American Indian/Alaska Native Elderly

This article describes informarion received from a survey of agencies seving American Indian/Alaska Native elderly. Also identified within the article are some of the traditional values of older American Indian/Alaska Natives, as well as concerns regarding their mental health needs and current life situations. Recommendations for training social workers and programming suggestions are also included.     

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.     

American Indian/Alaska Native Elders: A Growing Demographic that Is Changing How We View Aging

Today, AIAN Elders are more actively engaged in their families and communities, encouraging the development of intergenerational programs, language and cultural revitalization, being stewards in research conducted in their communities, as well passing on their knowledge and experiences on how to live as healthy Native people. Elders have traditionally been quiet and observant of their environment, but the current and future cohorts of Elders are advocates, leaders, and culture bearers for their families and communities and they are now in positions of leadership. Western society acknowledges the value of traditional knowledge and AIAN Elders are viewed as exemplars of healthy aging and their lessons and experiences can be attributed to our own lives. This commentary highlights the paradigm shift in how society views older adults, specifically AIAN Elders and their role in health and wellbeing.     

An Exploratory Study of Substance Abuse Among Latino Older Adults

ABSTRACT

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

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.     

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.     

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.     

Incremental Validity of Stressful Life Experiences in Predicting Psychiatric Comorbidity Among Women in Substance Abuse Treatment

ABSTRACT

The dynamic contribution of stressful life experiences in predicting psychiatric comorbidity continues to challenge clinical practice and research. This study tested incremental validity of stressful life experiences related to psychiatric comorbidity among 128 young women in a Midwestern substance abuse treatment facility. Respondents reported low income, homelessness, and health and mental health issues. Using the Addiction Severity Index (ASI), Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision, and Stressful Life Experience (SLE) Screen as correlates, hierarchical linear regression demonstrated support for incremental validity of SLE uniquely accounting for 6.5% of variance in ASI psychiatric scores. Findings support future use of SLE in clinical settings for assessment and intervention purposes.     

The Substance Abuse Treatment Self-Efficacy Scale

Abstract

Evaluating substance abuse services in ordinary treatment environments requires the use of instruments to measure various dimensions of the intervention process in order to link those processes with client outcomes. This paper reports on the further validation of the Alcohol and other Drug Self-Efficacy Scale (AODSES), designed to measure social workers' perceived self-efficacy with regard to the implementation of substance abuse services. In the first validation study, Kranz (2003) employed exploratory factor analysis to reduce the original 98 items to six factors (43 items) that accounted for 76% of the variance, and demonstrated excellent internal consistency. The current study is a reanalysis of the same data using confirmatory factor analysis, a more stringent test of construct validity. Results were strongly supportive of a 5-factor model with seven of eight indices showing excellent fit of the observed data to the model, and high internal consistency for all subscales. Potential practical applications for clinical evaluation in substance abuse environments and limitations of the study are discussed.     

Self-Esteem and Locus of Control Among American Indian,Black, and White AFDC Recipients

This study compares the self-esteem and locus of control reported by a random sample of 322 American Indian, Black, and White AFDC recipients. Personal interviews were conducted with all respondents. No differences were found among the races on self-esteem and locus of control. Work status and education level were found to be the two demographic characteristics that were significantly correlated with the dependent measure. As such, it was expected that work and higher educational achievement would result in greater self-esteem and internal control. This was found to be true for Blacks and Whites, but not for American Indians. We therefore speculate that this may indicate the greater assimilation and enculturation of Blacks into the predominant White value structure and mainstream society, compared to American Indians.     

The Influence of Parental,Peer, and School Factors on Marijuana Use Among Native American Adolescents

ABSTRACT

Marijuana use among Native American (NA) adolescents continues to be an ongoing concern and is often cited as the most critical health issue facing this population. Despite this recognition, few studies have examined the roles played by parental monitoring and school relationships among NA youth. This cross-sectional study used secondary data from the 2010 National Survey in Drug Use and Health to examine the combined influence of parental, peer, and school indicators on marijuana use among NA adolescents aged 12 to 17 years old (N = 287). The results of structural equation modeling suggest that peer factors and parental monitoring were significantly associated with marijuana use. In fact, the peer network was the most influential predictor. However, a significant relationship was not found between school relationships and marijuana use. Given the insignificance of school relationships, further research should examine the influence of peer interactions on marijuana use and the development of family-based prevention and intervention programs.     

