Adolescents with Gambling Problems: From Research to Treatment

Considerable interest in the area of youth gambling has prompted an increase in empirical investigations examining the correlates associated with youth experiencing severe gambling problems. Based upon the current state of knowledge and our clinical experience, the development of the treatment program for youth with serious gambling problems employed at the McGill University Youth Gambling Research and Treatment Clinic is described. The major tenets, underlying philosophy, and therapeutic processes are presented. A case study is included to illustrate the therapeutic approach. The authors present the need for greater funding for more basic and applied research and the necessity for further scientifically validated treatment and prevention programs.     

Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy

Children with histories of maltreatment are at significant risk of developing severe psychiatric problems. Treatment of such children is difficult and there are no empirical studies evaluating the effectiveness of outpatient treatment for children with trauma-attachment disorders. The present study examines the effectiveness of Dyadic Developmental Therapy, a treatment based on attachment theory, provided by one therapist in an outpatient setting. The 64 subjects all had trauma-attachment disorders, met the DSM-IV criteria for Reactive Attachment Disorder, and had histories of serious maltreatment. The 34 children in the treatment group were treated in weekly outpatient therapy at The Center For Family Development with Dyadic Developmental Psychotherapy. The 30 children in the control group were evaluated but did not received Dyadic Developmental Psychotherapy and received treatment from other providers at other clinics. Eligible subjects were children between the ages of five and seventeen years whose case had been closed in 2000 or 2001. All children had significant past histories of abuse, neglect, or orphanage care. Findings for children in the treatment group, as measured by the Achenback and Randolph Attachment Disorder Questionnaire, were significant decreases (p<.01) in symptoms of attachment disorder, withdrawn behaviors, anxiety and depression, social problems, thought problems, attention problems, rule-breaking behaviors, and aggressive behaviors. The findings for children in the control group showed no changes in the variables measured. Dyadic Developmental Psychotherapy appears to be an effective treatment for children with trauma-attachment disorders.The author would like to gratefully acknowledge Ms. Geraldine Gallucci, a master’s level social work intern, who was placed with The Center For Family Development. Ms. Gallucci ensured that the follow-up questionnaires were mailed to the families and returned to the agency.Arthur Becker-Weidmann is affiliated with Center for Family Development, Williamsville, USA.     

The Powerlessness of Control: A Unifying Model for the Treatment of Male Battering and Substance Addiction

ABSTRACT

The high incidence of partner abuse among substance addicted men calls for a unified model of treatment. Grace Therapy is an approach for the treatment of male batterers based on the 12-Step Program of AA/NA. Clinical evidence relates the internal processes of male batterers and substance-addicted men to similar issues in which feelings of powerlessness arise. Powerlessness has three levels: behavioral, mental, and spiritual. By addressing the behavioral and mental levels, men can become abstinent by avoiding the situations, behaviors, and mental motives that lead them to violence and substance abuse. Recovery and healing occur within the spiritual level through a transformation of the men's attitudes towards the world and themselves–a transformation from self-centeredness to God-centeredness, which produces a growing capacity within the men to care for others unconditionally.     

The Seven Challenges: An Effective Treatment for Adolescents with Co-Occurring Substance Abuse and Mental Health Problems

ABSTRACT

Recent developments in the provision of the substance abuse treatment for adolescents has included a focus on age appropriate treatment with consideration for adolescents' relatively low level of motivation for treatment and high incidence of co-occurring substance use and mental health problems. This study examines 3- and 6-month substance use and mental health outcomes for youth (n = 36) participating in The Seven Challenges Program. Results indicate significant reductions in both substance use and mental-health-related measures at 3 months with all measures except substance abuse frequency continuing to improve at the most distal 6-month assessment. The Seven Challenges treatment model is presented along with a discussion of the findings.     

Suicidal Ideation and Comorbid Disorders in Adolescents and Young Adults Diagnosed with Asperger's Syndrome: A Population at Risk

ABSTRACT

The purpose of this study was to examine the level of suicidal ideation and comorbid disorders (major depressive disorder, generalized anxiety disorder) among adolescents and young adults with diagnosed Asperger's syndrome (AS). A cross-sectional study using a self-administrated mail questionnaire and a Web-based questionnaire were used. Two samples were selected for this study. The first sample used snowball sampling, starting with parents of adolescents and young adults with diagnosed AS who participated in a qualitative study conducted in 2002. The second sample consisted of a volunteer sample of parents who visited Web sites for parents and individuals with diagnosed autism spectrum disorder. The sample included 10 adolescents and young adults with diagnosed AS. Fifty percent of the sample had a clinically significant level of suicidal ideation, 20% met criteria for a diagnosis of major depressive disorder, and 30% met criteria for generalized anxiety disorder.     

