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.     

Recovery Lessons Learned from Individuals with Psychiatric Disabilities

ABSTRACT

Over a long career in the public mental health system, the author has seen the progress in the service delivery that has given consumers more independence and ownership of their recovery. Until another breakthrough in brain science improves the outlook for prevention and treatment of brain disorders, the push to improve expectations with supports to manage their recovery needs to continue. The author describes Harbor City Services, Inc, a market-based social enterprise that creates jobs offering security against losing a job because of reappearing symptoms, including some jobs with the potential for growth beyond entry level. The growth of this business over 25 years shows the highs and lows of moving from public funding and charity to a self-supporting business. The author encourages the use of business strategies to improve the vocational opportunities that help sustain recovery and offers tips on employment and business.     

Coping Behaviors of Cocaine Dependent Women

Abstract

Four-hundred and forty-nine cocaine dependent women from three treatment programs were assessed for level of addiction severity, family difficulty, medical problems, and types of coping strategies at treatment entry. Results indicate that the women utilized more problem-focused coping at treatment entry than emotion-focused. And, findings also revealed that most women used similar coping strategies regardless of intensity or philosophy of the treatment program. ANOVA analysis revealed differences between groups in the use of express emotion and social withdrawal. Findings that reveal an association between social support and the utilization of more positive coping strategies have implications for engaging family members and support network persons in the treatment process. Relationships between social withdrawal and other emotion focused coping strategies have implications for aggressive outreach to engage women in treatment.     

"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.     

An Examination of Influences on Body Dissatisfaction Among Asian American College Females: Do Family,Media, or Peers Play a Role?

Abstract

Objective: The etiology of body dissatisfaction and its correlates (eg, disordered eating) among ethnic minorities is generally unknown. The purpose of this study was to replicate the tripartite model of influence in an Asian American college female sample in order to examine this relationship. Participants: Participants were 80 undergraduate Asian American females between the ages of 18 and 25. Methods: Participants completed a survey that included the Tripartite Influence Scale, Body Parts Satisfaction Scale, and Sociocultural Attitudes towards Appearance Questionnaire–3. Results: Mediation analyses indicated that thin-ideal internalization fully mediated the relationship between media influence and body dissatisfaction and partially mediated the relationship between peer influence and body dissatisfaction. Family influence did not significantly predict body dissatisfaction. Conclusions: Asian American college females experience body dissatisfaction through mechanisms that have not been examined in detail. These factors must be considered when creating targeted health promotion strategies and developing best practices for eating disorder assessment and treatment protocols at university health centers.     

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.     

Assessing University Students’ Self-efficacy to Employ Alcohol-Related Harm Reduction Strategies

Abstract

Objective: Develop and evaluate key psychometric properties of a self-report questionnaire specifically designed to assess student drinkers’ self-confidence to employ a variety of strategies intended to reduce unhealthy consequences of high-risk drinking. Methods: Four hundred ninety-eight participants rated their confidence (from “not at all confident” to “completely confident”) to employ 17 harm reduction strategies when drinking. Results: Factor analysis and internal consistency reliability analyses indicated that the 17 items constitute a single scale with good test–retest reliability. Consistent with other research examining previous use of such strategies, women in our sample reported significantly higher harm reduction self-efficacy than did men. Harm reduction self-efficacy was also associated with reported number of high-risk drinking episodes in the previous 2 weeks. Conclusion: This brief and easily administered questionnaire holds promise as a clinical tool to identify individuals with low harm reduction self-efficacy and as an outcome measure for health promotion and educational interventions.     

Strategies for work–family balance in a South African context

ABSTRACT

Finding and maintaining work–family balance has become an increasingly difficult challenge for South African families due to various factors, including economic, political, social and cultural changes that can impact negatively on family well-being. While pathways and strategies for work–family balance have been identified in other contexts, there is little available research on the topic in a South African context. Considering the knowledge that South African social workers have in this regard as a result of their training, qualifications and role in the South African context, South African social workers were selected as participants. The aim of this study was therefore to explore and describe, from the perspective of a group of South African social workers, strategies for work–family balance that can potentially contribute to family well-being in a South African context. A narrative inquiry research design was implemented. Thirteen female social workers between the ages of 23 and 46 who work in different social work contexts across South Africa were recruited by means of purposive and snowball/network sampling. Data were collected by means of written narratives and analysed by thematic analysis. The findings identify the following strategies: Setting clear boundaries, open communication in work and family domains, strengthening personal and professional support systems, planning, time management and prioritising, self-care, reasonable work environment and continuous personal and family assessment. While the findings share similarities with work–family balance strategies identified in other contexts, this study’s significance lies in the fact that it identifies strategies specifically for the South African context and that it does so from the perspective of South African social workers.     

