Substance Abuse among African-American Children: A Developmental Framework for Identifying Intervention Strategies

Abstract

Substance abuse has devastating effects on the lives of African-American children and adolescents who are both directly and indirectly victims of this problem. This article discusses child and adolescent substance abuse from a psychosocial developmental perspective within an Africentric paradigm. The authors explore contributing and intervention factors related to substance abuse that impact developmental milestones. They delineate preventive tactics for addressing the problem of substance abuse and delineate implications for social work practice.     

Adolescents in Treatment: Effects of Parental Substance Abuse on Treatment Entry Characteristics and Outcomes

SUMMARY

Research strongly supports an increased risk of substance use disorders among the adolescent children of addicted parents. However, little documentation exists of how these adolescents fare when they present for treatment. This article uses data taken from a two-state study on the effects of adolescent substance abuse treatment to examine the characteristics of adolescents with substance-abusing parents and their outcomes following an episode of outpatient treatment. Although such adolescents enter treatment with greater problem severity in a range of areas, outcomes appear similar to adolescents with no substance-abusing parents. The impact of family and individual counseling on outcomes was also examined, demonstrating mixed results for adolescents with substance-abusing parents.     

Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment

ABSTRACT

Despite increasing interest in “faith-based” substance abuse treatment and HIV risk reduction interventions, there is little systematic evidence of the efficacy of explicitly spiritual interventions. However, fundamental to effective interventions is an explicit conceptualization of mechanisms underlying behavior change. This paper discusses the definition of faith-based organizations, specifically as they relate to substance abuse treatment programs, briefly reviews relevant behavior change theories to identify key variables underlying change, presents an integrative conceptual framework articulating linkages between spiritual intervention components, behavior change processes and substance abuse outcomes, and discusses how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, the paper suggests that what happens in “faith-based” programs may not be so different from processes taking place in good social work practice in the addictions field.     

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.     

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACT

This systematic literature review compares the e?ectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines ?ndings of six randomized trials and three secondary analyses from randomized trials. Based on the ?ndings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory e?ect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an e?ort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’     

The Role of Technology in Mediating Use of Outpatient Substance Abuse Treatment Services

ABSTRACT

This study examined the relationship between Connect, a telephone-based information and support system, and the use of outpatient substance abuse treatment services. Regression models were formulated to examine the relationship between use of substance abuse treatment services and Connect. The results indicate that Connect use was not significantly related to the likelihood of using treatment (N = 240). However, an inverse relationship was found between Connect and use of treatment services (n = 123). The findings raise the conceptual issue of whether one introduces technology as an “add-on” to or as a “substitute for” traditional substance abuse treatment services.     

Agency Practices Affecting Social Workers Who Treat Substance-Abusing Clients

Abstract

This study interviewed 115 MSWs with substance abuse training working in general social service agencies to determine if they viewed their settings as facilitating or hindering their work with substance-abusing clients. This study builds on the work of Lightfoot and Orford (1986) who found that social workers were more hindered than helped by their agencies' practices regarding substance-abusing clients.

Results: A majority of workers viewed their agencies as facilitating substance abuse-related work through support from supervisors and administrators, availability of substance abuse training, workers' freedom to choose clients, and opportunities to supervise others on substance abuse-related issues. Supervisor data corroborated these findings. This is a hopeful sign for the profession contrasting with considerable social work literature documenting the profession's historic ambivalence toward substance-abusing clients.     

Substance Abuse,Homelessness, Developmental Decision-Making and Spirituality: A Women's Health Issue

ABSTRACT

A qualitative methodology was used to examine the relationship between homeless women's spirituality, substance abuse, moral reasoning and developmental decision-making. Findings indicated that a lack of development in spirituality and the ability to make decisions in childhood is related to homeless, addicted women's inability to maintain abstinence and achieve social independence. Spirituality impacted decisions to abstain from substance abuse and increased the women's social independence. Findings suggest that treatment needs to incorporate spirituality, family of origin, and the development of skills for independent decision-making. The authors propose that childhood maltreatment, homelessness and substance abuse impede spiritual development. Therefore, substance abuse treatment needs to include a focus on spirituality and moral reasoning in the recovery process.     

Gay Youth

Abstract

In recent years there has been a growing awareness among parents and social service professionals of the complex sexual identity development of adolescents. Despite this, adolescents continue to struggle to define their sexual identity. Gay and lesbian adolescents in particular are at risk for a host of problems, including substance abuse and suicide. In this context it is important for social service researchers to study adolescent sexual identity and to report their findings in such a way as to be accessible to professionals and to the public.     

