Physical and Sexual Abuse,Battering, and Substance Abuse

Abstract

Women born before 1945 are the older women of today. Many of these women were subjected to childhood physical and sexual abuse and spouse battering at a time where there were no laws to protect them and few people discussed such subjects. Some of these women became substance abusers or lived with substance abusers. While there are retrospective studies on the experiences of adult women who suffered abuse in the family, little is known about the experiences of women over the age of 60 years.

Similarly, there is information on substance abuse among young and middle-aged women, but very little information on or about older womens' experiences with substance abuse. In this study, we review the literature on abuse and substance abuse. We present three clinical cases of older women who have experienced various forms of abuse and who in turn abuse substances. The cases are analyzed. Assessment, treatment, and evaluation methods for social workers are discussed.     

Coping Styles in Persons Recovering from Substance Abuse

This qualitative study was conducted among persons recoveringfrom substance abuse. The data were collected in three rehabilitationfacilities in Trinidad in 2002–03. The aim was to examinethe types of coping strategies which subjects used and learnedin response to stressful and problematic life situations, startingwith experiences related to childhood and socialization. Thecoping styles reported were overwhelming in the category ofemotion-focused coping, developed in the main to regulate stressin uncontrollable situations in childhood and to cope with theloss of significant others. Only a minority used, or were ableto use, problem-focused or social support coping strategiesto meet stressful events. It is suggested that the observedbias in the development of the individuals’ coping ‘armamentarium’might have had, in the long run, negative implications for individuals’capacity to meet ongoing challenges of life. This has criticalimplications for how we fashion preventive approaches to theproblem of substance abuse.     

Korean Version of the Revised Problem-Oriented Screening Instrument for Teenagers Substance Use/Abuse Scale: A Validation Study

ABSTRACT

The objective of this study is to validate the Korean version of the revised Problem-Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse scale for measuring adolescent substance abuse problems. The Korean version of the revised POSIT was validated with a sample of 1,051 students in grades 7–12 in Korea. Exploratory factor analysis identified that the Korean version of the revised POSIT is a unidimensional screening instrument similar to the English version. The Korean version of the revised POSIT showed high internal consistency reliability and good convergent validity and demonstrated optimal performance at a cut-off score of 1, which was the score recommended by its developer. The Korean version of the revised POSIT is a reliable and valid instrument for measuring Korean adolescent substance abuse. However, validation with clinical samples is needed to improve its ability to correctly capture substance-abusing adolescents.     

Examining Protective Factors for Dysthymia Among Individuals Attending Substance Abuse Treatment

ABSTRACT

Dysthymia affects millions of people and has been associated with impaired psychosocial and occupational functioning and poor clinical treatment outcomes. Yet few studies have examined protective factors that can be utilized to help individuals with dysthymia in clinical settings, particularly among individuals with comorbid substance use disorders. The purpose of this study was to examine the potential protective quality of adult attachment dimensions, spirituality, and meaning in life among clients with and without dysthymia in treatment for addiction. Data were obtained from 305 self-report questionnaires administered to clients attending a residential substance abuse treatment center. Approximately 25% of the sample met criteria for dysthymia. Results from logistic regression analyses indicated that purpose and meaning in life and attachment anxiety were the most important protective factors against having dysthymia. These results suggest that mental health professionals may need to integrate these protective factors into the treatment of individuals with dysthymia and substance use disorders, which may enhance treatment outcomes and maximize treatment effectiveness. Future studies should continue to explore protective factors that can assist individuals who experience these comorbid conditions and consider replicating this study using an ethnically diverse sample and other clinical settings to determine the generalizability of the findings.     

Perceptions of Students about Younger and Older Men and Women who May Be Homeless

ABSTRACT

Future human service providers will interact with homeless persons in health, mental health, and social service practice contexts. This study investigated the perceptions of students enrolled in social work courses who are pursuing degrees in human service programs toward older and younger female and male homeless individuals. Respondents (N = 207) were given one of four vignettes in which a character was identified as an older male, a younger male, an older female, or a younger female who was frequently seen near an interstate highway, talking to him/herself and appearing unkempt, thin, and frail. Most respondents perceived the vignette character as mentally ill, neglectful of health, likely to have HIV, tuberculosis, hepatitis A and/or hepatitis B and/or hepatitis C, likely to experience suicidal thoughts/ideation, and to have head lice/scabies/body lice. Older men were more likely to be perceived as military veterans with a history of mental illness and substance abuse. Older women were least likely to be perceived as having a history of substance abuse or using a handout to purchase ethanol. Older women were perceived to be homeless because they could not afford other living accommodations. A general linear model revealed significant differences in 7 of 41 items that respondents answered based on the gender and age of the vignette characters. These perceptual differences between male and female homeless persons will require additional investigation.     

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.     

Implementing a Gero-Infused Curriculum in Advanced-Level MSW Courses in Health,Mental Health and Substance Abuse: An Evaluation

This article presents evaluation results from a curricular innovation aimed at increasing the capacity of social work graduates to serve older adults in health, mental health, and substance abuse settings. Working as a team, faculty developed, incorporated, and evaluated gerontology-infused syllabi and teaching modules in multiple sections of the 3 courses, with 2 sections serving as a comparison group. Results indicated that students exposed to the gero-infused curriculum increased their age-related knowledge and self-competence from pre- to posttest, and achieved a greater increase in knowledge than did the comparison group. Implications of the findings to social work education are discussed.     

