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.     

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.     

Latino Cultural Assets and Substance Abuse Services: Opportunity Knocks

SUMMARY

Latino cultural assets represent a vast untapped resource for the field of substance abuse in its quest to provide culturally competent services to an increasingly large numerical population group in the United States.     

Gender Differences in Silencing Following Childhood Sexual Abuse

ABSTRACT

The clinical literature commonly asserts that males are less likely than females to disclose child sexual abuse at the time it occurs and take longer to discuss their experiences. These hypotheses were tested in this study. This study included 145 men and 151 women. Participants were asked about disclosure at the time of the abuse and the length of time it took for them to discuss the experience. Comparison across these two studies found that boys were significantly less likely than girls to disclose the abuse at the time it occurred and also took significantly longer to discuss their childhood experiences later in life.     

Child Welfare and Alcohol and Other Drug Treatment (AOD): Bridging the Gap to Comprehensive Services

ABSTRACT

Chemical addiction is a significant factor in child abuse and neglect (U.S. Department of Health and Human Services [DHHS], 1999). Although research has indicated that an alliance between the child welfare and alcohol and other drugs (AOD) treatment fields is the best way to effectively address chemical addiction within families, collaboration has not generally been established. The lack of collaborative relationships between the child welfare and AOD fields can be attributed to a number of different factors. Similarities in proposed interventions for collaborative efforts between AOD treatment and child welfare agencies can be found throughout the literature. The establishment of a truly collaborative partnership between AOD treatment and the child welfare system is a necessary step towards achievement of functional and healthy families, a goal common to both disciplines.     

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.     

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.     

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.     

Possible Indicators of Childhood Sexual Abuse for Individuals in Substance Abuse Treatment

This study reviewed the charts of 217 patients discharged from two inpatient substance abuse treatment facilities to compare clients with a history of childhood sexual abuse to clients without such a history. Approximately 1/3 of the women and 1/10 of the men reported that they had been sexually abused as children. Individuals reporting a sexual abuse history differed significantly from individuals who did not report such a history in only a few respects. They were significantly more likely to report that they were still troubled by childhood experiences, that they had been physically abused in childhood, that there were sexual issues they were reluctant to share or discuss, that they had been physically harmed by another, and that they had made one or more suicide attempts. Research needs and implications for treatment providers are discussed.     

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.     

Counselor Turnover in Substance Abuse Treatment Centers: An Organizational-Level Analysis

This article draws on institutional and ecological perspectives on work and organizations to develop a workplace level model of variation in voluntary counselor turnover rates across privately funded substance abuse treatment centers in the United States. Results show that participatory management structures reduce turnover rates principally by promoting organizational commitment. The analysis also tests hypotheses regarding the effects on turnover rates of other relevant theoretic domains of treatment center structure and organization. We discuss theoretical implications of the findings and suggest directions for future research.     

Integrated Substance Abuse and Child Welfare Services for Women: A Progress Review

A review of empirical literature reveals improvements in service utilization and outcomes for women when substance abuse and child welfare services are integrated. The increased use of substances by women involved in the child welfare system has resulted in a call for integrated, coordinated, evidence-based practices. Since the late 1990s, specific system- and service-level strategies have been developed to coordinate and integrate the provision of substance abuse and child welfare services such that women are remaining in treatment longer and are more likely to reduce substance use and be reunited with their children. The strategies reviewed provide useful guidelines for developing components of effective, evidence-based programs for substance-involved women in the child welfare system.     

Gender Mainstreaming: The Answer to the Gender Pay Gap?

This article examines the argument that gender mainstreaming offers the way forward for closing the gender pay gap. It juxtaposes research on the process of gender mainstreaming with our account of the processes involved in Australian state government Inquiries into the gender pay gap since the late 1990s. We indicate that the continuous process of analysis and response that gender mainstreaming can offer demands political will, intensive links between research and action, and adequate resources — which means that gender mainstreaming is seldom delivered in practice. We use our account of the Australian Inquiries to argue that, provided adequate political and financial resources are in place, the gender pay gap can be narrowed through the institutional mechanisms of an industrial relations system but that the regulatory approach is limited by its vulnerability to changes in industrial relations policy. The article concludes that, whatever strategy is used to narrow the gender pay gap, it must be able to show those who use and observe it that gender itself is a continuous, effortful and political process.     

Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

A Comprehensive Approach to the Treatment of Gender Dysphoria

After a brief historical review of the clinical management of gender dysphoria, the authors argue for a comprehensive treatment model that recognizes a wide spectrum of gender identity disorders. This treatment model explores the meaning of a gender dysphoric individual's desire for sex reassignment in the context of the individual's biography and psychosociosexual adjustment. Unlike previous treatment approaches, this model makes no attempt to identify the 'true' transsexual. The model's treatment tasks are: assessment, management of comorbid psychiatric disorders, facilitation of identity formation, sexual identity management, and aftercare. The implications of this treatment model for classification and ethical standards of care are discussed.     

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery.