Assessing readiness to work from a stages of change perspective: implications for return to work

The Lam Assessment on Stages of Employment Readiness (LASER) was developed to assess welfare recipients' employment readiness. The LASER consists of 14 items corresponding to Prochaska's stages of change model (Prochaska, DiClemente and Norcross, 1992). A sample of 149 welfare recipients from a work training program participated in the study. The Confirmatory Factor Analysis (CFA) supported the three factors structure corresponding to Prochaska's Pre-Contemplation, Contemplation, and Action stages. A cluster analysis classified the sample into three groups according to their LASER scores. A six months follow-up on employment outcomes showed that those who were in Pre-contemplation stage had the poorest employment outcome (25%), those who were in the Action stage had the best outcome (56%) and those in the Contemplation stage were in between (38%). Implications for work rehabilitation and treatment matching were discussed.     

Student perceptions of the danger of drug use: a factor analysis.

Australian secondary school students from three Year levels were asked to rate the danger involved in various uses of alcohol, tobacco, inhalants, marijuana and other illicit drugs. These ratings were then factor analyzed for each Year level. The results showed a more refined discrimination among the older students, with type of drug and frequency of use being important considerations. Familiarity was a major consideration for the younger students. The cognitive factors derived from the data are consistent with expectations based on the gateway theory of drug use.     

Peer influence and drug use among adolescents in rural areas

A sample of 1,004 eighth and tenth grade students in twenty-three small Central/East Texas communities was assessed to determine 1) their perception of the number of their friends who use drugs, 2) the amount of information they received about drugs from their friends, and 3) the connection between those perceptions and drug use. A multiple regression model which included grade, gender, the degree to which friends are perceived to use drugs and the amount of information about drugs received from friends explained 39 percent of the variance in the degree to which rural adolescents were involved in drug use. An item specific analysis of the subcomponents of these composite variables explained 44 percent of the variance in the degree to which rural adolescents were involved in drug use. This same four-factor model accurately classified over 81 percent of non-drug-users and 67 percent of users using discriminant analysis. Students who perceived a higher degree of drug use among their friends and who received more information about drugs from their friends used drugs more frequently. Lower marijuana use in these rural areas as compared to the nation, both as a peer perception and as a fact, may protect these students to a degree from broader patterns of drug use. The findings of this study support the theory that peer pressure is related to drug abuse, even in rural areas.     

Ethnic identity, neighborhood risk, and adolescent drug and sex attitudes and refusal efficacy: the urban African American girls' experience

This study examined the impact of ethnic identity and neighborhood risk on drug and sex attitudes and refusal efficacy among early adolescent urban African American females (n = 175). The model also predicted a moderating relationship of ethnic identity on neighborhood risk for drug and sex attitudes and refusal efficacy. Data were collected as part of a larger drug education program and analyzed via hierarchical multiple regression. The analyses controlled for household structure and menarche. Results indicated a direct relationship of higher ethnic identity and higher sexual refusal efficacy, higher disapproval of drug use, and lowered intentions to use drugs. Neighborhood risk was directly related to lower disapproval of drug use. There was a small moderating effect of ethnic identity on neighborhood risk for intention to use drugs. Findings provide support for prevention programs for African American youth that seek to reduce risk behaviors by increasing ethnic identity, particularly in low resource communities.     

A path analytic examination of differential social control theory

Differential social control theory was investigated with survey data from 860 adolescents using path analytic techniques. Peer non-use expectations, peer use, and the adolescent's own attitude each have a direct influence on drug use. Peer non-use expectations have the largest total effect on drug use and are directly influenced by parental, peer, and school attachments. Student's attitude has a direct effect on drug use, however, a majority of the association is spurious. Peers' drug use has the largest, direct influence on drug use. The likelihood of adolescents' associating with drug using friends is reduced by a close relationship with their parents and by knowing that their friends disapprove of drug use. The model explained 60 percent of the variance. Students do not use drugs if they are unwilling to jeopardize their relationship with their parents and non-using friends. They are also less likely to use drugs if they think their parents and friends disapprove of drug use and if their friends do not use drugs themselves.     

