Gambling Among Older Adults in Singapore Some Preliminary Empirical Findings

The purpose of this study is to shed light on gambling among older adults (age 60 and above) in Singapore. A sample of 74 older adults who were participants of a community-based elderly outreach program was surveyed. The results indicate that 27% of the respondents had gambled in the past one month and their favorite gambling game was 4D. Those who gambled were found to have more free time than those who did not (64 hours per week vs. 38 hours per week). Almost all the respondents (97%) did not know where to get help for problem gambling.     

Mistrust and Self-Isolation: Barriers to Social Support for Older Adult Methadone Clients

Objectives: The purpose of this study is to explore barriers to the use, maintenance, and expansion of social supports in older adult methadone clients. Methods: The data for this analysis were derived from a qualitative study of the needs of aging methadone clients. Data were collected through face-to-face interviews with 24 methadone clients over the age of 50. Results: A lack of trust was identified as a principal barrier to the use, maintenance, and expansion of the social supports of older adult methadone clients. Causes of this mistrust include issues associated with aging, past traumatic experiences, and difficult personal relationships. Implications: These findings imply that addressing the issue of self isolation and recognizing the reason older adult methadone clients engage in this behavior is a key element in getting this specific population to use, maintain, and foster healthy social supports. A common phrase echoed throughout the interviews is that a person cannot trust anybody. Because of this mistrust, some clients keep to themselves by electing to self-isolate and decline to use, maintain, or foster new relationships. As a result, these individuals are less likely foster and/or engage in healthy social relationships, which are a key component of substance abuse treatment and abstinence maintenance.     

Gambling and problem/pathological gambling among ex-offenders in Hong Kong

This paper considers the issue of ex-offenders who can be identified as having an addiction to gambling; one that has been long-neglected in Hong Kong. It reports on a study in which 378 ex-offenders were asked to assess their gambling involvement. The paper identifies the importance of social workers developing a better understanding of this issue in their work with ex-offenders and the findings suggest there is further scope for research and analysis about the extent of this problem and its management.     

Supportive Housing for Addicted,Incarcerated Homeless Adults

ABSTRACT

Homeless populations often suffer from mental illness, substance abuse, and criminality. Interventions, such as supportive housing, can have positive impacts, although benefits can be limited. This study examined outcomes for clients (N = 102) of a new supportive housing intervention. Use of formal treatment, jail contact, and community stability were compared pre- and post-housing. Jail bookings and residential substance abuse treatment significantly declined post-housing, while clients improved in income level, access to food, and housing stability. Results from official justice and treatment system data suggest that supportive housing can lead to significant changes. Future research is necessary to understand the relationship between client characteristics and outcomes.     

Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities

The study examined the effect of adult children’s disability on parents’ physical health in later life and the extent to which parents’ symptoms of alcoholism in mid-life moderates the link between children’s disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child’s mental health problems on parents’ later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.     

An Exploration of Cohesion and Recovery Outcomes in Addiction Treatment Groups

This article explores the relationship between group cohesion and recovery outcome variables in inpatient addiction treatment groups. We surveyed 104 people in group therapy using measures of cohesion, self-efficacy, social support, and coping. Length of stay in treatment has a relationship with cohesion. Significant higher order interactions were found with group cohesion (length of stay by type of addiction and length of stay by type of referral). The interaction of gender by addiction on measures of social support and self-efficacy were also significant. The latent construct of collective efficacy was confirmed using factor analysis, and we discuss collective efficacy and implications for group work with addictions.     

Adverse Childhood Experiences and Substance Use History among Vulnerable Older Adults Living in Public Housing

ABSTRACT

Previous research shows strong correlations between adverse childhood experiences (ACE) and later life health. The current study examines the relationship between ACEs and substance use among older adults living in public housing. Results show that about one-third of participants had four or more ACEs, and ACE score predicted likelihood of substance use history. Over half of older adults with four or more ACEs experienced substance abuse in their lifetime compared to one out of ten older adults with less than four ACEs. Findings shed light on a vulnerable group and point to next steps in research and practice.     

Treatment Barriers to Social and Health Care Services from the Standpoint of Female Substance Users in Finland

Abstract

This qualitative study discusses barriers affecting female substance user’s treatment access to welfare services. The study consisted of seven group discussions and three individual meetings with 13 women in Helsinki, Finland. Institutional ethnography was used as the theoretical framework for the study. The research questions are: (a) What treatment barriers do women face?, (b) What reasons are there for them not receiving services?, and (c) How do the ruling relations coordinate women’s experiences? Women faced multiple barriers affecting their access to services. They could be interpreted as being: determined by the service system, such as a difficulty in meeting the various criteria in order to be granted access to services; determined by the lack of trust; or determined by personal choices. The study suggests that the service system should be organized according to the needs of the service users. Future research is needed to address the questions such as how social and health care services could better co-operate, and how the different sectors of the service system could break down the institutional barriers.     

