Effects of Family Involvement on Length of Stay and Treatment Completion Rates with Cocaine and Alcohol Abusers

SUMMARY

Substance abuse is a problem of national concern. This study sought to replicate and further develop findings from a previous study that found cocaine abusers continued in and completed treatment less frequently than alcohol abusers, and that family involvement may influence continuation in and completion of treatment for both cocaine and alcohol abusers.

A sample of 99 primary cocaine abusers and 105 primary alcohol abusers in outpatient treatment were followed during the course of their treatment. Results indicated primary alcohol abusers were significantly more successful in completing treatment than primary cocaine abusers. Family involvement in treatment significantly increased the likelihood that cocaine and alcohol abusers would complete the full course of treatment.

It is possible that treatment could be improved and completion rates increased by coordinating the involvement of the family.     

Lesbian Mothering in the Context of Intimate Partner Violence

SUMMARY

Twenty-four lesbian mothers (12 African American, 9 White, and 3 Latina) who had experienced physical abuse by a same-sex partner were interviewed. Three types of IPV were found: intimate terrorism, situational violence, and mutual violent control. Further, relationships between mothers/abusers, mothers/children, and abusers/children were examined. Regarding relationships with abusers, 71% of mothers reported lengthy sagas, 17% had worked it out, and 13% made a clean break from the abuser. Regarding relationships with their children, 48% of mothers hid the violence, 26% minimized it, and 26% openly communicated about the situation. Relationships between abusers and the mothers' children were found to be either co-parental (29%), playmate (21%), abusive (21%), or non-parental (21%). Correlations among relational and demographic variables were also examined.     

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.     

University Binge Drinking Patterns and Changes in Patterns of Alcohol Consumption Among Chinese Undergraduates in a Hong Kong University

Abstract

Objective: To examine patterns of binge drinking and changes in drinking patterns among Chinese university students. Participants and Methods: Responses to an anonymous questionnaire were compared between a random sample of 411 second year Chinese undergraduate students in 2006 and 2,630 first year students from the previous year. Students reporting any symptoms of alcohol abuse were classified as alcohol abusers whereas those reporting repeated inability to curtail use were categorized as alcohol dependent. Results: After 1 year of university, greatly increased rates of past-month drinking of different degrees were found in both genders. Binge drinking among second year undergraduates was significantly correlated with male gender, living in a student residence hall, smoking, drinking to relieve stress, and having friends who frequently drank. Conclusions: Alcohol misuse is a health hazard to Chinese students in a university environment. Proactive policies aimed at preventing harmful alcohol use should be considered by university authorities.     

The Self-Report Causes of Loneliness of Drug Users During Withdraw

Abstract

Loneliness is generally a prevailing experience which is particularly familiar to adolescents and young adults. It is a subjective experience which is influenced by one's personality, life experiences, and situational variables. The present study examined the connection between drug cessation and the antecedents of loneliness. Drug abusers, during their stay in detox centers, were compared to drug abusers who participated in a methadone maintenance program and those two groups were compared to the general population who are non drug users. A total of 304 participants volunteered to answer a 30-item yes/no questionnaire, reflecting on their loneliness experiences and what caused them. The factors that comprise the causes of loneliness are: Personal inadequacies, Developmental deficits, Unfulfilling intimate relationships, Relocation/significant separations, and Social marginality. Results revealed significant differences between the scores of the three groups.     

Victims’ Retrospective Explanations of Sibling Sexual Violence

ABSTRACT

While sibling sexual abuse may be the most common form of sexual violence within the family, relatively few studies have been conducted on this topic. The current study addresses this gap in the literature through analyses of thematic categories in narratives gathered from an online survey of sibling sexual violence. Survivors were asked to report why they believed their siblings had become sexually abusive toward them. Participants believed that their abusers had learned to be abusive due to their own victimization or exposure to pornography, were abusive to establish dominance over them, or had some undisclosed mental illness. While the study does not claim to test these explanations or include abusers’ own narratives, it offers insight as to how sibling sexual violence survivors make sense of their experiences and assign blame to abusers and their families. It also offers insights into future inquiries about sibling sexual abuse.     