A Meta-Analysis of Culturally Sensitive Interventions Designed to Reduce High-Risk Behaviors Among African American Youth

ABSTRACT

This study sought to determine the effectiveness of culturally sensitive interventions (CSIs) in reducing high risk behaviors with African American youth. A meta-analysis was conducted to assess the effectiveness of CSIs across seven studies. African American youth who participated in CSIs were less likely to engage in high risk behaviors compared to those who did not participate. The effect size was moderate (g = .35). Although the findings should be considered tentative, the results provide an initial quantitative assessment of CSI effectiveness that future evaluations and meta-analyses can build upon as CSI research expands.     

School context and American Indian substance use

The present study extends prior research exploring the role of school contextual factors in predicting individual adolescent substance use by examining how a school’s racial composition is associated with American Indian adolescent tobacco and marijuana use. Using a subsample of 523 American Indian students from the restricted use Add Health data, we consider both individual and school contextual factors across 99 schools. Our results suggest that a school’s racial composition is associated with individual tobacco and marijuana use among American Indian youth, but in different ways depending upon the substance. Our findings illustrate the importance of extending research on the correlates of substance use for racial and ethnic minorities beyond studies examining African-Americans and/or Hispanics.     

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.     

AIDS Risk Behaviors among American and Australian Homeless Youth

We examined HIV/AIDS risk behaviors among homeless youth in cross-national data collected in Melbourne, Australia ( n = 398), and Los Angeles, California ( n = 498). Using structural equation modeling, we found that the Australian youth reported greater involvement in AIDS risk behaviors than the American youth and the Australian youth were more involved in intervening risk factors that promote risk behaviors and less involved with protective factors that reduce risk behaviors. Youth reporting the highest rates of delinquent behaviors also had peers engaging in delinquent acts, used alcohol and marijuana, and were more likely to utilize social services. These findings underscore the importance of having a service sector that is able to adequately address the needs of homeless youth .     

American Indian studies and its evolution in academia

This article traces the progression of American Indian Studies programs and the discipline's evolution in academia. Our research is divided into three sections. The first describes the era of the turbulent 1960s, when programs began and struggled to assert themselves as worthy of independent intellectual status. The second part focuses on American Indian studies programs' efforts to continue maturing as an interdisciplinary field of inquiry. This section includes a discussion of the evolving methods, theories, and concepts used for analysis and research concerning the diversity of American Indian cultures. There were certain structural, personnel, and curriculum problems which presented themselves along the road to academic maturity, some of which remain. The final section suggests characteristics necessary for an ideal American Indian studies program into the 21st century.     

Contextual identity experiencing facilitates resilience in Native American academics

This article discusses the socio-cultural dynamics that interact with ethno-racial identity experiencing in a previously under-researched group. A qualitative interdisciplinary study with 40 Native American academics from 28 mainstream universities across the U.S. served as a case example with findings that contrasted with historically influential theoretical frameworks postulating identity confusion and conflicts at the intersection of one’s mainstream education and profession versus one’s ethno-racial community grounding. Instead of feeling pressure to identify with only one worldview, the contextual, dynamic identities associated with the inclusive and flexible self-concept of tribal participants allowed them to in turn take advantage of two divergent cultural meaning systems pertaining to their distinct socio-cultural contexts. These shifts were experienced as not endogenous but rather exogenous variables, which did not cause the historically theorized issues. Participants felt their tribal identities instead facilitated meaningful integration of the existing incongruences, which resulted in unexpectedly resilient subjective experiencing.     

Navigating Housing Instability and Substance Use: Hidden Tensions Facing Youth in Small Town America

Abstract

Recent scholarship indicates that youth homelessness is a significant problem outside urban areas. However, previous studies have not examined how local contexts shape the experiences of youth who are homeless in rural areas and small towns with high rates of poverty and epidemic drug use. To address this gap, this analysis draws from two components of a large national study of homelessness among youth, using data collected in a small non-urban setting in the Northwest including (1) a subset of 41 (out of 215 nationally) in-depth interviews with youth and (2) a subset of 16 surveys (out of 523 nationally) with service providers. We explored availability of services and how youth navigate housing instability and the service landscape in small communities. We discovered that current or prior addictions sometimes posed risks to the safety of youth and compromised their ability to rely on family supports – a support proving critical in the absence of a formal service infrastructure. Our results suggest that youth experiencing housing instability in the context of high rates of drug use and limited formal services must often choose between meeting competing needs: a place to stay versus sobriety. We discuss the implications for policy, practice, and research.