Parenting a 6-Year Old Is Not What I Planned in Retirement: Trauma and Stress among Grandparents Due to the Opioid Crisis

ABSTRACT

There is little research about trauma, financial stress, and social service needs emanating from the experience of parenting grandchildren caused by the opioid crisis in the United States. We conducted a qualitative study with 15 grandparents who currently or in the past had custodial care of their grandchildren. We also interviewed nine issue-related stakeholders in Eastern Massachusetts. Specific inquiries centered on events leading up to a change in guardianship, stressors related to legal, financial, and family issues, and system-wide response to the grandparents’ needs. Results indicate that the opioid crisis presents distinct challenges for the grandparent-led families and for the systems that serve the new family arrangement. Crisis triggers a change in guardianship and continues throughout the years. The continued crises stem from events related to the parent’s opioid use disorder (OUD) and from expenses related to raising a young family, especially when the grandchild has adverse childhood experiences. Our analysis shows that systems break down on a number of levels, and the fluidity of custodial arrangements due to parents’ OUD status does not map onto existing support or benefit systems. Policy responses must focus on the immediate and long-term needs of grandparent caretakers, especially since the opioid crisis is likely to continue.     

Alcohol and drug abuse: removing structural barriers to treatment for historically disadvantaged communities in Cape Town

The article reports on an exploratory study that examined access to alcohol and other drug treatment for historically disadvantaged communities in the Cape Town metropole. In-depth interviews were conducted with 20 key informants from various sectors of the alcohol and drug treatment system, including treatment service providers, members of local drug action committees and social workers from district social service offices. Findings highlighted three structural barriers to service delivery: (i) difficulties in developing and implementing a strategic plan relating to alcohol and drug problems due to poor capacity and other infrastructural issues, such as a lack of information, poor intersectoral collaboration and limited consultation with service providers; (ii) limited allocation of resources to alcohol and drug treatment which has restricted the availability of affordable services as well as the capacity of established services to meet increased demand for services in this area; and (iii) fragmented service delivery. The study highlighted the need for further transformation of the South African social welfare system responsible for alcohol and drug treatment service delivery through public–private partnership development and the introduction of a management information system.     

Predicting Retention in Three Substance Abuse Treatment Modalities Among Anglo,African American,and Mexican American Juvenile Offenders

Abstract

Many of the same factors that predict delinquent behavior also predict adolescent drug use. This study examined factors that predict, and interventions that maximize, substance abuse treatment retention in three modalities among high-risk Anglo, Mexican American, and African American juvenile offenders. The study sample includes youth (N = 211) who were discharged from probation supervision and who received substance abuse services through a CSAT-funded federal demonstration project. The key predictors examined included the stage-of-change (i.e., precontemplation, contemplation, preparation) in which a juvenile fell, various dimensions captured by the Comprehensive Addiction Severity Index for Adolescents, and other intervention status (probation, case management, and mental health treatment). The research questions were addressed using statistical models known as survival analysis that treated time from entry into substance abuse treatment to exit from substance abuse treatment as the outcomes. Among key findings were that females were 73% more likely to leave day treatment relative to males; for each additional family problem ever experienced, Mexican American adolescents were 15% more likely to leave residential treatment compared with African American adolescents; and African American and Mexican American adolescents in the contemplation stage-of-change were 50% less likely to leave day treatment compared with Anglo adolescents. Applications for practice and research with this population are discussed.     

Variations in the Life Histories of Incarcerated Parents by Race and Ethnicity: Implications for Service Provision

ABSTRACT

Incarcerated parents have complex life histories that often remain unresolved during incarceration, can continue to create barriers to prosocial success on release, and present similar intergenerational challenges for their children. This study examines the life histories of incarcerated fathers and mothers from the Pacific Northwest and how their experiences vary based on race and ethnicity. Five areas examined were exposure to trauma, child welfare involvement, mental health and substance abuse problems, juvenile justice and adult criminal justice involvement, and intergenerational criminal justice involvement. The sample comprised 359 incarcerated parents, and their racial/ethnic composition was 59% White, 14% African American, 11% multiracial, 8% Native American, and 7% Latino. Few differences were found across racial and ethnic groups. Mothers appeared more similar to each other across groups than fathers. Results illustrated similarities yet some surprising differences with national trends on key study variables. Implications for future research and intervention and prevention are discussed.     