Reconceptualizing Substance Abuse Treatment in Therapeutic Communities: Resiliency Theory and the Role of Social Work Practitioners

ABSTRACT

Although therapeutic communities (TC) have achieved promising results in the treatment of substance abusers, several areas have been identified which might further enhance TC treatment effectiveness. Two of these, resiliency theory and the role of social work practitioners, are discussed. Resiliency theory provides a framework for re-conceptualizing interventions as they apply to therapeutic communities. Resiliency is explicated and illustrated via a case study of a therapeutic community TROSA (Triangle Residential Options for Substance Abusers), a non-profit TC in Durham, North Carolina. A number of contributions that social work practitioners can make to TCs are described.     

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.     

Powerlessness and Abuse and Neglect of Older Adults

ABSTRACT

This article is a qualitative study which addresses the interacting relationship between the environmental context of care giving and abuse and neglect of older adults. These are examined through a thematic content analysis of risk factors identified in sixteen ‘in depth’ interviews of abused and neglected victims including two of their abusers. The interviews provide a portrait of their past and present situations, their roles and relationships and the process through which the interviewees move into their described process of powerlessness.

The interviewees are analysed through a critical, systemic, ecological analysis of the historical, gender and cultural perspectives of the interviewees. Through the relationships of the victims and their abusers in the macro, meso, exo and micro systems, questions are raised about the growing debate regarding changes in family patterns and demographics that affect how societies define the provision of care to their dependent adults. They demonstrate that violence is produced by complex interacting systems and significant events, that impact on the life courses of some older adults and some care givers leading them into powerless positions and resulting in abuse and neglect.     

Mental Health and Criminal Justice Issues Among Perpetrators of Elder Abuse

ABSTRACT

Recent studies on elder abuse suggest that the pathology or impairment of the abuser may be a stronger predictor of elder abuse than characteristics of the victim. To examine the relationship between elder abuse, abuser pathology, and the criminal justice system, the New York City Department for the Aging (DFTA) undertook a survey of older victims of reported domestic abuse seeking assistance from the DFTA Elderly Crime Victims Resource Center. Preliminary findings from the survey indicate that impaired abusers were significantly younger than unimpaired abusers and more likely to live with their elderly victims, to be unemployed, and to have a history of involvement with the criminal justice system.     

Most Successful Intervention Strategies for Abused Older Adults

ABSTRACT

In this Project CARE study, intervention plans for 83 cases, with a total of 473 strategies, are analyzed in a qualitative content analysis method. The 473 strategies are designed and implemented by an abuse-trained, multidisciplinary, health and social service agency, home care team. Each strategy is rated by the team for its acceptance/refusal by clients and levels of success. The most accepted and successful strategies for abused older adults are concrete: nursing and other medical care and homemaking assistance, followed by empowerment strategies, such as support groups for abused older adults, information about rights and resources and volunteer buddy/advocates. Less successful strategies for abused persons are referrals to general community activities and programs. For caregiver abusers, the most successful and accepted interventions involve individual supportive counselling to reduce anxiety, stress and depression and education and training. Abuser-oriented strategies are most accepted and successful in the study. Thus, it would seem pertinent for intervenors to focus services and strategies on abusers and not only on abused older adults, in particular offering them supportive individual counselling to reduce anxiety, stress, and depression. For abused care receivers, home-based services can offer the necessary support to move out of their abuse situation with the help of volunteers and support group activities.     

Beyond privacy: bodily integrity as an alternative framework for understanding non-consensual pornography

ABSTRACT

Activists and legal scholars seeking remedies to non-consensual pornography (known colloquially as ‘revenge porn’) have generally framed it as a violation of privacy; however, the concept of privacy a fraught history, linked to women’s exclusion from the public sphere, denial of their sexual expression, and impunity for abusers. I argue that the concept of body integrity better maps onto the experiences described by victims, who seldom distinguish between digital representations of their body and the body itself and who often liken non-consensual pornography to sexual assault. However, a feminist approach to bodily integrity (rather than one rooted in classical liberalism) is require in order to account for the disproportionately negative consequences non-consensual pornography has for women.     

Latinas in Treatment

Abstract

This study analyzed secondary data collected from a recovery home specifically for Hispanic female substance abusers, and from four other recovery homes. Demographics, drug use history, and length of stay were compared to determine if participants of the culturally specific home remained in the program longer, and the reasons why. Results indicated that the women in the Hispanic recovery home stayed over a month longer and were more likely to be poor, unemployed, and methamphetamine or heroin addicts. Regression analysis was used to determine how these and other characteristics predicted length of stay, a variable that has been found to correlate with successful outcomes. Length of stay was associated with the culturally specific program, prior arrests, and years of problem drug usage. Implications for program design and treatment are discussed.     

