The Evolution of Substance Abuse Treatment in Juvenile Justice

ABSTRACT

This paper discusses the scope of substance abuse and related problems among juvenile offenders, and describes three models of addressing the problem based on a review of current approaches, ranging from Treatment Alternatives to Street Crimes programs (TASC), to juvenile drug courts, to an integrated treatment network model. The relevant strengths and weaknesses of each in supporting lasting change in substance-abusing juvenile offenders and their families are presented, and a call to action is offered for communities wishing to aim their interventions innovatively and precisely in the direction of substance abuse among their delinquent youth.     

Spiritual Interventions in Substance Abuse Treatment and Prevention

Abstract

This article reviews the recent research literature related to the use of spiritual interventions in the prevention and treatment of substance abuse. Empirical outcome studies are critically reviewed and a brief overview is given of spiritual interventions which have yet to be studied empirically. Areas for further research are delineated and philosophical and methodological issues related to the study of spiritual interventions are discussed.     

Measuring the Influence of Social Context Referents in Substance Abuse Treatment: An Instrument Validation Study

ABSTRACT

This paper introduces a newly developed assessment tool, the Ecological Assessment of Substance abuse Experiences (EASE) that has been designed to measure the influence of social context referents (i.e., family, peers, and community) on clients' attitudes and outcome beliefs related to substance abuse and recovery. An initial exploratory factor analysis was conducted with a small sample of adult treatment-seekers (N =103) to identify its underlying factors and to examine the instrument's item-factor fit. Items clustered onto four orthogonal factors: “belonging-recovery,” “belonging-drugs/alcohol,” “disconnect-recovery,” and “attitudinal congruence-recovery.” Preliminary findings suggest that socio-emotional outcome beliefs and attitudes about drug use and recovery behaviors, as related to family, peers, and community contexts, may be significant areas to address during routine assessment practices that may lead to more comprehensive and contextually appropriate treatment plans.     

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 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.     

Post-Modern Ideas in Substance Abuse Treatment

ABSTRACT

This article describes the use of post-modern ideas in the treatment of substance abusers at a long term residential and day treatment center. It describes some of the changes that ensued as a result of a transformation from a “therapeutic community” (TC) model to a “solution-focused” model. The TC is a deficit model that focuses on a person's flaws and weaknesses. Solution-focused therapy, on the other hand, focuses on what a person has done and is doing right and his or her strengths, assets, and resources. This approach not only improves the quality and effectiveness of substance abuse treatment for clients, but also creates a better working environment for staff.     

Comorbid Substance Abuse and Mental Illness

Abstract

Literature concerning assessment and treatment of comorbid substance abuse and mental illness is reviewed. Currently, comorbidity is under-diagnosed and dually diagnosed clients are under-served. Those clients, who are so diagnosed, are most often offered dichotomous parallel or serial interventions. However, research suggests that an integrated approach is preferable. Enhanced training of mental health and substance abuse professionals is urgently needed as is further research concerning the efficacy of various treatment modalities. Improved identification and treatment of comorbidity may reduce the revolving door effect among these individuals and thereby lower health care costs.     

Enhancing Health-Conscious Behaviors Among Clients in Substance Abuse Treatment Programs

The physical health of substance abuse clients significantly deteriorates because of the client’s prolonged abuse of alcohol and other drugs and accompanying behaviors. The purposes of this study are (a) to understand how substance abuse clinicians think about the health needs of their clients, (b) to identify the mechanisms through which clinicians seek to enhance health-conscious behaviors among their clients, and (c) to identify how substance abuse clinicians view their role in enhancing health-conscious behaviors among their clients. A qualitative study was conducted using in-depth, semistructured interviews with substance abuse clinicians (N = 16) from 4 substance abuse treatment centers. Using the theory of planned behavior as a framework for understanding the promotion of health-conscious behaviors in substance abuse treatment, the findings suggest that substance abuse clinicians are capable of enhancing health-conscious behaviors among clients in substance abuse programs.     

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.     

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.     

Creating Culturally Grounded Videos for Substance Abuse Prevention

ABSTRACT

This article describes and critiques the pilot phase of a project in which an ethnically diverse group of students from a large southwestern urban high school created culturally based substance abuse prevention videos for urban middle school students. The rationale evolved from research that suggested that a peer-created, culturally-specific approach to drug abuse prevention would be more effective than would programming created by adults operating from a “so-called” culturally-neutral” perspective. The dual perspective of this article includes both the field experiment per se and the data collected, using a case study perspective. Overarching themes of culture and power are discussed, as are the elements of age and gender. Implications extending beyond the pilot offer insights for researchers and practitioners.     

Building Trauma Informed Practice: Appreciating the Impact of Trauma in the Lives of Women with Substance Abuse and Mental Health Problems

ABSTRACT

This paper examines the lifetime interpersonal abuse experienced by a substance abuse treatment sample of 1,955 women with co-occurring disorders. Substantial rates of intimate and community-based interpersonal abuse and other life stressors are documented. Regression analysis shows that while trauma severity is significantly related to trauma distress, its impact on psychological symptom distress and drug severity is quite modest. The implementation of a trauma informed approach featuring trauma-specific treatment, service integration and consumer empowerment is described as a promising practice model for assisting women seeking help in substance abuse treatment programs.     