Treatment Utilization Among Metropolitan and Nonmetropolitan Participants of Corrections-Based Substance Abuse Programs Reentering the Community

ABSTRACT

This study examines differences in drug use and recidivism outcomes at 12 months postrelease from jail or prison as a function of geographic location and treatment utilization. Participants (N= 700) were previously enrolled in drug treatment during the last 6 to 9 months of their incarceration and were released to the community on either parole or serve-out. Findings from this study indicated that offenders returning to metropolitan areas reported more use of community treatment services following release than offenders in nonmetropolitan areas. Although offenders in both metropolitan and nonmetropolitan areas who reported community treatment following release were less likely to be reincarcerated, community treatment utilization was not a significant correlate of relapse. Findings are discussed, and future directions include favorable outcomes when community treatment is utilized.     

Skills for Recovery: A Recovery-Oriented Dual Diagnosis Group for Veterans with Serious Mental Illness and Substance Abuse

Individuals with serious mental illness (SMI) are at a high risk for abusing alcohol and illicit substances relative to the general population. This use, even in small quantities, can negatively affect mental and physical health. Group therapy is an evidence-based treatment for individuals dually diagnosed with SMI and a substance abuse disorder. The Skills for Recovery group used a recovery-oriented therapy manual for dual diagnoses and was informed by the International Association for Social Work with Groups' Standards for Social Work Practice with Groups throughout the development and implementation of the group.     

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.     

Coping Strategies and Relapse of Substance Abusers: A Case Study of the Therapeutic Community Program in Indonesia

The present study examined the ability of people with substance‐dependence problems to cope with stressful events and refrain from resuming alcohol drinking and the use of drugs. This study specifically examined the length of time that substance abusing‐residents spent in a state‐owned, residential‐based therapeutic community program at Lembang‐Bandung, West Java, Indonesia. A study sample of 68 residents completed a questionnaire with four sections. The results of this study showed no significant differences in the scores rating the coping behavior of the residents according to the length of stay in the program. This study also found no significant differences in the Coping Behavioral Inventory scores of the residents according to the level scores of total Coping Strategy Inventory. It is important for social workers to understand the relationship between the length of stay of residents and their ability to cope so that they can effectively engage in intervention work with individuals with substance‐dependence issues who participate in the therapeutic community.     

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.     

Lesbians and Alcohol Abuse: Identifying Factors for Future Research

ABSTRACT

This article explores the reasons why lesbians become substance abusers more frequently than individuals in the heterosexual population. A variety of reasons for this phenomenon are explored using 18 studies to assist in helping to identify reasons for the higher rate of substance abuse among the lesbian population. Factors identified as crucial for further research include: self-esteem, social identity and the influence of bars on substance abuse, the prevalence of suicide, disclosure identification, coming out, religious influence, sexual abuse, and gender self-presentation (butch-appearing masculine/femme-appearing effeminate).     

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.     

Asian Carers' Perceptions of Care Assessment and Support in the Community

Within a study of the use of carer assessment forms, Asian carerswere given the opportunity to describe and comment on theirperceptions and experiences of community care assessment andsupport. Although their confidence in community care workerswas not exclusively related to ethnicity, they relied a greatdeal on semi-informal contacts with minority ethnic workersthrough their own local communities. The concept of ‘friendship’with professionals was important to many Asian carers. In commonwith the findings of other carer studies, many Asian carerswere uncertain about their experience of formal assessment andunclear about their entitlements and availability of communitycare support. ‘Outreach’ contact and ‘befriending’support was greatly appreciated. Day-care and sitting supportwere seen as a priority for formal services. Apart from contactwith general practitioners, there was limited awareness or experienceof community health-care support. Most of these Asian carerswere involved with carer support groups. They spoke of the benefitsin terms of social interaction and mutual support, counteractingfeelings of isolation, and access to information and formalsupport.     

Religion and Spirituality as Defined by Older Adults

ABSTRACT

This exploratory qualitative study examined the intrinsic definitions of spirituality and religion across three different religious or ethnic groups of older adults – Jewish, African American Protestants and Caucasian Protestants. The study explores how older adults from these various backgrounds self-identify with the terms religion and spirituality. Because both African-Americans and Jewish older adults are underrepresented in the research on spirituality and religion, their inclusion lends insights to this topic and helps to anchor the findings in a cross-cultural context. Focus groups were employed to understand how these groups characterize their relationship to spirituality and religion. Social work professionals can utilize these findings to work more effectively with the diverse and complex issues of older adults.     

Exploring the Dynamics of Middle-Aged and Older Adult Residents' Perceptions of Neighborhood Safety

This study examined what variables best predict concerns about neighborhood safety among middle-aged and older adults. Eighty-five participants were selected from a Midwestern urban area. Participants completed a 22-item questionnaire that assessed their perceptions of neighborhood safety and vigilance. These items were clustered as: (a) community care and vigilance, (b) safety concerns, (c) physical incivilities, and (d) social incivilities. Police crime data were also used in the analyses. Our findings suggest that aspects of the broken window theory, collective efficacy, and place attachments play a role in affecting residents' perceptions of neighborhood safety.     

Community capacity and micro-economic development: a study from Peru

A secondary analysis of survey data collected in 1999 was conducted to explore the associations between community capacity and micro-economic development in 20 communities of Peru's mountain region. Elements of community capacity are human capital, social capital and organisational resources. Indicators of micro-economic development are annual household income in soles (Peruvian currency) and perceptions of changes in income and property. Findings revealed that human capital was the most significant predictor of income. Social capital was a significant predictor of the belief that amount of property had increased but not a significant predictor of the belief that incomes had increased. Participation in a development programme for a year or more was the only significant predictor of all three indicators of micro-economic development.