Research with Older Adult Methadone Clients: The Importance of Monitoring Suicide Ideation

ABSTRACT

This study reports on the importance of monitoring suicide ideation among older adult research participants. A recently completed randomized controlled trial of older adults who are current clients in methadone maintenance treatment (MMT) served as a case study to elucidate a suicide protocol that was designed to account for the potential instances of suicide ideation within the research project structure. As the numbers of older adult heroin users increases, this study’s findings seek to influence research protocols that involve older adults with addictions who may be particularly vulnerable to suicide risk due to comorbid psychiatric conditions and psychosocial adversities.     

Improving Graduation Rates in Drug Court Through Employment and Schooling Opportunities and Medication-Assisted Treatment (MAT)

ABSTRACT

Drug courts have been a key part of the criminal justice system since 1989, and this study contributes to the existing body of research by identifying which participants (n = 248) were most likely to graduate from a drug court in Indiana (United States). Three variables emerged as significant predictors of graduation. First, participants who were employed or were students at the time of admission were nearly 2.5 times more likely to graduate than participants who were not. Second, participants who were using opiates as their primary drug of choice were over 80% less likely to graduate than participants who were using non-opiates as their primary drug of choice. Third, participants who had violations in the first 30 days of the program were nearly 50% less likely to graduate than participants who did not violate in the first 30 days. Offering medication-assisted treatment (MAT), such as methadone, Suboxone, or Vivitrol, to participants who have an opiate use disorder may improve graduation rates for this population. Additionally, graduation rates may also improve by offering more resources to assist participants in gaining and maintaining employment or schooling, and this seems to be especially important within the first month of the program.     

The Influence of Rural and Urban Substance Abuse Treatment Counselor Characteristics on Client Outcomes

ABSTRACT

Focus group data were collected from 28 substance abuse treatment counselors employed in rural and urban areas to examine their perceptions of factors influencing treatment outcomes. The influence of the counselor characteristics (i.e., education, experience, and recovery status) on client outcomes and geographic differences is explored. Focus group data were analyzed by three raters using line-by-line coding, focused coding, and memoing. This analytic approach revealed geographic differences in the counselors’ perceptions of the effect of counselor education, experience, and recovery status on client outcomes. Recommendations for treatment planning and future research are provided.     

Rehabilitation policy for drug addicted offenders in China: current trends,patterns, and practice implications

ABSTRACT

Drug use in China is both associated with criminal behaviour and regarded as social deviance. Drug addicted offenders can either be assigned criminal punishment or compulsory drug treatment, depending on the severity of the crimes they have committed. Compulsory drug treatment is in many ways similar to imprisonment in China. However, both compulsory drug treatment and imprisonment fail to prevent drug relapse. The authorities have implemented methadone maintenance treatment and non-medical social work interventions, although they are still in their infancy. More efforts should be made to deliver post-institutionalization programmes to help ex-inmates stay away from drugs and crime.     

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.     

Build the social justice bridge: participatory photography with the international group work community

ABSTRACT

“Build the Social Justice Bridge” was a participatory photography project that engaged international group workers in an assessment of group work as a social justice profession. Inspired by principles of photovoice research, the project invited social work students, educators, and practitioners from around the world to contribute photographs and brief narratives that represented the relationship between group work and social justice. The photographs were exhibited during the opening session of the 2018 Symposium of the International Association for Social Work with Groups (IASWG) in South Africa, where more than 200 participants from ten countries reflected on the meaning of the photos for the group work community. In viewing the photos, symposium participants identified a common vision of social justice as well as culturally-specific approaches to group work. Implications are drawn for the internationalization of professional knowledge.     

Effects of a Therapeutic Community on Korean Substance Abusers in Prison

ABSTRACT. This study tested the effectiveness of a therapeutic community (TC) intervention on imprisoned Korean substance abusers. Volunteer participants from 2 Korean prisons were randomly assigned to either the experimental group (n = 24) with the TC intervention or a control group (n = 24) with optional supportive sessions. Pretest and posttest data were collected on measures of abstinence self-efficacy and problem-solving skills. Participants in the TC intervention showed significant increases in abstinence self-efficacy and problem-solving skills, whereas those in the control group did not. The differences in abstinence self-efficacy for the TC were found for 2 of 3 subscales: Problem-Solving Confidence and Approach-Avoidance Style but not Self-Control. Further study is needed to replicate these findings with larger Korean prison populations and to establish the relationship between these skill dimensions and subsequent drug use and criminal recidivism for this population. Nevertheless, the findings suggest potential benefits of using a TC intervention with imprisoned Korean substance abusers.     