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.     

Integrating Art Therapy Methodology in Brief Inpatient Substance Abuse Treatment for Adults

ABSTRACT

Decades of drug addiction research and clinical work have underscored the need for multifaceted and comprehensive treatment responses in order to sufficiently address the varied needs of individuals struggling with addiction. One valuable treatment component that can be incorporated into traditional treatment protocols to expand the comprehensive nature of treatment response is art therapy. A conceptual framework is presented, detailing the integrative opportunities and benefits of including an art therapy component to short-term hospital-based inpatient substance abuse treatment programs. A creative arts component can be particularly beneficial for brief inpatient programs, where the client population is diverse, in crisis, and at high-risk for relapse; and where clinicians need to obtain comprehensive client information from multiple sources in a short amount of time. Art therapy methodology can provide a mechanism for collecting such collateral information for assessment purposes, can be employed to facilitate therapeutic change, and is used to track and document client progress and clinical change over time. Practice guidelines and specific treatment techniques are presented through short case examples.     

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.     

Social Work and the Treatment of Substance Abuse in Israel

SUMMARY

This paper examines the role of the social worker within the field of substance abuse in Israel at the start of the 21st century, its implications for the profession, and the training of its practitioners. Addiction to psychoactive substances is viewed as a bio-psycho-social phenomenon caused by a wide variety of factors and the respective interactions between them, placing it within the realm of the expertise of the social worker. The social worker plays a central role in providing both administrative and clinical interventions with this population. Additional ways in which the education and training of social workers can prepare them to deal more efficiently and comprehensively with the problem of substance abuse in both practical and academic terms is discussed.     

Culturally Competent Substance Abuse Treatment for Asian/Pacific Islander Women

Summary

In response to the urgent need for substance abuse treatment among pregnant and postpartum Asian/Pacific Islander (A/PI) women, heath care and social service providers in a rural community of Hawaii established a culturally based, women-centered residential treatment program. The program was designed to address barriers that often prevent A/PI women from engaging and completing treatment. Treatment included Hawaiian healing practices or deep cultural therapy, provision for newborns to live with their mothers, infant health-care services, parent education, and infant-mother bonding guided by kupu-na (elders) of the community.

Analysis of twenty-one in-depth interviews revealed factors that A/ PI women participants found vital to their treatment process: having their children with them in a non-punitive, mutually respectful treatment milieu; working with consistent, competent residential staff and culturally-sensitive interdisciplinary professionals; and involvement in a range of substance abuse interventions, including cultural healing practices.

Findings underscore the importance of learning about and affirming women's lived-experiences and cultural contexts in the development of culturally competent practice models, interventions, research procedures, and policies that focus on the complex needs of chemically dependent pregnant and parenting women (Brindis & Theidon, 1997).     

Perception of Substance Use Problems in Asian American Communities by Chinese,Indian, and Vietnamese American Youth

SUMMARY

The study was a cross-sectional survey using a convenience sample of 87 Asian American youth respondents to examine their perceptions of substance use problems in the Asian American community. The authors examined respondents' perceptions of the severity of substance use problems in the Asian American community, perceived characteristics of persons with problems of substance use, perceived etiology of substance use problems, beliefs about treatment, perceived help-seeking preferences and helpful services. The youth demonstrated an increased awareness of the severity of substance use problems in the community, although such awareness was more prominent for drinking problems than drug use problems. Respondents showed a positive attitude toward treatment, although such an attitudinal change was not yet accompanied by a change in their behavioral preferences. Findings suggested a tendency for Asian American youth respondents to utilize personal resources rather than professional help or formal treatment programs in response to substance use problems. In addition, respondents shared similar “myths” of Asian problem drinkers and drug users. Implications for developing culturally relevant interventions for prevention and treatment as well as future research are discussed.     

Disability and Abuse in Relation to Substance Abuse

Abstract

This analysis reviewed five years of a state's substance abuse treatment admissions and discharges in order to identify specific patterns among persons who had a disability. Using a series of group comparisons, Chi-squares, and logistic regressions, specific patterns of violence and abuse to this population were identified. Results indicate that persons who had a disability and abused substances were more likely to be victimized by physical abuse and domestic violence when compared with their peers without a disability. A person with a disability had about one-half to one-third the odds of receiving long-term residential, short-term residential and intensive outpatient care when compared with persons without a disability.     

Substance Abuse Among Puerto Rican and Dominican Gang Members in a Small City Setting

SUMMARY

Joining a gang increases an adolescent's risk for substance abuse. To better understand the contextual development of drug use behavior, this retrospective ethnographic study describes a sample of 76 young small-city mainland Puerto-Rican and Dominican males who joined gangs when they were younger. Data is presented and discussed on the drug abuse behavior including their drug using progression and the context in which such use occurs. The young average age of onset 11.2 (sd = 2.6) combined with the rapid progression to more dangerous drugs, which generally occurs within six years, demonstrates the elevated risk associated with small city gang membership. Differences in the patterns of drug use were also found between the English and Spanish speaking groups. The authors discuss the implications of the study findings on the development of interventions. Recommendations address future research possibilities on drug abuse within Latino gangs.