Women in Substance Use Treatment

Abstract

The objective of this study was to examine the differences between women with children in substance use treatment who are involved in Child Protective Services (CPS+) and those who are not involved (CPS-). Using a sample of all alcohol and other drug (AOD) clients (N = 6,023) receiving substance use treatment over a three-year period (1997-99), the study found that CPS+ women were more likely to be younger, have more children, have been arrested less often, be mandated to receive treatment, to have an unsatisfactory exit status or be transferred to another treatment program at discharge. CPS+ women were also more likely to have attended outpatient or day treatment for the AOD treatment. This study points out that there may be specific risk factors in place for a subgroup of women with children in AOD treatment.     

Portal surveys of time-out drinking locations: a tool for studying binge drinking and AOD use

Portal surveys, defined as assessments occurring proximal to the entry point to a high-risk locale and immediately on exit, can be used in different settings to measure characteristics and behavior of attendees at an event of interest. This methodology has been developed to assess alcohol and other drug (AOD) use at specific events and has included measuring intentions to use collected at entry and reported use on exit, as well as chemical tests for AOD consumption at both entrance and exit. Recent applications of the portal survey procedure to electronic music dance events that occur in established venues (e.g., bars or nightclubs) are discussed.     

Child Welfare and Alcohol and Other Drug Treatment (AOD): Bridging the Gap to Comprehensive Services

ABSTRACT

Chemical addiction is a significant factor in child abuse and neglect (U.S. Department of Health and Human Services [DHHS], 1999). Although research has indicated that an alliance between the child welfare and alcohol and other drugs (AOD) treatment fields is the best way to effectively address chemical addiction within families, collaboration has not generally been established. The lack of collaborative relationships between the child welfare and AOD fields can be attributed to a number of different factors. Similarities in proposed interventions for collaborative efforts between AOD treatment and child welfare agencies can be found throughout the literature. The establishment of a truly collaborative partnership between AOD treatment and the child welfare system is a necessary step towards achievement of functional and healthy families, a goal common to both disciplines.     

An ethical code for AOD faculty: a proposed set of guidelines

Ethical codes of conduct are accepted requirements for membership in state and national organizations that grant credentials to those who are employed as alcohol and other drug (AOD) counselors, prevention specialists, and clinical supervisors. It seems appropriate to explore the possibility of an ethical code directly linked to addiction faculty which will outline their unique educational responsibilities and standards. The authors suggest development and adoption of such an ethical code for college-level addiction studies faculty and this proposal is offered as a move toward that possibility.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

The Extent and Nature of Practitioners,Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

This article considers the extent and nature of social work and social care practitioners' experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.     

Substance Abuse in Lesbian,Gay, Bisexual,and Transgender Communities

Abstract

This article calls attention to the lack of knowledge concerning alcohol and other drug (AOD) use in lesbian, gay, bisexual, and transgender populations. Twenty-five Internet Web sites related to the LGBT substance use are reviewed.     

Heavy alcohol use compared to alcohol and marijuana use: do college students experience a difference in substance use problems?

This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more likely to be younger and report a higher mean number of drinks per occasion and experiencing all AOD problems studied compared to alcohol-only users. Multivariate logistic regression analysis findings reveal the relationship between dual-substance use and increased risk for AOD problems remained after controlling for demographics and alcohol use behaviors. Such problems include greater odds of legal problems and riding with or being an intoxicated driver. College students using alcohol and marijuana are at much higher risk for AOD problems than are students who use alcohol only, even when heavy drinking is taken into account.     

Social work students in the aftermath of Hurricanes Katrina and Rita: correlates of post-disaster substance use as a negative coping mechanism

Social work students’ post-disaster coping while in the field is an important workforce issue with ethical implications. The current study utilized secondary data collected in a previous study examining post-disaster alcohol and other drug (AOD) use among social work student volunteers (N = 416) in the wake of Hurricanes Katrina and Rita (HKR). The current sample included participants from the original study who responded to a single-item measure of AOD use as a negative coping mechanism (N = 290). The present study examined potential explanatory variables of AOD use in the aftermath of HKR, including demographic (age, gender, and race) and psychosocial characteristics (hurricane-related stressors, previous traumatic stressors, and post-traumatic stress). The multivariate logistic regression model distinguished between students who never or rarely used AOD and those who used AOD often to cope with HKR, accounting for 24% of model variance. Social work students who report post-disaster AOD use may risk experiencing additional, trauma-related vulnerabilities, should be further assessed, and provided necessary specialized supports to enable their well-being and to prevent impaired practice.     

Child Abuse Investigations: Reasons for using Child Advocacy Centers and Suggestions for Improvement

Child protective service (CPS) and child abuse law enforcement (LE) investigators have been required by the majority of states to work together when investigating criminal cases of child abuse. Child Advocacy Centers (CACs) and other^. multidisciplinary models of collaboration have developed across the United States to meet these requirements. This study surveyed 290 CPS and LE investigators who use a CAC in their investigations of criminal cases of child abuse. Reasons given for using, centers, include legal or administrative mandate and protocol, child appropriate environment, support, referrals, capacity for medical exams, expertise of center interviewers and access to video and audio technology. Respondents also identified ways that centers could be more helpful.     

Examination of the Role of Therapeutic Alliance,Treatment Dose,and Treatment Completion in the Effectiveness of The Seven Challenges

Adolescent alcohol and illicit drug (AOD) use is a major public health concern. This longitudinal study examines the effectiveness of The Seven Challenges in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Participants were 89 adolescents (72 male, 17 female) enrolled in a 3 month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using AOD, reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Despite a small sample and other limitations, findings add to existing literature that suggests that The Seven Challenges is an effective substance abuse treatment for adolescents. Furthermore, findings suggest that adolescent substance abuse treatment should focus on clients meeting pre-determined program goals as well as on dose.     