Hearing the Voices of Abused Older Women

Summary

This paper focuses on a qualitative research process that gathered responses from 64 older women aged fifty and older on their experience of violence and abuse. What older women said about abuse in their lives supports the use of a feminist framework as well as the age based analysis of the elder abuse field. Some respondents spoke of abuse from childhood into their later years. Some spoke of partners witnessing or experiencing abuse as children. Some women express concern about possible abuse by their adult children of their own children.

Abused older women like younger women need a safe environment, emotional support, advocacy, information, and peer support. While it is important to consider the perspectives and knowledge of service providers when developing policy and practice on abuse of older women, it is critical to ask the women survivors of abuse or neglect what they believe would benefit them, and others in similar situations.     

A Comparison of Child Fatalities by Physical Abuse Versus Neglect: Child,Family, Service,and Worker Characteristics

ABSTRACT

In the field of child welfare, attention has been given to risk factors for child maltreatment fatalities with little attention to the difference between children who die from abuse versus neglect. As part of a larger study, child welfare workers (n = 104) from 14 different states responded to an anonymous online survey that described the child, family, and case characteristics before death and worker characteristics/experiences before and after death. Results supported that prior to death, neglectful families presented with less risk than abusive families, in the areas of parent–child attachment, child behavior problems, and changes in household composition while reporting that they received more services. With regard to child welfare practice, workers did not report any differences in how they handled cases before death nor did they report differences in their posttraumatic stress symptoms at the time of the survey. These findings can be used as a springboard for future research that focuses on fatal maltreatment.     

“Don't Leave Me Hanging”: Homeless Mothers’ Perceptions of Service Providers

ABSTRACT

Few interventions have been developed for substance-abusing homeless mothers. Among those interventions, high dropout rates (up to 85%) are consistently reported. Understanding homeless mothers’ experiences with service providers may be an important first step to understanding ways to increase treatment engagement. Therefore, the current study used qualitative methods to gain a better understanding of homeless mothers’ perceptions of service providers. A total of 28 mothers who were currently residing at a homeless shelter in a Midwestern city participated in three focus groups. Overall, mothers held negative perceptions of service providers related to understanding, support, and fear. Based upon this study's findings, recommendations are offered to improve service delivery and guide future research.     

Restructuring Long-Term Care in Spain: The Impact of The Economic Crisis on Social Policies and Social Work Practice

ABSTRACT

Care needs of the aging population are increasing in Southern European countries. The purpose of this article is to explore the implications of meeting these needs while taking into account the recent economic crisis, which has deeply affected countries such as Spain. This study is part of a European project (ISCH COST Action IS1102) and is based mainly on qualitative information that focuses on in-depth interviews with social service workers (n = 19) who provide the service and program recipients or their caregivers (n = 14). In addition, two discussion groups were conducted with professionals (n = 9) and program volunteers (n = 5), as well as a workshop/discussion group (n = 28) with politicians, service providers, and participants. Six thematic premises were identified with differing views being highlighted relevant to the participants' roles in the program. Future research should explore social service strategies to deal with the increase in care needs as well as community-based responses.     

Elder Abuse in Turkey and Associated Risk Factors

Abstract

Elder abuse is one of the most important problems encountered by the elderly. Health, economical and psychological dimensions of the experience of aging also pose risk for elder abuse. This study aims to determine the abuse to which elder people are exposed based upon their own evaluations and to investigate the risk factors associated with elder abuse. This is a cross-sectional study among quantitative designs. Population of the study comprises 309 outpatient elders over the age of 65 referring to Ayd?n Do?an Geriatrics Clinic of Ankara University, Turkey. Collected data were analyzed by chi-square test and logistic regression. In total, 70.9% of the elderly participating in this study experienced abuse more than once. Majority of the participants were victims of emotional abuse (64.1%), followed by neglect and abandonment (26.9%) and economic abuse (12.6%). There was significant relation between sex, marital status, health status of the elderly and being abused (p?p?相似文献   

Effects of the war on marriage relationships 1

Abstract

This article discusses the major themes that emerged from a Smith College School for Social Work student's Master's thesis, “Communication Styles in Wind River Native American Clients and the Therapeutic Responses of their Clinicians”. The project explores differences in communication styles between Wind River native people and Anglo‐Americans. Secondly, it seeks to discover therapeutic approaches and styles that are effective with Wind River native people.

