Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment

ABSTRACT

Despite increasing interest in “faith-based” substance abuse treatment and HIV risk reduction interventions, there is little systematic evidence of the efficacy of explicitly spiritual interventions. However, fundamental to effective interventions is an explicit conceptualization of mechanisms underlying behavior change. This paper discusses the definition of faith-based organizations, specifically as they relate to substance abuse treatment programs, briefly reviews relevant behavior change theories to identify key variables underlying change, presents an integrative conceptual framework articulating linkages between spiritual intervention components, behavior change processes and substance abuse outcomes, and discusses how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, the paper suggests that what happens in “faith-based” programs may not be so different from processes taking place in good social work practice in the addictions field.     

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.     

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery.     

Culturally Competent Substance Abuse Treatment with Latinos

Abstract

The Latino population in the United States is a complex and multifaceted population. Latinos are a very dynamic and mobile cultural group. The 2000 United States Census registered Latinos in practically every state. Clinicians involved in assessing and treating Latinos must consider a complex set of environmental and systemic cultural factors that have a direct impact on their problem and potential healing. Treatment must begin by systematically assessing the cultural fit between clinicians and clients.     

Physical Activity as a Helpful Adjunct to Substance Abuse Treatment

ABSTRACT

While limited research exists on the topic of physical activity as an adjunct to substance abuse treatment, a review of relevant multidisciplinary literature indicates a logical rationale for its potential benefits to recovery from addiction. This article provides an overview of common variables that contribute to addictive disease and summarizes the relationship of regular physical activity to improvements on many of these variables. The stages of change from the Transtheoretical Model (TTM, Prochaska & DiClemente, 1982; Prochaska & Velicer, 1997) are described in the context of effectively matching clients in substance abuse therapy to interventions that may include physical activity. Finally, important practical suggestions for implementing physical activity as a useful adjunct to substance abuse treatment are provided.     

A Narrative Approach to Groups

This paper considers the ways that narratives can be used in groups to create meaning, organize the past, explain the present and consider alternatives for the future. Narratives are formats for self-creation; they can also be used to provide support or education, promote self-understanding and interpersonal effectiveness. Already familiar in self-help groups and reminiscence groups for the elderly, narrative approaches can be useful in many other formats. In this paper I discuss ways of eliciting narratives, understanding their meaning from many perspectives and using them to promote growth and healing in groups. The group leader's role is reconfigured into that of participant observer and manager of the group process. It is up to the leader to provide a context in which multiple accounts can emerge for consideration.     

Disability and Abuse in Relation to Substance Abuse

Abstract

This analysis reviewed five years of a state's substance abuse treatment admissions and discharges in order to identify specific patterns among persons who had a disability. Using a series of group comparisons, Chi-squares, and logistic regressions, specific patterns of violence and abuse to this population were identified. Results indicate that persons who had a disability and abused substances were more likely to be victimized by physical abuse and domestic violence when compared with their peers without a disability. A person with a disability had about one-half to one-third the odds of receiving long-term residential, short-term residential and intensive outpatient care when compared with persons without a disability.     

Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

Substance Abuse Treatment with Adolescent African American Males

Abstract

The use of substances by adolescent African American males is of particular concern because of the damaging effect that drug abuse has not only on the individual and his family but also on the African American community. The literature is scant regarding treatment services and few therapeutic interventions have been specifically designed to holistically meet the needs of these youth. This article proposes the use of Afrocentricity and Reality Therapy as therapeutic bases for substance abuse treatment with this population.     

Spiritual Interventions in Substance Abuse Treatment and Prevention

Abstract

This article reviews the recent research literature related to the use of spiritual interventions in the prevention and treatment of substance abuse. Empirical outcome studies are critically reviewed and a brief overview is given of spiritual interventions which have yet to be studied empirically. Areas for further research are delineated and philosophical and methodological issues related to the study of spiritual interventions are discussed.     

Possible Indicators of Childhood Sexual Abuse for Individuals in Substance Abuse Treatment

This study reviewed the charts of 217 patients discharged from two inpatient substance abuse treatment facilities to compare clients with a history of childhood sexual abuse to clients without such a history. Approximately 1/3 of the women and 1/10 of the men reported that they had been sexually abused as children. Individuals reporting a sexual abuse history differed significantly from individuals who did not report such a history in only a few respects. They were significantly more likely to report that they were still troubled by childhood experiences, that they had been physically abused in childhood, that there were sexual issues they were reluctant to share or discuss, that they had been physically harmed by another, and that they had made one or more suicide attempts. Research needs and implications for treatment providers are discussed.     

