A critical and comparative review of the prevention of drug and alcohol abuse in Israel

The article reviews the various programs and intervention strategies of substance abuse prevention in Israel. It concentrates mainly on the stages of primary and secondary prevention among youth. School-based prevention programs, those designated for detached youth as well as community-based programs, are presented and analyzed. The prevention efforts in Israel are also compared to those in other Western countries. The discussion includes recommendations for future developments in this domain.     

Family therapy: An orientation

Conclusion The family therapist is an active, involved therapist. He must be emotionally lithe and resilient, prepared to deal with, or deal out, the unexpected. His challenge is to learn to use his own impulses and reactions in a way that the family can use to understand themselves better. He makes use also of any people and resources in the family's environment which might be of help to them. There are some basic techniques and orienting principles available to the family therapist, and it is these which it has been the task of this paper to set forth. Beyond these, the responsibility rests with each family therapist to comprehend himself and his place in his own family, and then to use his creativity to transform what he knows and what he feels into a form which can be used by the families he treats in their development.     

Elder abuse research: a systematic review

The purpose of this research was to provide a systematic review of, and assign an evidence grade to, the research articles on elder abuse. Sixteen health care and criminal justice literature databases were searched. Publications were reviewed by at least two independent readers who graded each from A (evidence of well-designed meta-analysis) to D (evidence from expert opinion or multiple case reports) on the quality of the evidence gained from the research. Of 6,676 titles identified in the search, 1,700 publications met inclusion criteria; omitting duplicates, 590 publications were annotated and graded.     

Sexual abuse and group therapy

This article described the formation of a structured, open-ended, time-limited, repeatable group for sexually abused girls. The sexually abused pre-adolescent and young adolescent must address developmental tasks while attempting to cope with tremendous guilt, shame, and loss of self-esteem. The value of group therapy as a support to sexually abused children was explored and a format was devised to help them deal with their issues. Discussion questions and topics designated for each session helped meet their specific needs. The group members evaluated the group as being helpful overall. In conclusion, the expansion of psychotherapeutic services to sexually abused children through a structured group format has been proposed. If others are encouraged to engage in such work, then the purpose of this article has been achieved.     

Searching for elder abuse: a systematic review of database citations

The aim of this review was to describe trends and patterns in elder abuse literature and research. All citations in PUB MED, CINAHL, and PsycINFO databases located using the search term "elder abuse" were retrieved (3,059 citations) and 2,418 unique references were identified. Using manifest content analysis, non-research material (1,986 references) was sorted by type and research references (34 dissertations and 398 research articles) were categorized. Research article references most commonly: (1) investigated prevalence, typology, and definitions of elder abuse; (2) utilized quantitative methodology; (3) had first author affiliations to medicine, nursing, and social sciences; and (4) sampled populations of professionals, personnel, cases, or charts. The USA was most frequently listed of 24 identified countries of origin. Elder abuse research shows lack of diversity, slow increase of qualitative research, limited involvement of older persons and family members as participants, and minimal research from developing countries. This review contributes to knowledge valuable for researchers and experts planning future studies or elder abuse projects.     

SAMHSA plans changes to NSDUH: DSM‐5 updates

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced last week that it will start collecting data on vaping, marijuana withdrawal symptoms, synthetic marijuana, and updates to accord with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) to focus on craving, in the annual National Survey on Drug Use and Health (NSDUH).     

Southerly winds: Family therapy and Latin America

This article serves as a conversational and conceptual introduction to this special issue. It is written not in Latin America – as the other articles are – but in Australia and it is written by a Chilean who left Chile due to the ravages that the 16 year long dictatorship had on those lands. Using reflections on my experience – as a citizen and later as a student in psychology and in family therapy – both in that country and since, I touch on post-colonial issues and on epistemic violence to interrogate ‘invisibilities’ held in mainstream forms of knowledge in the field, invisibilities that come to us from the Western North. Using references to the work of Edward Said and Gabriel García Márquez, the article invites us to review core assumptions and postures in the conceptual frame of systemic work and proposes a methodology that supports alternative forms of knowledge – knowledges of the South – to forge a voice, a resistance to globalising tendencies that threaten to undermine the work we strive to do.     