Mothers and fathers in treatment for methamphetamine addiction—Parenting,parental stress,and children at risk

Parents addicted to methamphetamine (“crystal meth”) are likely to be impaired in meeting parental responsibilities, and the developmental settings can be highly disadvantageous for children. Therefore, parenting by methamphetamine‐addicted mothers and fathers needs further exploration, while considering the impact on children affected by parental substance use. In our study, we analysed parenting practices and parental stress as well as children's behavioural problems using standardized assessments. The sample consisted of 87 methamphetamine‐addicted parents in recovery. We obtained data on parents' current substance use and on their psychological distress. Multiple regression analysis was performed to identify predictors of children's overall problems. Parents reported high levels of parental and psychological distress, even after achieving abstinence. Especially depressive perceptions of parenthood appeared problematic. While recovering from methamphetamine addiction, parents exhibited a precarious psychosocial situation and problematic parenting behaviour. Dysfunctional parenting practices were evident in both indifferent and overreactive tendencies. Children were at risk of behavioural and emotional problems. Variables associated with parenting showed significant predictive value for children's overall problems, beyond current substance use, and psychological distress. These findings are discussed in terms of a family‐oriented perspective in order to promote parenting capabilities of methamphetamine‐addicted parents and to prevent problematic development of their children.     

Current Developments in Social Care Services for Older Adults in the Czech Republic: Trends Towards Deinstitutionalization and Marketization

ABSTRACT

Deinstitutionalization and marketization of eldercare has been delayed by 20 years in the Czech Republic compared to Western Europe, and it takes place in a completely different context, characterized by the legacy of communism, a growing older population, and less generous public subsidies. This study is the first in the Czech Republic to examine how deinstitutionalization and marketization effect implementation of these principles on the availability and quality of eldercare services at regional and municipal levels. A mixed-method approach was used, combining several data sources (policy documents, administrative data, statistics, expert panel, and secondary use of qualitative data). The findings suggest that the support for and availability of home-based care has declined, despite the ever-increasing number of older adults and policy preference for deinstitutionalization. Furthermore, home-based services have failed to adjust to growing care needs of older adults (e.g., inflexible schedules, limited provision of time-demanding care, inadequate staff composition). This situation occasioned an unintended outcome: the emergence of nonregistered, semilegal, for-profit nursing homes offering low-quality care and poor working conditions, and subject to no quality control. The health and even lives of older adults are at risk if they choose such services. Research is needed to study older adult decision making and offer them tools to identify and avoid questionable services.     

Use of Nondeliberative Practice in Groups for Older Adults with Substance Use and Mental Health Disorder: Group in an Art Gallery

ABSTRACT

This article presents an application of Norma Lang’s nondeliberative theory in groupwork with clients of Community Outreach Programs in Addictions (COPA), a Toronto community-based organization that assists adults age 55 and older who struggle with addictions and mental health. The article illustrates how we challenged concepts of group work which are predominantly discussion-based problem solving or premeditated by hosting a group in a major art gallery with clients considered difficult to serve. What was done is juxtaposed with what might have been done with greater knowledge of nondeliberative theory.     

Trauma and Stress Among Older Adults in the Criminal Justice System: A Review of the Literature with Implications for Social Work

The purpose of this article was to review the empirical literature that investigated trauma and stress among older adults in the criminal justice system. Nineteen journal articles published between 1988 and 2010 were identified and extracted via research databases and included mixed age samples of adjudicated older and younger adults (n = 11) or older adult only samples (n = 8). Findings revealed past and current trauma and stress, consequences and/or correlates, and internal and external coping resources among aging offenders. The implications and future directions for gerontological social work, research, and policy with older adults in the criminal justice system are advanced.     

Emotion Socialization in the Context of Risk and Psychopathology: Maternal Emotion Coaching Predicts Better Treatment Outcomes for Emotionally Labile Children with Oppositional Defiant Disorder

We examined whether maternal emotion coaching at pretreatment predicted children's treatment response following a 12‐week program addressing children's oppositional defiant disorder (ODD) symptoms. A total of 89 mother–child dyads participated. At pretreatment, mothers and children engaged in an emotion talk task. Mothers also reported their beliefs about emotions at pretreatment and their child's disruptive behavior symptoms, emotion regulation, and emotion lability/negativity at pre‐, mid‐, and post‐treatment. Clinicians reported children's symptom severity at pre‐ and post‐treatment. Children's emotion lability/negativity moderated effects of maternal emotion coaching on children's post‐treatment ODD symptoms, with stronger benefits of emotion coaching for children high in emotion lability/negativity. Results suggest that emotion coaching may promote treatment response for children with ODD who are especially at risk due to their emotionality.