A Peek Inside the Box: How Information Flows Through Substance Abuse Treatment Agencies

This article describes how integrated health information technology affects the collection and flow of client-level intake and assessment data within substance abuse treatment agencies. We combined process mapping and qualitative inquiry methods to analyze staff interviews (N = 54) from eight agencies in four U.S. states. Integrated health information technology was related to expedited and improved flow of information, while nonintegrated health information technology systems were associated with double data entry, multiple eligibility screenings, and different intake processes across levels of care. Process mapping is an effective tool to identify barriers to efficient client-level data management and opportunities to leverage health information technology to streamline the intake process of substance abuse treatment agencies, improve staff productivity, and enhance the accuracy and information flow.     

Counselor Turnover in Substance Abuse Treatment Centers: An Organizational-Level Analysis

This article draws on institutional and ecological perspectives on work and organizations to develop a workplace level model of variation in voluntary counselor turnover rates across privately funded substance abuse treatment centers in the United States. Results show that participatory management structures reduce turnover rates principally by promoting organizational commitment. The analysis also tests hypotheses regarding the effects on turnover rates of other relevant theoretic domains of treatment center structure and organization. We discuss theoretical implications of the findings and suggest directions for future research.     

The Efficacy of the Social Norms Approach to Substance Abuse Prevention Applied to Fraternity Men

Abstract

Students tend to overestimate the amount of alcohol consumed among their peers and often drink to that imaginary level. The social norms strategy, designed to correct norm misperceptions, has been correlated with a decrease in reported consumption in the general college population. However, it has had little or no impact among Greek students, the group that consumes the most alcohol. The authors investigated and subsequently found three possible flaws in the application of the social norms strategy that may account for the failure to decrease binge drinking among fraternity men: there is no predominant, healthy drinking norm in this population; students are influenced more by people within their network(s) than by others; and binge drinking is the norm in this group and may serve to perpetuate the problem. The findings, though preliminary, provide the first step in developing interventions beyond the social norms approach to address binge drinking among fraternity men.     

Assessing Social Work's Contribution to Controlled Studies of Adolescent Substance Abuse Treatment

ABSTRACT

Findings from a review of social work's contribution to the adolescent substance abuse treatment outcome literature between 1990 and 2001 are presented. Social work involvement in adolescent substance abuse treatment was evaluated through a computerized bibliographic search of medical and social science databases and by a manual search of 13 core social work journals. Results indicate that social work has contributed little to knowledge development in adolescent chemical dependency treatment. Investigators affiliated with a department or school of social work accounted for three of 15 controlled treatment outcome studies. Only one report was published in a core social work journal. Efforts to develop clinical guidelines in this important practice domain will founder until a sufficiently directive body of practice-relevant research accumulates to guide evidence-based substance abuse treatment for adolescents.     

The Evolution of Substance Abuse Treatment in Juvenile Justice

ABSTRACT

This paper discusses the scope of substance abuse and related problems among juvenile offenders, and describes three models of addressing the problem based on a review of current approaches, ranging from Treatment Alternatives to Street Crimes programs (TASC), to juvenile drug courts, to an integrated treatment network model. The relevant strengths and weaknesses of each in supporting lasting change in substance-abusing juvenile offenders and their families are presented, and a call to action is offered for communities wishing to aim their interventions innovatively and precisely in the direction of substance abuse among their delinquent youth.     

Adolescents in Treatment: Effects of Parental Substance Abuse on Treatment Entry Characteristics and Outcomes

SUMMARY

Research strongly supports an increased risk of substance use disorders among the adolescent children of addicted parents. However, little documentation exists of how these adolescents fare when they present for treatment. This article uses data taken from a two-state study on the effects of adolescent substance abuse treatment to examine the characteristics of adolescents with substance-abusing parents and their outcomes following an episode of outpatient treatment. Although such adolescents enter treatment with greater problem severity in a range of areas, outcomes appear similar to adolescents with no substance-abusing parents. The impact of family and individual counseling on outcomes was also examined, demonstrating mixed results for adolescents with substance-abusing parents.     

Enhancing Health-Conscious Behaviors Among Clients in Substance Abuse Treatment Programs

The physical health of substance abuse clients significantly deteriorates because of the client’s prolonged abuse of alcohol and other drugs and accompanying behaviors. The purposes of this study are (a) to understand how substance abuse clinicians think about the health needs of their clients, (b) to identify the mechanisms through which clinicians seek to enhance health-conscious behaviors among their clients, and (c) to identify how substance abuse clinicians view their role in enhancing health-conscious behaviors among their clients. A qualitative study was conducted using in-depth, semistructured interviews with substance abuse clinicians (N = 16) from 4 substance abuse treatment centers. Using the theory of planned behavior as a framework for understanding the promotion of health-conscious behaviors in substance abuse treatment, the findings suggest that substance abuse clinicians are capable of enhancing health-conscious behaviors among clients in substance abuse programs.