The therapy alliance: a moderator in therapy outcome for families dealing with child abuse and neglect

The role of the therapy alliance in therapy outcome for families dealing with child abuse and neglect was examined using the family as the unit of analysis. The alliance was tested as a moderator in relationship to posttreatment levels of symptom distress and physical violence. Results show that the bonds, goals, and tasks subscale scores are significantly related to posttreatment levels of symptom distress and that the goals subscale score is significantly related to posttreatment level of violence. There is an interaction between bonds and level of violence at intake, suggesting that the greater the level of violence at intake, the more important the bonds domain.     

Family therapy and terminal illness

Abstract

This article describes the experience of a family therapist working in a family with an adolescent child suffering from a terminal illness. This work was undertaken in the framework of the Mexican Institute of Social Security.

In dealing with patents afflicted with incurable diseases such as renal deficiency, osteosarcoma or leukemia, which will eventally lead to death, it is important to know about the successive stages in this progression from life to death and to understand them. Some authors have studied in general the reactions of the dying and their families. Kubler-Ross (1970) reports denial, resentment, bargaining, depression and acceptance; Eric Lindemann (1944) mentions pain, anxiety, tension and guilt as the main components of mourning.

Psychotherapy with the terminal patient and their family is intimately concerned with the separation process, which is always accompanied by anxiety; this can become so acute that it feels like death or total annihilation. The family responds in many ways to this anxiety, but will often not express these feelings; the therapist has to try to discover at which stage of mourning the family has arrived. This is even more important where the patient is an adolescent who has no hope of achieving his longing to live. It is important that we are dealing here with anticipatory mourning, which can prevent serious reactions following bereavement. Great care is required in uncovering feelings of hostility, anger, fear, repulsion and frustration. The patient too must be encouraged to express his feelings; this will relieve tension, and make it easier for the family to accept the reality of what is going to happen.

It is important to keep the family informed about the medical requirements of the treatment. These should be explained very clearly, so that all members understand, accept and cooperate in such tasks as ensuring attendance at out-patient consultations, laboratory investigations and taking the medicine prescribed. We find that often only one member of the family, usually the mother, carries the whole responsibility of caring for the patient. All these matters need to be discussed with the whole family, together with such matters as the patient's school attendance, any problems of family relationships, and plans for the future. The worker needs to help family members to continue their personal growth and development while understanding this crisis, which might otherwise arrest them.

Treatment should not be rigidly planned at the start; as in all psychotherapies, it is necessary to make an initial evaluation of the degree of function and dysfunction in the family. This appraisal is made by exploring family problems, areas of conflict and the resources which are mobilized to support the system. In this process the worker collects all the elements which enable him to get a picture, free from his own technical preferences, so that the data can be integrated, taking into account the opinions of experts on structural family therapy, triaxial or psychodynamic views among others.

In the case I shall describe, we used a combination of theories and techniques, mainly derived from systems theory and psychoanalysis. A purist attitude was not adopted, because our main aim was to find what was of most immediate benefit to patient and family.     

Therapy for child sexual abuse:women talk about helpful and unhelpful therapy experiences

Women with histories of childhood sexual abuse (CSA) were asked to describe what was helpful and unhelpful to them in therapy. From 191 completed postal questionnaires, a subsample of 20 participants was interviewed. This paper focuses on three specific areas of therapy raised by interviewees: (1) Establishing a therapeutic relationship; (2) talking about experiences and effects of CSA; and (3) dealing with errors in therapy. Findings suggest that to avoid making serious therapy errors, therapists (1) need special skills to be aware of the dynamics and effects of CSA and of abuse-focused therapy and to deal with abuse-related material, and (2) need to develop an equal and open therapy relationship that includes ongoing consultation with clients about their experiences of therapy. doi:10.1300/J070v15n04_03.     

