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.     

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.     

Delivering LGBT-sensitive substance use treatment to sexual minority women

Abstract

Epidemiologic studies have consistently found elevated rates of alcohol and other substance use among sexual minority women (SMW), and despite calls for “lesbian, gay, bisexual, and transgender (LGBT)-specific” services and culturally tailored interventions, few such services exist. This study involved qualitative interviews with directors from substance use treatment programs (N?=?10) about how they addressed the needs of SMW. Strategies implemented primarily focused on creating a safe and welcoming environment for sexual minority clients. Findings highlight challenges involved in meeting the treatment needs of SMW and provide guidance to researchers and service providers on how to improve the quality of care for them.     

Neurobiological Causes of Addiction

Abstract

Neurobiology and molecular genetics are contributing heavily to a new understanding of the causes of chemical dependence (“addiction”). Willful chemical abuse is a problem that continues to produce significant societal costs including accidents, medical expenses, and family suffering. Pathological chemical dependence, on the other hand, is being recognized as a true medical disease that is also devastating, but in different ways. There is strong evidence in animals and humans that chemical dependence involves a dysregulation of the pleasure pathway (the “medial forebrain bundle”), located in the mesolimbic portion of the brain. Dopamine is one of the medial forebrain bundle's major neurotransmitters. In this paper, we provide a research-based model for the causes of chemical dependence and its treatment, and integrate this information with classic Twelve Step treatment programs.     

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.     

Between Money,Morality and Masculinity

Abstract

This paper focuses on the supply-side of Chiang Mai's gay bars, that is, the male sex workers called dek bar or “bar boys”¹ in Thai. I formulate some explanations why these young men -more than half of whom do not consider themselves to be “homosexual” -take on a job as a male sex worker. In this analysis I focus on certain notions in traditional Thai society, trends in contemporary urban Thai society, the economics of work in a gay bar, as well as the sexual behaviour of male sex workers and the concepts they use to describe their work.     

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.     

The Presentation of Self and the New Institutional Inmate: An Analysis of Prisoners' Responses to Assessment for Release*

This paper bases an analysis of the prison experience on Goffman's The Presentation of Self in Everyday Life rather than on Asylums. It describes the situation of prisoners in an institution where release decisions are individualized and where release recommendations depend on official assessments of the character, background, and moral “change” of each prisoner. The paper then focuses on the work that prisoners do to demonstrate institutionally approved character and “change” to the prison staff or, in the words of prisoners, to “show them who you are.” The concepts and premises of dramaturgy are employed to analyse prisoners' techniques of self-portrayal and to analyse prisoners' resistance to institutional assessment through describing their behaviour as simply “conning” and “manipulating.”     

Fostering Validating Responses in Families

SUMMARY

Families and family interactions can play a role in the development (vs. prevention), maintenance (or remediation), and treatment of borderline personality disorder (BPD); and, having a family member with BPD can have a significant impact on family functioning. This paper reviews a transactional model for the development and maintenance of BPD, with implications for treatment, particularly from the perspective of dialectical behavior therapy (DBT). The paper also describes a subset of DBT interventions specifically developed for work with couples and families to turn the destructive “inaccurate expression/invalidation cycle” into the constructive “accurate expression/validation cycle,” which is illustrated by a case example.     

Requisite conditions for the formation and viability of a counter‐cultural community

Many scholars have noted that religion is essential for a counter‐culture or utopian community to survive. It has also frequently been maintained that any religion will do, that the content of the religion is inconsequential. This article focuses on the formation and viability of alternative societies and concludes that either harsh circumstances or a particular religious orientation is necessary. Three social conditions and four characteristics of the religious world‐view are specified as being necessary for the formation of an “intentional counter‐culture community.” Each of the predisposing structural factors and each of the characteristics of the world view must be present for the formation and viability of this type of alternative culture. In the “circumstantial counter‐culture community,” religion is much less important; oppressive conditions serve as a functional alternative to the specific religious outlook.     

Beyond “Dry Drunkenness”: Facilitating Second Stage Recovery Using Wilber's “Spectrum of Consciousness” Developmental Model

ABSTRACT

The usefulness of Wilber's “Spectrum of Consciousness” developmental model in the treatment of substance abuse is demonstrated by a case study that illustrates how underlying emotional pain and intimacy issues can be worked through in the counselling process with a client during the second stage of recovery from addiction. Wilber's model allows for narcissistic, critical self, social, identity, intimacy, existential, and psycho-spiritual issues to be integrated into the counselling process for long-term recovery. This model provides social workers and addictions counselors with a useful map in embracing client recovery.     