Development of a Questionnaire to Assess University Students’ Intentions to Use Behavioral Alcohol-Reduction Strategies

Abstract

Objective: To evaluate the psychometric properties of a new self-report questionnaire designed to assess college students’ intentions to employ 31 specific alcohol-reduction strategies. Method: Students attending a large public university were recruited to complete alcohol-reduction, drinking history, and personality questionnaires online. Results: Based on item–total correlations and principal components analysis, the authors eliminated 3 items and calculated average intention ratings across the remaining 28 items. The resulting scale had appropriate unidimensionality and excellent internal consistency. Correlations of intention questionnaire scores with measures of drinking history, alcohol outcome expectancies, sensation seeking, and impression management provided some support for criterion and discriminant validity of the questionnaire. Conclusion: This questionnaire could be employed as an outcome measure to evaluate prevention programs and as a clinical tool to identify clients who have little intention to employ drinking reduction strategies in heavy drinking situations.     

Choose who’s in your circle: how women’s relationship actions during and following residential treatment help create recovery-oriented networks

ABSTRACT

Women in recovery from substance use disorders often have difficulty establishing recovery-supportive networks. This exploratory study uses qualitative thematic analysis to examine how 88 women in recovery describe the actions they take to manage their personal social networks 12 months after intake into residential substance use treatment. Participants describe disconnecting or limiting contact with recovery-endangering people and adding recovery-supportive people to their networks as primary relationship actions for maintaining recovery. Their actions to build recovery-supportive networks can provide a focus for clinical work to help them become integrated into their communities.     

Recovering Process from Child Sexual Abuse During Adulthood from an Integrative Approach to Solution-Focused Therapy: A Case Study

ABSTRACT

In recent times, strengths-based recovery approaches that focus on the present and build strategies that look toward the future have become popular. However, some cases require the consideration of experiences from previous stages of the clients’ development. This single-case study explores the psychotherapeutic process of a middle-aged woman who presented with a history of child sexual abuse (incest) and a long-term adult diagnosis of depression that was treated in public health services. This psychotherapy involved an integrative approach to solution-focused therapy; specifically, the approach proposed by Yvonne Dolan to work with adult survivors of sexual abuse, in conjunction with techniques and strategies from the transtheoretical model. Measures incorporating therapeutic working alliance and outcomes were administered over sessions. Results showed positive outcomes from this therapeutic intervention, which remained at 3-month and 12-month follow-ups. Implications for practitioners’ specialist practice in health services are discussed, given the complexity of comorbid mental health conditions with a history of child sexual abuse.     

Interviewing Strategies with Sexually Abusive Youth

SUMMARY

Adolescents who have sexually abused may pose a serious problem for both the community and the treatment provider concerning the management of risk and the application of effective intervention strategies. Fundamental to providing good clinical treatment is an assessment that results in an individualized treatment plan specifically tailored to the young person's needs. An integral but often overlooked part of this involves interviewing clients in a way that elicits accurate information and facilitates the development of a therapeutic relationship upon which effective therapy can be undertaken. This article will describe interviewing strategies and highlight the importance of the client-therapist relationship in providing effective therapeutic interventions.     

Narratives of Low-Income Mothers in Addiction Recovery Centers: Motherhood and the Treatment Experience

ABSTRACT

This study examines the narratives shared by low-income women in addiction recovery centers about the meaning they attach to being a parent in recovery and how they view current program models that include children in daily treatment. Their stories reflect the centrality of the mothering role to women in recovery and offer insights that can guide treatment and program planning with families.     

Environmental conversions and muslim activists: constructing knowledge at the intersection of religion and politics

ABSTRACT

This paper examines the production of knowledge by Muslim environmental activists in the United States and Great Britain, applying Eyerman and Jamison’s theory of cognitive praxis to demonstrate how religious and political knowledge and practices are synthesised by the activists. The paper emerges from research conducted with Islamic environmental organizations in the United States and Great Britain in 2012–2013 and utilises data gathered from interviews conducted with Muslim environmental activists working in those organizations and from the publicly available newsletters, websites, and articles produced by the activists and organizations. I argue that through the integration of environmental and religious knowledge, Muslim environmentalists construct a ‘critical community’ within Islam that seeks to transform orthodox Islamic knowledge and practice. In the process, Muslim environmentalists demonstrate that religiously-grounded social movements may simultaneously pursue religious and political change.     