An exploratory study examining the spatial dynamics of illicit drug availability and rates of drug use

This study examines the spatial relationship between drug availability and rates of drug use in neighborhood areas. Responses from 16,083 individuals were analyzed at the zip code level (n = 158) and analyses were conducted separately for youth and adults using spatial regression techniques. The dependent variable is the percentage of respondents using drugs in the past year. Neighborhood drug availability (the major independent variable) was measured by the percentage of non-drug users who had been approached to purchase drugs. Data were obtained as part of the Fighting Back community evaluation. For youth (aged 12 to 18), drug sales in adjacent and surrounding areas were positively associated with self-reported drug use in areas where youth were residents. For adults, drug sales within the neighborhood were negatively associated with drug use, while drug sales in immediately adjacent neighborhoods were positively related to self-reports of drug use. Findings suggest that the areas where rates of drug users are greatest are not necessarily the same area where drugs are sold. Designing strategies to reduce the supply of drugs should receive input from city and regional planners and developers, as well as law enforcement and public health professionals.     

Life events and peer substance use and their relation to substance use problems in college students

Substance use disorders among college students are not well understood, and the present study examined the relationship of two environmental factors to alcohol and drug use problems in 616 (316 women) college students. Participants completed measures assessing substance use problems, life events, and substance use among peers. Alcohol use problems were significantly associated with higher drug use problems and regular use of illicit drugs among friends. Drug use problems were significantly associated with male gender, higher alcohol use problems, regular use of alcohol and drugs among friends, illicit drug use among romantic partners, and higher numbers of negative life events. Results extend previous research and suggest that college students who experience multiple negative life events and/or affiliate with substance using friends and romantic partners may be at risk for developing a substance use problem.     

The trans-theoretical stages of change model and motivational interviewing for building maternal supportiveness in cases of sexual abuse

When a child has been sexually abused, the non-offending parent plays a crucial role in determining that child's recovery. However, the disclosure of sexual abuse in families often throws non-offending parents into a dilemma about whether or not to side with the perpetrator or child, leaving them in an ambivalent position. In order to enhance the ability of parents to protect and support their children, this paper proposes the use of the Trans-theoretical Stages of Change model and Motivational Interviewing. Techniques of Motivational Interviewing will be discussed and then illustrated with a case example.     

Patterns of Alcohol and Marijuana Use at School

The problem of adolescent substance use has been examined extensively. Beyond simple prevalence estimates, however, little research has been conducted on substance use in the school context. The present investigation was an in‐depth study of students' attitudes and behaviors regarding alcohol and marijuana use during the school day. Based on a representative sample of 1123 high school students, this study assessed the frequency of alcohol and marijuana use at school among demographic subgroups, the accessibility of drugs in school, and students' perceived consequences of being caught using drugs in school. The results showed that male and Hispanic students had higher levels of drug use at school than female and white students, respectively; that school drug use increased with age, and that alcohol and marijuana were easily obtained and used on school grounds. A large percentage of students were not aware of the specific actions taken in their schools to punish drug use. The need for additional research on school‐related drug use is emphasized.     

The Strengthening Families Programme (SFP) 10‐14 and substance misuse in Barnsley: the perspectives of facilitators and families

The aim of this study was to evaluate the Strengthening Families Programme for young people aged ten to 14 and their parents (SFP 10‐14) in Barnsley, a northern English city, based on the experience of facilitators and families who had participated in the programme. A mixed methods design blending both quantitative and qualitative data was used in the study carried out in two phases over a nine‐month period in 2005. Quantitative data were collected through: the SFP 10‐14 Parent/Caregiver Survey Questionnaire, the SFP 10‐14 Young Persons' Survey Questionnaire and the Strengths and Difficulties Questionnaire. Questionnaire data were compared at the beginning of the SFP 10‐14 programmes (weeks 1–2) and at the end of the programmes (week 7). In addition, two focus group meetings were held with families who had undertaken the SFP 10‐14 programme; and three focus group meetings were conducted with facilitators of SFP 10‐14 programmes. Once quantitative and qualitative data had been analysed separately, a synthesis of the main findings from both approaches was then completed. Following the programmes, parents reported significant changes in communication limit setting, emotional management, prosocial behaviour and drugs/alcohol use. Total difficulties scores were also significantly different pre‐ and post SFP 10‐14 programmes. For the young people, communication, and emotional management were improved and their drugs/alcohol use was less. Their total difficulties scores were also significantly different. Qualitative evidence indicated that families who participated in the study found the SFP 10‐14 useful in preventing young people's alcohol and drug use in terms of: learning more about alcohol and drugs, using knowledge and skills to reduce behaviours that might lead to alcohol and drug use and, for young people, dealing with peer pressure that might lead to drug and alcohol use. Parents/caregivers and young people reported that the SFP 10‐14 had played a part in improving family functioning through strengthening the family unit. The findings from this exploratory study suggest that the SFP 10‐14 may be a useful primary prevention intervention in helping to prevent drug and alcohol misuse in young people. Copyright © 2009 John Wiley & Sons, Ltd.     