Anxiety and social stress related to adolescent gambling behaviour

Abstract

This study examined the relationship between anxiety, social stress, and gambling behaviour among 1,044 high school students in grades 7 to 11. Adolescents completed questionnaires concerning their state, trait, and generalised anxiety, social stress, and gambling behaviour. Results reveal that adolescent probable pathological gamblers report more state anxiety, trait anxiety, and higher levels of social stress compared to non‐gamblers, social gamblers, and gamblers at‐risk for serious problems. Gamblers with high state and trait anxiety engaged in more severe gambling behaviours, greater substance abuse, reported different reasons for gambling, and endorsed more dissociation items. The results provide additional support for Jacobs’ (1986) General Theory of Addictions. The implications for treatment and prevention programs are discussed.     

Assessing Social Work's Contribution to Controlled Outcome Studies in the Alcohol Dependence Treatment Literature

ABSTRACT

Alcohol use disorders are among the most prevalent and disabling conditions encountered by social work practitioners. Although a substantial body of research findings has accrued evaluating the effectiveness of available alcohol dependence treatments, few efforts have been made to assess the contribution that social work has made to this database. Thus, this study examined the contribution of social work to the alcohol dependence treatment outcome research literature over the past half-century. Controlled investigations of alcohol dependence treatments published between 1950 and 2000 were analyzed by publication outlet type and primary author's professional affiliation. Computerized bibliographic searches of medical and social science databases were conducted and a manual search of 13 core social work journals to identify controlled studies of alcohol dependence interventions. Results indicate that researchers affiliated with schools or departments of social work as well as studies contained within core social work journals have contributed little to knowledge development, with respect to controlled studies, in the alcohol dependence treatment literature. Greater social work involvement in chemical dependency research would contribute much to current efforts to promote evidence-based practice and clinical guideline development in this important practice area.     

The Seven Challenges: An Effective Treatment for Adolescents with Co-Occurring Substance Abuse and Mental Health Problems

ABSTRACT

Recent developments in the provision of the substance abuse treatment for adolescents has included a focus on age appropriate treatment with consideration for adolescents' relatively low level of motivation for treatment and high incidence of co-occurring substance use and mental health problems. This study examines 3- and 6-month substance use and mental health outcomes for youth (n = 36) participating in The Seven Challenges Program. Results indicate significant reductions in both substance use and mental-health-related measures at 3 months with all measures except substance abuse frequency continuing to improve at the most distal 6-month assessment. The Seven Challenges treatment model is presented along with a discussion of the findings.     

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.     

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT

This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict women's unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.     

Substance Abuse in the New South Africa

ABSTRACT

Over the past five years South Africa has experienced a political transformation that has riveted attention around the world. A country once known for its policy of racial separation or apartheid has emerged as a new democracy with a racially integrated government of national unity. South Africa is now one of the most sought after tourist destinations and has attracted foreign investment from every major country around the world. Ironically, it is also emerging as one of the most lucrative countries for drug trafficking, substance abuse and the crime that typically follows. This article will examine the growing problem of drug and alcohol abuse in the new South Africa. The social and economic implications and the demand reduction methods will also be explored. Finally, the status of chemical dependency treatment and available support groups will also be discussed.     

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.     

Sexual Abuse Victimization and Psychological Distress Among Adolescent Offenders

ABSTRACT

This study focused on sexual abuse victimization and psychological distress among 272 adolescent offenders. The respondents were interviewed while they were being detained in a short-term holding facility. Female respondents reported more sexual abuse victimization and psychological distress than did their male counterparts. Furthermore, church attendance moderated the association between sexual abuse victimization and psychological distress among the male respondents. Implications of these findings for research and interventions with adolescent offenders are discussed.     

Neuroscience in Social Work Practice and Education

Abstract

In the past two decades, advances in neuroscience research have revolutionized the scientific community's understanding of branehavior connections. Social work is now taking note of this trend. Specialists in substance abuse, addiction, and co-occurring diagnoses are beginning to relinquish long-held beliefs in mind-body dualism in favor of a truly integrated biopsychosocial understanding. This article identifies challenges related to social work and argues that neurobiological knowledge is essential for a biopsychosocial understanding of substance abuse and addiction, other mental disorders, co-occurring conditions, and human behavior. It gives examples of drawing on neurobiological knowledge for practice applications. These include educating users, families, and providers about neurobiological aspects of substance abuse (psychoeducation); using neuroscience research on mental illness and addiction to develop integrated approaches for dually diagnosed persons; and considering a range of medication options to alleviate cravings and reduce relapse.     

The Subjective Experience of Youth Psychotropic Treatment

Abstract

The psychotropic treatment of youth is increasing dramatically. This article examines child and adolescent psychopharma-cological research and argues that social work practice and research must examine the complex relationships, social and psychological, in youth pharmacologic treatment. Regarding identity formation, this article explores the developmental consequences when youth adopt an illness narrative to make sense of everyday medication treatment. A conceptual framework for mapping the socio-cultural context of youth medication management is outlined. In the conclusion, youth psychotropic treatment is connected to a perplexing ‘interpretive gap,’ which highlights the subjective quality of medication treatment.