Understanding and responding to chronic neglect: A mixed methods case record examination

Neglect is the most prevalent form of maltreatment, and thus comprises the bulk of cases for Child Protective Service (CPS) agencies, yet it remains under-studied. Cases in which children experience repeated or “chronic” neglect are particularly concerning. A growing body of research indicates that the effects of chronic neglect create a harmful accumulation of problems for child well-being, including detrimental impact on early brain development, emotional regulation, and cognitive development. The aim of this retrospective case record review study was to examine risk and protective factors of chronic neglect and relevant CPS agency responses and practices. Results demonstrated that families experiencing chronic neglect had multiple significant stressors (four or more stressors for all families in this study), such as domestic violence, poverty, children with behavioral problems, and/or substance abuse, indicating chaotic and toxic living environments. Key implications are outlined for strengthening CPS response to cases of chronic neglect, including the need for comprehensive assessment of families, more effective and consistent use of standardized risk assessment tools, and better recognition of past patterns of neglect to mitigate the risk of accumulation of harm.     

News coverage of alcohol and other drugs in U.S. college newspapers

This study investigated the substance use-related content of a sample of student-run college newspapers. Two independent coders examined 157 news stories, features, editorials, commentaries, letters, photographs, and cartoons. Items about alcohol appeared in one out of every two issues, while items about other drugs appeared in one out of every five issues. Basic information about alcohol and other drug (AOD) use was reported in about one-fifth of the items, while three-fourths dealt with social, legal, safety, or health problems associated with AOD use, especially alcohol consumption. Just over half referred to some type of control policy, most often an enforcement action. Around one-fourth mentioned educational efforts to promote AOD prevention. Very few dealt with detection, intervention, or treatment. Most college newspapers are missing good opportunities for more extensive coverage of AOD issues that would better inform their readers, especially about factors contributing to campus AOD problems and specific program and policy options.     

Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

Food neglect and maltreatment re-report

This study examines the time to re-report following the close of a maltreatment investigation for cases involving food neglect. Data on families of children 0 to 17 involved in Child Protective Services (CPS) investigations from a merger of the 2010 cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II) and the National Child Abuse and Neglect Data System (NCANDS) were used (n = 3580). More than half of the families had a history of CPS involvement, a third received CPS services, and one-in-ten families had their child place in out-of-home care following an investigation. After controlling for other types of maltreatment allegations and multiple covariates, families investigated for food neglect had a greater chance of being re-reported for a subsequent CPS investigations in a shorter length of time than families without an allegation of food neglect. While only a small percentage of families had a food neglect allegation, problems adequately feeding a child - whether due to severe poverty, inattentiveness, or abusive negligence - placed a family at a higher risk of a future CPS investigation.     

The crucial role played by social outrage in efforts to reform child protective services

In this paper, we question the widely, if tacitly, held perspective that exceptional and immensely publicized instances of child abuse and neglect offer little guidance or understanding in improving the efficacy of child protective services (CPS). Using insights from Carl Jung, Max Weber and Henry Mintzberg, we argue that not only do such archetypical cases and the attendant moral outrage serve as catalysts for legislative and judicial actions; they also motivate structural and procedural changes in CPS operations. We propose extending to CPS a risk model commonly considered in the fields of environmental science, food safety and chemical engineering, where risk is conceptualized as a function of both technical hazard and moral outrage. We point out, however, that unlike in these non-CPS fields where the typical response is to ‘manage’ outrage via public education or public relations campaigns and to allow outrage to influence only the more immediate and exceptional decisions following an outrageous event, in the CPS field where children are the focal point, exceptional decision processes also seep into routine decision making by necessity. We term our proposed enhanced risk model the Socially Outraged Risk Expression (SORE). We conclude with recommendations for an empirical test of SORE.     

The Nature and Extent of Substance Use Education in Qualifying Social Work Programmes in England

Alcohol and other drug (AOD) use is a common feature of modern social work practice. Concerns about the problematic use of such substances cross all areas of social work practice, including adults' and children's social care. In England, surveys have highlighted social workers' experiences of AOD education during their qualifying social work training. However, this study sought the perspectives of the social work educators. Its primary aim was to explore the nature and extent of education on AODs on the qualifying social work programmes in England. Using an online survey tool, all qualifying social work programme leads were invited to take part (n = 157). Fewer than half responded (40%, n = 63). Initial findings appeared positive suggesting that 94% of responding qualifying programmes provided some teaching and learning on AODs. Further analysis revealed significant variation in what is taught and the depth of coverage. It highlighted a lack of consistency across programmes and possible over-reporting. However, the majority of respondents felt that teaching and learning on AOD use should be a higher priority for their qualifying social work programmes.     

Risk assessment in child sexual abuse cases

Despite continuing improvements in risk assessment for child protective services (CPS) and movement toward actuarial prediction of child maltreatment, current models have not adequately addressed child sexual abuse. Sexual abuse cases present unique and ambiguous indicators to the investigating professional, and risk factors differ from those related to physical abuse and neglect. Incorporation of research on risk factors specifically related to sexual offender recidivism into existing CPS risk assessment models may improve the ability to assess the risk of future sexual maltreatment to children. This article reviews the literature on risk factors for sexual offense recidivism and discusses their relevance and application to CPS assessment models. An evidence-based model for assessing risk in child sexual abuse cases is proposed.