Assessing readiness for couple therapy: the Stages of Relationship Change Questionnaire

Client readiness for change is garnering increased interest both conceptually and methodologically. This article describes the reliability, validity, and utility of a measure of readiness for couple relationship change, Schneider's (2003) Stages of Relationship Change Questionnaire (SRCQ). Based on the Transtheoretical Model of Change, the instrument measures change along nine domains of marital functioning. Results indicate that this one-factor instrument may reliably measure readiness for change and discriminate between various stages of change. Most in this sample (n = 406) were in early stages of change, with men more often in the stage of precontemplation and women more often in contemplation. The SRCQ can be completed and scored in under 10 min. Clinical use and research implications are discussed.     

Drug and Alcohol Addiction in Singapore: Issues and Challenges in Control and Treatment Strategies

SUMMARY

The problem of drug addiction in Singapore has been relatively under control over the past few years. This is a result of the strategy of controlling supply to reduce demand for drugs. Alcohol consumption in Singapore is relatively low compared to Western countries. This paper provides an overview of the drug and alcohol control and treatment strategies adopted in Singapore. While new strategies have been formulated, some issues and challenges still remain. These issues and challenges are discussed and findings of a recent study conducted by the author are described. They include the need to focus on gateway drugs like alcohol, intervention involving family members, opportunities for regular employment for drug addicts, and the role of religion in aftercare treatment.     

Long-term impact of Drug Abuse Resistance Education (D.A.R.E.). Results of a 6-year follow-up

The long-term effectiveness of Drug Abuse Resistance Education (D.A.R.E.) was assessed by contrasting drug use and other D.A.R.E.-related attitudinal latent variables among 356 twelfth-grade students who had received the program in the 6th grade with 264 others who did not receive it. A prior study of these subjects when they were in 9th grade had shown no significant differences. A follow-up survey in 12th grade assessed central D.A.R.E. concepts such as self-esteem, police bonds, delay of experimentation with drugs, and various forms of drug use. Although the authors found no relationship between prior D.A.R.E. participation and later alcohol use, cigarette smoking, or marijuana use in 12th grade, there was a significant relationship between earlier D.A.R.E. participation and less use of illegal, more deviant drugs (e.g., inhalants, cocaine, LSD) in a development sample but not in a validation sample. Findings from the two studies suggest a possible sleeper effect for D.A.R.E. in reference to the use of harder drugs, especially among teenage males.     

Utility Theory and Adolescent Drug Abusers in Hong Kong

Bauman (1980) showed that the perceived costs and benefits of drug abuse predicted adolescents' subsequent marijuana abuse. The purpose of this study was to replicate the Bauman study with Chinese adolescents in Hong Kong, adding further analysis of individual items of perceived costs and benefits of their drug usage. A total of 77 youth at risk (aged 12–21) were interviewed with a structured questionnaire and their attitudes toward drug abuse, stress level, coping strategies, and parents' marital status were obtained. Congruent with the utility theory, results indicated that the more positive their attitude toward drug abuse, the more likely their involvement in drugs and the higher the observed stages of abuse. However, there was no significant difference between the drug abusers and non-users in some antecedent variables including stress levels in most areas of the adolescent lives, in most stress coping strategies, and parents' marital status. Results are discussed in relation to prevention of adolescent drug abuse.     

Predicting continued use of marijuana among adolescents: the relative influence of drug-specific and social context factors.