A Canadian experience with an intervention programme for vulnerable families: lessons for German social work and policy

Schools are an important community resource that can foster social connections and enhance the health and wellbeing of children and families in Germany through information, health promotion and interventions. While developing social connections between the school and vulnerable families—those who are most limited in their access to other sources of information, education and intervention—is complex and challenging, it is nonetheless critical. This paper reports on the role of Families and Schools Together (F&ST), a school-based intervention aimed at vulnerable families, in building and promoting the social connections, or social capital, that strengthen families and communities. Thematic analysis of semi-structured interviews revealed that programme participants perceived an increase in their social capital in all three of its dimensions (bonding, bridging and linking). The paper highlights the importance of social capital in building stronger, more resilient families and of strengthening relations between parents and schools, and contributes to the sharing of experience and views on matters concerning families in Germany.     

Effects of an Assisted Living Facility Specifically Designed for Individuals with Memory Disorders: A Pilot Study

Despite evidence suggesting the physical environment can enhance mood and quality of life (QoL) of dementia patients, this issue has not been examined extensively within the setting of an assisted living (AL) facility. This study investigated cognition, QoL, and neuropsychiatric symptoms in 39 individuals with a memory disorder during their initial 6 months at an AL facility designed specifically for this population. Despite continued decline in cognition, participants reported lessening of several negative emotions. No significant changes in QoL or neuropsychiatric symptoms were reported. Findings suggest that moving from home to an AL facility designed specifically for individuals with memory disorders has potential positive implications.     

An Internet-Based Self-Help Program for the Treatment of Fear of Public Speaking: A Case Study

ABSTRACT

This article discusses the development of the first totally self-administered online CBT program for the treatment of a specific social phobia (fear of public speaking) called talk to me. The online program includes three parts. The assessment protocol gives the patient information about the problem, including impairment, severity, and the degree of fear and avoidance regarding the main feared situations. The structured treatment protocol ensures that the patient does not skip any steps in the treatment. The treatment protocol is a CBT program that provides exposure to the feared situation using videos of real audiences. Finally, the control protocol assesses treatment efficacy, not only at posttreatment, but also at every intermediate step. In this work we describe talk to Me and its practical application through a case study.     

Non-Abstinence-Based Supportive Housing for Persons with Co-Occurring Disorders: A Human Rights Perspective

Surveys of providers of social services in Portland, Oregon, in 2003 and 2007 revealed a significant policy shift in meeting the housing needs of chronically mentally ill, homeless persons with ongoing substance-abuse problems. The shift in policy, taking place in Portland, Seattle, Washington, Minneapolis, and other U.S. cities, from a sobriety-first requirement to a housing-first philosophy has occurred largely because of cost-effectiveness. Only when such housing is provided as a human right can we say that a true paradigm shift has occurred.     

In sickness and in health: A qualitative study of elderly men who care for wives with dementia

It is estimated that approximately 1,000,000 elderly men care for spouses with Alzheimer's disease or other forms of cognitive impairment, yet we have only a limited understanding of their work, and central questions arise. What do men caregivers do, and what meanings do they ascribe to their work? What are their distinctive strengths and vulnerabilities, and what can we learn about men and caregiving from their stories? This qualitative study was based on in-depth, open-ended interviews with 14 elderly men who are primary caregivers to wives with dementia. All interviews were taped, transcribed, and manually coded. The resulting information then underwent analysis from which three major themes emerged: feelings of isolation and invisibility of their care work, a style of caregiving that jointly utilizes management and nurturing, and feelings of commitment, responsibility, and devotion.     

Sanyog: A Speech Enabled Communication System for the Speech Impaired and People with Multiple Disorders

SUMMARY

The paper presents a multilingual communication tool that has been designed for helping in the communication needs of people with severe speech and multiple disorders. The system accepts icons, selected through special access switches, as input and can form natural language sentences, which can be spoken out using in-built text-to-speech synthesizer. The system has been deployed and is being field tested at the schools for the children with cerebral palsy in India.     

An ICT-Driven Hybrid Automation System for Elderly Care Support: A Rehabilitation Facility Study Case

Abstract

The demographic statistics in developed countries suggest growth in the elderly segment of the population. At the same time, other studies forecast a shortage of nurses, increasing the pressure on hospitals to provide treatment for longer periods of time. These trends suggest a need for new ways of taking care of the elderly population that support safe, comfortable, and independent living. Meanwhile, prominent advances in information and communications technology (ICT) have enabled new systems that address various needs of the elderly. This article presents a case study of a rehabilitation facility located in Tampere, Finland, that uses an automation system in which ambient assisted living (AAL) and building automation (BA) system functionalities are combined. It details a field study summarizing the needs of the users, describes functional scenarios supported by the system, and reports the results of the first usability tests suggesting acceptance of a new technology by residents and caregivers. The unique combination of ambient assisted living and building automation offers a safer and more comfortable environment for the elderly as well as helps caregivers on-site in managing their workloads.     

Social Support: A Key to Positive Parenting Outcomes for Mothers in Residential Drug Treatment with Their Children

SUMMARY

This study explored parenting experiences of ten mothers residing with their young children in four residential drug treatment facilities in New York City and how these experiences related to the perceived support of the social environment of the facility. Through the lenses of the self-in-relations theory and family-centered service model, the study examined the supportive function of the treatment program including the program structure, the staff, and fellow mothers in affecting the mothers' parenting experience and outcomes. Programmatic, policy, and research implications of the study's findings are discussed.     

The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study

Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home.

Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis.

Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3).

Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.