Family Structure and Child Well‐being: Integrating Family Complexity

Although children's family lives are diverse, the measurement of children's living arrangements has lagged, focusing on the relationships of children to parents while largely ignoring sibling composition. Using data from the 2008 Survey of Income and Program Participation (N = 23,985) the authors documented patterns of family complexity among a nationally representative sample of children ages 0–17 living in a range of family structures. They also examined the independent and joint associations of family structure and family complexity on child economic well‐being. Family complexity was independently related to economic disadvantage, namely, a lower income‐to‐needs ratio and a higher likelihood of public assistance receipt. The role of family complexity was partially contingent on family structure, with the positive association between family complexity and receipt of public assistance more pronounced for children in families with 2 married biological parents. This study demonstrates the utility of integrating family structure and family complexity in studies of children's well‐being.     

Evaluating and improving prevention programs: a strategy from drug abuse.

This paper describes a methodology used to overcome the difficulties in evaluating and improving prevention programs. The methodology was applied in this case to a drug abuse prevention program. The methodology includes using health-oriented rather than pathology-oriented outcome measures, random assignment to groups, multiple settings, multiple outcome measures, goal-free evaluation, and the recording of process variables. The first year results showed program effectiveness in one setting and not in the other. Process analyses pointed toward improvements that could be made. Those improvements were implemented and led to greater program effectiveness in the second year.     

A systematic review on community-based interventions for elder abuse and neglect

Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.     

A rapid systematic review on the association between childhood physical and sexual abuse and illicit drug use among males

This paper aims to review studies in relation to the association between childhood physical (CPA) and sexual abuse (CSA) and illicit drug use among the male clinical and general community populations using a systematic approach. Primary studies were identified using online databases which were searched comprehensively using a set of pre‐determined search criteria and terms. Other sources included expert contact and the reference list of a relevant review. Associations between exposure (CPA/CSA) and outcome (illicit drug use) were considered with regards to an array of factors. A total of 5012 references were initially identified out of which 18 studies met the necessary criteria for reviewing. The review demonstrates tentative support for factors such as earlier drug initiation, intravenous drug use and greater frequency of use among some of the samples. It also demonstrates the difficulties involved in drawing conclusions due to the complex and multifaceted nature of drug use and the variability in the quality of the research available in this area. Limitations of the current review are highlighted and recommendations offered for future research with consideration given to practical implications in clinical and forensic settings. Copyright © 2010 John Wiley & Sons, Ltd.     

An evaluation of the fidelity of implementation of a school-based drug abuse prevention program: project toward no drug abuse (TND)

This article provides an implementation fidelity evaluation of the fourth experimental trial of Project Towards No Drug Abuse (TND). Two theoretical content components of the curriculum were examined to increase our understanding of the active ingredients of successful drug abuse prevention programs. A total of 18 senior high schools were randomly assigned by block to receive one of three conditions: cognitive perception information curriculum, cognitive perception information + behavioral skills curriculum, or standard care (control). These curricula were delivered to both regular and continuation high schools students (n=2331) by trained project health educators and regular classroom teachers. Across all program schools, the two different curricula were implemented as intended, were received favorably by students, and showed significant improvements in knowledge specific to the theoretical content being delivered. This pattern of results suggests that the experimental manipulations worked as intended, and thus, permit the attribution of future behavioral outcome differences between conditions to differences in content of Project TND material provided rather than to differences in the fidelity of delivery. Further, our findings indicate that Project TND can be implemented effectively with low and high risk youth in a general environment as well as with high risk youth in a more specialized environment.     

Oxford house: a review of research and implications for substance abuse recovery and community research

After treatment for substance abuse, whether it is in hospital-based treatment programs, therapeutic communities, or recovery homes, many patients return to former high-risk environments or stressful family situations. Returning to these settings without a network of people to support abstinence increases chances of a relapse. As a consequence, substance abuse recidivism following treatment is high for both men and women. Alternative approaches need to be explored, and there are some promising types of recovery homes. From a public health perspective, a series of studies conducted at DePaul University suggests that one type of recovery home for alcohol abuse recovery has much potential. For example, within this self-help communal living setting, recovering alcoholics were able to maintain employment, thereby reducing their need for government subsidies. Maintaining employment for recovering alcoholics may promote increased personal responsibility, which may impact self-efficacy beliefs. These pilot studies, then, raised both theoretical and practical issues needing further evaluation.