Most research on the determinants of adolescent drug use has focused on predictors of either initiation or current use. Little attention has been given to the determinants of continued use of drugs after initiation, even though some researchers have found that the consequences of continued use are more serious than those associated with experimental or occasional use. In this study, a longitudinal sample of 456 secondary and high school students who had already tried marijuana was used to examine the determinants of continued use of marijuana. Nearly 38 percent of those who had tried marijuana continued using, according to the definition operationalized in this study. Potential predictor measures were grouped in a drug-specific domain and a social context domain, and their effects on continued use, controlling for background characteristics, were examined in logistic regression models. Results showed that only the drug-specific domain had a statistically significant effect on the likelihood of continued use. Students who felt that the adverse physical and psychological effects of marijuana were not very important reasons for discontinuing use and those who had gotten stoned during their experimental stage of use were the most likely to continue use after initiation. The results suggest that the perceived physical and psychological effects of the drug are more important determinants of continued use than are social factors or benefits related to use. Any relationships between social factors and continued use are mediated by the perceived effects and risks of the drug.     

Applying the transtheoretical model to female and male perpetrators of intimate partner violence: gender differences in stages and processes of change

The Transtheoretical Model has been recently applied to men seeking services at battering intervention and prevention programs (Eckhardt, Babcock, & Homack, 2004; Murphy & Baxter, 1997). This study considers whether women arrested for intimate partner violence differ from male perpetrators in terms of stages of change and processes of change. No gender differences were found regarding stage of change. In general, all individuals presenting for treatment were in the early stages of change. The use of various processes of change was strongly related to stage of change, with individuals in the more advanced stages of change using more behavioral and experiential strategies to become nonviolent. However, except for the use of social liberation strategies, there were no gender differences in the use of the various processes. These findings suggest that the Transtheoretical Model may apply to female perpetrators equally as well as to male perpetrators. Intervention programs designed for male batterers using the Transtheoretical Model may also be helpful in the treatment of women arrested for domestic violence.     

Directions for developmental screening in child welfare based on the ages and stages questionnaires

Many young children investigated for maltreatment have developmental problems qualifying them for early intervention services, yet only a portion of these children receive such services. To address this gap, all children ages 0-3 with child welfare (CW) substantiated maltreatment in Pennsylvania are screened for developmental and socioemotional problems using the Ages and Stages Questionnaires (ASQ). This study views screening results for over 500 children to address whether children's substantiation status, living situation, and administering worker as CW or early intervention (EI) predicts screening rates. Bivariate and logistic regression analyses were used. Results showed that 22% of children scored in the problem-range of at least one developmental area and 18% scored in the problem-range of social-emotional concerns warranting EI referral. Results of bivariate analyses showed that children who spent time in the NICU were more likely to have developmental concerns. Socioemotional concerns were related to child race, foster care living situation, child as the subject of the referral, and physical neglect. Older children and children whose referral involved lacking basic needs showed both developmental and socioemotional concerns. There were no significant differences in screening results of children with substantiated versus unsubstantiated maltreatment. Children whose screening was conducted by EI were more than three times as likely to show developmental concerns compared with those screened by CW. Child welfare workers need more support when conducting developmental screening, and policies that limit screening to children with substantiated maltreatment or to children in out-of-home care should be reconsidered.     

Substitution of marijuana for alcohol: the role of perceived access and harm

Research has shown significant declines in gateway drug use among participants in a school/community substance abuse prevention intervention in a midwestern, suburban school district (Lohrmann, Alter, Greene, & Younoszai, 2005). Though still at or below national levels, student marijuana use was not impacted as positively. The current study investigated the possibility that efforts to prevent alcohol use resulted in an unintentional substitution effect thereby increasing marijuana use. Factors including perceived access to alcohol and marijuana, along with perceived harm associated with alcohol and marijuana use, were examined to determine their role in marijuana use. Findings revealed a relationship between perceived access to and perceptions of harm associated with marijuana and its use that depended on the level of perceived access to and harm associated with alcohol.     

TV DRUG ADVERTISING AND PROPRIETARY AND ILLICIT DRUG USE AMONG TEENAGE BOYS

In this five-wave panel study, the relationships between exposureto drug advertising on television and (a) use of proprietarydrugs, (b) use of illicit drugs, and (c) an attitude of readinessto take proprietary drugs were examined. The major finding wasa negative relationship between exposure to drug advertisingon television and use of illicit drugs, which remained negativeunder a large number of controls. No indirect relationship betweenthe two variables was found via the use of proprietary drugsor via an attitude of readiness to take proprietary drugs