionThe findings raise questions about how program support and education should be provided. Difficulties in defining fidelity within the flexibility of the Parenting Young Children program are also discussed.     

Using the NIAAA brief alcohol screener in social work practice for selected prevention targeting youth

ABSTRACT

This article discusses the use of brief screeners in social work practice to identity adolescents in need of selected interventions for alcohol and other drug use problems. Brief screeners can increase access to alcohol or other drug intervention services and promote the diffusion of evidence-based interventions to underserved communities when integrated in Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiatives. The two-item NIAAA Brief Alcohol Use Screener is discussed as a developmentally tailored assessment tool that can be integrated into SBIRT in social work practice to improve detection of early-stage alcohol problems among adolescents who lack routine access to preventative health care. The use of brief, empirically supported alcohol screeners in trainings for social work students and new professionals can enhance their preparation and competence to offer child and adolescent clients appropriate selected intervention options to reduce harms associated with underage alcohol use.     

Passing a Mental Health Levy

ABSTRACT

The “devolution revolution” has decreased federal and state roles in the funding of social services and increased the burden on local sources, both public and private. This article describes how a community passed an initially unpopular property tax levy earmarked to support local drug, alcohol and mental health services. The article illustrates how social workers employing specific community practice knowledge provided leadership to the successful campaign. This example of community practice leadership includes building and maintaining coalitions, managing group tension and conflict and demonstrating fundamental social work values.     

Factors driving Salvadoran youth migration: A formative assessment focused on Salvadoran repatriation facilities

BackgroundBeginning in early 2014, the United States' southern border was flooded with an unprecedented number of Central American migrant youth attempting to enter the United States. In response to the influx of immigrants, the Obama administration requested $3.7 billion in emergency funding to be allocated to border security, detention, removal, immigration courts, and care for children. We conducted this research with the aims of identifying and understanding push factors for Salvadoran youth migration and of raising awareness of the need for services among recently deported youths.MethodsData for this mixed-methods study are drawn from field research conducted in El Salvador between 2014 and 2015. We conducted direct observation and 14 in-depth semi-structured interviews with case workers. We analyzed quantitative data from the Salvadoran respondents to the Latin American Public Opinion Project (LAPOP) and data from the Dirección General de Migración y Extranjería (DGME).ResultsIn the context of an intergenerational culture of migration, case workers describe how family reunification, security, coyote payment, and socioeconomic factors contribute as push factors for Salvadoran youth migration. Quantitative data illustrate a spike in youth repatriated by land in July 2014, and family reunification, insecurity, and economic factors were primary push factors reported for youths repatriated to El Salvador via land.ConclusionsThis assessment of Salvadoran youth migration push factors relied on interview data provided by case workers who have processed the multiple complex stories of youths at risk for migration. Quantitative data triangulated findings that show how family reunification, violence, and socioeconomic factors act within an intergenerational culture of migration to push Salvadoran youths into a dangerous migration attempt. Our findings can be used to inform the development of strategies to provide services to Salvadoran youths at risk for future migration and to generate mechanisms for providing those services.     

Caseworkers' perspective on risk factors in the family environment influencing mothers' difficulties in meeting children's needs

ObjectivesThis study examines, from the caseworkers' point of view, which needs of children are the most difficult for parents in neglectful contexts to respond to and which risk factors make this response more difficult.MethodA sample of 55 parents being followed by child protection services for neglect or high risk of neglect accepted to participate in the study. Their caseworker filled out a grid regarding the response provided to the children's needs and the risk factors in the family environment.ResultsThe results indicate that the children's age is related to the difficulties of responding to their needs. The caseworkers are particularly concerned about guidance and boundaries provided to preschool-age children, but less so about that provided to school-age children. When the children's age is controlled for, parents' mental health problems explains a significant proportion of the variance in parents' response to their children's need for stimulation, emotional warmth, and guidance and boundaries. Caseworkers' worries about drug and alcohol misuse also explain a significant proportion of their concerns about the mothers' ability to ensure their child's safety.ConclusionCaseworkers are more worried about the parental response offered to preschool children than to school-age ones. However, a constant and coherent response to growing children is still important for their developmental trajectories. Moreover, mental health and substance abuse explain caseworkers' concerns about mothers' engagement toward their child. These data raise questions about which type of services to offer, because intervening in families where parents deal with personal issues while addressing child neglect is complex.