“I'm in this world for a reason”: Resilience and recovery among American Indian and Alaska Native two-spirit women

ABSTRACT

American Indian and Alaska Native sexual minority (two-spirit) women are vulnerable to substance misuse and mental health challenges due to multiple minority oppressed status and exposure to stress and trauma. Yet, these women find pathways toward healing and wellness. We conducted a qualitative data analysis of interviews derived from a national health study and gained an understanding of 11 two-spirit women's resilience and recovery patterns. Emergent from the data, a braided resiliency framework was developed which elucidates multilayered abilities, processes, and resources involved in their resiliency. We recommend that resilience-promoting strategies be incorporated into substance misuse and mental health interventions.     

Dealing with Resistance: Working with Involuntary Clients in Community-Based Drug Treatment Programs in China

ABSTRACT

This study explores strategies for dealing with client resistance that are commonly used by a group of selected counsellors who work closely with illicit drug users in the community-based compulsory treatment programs in China. Through semistructured in-depth interviews with 16 counsellors, this study finds that different forms of client resistance were experienced in their day-to-day practice, encompassing passive and active behaviours. Five typical strategies are used by Chinese counsellors in this study to deal with client resistance: showing respect and caring and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination. Considering these strategies can also be seen as general principles for dealing with involuntary clients in other fields of social work services, the findings of this study may have broader impact.

IMPLICATIONS

• Effective ways that can be used by counsellors for reducing illicit drug users’ resistance during treatment include: showing respect and caring, and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination.

• Professional social work training is urgently needed among community-based drug treatment social work practitioners in China, to achieve efficient practices and better outcomes.

     

Psychosocial experiences of concussed collegiate athletes: The role of emotional support in the recovery process

Abstract

Objective: Understand from whom concussed football players seek and receive emotional support, and whether this support is associated with injury perceptions. Participants: Football players (N?=?26) from three NCAA Division I programs. Methods: With approval from the head athletic trainer, concussed athletes (2017 season) completed short surveys within 4–6?days of diagnosis and when cleared to return. Results: Concussed athletes perceived their injury as a normal consequence of playing football, not serious, and reported little, if any, depression and anxiety. Athletes reported the most support from athletic trainers; the least from coaches and teammates. Emotional support was associated with fewer adverse psychosocial reactions, more sport-injury related growth, and greater intentions to report future concussion symptoms. Conclusion: Results from this pilot study suggest that emotional support during the concussion recovery process should be understood and fostered by university officials charged with the health and well-being of collegiate football players.     

Reducing High-Risk Drinking Among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention

Abstract

Objective: This study examined the effects of a single-session motivational interviewing–based in-person brief alcohol intervention that contained student-athlete–specific personalized drinking feedback. Participants: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting screening criteria for heavy episodic drinking. Methods: Baseline assessments of alcohol use frequency and quantity, norm perceptions of peers' alcohol use, experiences of negative consequences, and use of protective behaviors were administered to student-athletes prior to a 1-session brief intervention containing personalized feedback highlighting the relationship between alcohol use and athletic performance. Follow-up assessment was conducted 3 months post intervention. Results: Student-athletes participating in the athlete-specific brief intervention showed significant reductions in their alcohol use and alcohol-related negative consequences, increases in use of protective behavioral strategies, and corrections in norm misperceptions at 3 months post intervention relative to a no-treatment comparison group. Conclusions: Student-athlete–specific brief alcohol interventions show promise in addressing high-risk drinking, reducing associated harms, and supporting health.     

The impact of trait mindfulness on relational outcomes in novice yoga practitioners participating in an academic yoga course

Objective: This study examined the role of dispositional mindfulness in impacting the relational benefits of yoga in novice practitioners in an undergraduate academic yoga course. Participants: 21 college students enrolled in a yoga course throughout a 15-week academic semester (January–April 2016). Methods: Participants attended lab assessments at the beginning and end of the semester and were asked to complete eight consecutive Internet-based daily surveys across six separate bursts, yielding 48 data points for each participant. Results: Multivariate time-series analyses revealed within-person subgroup differences such that in general, those in the high trait mindfulness group gleaned benefits from yoga practice with respect to relational outcomes. Conclusions: This study demonstrated trait mindfulness impacts relational outcomes in novice yoga practitioners, suggesting those low in trait mindfulness may not garner immediate relational benefits from yoga and could benefit from additional strategies to bolster against any negative influences of initiating yoga practice.