Selected Websites for High-to-Low End NPO Website Development

ABSTRACT

SubstanceAbusePrevention.org, a virtual Community, is a 3.5-year project initially funded by the US Department of Commerce, Technology Opportunity Program. Its purpose was “to determine what proven components of substance abuse prevention in ‘real’ communities can be effectively transferred into ‘virtual’ communities.” Teens in drug treatment helped university researchers translate resiliency-based prevention practices into a Web site that would appeal to their peers. The 24 strategies tested fall in the categories of prevention exercises, games, multimedia, and information. This article describes the development process along with the lessons learned and future directions. The information is useful for those wanting to design and develop interactive Websites that address human service problems.     

In college and in recovery: Reasons for joining a Collegiate Recovery Program

ABSTRACT

Objective: Collegiate Recovery Programs (CRPs), a campus-based peer support model for students recovering from substance abuse problems, grew exponentially in the past decade, yet remain unexplored. Methods: This mixed-methods study examines students' reasons for CRP enrollment to guide academic institutions and referral sources. Students (N = 486) from the 29 CRPs nationwide operating in 2012 completed an online survey in 2013. Results: Students were somewhat older than traditional age (mean age = 26). Now sober for 3 years (mean), they had experienced severe dependence on multiple substances. One third reported they would not be in college were it not for a CRP, and 20% would not be at their current institution. Top reasons for joining a CRP were the need for same-age peer recovery support and wanting to “do college sober,” recognizing that college life challenges sobriety. Conclusions: CRPs appear to meet their mission of allowing recovering students to pursue educational goals in “an abstinence hostile environment.” Findings emphasize the need for more institutions to address the support needs of students in recovery.     

Reducing depression among mothers in a residential treatment setting: building evidence for the PST4PPD intervention

ABSTRACT

Objective

The prevalence of postpartum depression (PPD) nearly doubles among low-income mothers in the United States compared to the general population. Problem Solving Therapy (PST) is an effective treatment for populations of low-income women and more accessible than costly, long term interventions. This study aimed to assess the feasibility of implementing a problem-solving-focused intervention originally designed for home visits. Method: This study was conducted in a residential treatment facility (RTF). A chemical dependency counselor delivered the 5-session intervention named “PST4PPD”. A one-group pretest/posttest design was adopted. The standardized tools: Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) were used to assess depressive symptoms. The New General Self-Efficacy Scale (NGSE) was used to measure self-efficacy. Results: Among the 41 eligible women, 90% (n = 37) completed the intervention. The research found statistically significant decreases in depression (EPDS t(36) = 6.70, p <.001; PHQ-9 t(36) = 4.67, p <.001) and increases in self-efficacy (NGSE t(36) = ?2.41, p =.02). Conclusions: This pilot study finds positive results and feasibility of “PST4PPD”, a community-based, affordable intervention to lower symptoms of postpartum depression. Recommendations for future research and practice, including suggestions for engaging and retaining low-income mothers in PPD interventions, are discussed.     

Partially shared objects and the (Elusive) potential of expansive learning: the case of “jury” in community-based citizenship classes for Nepali-speaking Bhutanese refugee elders

ABSTRACT

This article focuses on community-based citizenship classes for Bhutanese refugee elders held in central Ohio. As part of a larger longitudinal study centered in the ethnographic and discourse analytic traditions, the article analyzes a classroom moment where the notion of a “jury” is briefly taken up and discussed. This moment is put into dialogue with relevant data from student interviews and teacher playback sessions using cultural-historical activity theory as an analytical framework to argue that the understanding of a “jury” is a “partially shared object” that reveals asymmetrical power relations between activity systems, with implications for expansive learning opportunities.     

Pathogenic and Protective Relations in Alcoholic Families (I): Development of the Ritual Invasion Scale

ABSTRACT

Family of origin daily routines and celebratory rituals may serve to protect offspring from the harmful effects of parental drinking. However, parental alcoholism may disrupt these positive rituals, and this “invasion” has been proposed as a mechanism for transmitting risk to offspring. This paper describes the development of a “Ritual Invasion Scale” which may facilitate research and treatment applications with these families.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

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.