The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

Examining Factors Associated With Program Completion Among Women Participants in a Statewide Drug Court Program

The study purpose was to examine factors affecting women in completing drug court. Participants were 212 women drug court participants selected via stratified random sampling (by county) from the larger Kentucky Drug Court participant population. Various secondary data sources were used (e.g., participant assessment, Management Information System), and multivariate logistic regression examining 17 independent variables showed 4 variables were significantly associated with program completion for women: employment at program assessment, intravenous opiate use, number of times hospitalized for psychological or emotional problems, and conviction of a misdemeanor-eligible violent crime before drug court. Study findings can be used by social workers and other practitioners to better understand women’s drug court participation and to identify ways to tailor program services for women’s unique needs.     

Psychiatric,Family, and Ethnicity-Related Factors That Can Impact Treatment Utilization Among Hispanic Substance Abusing Adolescents

SUMMARY

There is great significance to improving our understanding of predictors of treatment utilization among Hispanic substance abusing youth. One hundred and ten Hispanic substance abusing adolescents and their parents participated in a study of treatment utilization. Analyses showed that adolescents with lower numbers of externalizing disorders (χ² = 4.18, df = 1, p < .05) and parents with better parenting strategies (χ² = 8.73, df = 2, p < .05), predicted overall treatment utilization (residential + outpatient). Better parenting practices and higher parental years in the U.S. predicted more utilization of outpatient services and lower parenting stress predicted more utilization of residential services. Without specialized engagement strategies, adolescents and families most in need may be the least likely to engage in recommended treatment.     

Racial Disparities in Drug Court Graduation Rates: The Role of Recovery Support Groups and Environments

There are more than 3,000 drug courts in the United States, and research has demonstrated that, in some drug courts, African American participants are less likely to graduate than their White counterparts. Quantitative studies have documented the problem, but qualitative studies are needed to develop an in-depth understanding of this phenomenon through participants’ experiences. This qualitative study asked African American participants (n = 31) about their lived experiences in drug court to develop insight into the factors that might contribute to racial disparities in drug court outcomes. African Americans had favorable views toward both mandated and natural recovery support groups, and they felt that participating in these support groups increased their likelihood of graduating drug court. Conversely, African Americans felt that a barrier to graduating drug court was their environments, mainly risk factors posed by family, neighborhoods, and peers. Implications for drug court practice are discussed.     

Symptoms of Eating Disorders Among Females in Drug Addiction Treatment

The aim of this study is to measure and describe symptoms of eating disorders among females in treatment for drug addiction in Norway. Previous clinical and epidemiological studies have revealed coprevalence between eating disorders and substance use or abuse. However, few studies have measured eating disorders in drug-using samples and even fewer within the context of drug treatment. In this study, 29 females with drug use disorder in residential treatment were tested with the Eating Disorder Inventory–2. A subgroup of 9 females (31%) with significant symptoms of eating disorders was identified. The characteristics of this group and possible clinical consequences are discussed.     

Illuminating the Black Box From Within: Stakeholder Perspectives on Family Drug Court Best Practices

This article describes a mixed-methods, concept mapping study in an urban family drug court (FDC) designed to identify keys to FDC success from stakeholders’ perspectives. Participating FDC team members and clients developed a set of items they deemed integral to an FDC, thematically clustered the items, and then rated their relative importance. Using these data, cluster analysis and multidimensional scaling generated 6 themes perceived as contributing to positive outcomes. Resultant concept maps revealed that, compared to team members, clients view relational aspects of the FDC as more important. The findings point to implications for future research and social work practice.     

Multiple Family Group Therapy in a Drug and Alcohol Rehabilitation Centre

In the last decade there has been increasing interest in working systemically with groups of families. Multiple family groups (MFGs) have been used in mental health settings with schizophrenia, eating disorders and drug and substance abuse. This article describes the MFG program used in Higher Ground Alcohol and Drug Rehabilitation Trust, a rehabilitation centre in Auckland, (New Zealand). Higher Ground provides an 18‐week residential therapeutic program for people with a severe substance abuse disorder. The MFG in Higher Ground focuses on developing better communication patterns and better boundaries between family members, fostering mutual support, and promoting self‐responsibility.     

Alcohol Use and Prior Substance Abuse Treatment in Relation to Gambling Problem Severity and Gambling Treatment Outcome

Recent research has made it clear that problematic gambling is often accompanied by problematic alcohol use. Unfortunately, little is known about the nature of this association, especially as it relates to gambling treatment outcome. The purpose of this study is to explore the effect of current alcohol use level and previous substance abuse treatment on the symptoms of a large cohort of pathological gamblers as well as on their response to treatment for pathological gambling. The sample included 464 men and 301 women recruited at six gambling treatment programs in Minnesota. Gambling treatment patients were assessed on a number of gambling problem severity and related clinical variables using the Gambling Treatment Outcome Monitoring System (GAMTOMS). Patients with frequent alcohol use had greater gambling involvement at baseline than infrequent alcohol users. Patients with a previous history of substance abuse treatment had more severe psychosocial problems, ostensibly resulting from their gambling behavior, than patients without past substance abuse treatment. A MANOVA with repeated measures showed that neither pretreatment alcohol use, nor past substance abuse treatment exerted significant effects on gambling treatment outcome. While the level of pretreatment alcohol use and a history of substance abuse treatment are markers for greater gambling problem severity, treatment outcome for pathological gambling was not adversely impacted by these variables.     