Brief Report: Child Sexual Abuse Inquiries in Hong Kong, 2000–2017

Community advocates in Hong Kong found no formal curriculum on child sexual abuse (CSA) prevention and started a newspaper column in 1999 to disseminate public education. This study analyzed the inquiries sent to this prevention column from 2000 to 2017. Content analysis found that, in 515 inquiries, 170 (33%) reported CSA incidents. Based on age information in 147 incidents, female abusers (n?=?28) targeted victims averaging 6.48 years of age, which is 3.08 years significantly younger than those abused by male abusers (n?=?119). In 82 inquiries with abusers’ age information, 42 minor “abusers” were reported. Early sex education is highly recommended.     

Using Online Databases to Guide Practice and Research

Abstract

As tools for human service practitioners and researchers, online databases to locate evaluation literature are becoming increasingly useful. This article uses a clinical problem (concern about the effectiveness of electroconvuisive shock therapy for depressed persons), and a researcher's problem (planning a study to evaluate group treatment for child abusers), to illustrate logic of online searches for evaluation literature. New techniques for synthesizing many studies may require sweeping changes in how abstracts are formulated for bibliographic databases. Study synthesis techniques suggest ways to code studies to describe treatment method, client type, outcome measures, indices of study quality, and indices of treatment effect size. By replacing abstracts with such coded information, evaluation studies could be synthesized continuously for their program and policy implications.     

Characteristics of Homeless Alcohol and Drug Abusers Identified Through an Assertive Outreach Program

Differences between substance abusers and non-abusers, and among abusers of alcohol, drugs, or both substances, were investigated for 1166 persons identified as homeless or at risk of homelessness by an assertive outreach program in a moderate size city. The 603 self-reported substance abusers included disproportionate numbers of male, Black, unmam'ed, and currently homeless persons with a history or symptoms of mental illness, who expressed a primary need for assistance dealing with the social seIVice system. Type of abuse was associated with demographic charaeten'stics, length of homelessness, mental illness status, and primary expressed needs. An accurate picture of subgroup differences can aid design and delivery of services for the homeless.     

Evaluation of targeted human papillomavirus vaccination education among undergraduate college students

Abstract

Objective: To design and evaluate pharmacy student-led educational sessions to improve health beliefs about the HPV vaccine in college-aged students. Participants: Students aged 18–26 attending a large, urban university, including 545 respondents to a December 2014 needs assessment survey about HPV-related health beliefs, 131 students participating in educational sessions during 2015–2016 (intervention group), and 369 undergraduate respondents completing the needs assessment survey (control group). Methods: A needs assessment survey was conducted to inform design and implementation of pharmacy student-led educational sessions. A similar survey was administered to students after attending educational sessions. Health beliefs were compared for the intervention versus control group. Results: The intervention group was less likely to report high perceived barriers to HPV vaccination and more likely to report high perceived benefits and intention to vaccinate (if previously unvaccinated). Conclusions: Pharmacy student-led, health belief-based educational sessions were associated with improved health beliefs about HPV vaccination.     

Current Empirical Assessment Methods for Adolescents and Children Who Sexually Abuse Others

Abstract

The assessment of adolescents and children who commit sexually abusive behavior is a complex and challenging task. Incorporating empirically based assessment methods into psychosexual evaluations promises appropriate coverage of relevant domains, sound interpretation of the meaning of data, reduced clinician biases and error, and greater certainty in decision-making. In this paper we review empirically-based assessment methods currently available for use in psychosexual assessment of adolescents and children who sexually abuse others. Our review describes the robustness of these measures and provides guidance for their appropriate use in assessment. The review highlighted that several empirically-based measures are suitable for clinical use with adolescents, but very little is available to guide assessment of children's abusive behavior per se.     

Social Work Assessment of Children with Oppositional Defiant Disorder

Abstract

A review of the empirical literature was conducted concerning the use of the Child Behavior Checklist(CBCL) in the assessment and treatment of children meeting the DSM-IV criteria for Oppositional Defiant Disorder. Even though the information is more limited on the CBCL in regards to ODD, compared to youth with Conduct Disorder, it is evident that this scale is a practical rapid assessment instrument with clinical, administrative, research, and program evaluation uses. Social workers serving children meeting the criteria for ODD, and those engaged in research and evaluation with such children, are encouraged to consider using the CBCL as a part of a comprehensive social work assessment package.