Semi‐structured, exploratory interviews were conducted with ten clinicians who worked with Native American clients on the Wind River Reservation in Wyoming. The participants included mental health care professionals and paraprofessionals from the following professions: psychology, social work, counseling, nursing, and community action.

The findings of the research revealed the importance of understanding cultural differences in human interaction and meaning making as conveyed in communication style. As clinicians, these complex and often subtle differences play a crucial role in our ability to establish a therapeutic alliance and conduct sensitive, effective therapy. Many theoretical models, such as psychodynamic, cognitive and behavioral, family systems, ecological, constructionist, and narrative theories support the successful approaches discussed in the article.     

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.     

Missing Elements in the Protection of Children: Three Cases from China

ABSTRACT.

The article analyzes 3 severe cases of child abuse that were widely discussed in the mass media in China in 2007 based on a framework used by the International Society for Prevention of Child Abuse and Neglect in its official publication World Perspectives on Child Abuse. The framework sets out the basic elements that must be included in systems of child protection: a) a responsible government or government-authorized organization; b) a set of institutional arrangements for reporting cases of child abuse, investigation, and intervening when necessary; and c) state guardianship or mechanisms to remove children from their parents’ care when necessary. By applying the framework to the 3 cases under analysis, the authors found that these basic elements are missing from the Chinese child protection system, and therefore, they recommend that a reform of the system to address these elements should be a priority for Chinese social policy. The article makes a number of recommendations for reform.     

Postcards to God

Abstract

Postcards to God was a creative method to allow individuals to express their spirituality. The purpose of this study was to examine the validity of this innovative method. At a skilled nursing facility in a geriatric residence, 19 older disabled workshop participants created collage and message “Postcards to God,” and completed a brief survey. Postcard content and construction were coded and analyzed using qualitative methods around self-reports along two attitudinal dimensions: (a) making a postcard to God, and (b) level of religiousness. Spiritual and religious dimensions were related to postcard thematic content. Postcards were used for expressions of spirituality and prayer across all levels of self-reported religiousness. The Postcards project seems like a useful way to facilitate spiritual expression. If validated in further study, this method may prove a useful way to promote spiritual expression in a variety of older and frail populations.     

Further Evidence of Racial Disparities in Drug Court Outcomes: Enhancing Service-Delivery to Reduce Criminal Recidivism Rates for Non-White Participants

Abstract

The first drug court began in 1989, and since their inception, they have expanded to over 3,000 in the United States and United States territories. The long-term goal of drug courts is to reduce criminal recidivism rates for nonviolent offenders who have substance use disorders. This study adds to the literature by using secondary data to compare criminal recidivism rates between drug court participants (n?=?163) and probationers who had diagnosed substance use disorders and arrests that were eligible for drug court but they did probation instead (n?=?185). Criminal recidivism was measured up to 36?months post drug court/probation discharge, which provides a more accurate assessment of the long-term effectiveness of drug court. Furthermore, this study identified which drug court participants were most likely to recidivate. Drug court participants were less likely to recidivate than the probation group. However, differences between the two groups may have contributed to the difference in criminal recidivism rates and also suggest that screening criteria may exclude some non-White participants from drug court. Non-white participants were more likely to recidivate than their White counterparts. Implications for future research and drug court practice are discussed, focusing on enhancing the service-delivery of education and employment opportunities to non-White drug court participants.     

Pavlova and pineapple pie: Selected identity influences on Samoan‐Pakeha people in Aotearoa/New Zealand

Abstract

This paper examines influences on the increasing numbers of those with one Pakeha parent and one Samoan parent in Aotearoa/New Zealand. It is based on a small, qualitative study and utilises a narrative approach. It describes selected influences at macro, meso, and micro levels of social structure as a framework for examining how this population view themselves and construct their identities. At the macro level, post‐colonial dynamics of requiring “authenticity” from minority groups is explored, as it demands high standards of legitimacy from those of both Samoan and Pakeha ancestry. Essentialist and one drop rule theories of ethnic identity tend to classify this population as belonging solely to the Samoan category. At the meso level, these people as children are uncritically treated as if they are only Samoan. At the micro level, the influences of their nuclear and extended families tended to encourage a Samoan identity in most participants. There was a marked variation in the ways the participants interpreted their lives, despite some similarities of experience.