Assessing Social Work's Contribution to Controlled Studies of Adolescent Substance Abuse Treatment

ABSTRACT

Findings from a review of social work's contribution to the adolescent substance abuse treatment outcome literature between 1990 and 2001 are presented. Social work involvement in adolescent substance abuse treatment was evaluated through a computerized bibliographic search of medical and social science databases and by a manual search of 13 core social work journals. Results indicate that social work has contributed little to knowledge development in adolescent chemical dependency treatment. Investigators affiliated with a department or school of social work accounted for three of 15 controlled treatment outcome studies. Only one report was published in a core social work journal. Efforts to develop clinical guidelines in this important practice domain will founder until a sufficiently directive body of practice-relevant research accumulates to guide evidence-based substance abuse treatment for adolescents.     

The Efficacy of a Condensed Seeking Safety Intervention for Women in Residential Chemical Dependence Treatment at 30 Days Posttreatment

This study examined the efficacy of a condensed version of the Seeking Safety intervention in the reduction of trauma-related symptoms and improved drug abstinence rates among women in residential chemical dependence treatment. One hundred and four women were randomly assigned to treatment including a condensed (six session) Seeking Safety intervention or the standard chemical dependence intervention. The Seeking Safety participants reported lower sexual-abuse-related trauma symptoms at 30 days posttreatment as compared to participants who received only standard treatment. However, the condensed Seeking Safety intervention was not more advantageous in reducing overall trauma symptoms or relapse 30 days after treatment ended.     

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.     

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.     

Applying an Ecological Framework to Understanding Drug Addiction and Recovery

ABSTRACT

A new conceptual model of drug addiction and recovery, the Acculturation Model, is presented, with “addiction” and “recovery” understood as distinct sociocultural phenomena with their unique prescribed behaviors, rituals, symbols, and language that serve to construct and consolidate a cultural identity. The model suggests that individuals in recovery from drug addiction will need to make a cultural transformation in order to maintain sobriety. Examples of specific rituals that may help facilitate movement from addiction to recovery are detailed.     

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.     

Experiences of Drug Use and Parenting among Women in Substance Abuse Treatment: An Exploratory Study

The purpose of this exploratory study was to explore the multiple contexts of vulnerability, drug use and parenting for women in substance abuse treatment. Nineteen purposively sampled women provided qualitative data through semi-structured interviews. Findings revealed that adverse childhood experiences and intimate partners were important pathways into drug use initiation. Identities as mothers emerged as a key finding, intimately linked to women's motivation to seek and complete treatment. Understanding the challenges to recovery among mothers in treatment is an important priority for social workers. This study highlights the complexity of women's experiences and suggests implications for future practice and research.     

Diversion From the Juvenile Justice System: Observations of a Teen Court Program

Teen courts are a multidisciplinary intervention used to divert youth with minor offenses from the juvenile justice system. Observations were conducted at 13 hearings in an urban jurisdiction, with information gathered about the youth respondent, peer jurors, and adult volunteers. Peer jurors engaged in the majority of communication with the respondent during hearings. Adult volunteers, often members of the legal or judicial community, fulfilled supporting functions. Findings suggest that a youth-oriented process with support from adult volunteers can result in active participation from youth, and that teen courts provide opportunities for community involvement.     

Adolescent Depression as a Contributing Factor to the Development of Substance Use Disorders

An exploratory investigation of the variables linking adolescent substance abuse and depression was conducted using the “grounded theory” qualitative research approach. A convenience sample was drawn from African American adolescents, aged 12 to 18 years, who reside in a public housing community in Baltimore, Maryland. The results revealed approximately 5% of the sample openly admitted to using drugs because they are sad, feel like a failure, lack energy and because they have family problems. Moreover, 26% of the respondents reported drinking alcoholic beverages; 26% of the population reported smoking marijuana and 16% of the respondents reported they smoke cigarettes. Additionally, life stressors (i.e. an absent parent from the home, childhood illnesses, family discord, living in kinship or foster care environments, living in single-parent households and unemployment) are adversely impacting the lives of African American adolescents residing in a public housing community.     

Allegations of child sexual abuse in parenting disputes: An examination of judicial determinations in the Family Court of Australia

This study examined Family Court of Australia (FCA) judicial determinations in parenting disputes when allegations of child sexual abuse (CSA) are made by an interested party, usually the mother. For the study, 156 published judgments from 2013–2015 were examined to measure how often allegations of CSA are substantiated, suspected to be true, and disbelieved. The characteristics most common in substantiated versus unsubstantiated cases, evidence of abuse presented, and resulting parenting orders were assessed. Findings indicate that, against international comparisons, FCA judges substantiate cases very conservatively, with rates of substantiation much lower than in other studies. Allegations made by mothers against fathers were disproportionately unsubstantiated, as were those which did not fall under the Magellan case management system. Cases where the only evidence of CSA was a child’s disclosure and parent’s allegation were common in both substantiated and unsubstantiated cases, meaning that a lack of other evidence does not preclude a positive finding of risk of CSA by the FCA. Those cases also involving a protection order against the accused were more likely to be substantiated. Confirmation biases and a judicial tendency to err on the side of false negatives are discussed.