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.     

Characteristics and Outcomes of College-Age Adults Enrolled in Private Residential Treatment: Implications for Practice

Substance use among college-age adults is of interest due to high levels of use and low levels of treatment access and engagement relative to other adults. Data collected from 1,972 clients in residential services were analyzed to investigate differences in use patterns, treatment outcomes, and other life area problems. Participants completed an Addiction Severity Index (ASI) and the University of Rhode Island Change Assessment (URICA) at baseline, and an ASI and Treatment Services Review at 1-month and 6-month postdischarge interviews. Almost a quarter (24.1%) of participants were college age (18–25 years old). They were more likely to be White and male, and less likely to complete treatment although they had a longer average length of stay. College-age adults improved on all outcome measures, and posttreatment service use shows significant difference between college-age and older participants. Implications for practice are discussed.     

Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse

The objective of this article is not to present a scientific or systematic study, but to provide an initial framework for designing a training workshop to enhance health practitioners’ (nurses, social workers, physicians, etc.) knowledge regarding substance abuse treatment and to decrease their bias toward substance-abusing women, particularly pregnant women in rural communities. We incorporated the 4 Transdisciplinary Foundations from the Substance Abuse and Mental Health Services Administration Competencies Model, with specific competencies targeted that related to provider bias. After the conference, 52 of the 70 participants completed a questionnaire to self-assess knowledge level and confidence in skill related to substance abuse management. Participant mean scores were statistically significantly higher following the conference than 1 week prior (p < .001) in the area of “gender difference with substance abuse,” moving from an average of 2.6 to 4.5 on a 5-point Likert scale. Our conference was successful in increasing attendees’ knowledge about gender difference and substance abuse among pregnant patients.     

Assessing reporting patterns of child sexual abuse within the Catholic Church using discontinuities in model parameter timeseries

Prior to 2002, little was known about sexual abuse within the Catholic Church. After the Boston Globe broke the story about John Geoghan - a priest in the Boston Archdiocese who was accused of abusing numerous children, convicted of one count of indecent assault, and eventually murdered in prison - the Church had many questions to answer. To this end, the United States Conference of Catholic Bishops (USCCB) commissioned John Jay College of Criminal Justice to research the nature and scope, as well as the causes and context of child sexual abuse within the Catholic Church.This research analyzes the data from the John Jay studies using a new quantitative technique, capable of adjusting for distortions introduced by delays in abuse reporting. By isolating discontinuities in model parameter timeseries, we determine changes in reporting patterns occurred during the period 1982-1988. A posteriori to the analysis, we provide some possible explanations for the changes in abuse reporting associated with the change-point. While the scope of this paper is limited to presenting a new methodological approach within the frame of a particular case study, the techniques are more broadly applicable in settings where reporting lag is manifested.     

Variations in the Life Histories of Incarcerated Parents by Race and Ethnicity: Implications for Service Provision

ABSTRACT

Incarcerated parents have complex life histories that often remain unresolved during incarceration, can continue to create barriers to prosocial success on release, and present similar intergenerational challenges for their children. This study examines the life histories of incarcerated fathers and mothers from the Pacific Northwest and how their experiences vary based on race and ethnicity. Five areas examined were exposure to trauma, child welfare involvement, mental health and substance abuse problems, juvenile justice and adult criminal justice involvement, and intergenerational criminal justice involvement. The sample comprised 359 incarcerated parents, and their racial/ethnic composition was 59% White, 14% African American, 11% multiracial, 8% Native American, and 7% Latino. Few differences were found across racial and ethnic groups. Mothers appeared more similar to each other across groups than fathers. Results illustrated similarities yet some surprising differences with national trends on key study variables. Implications for future research and intervention and prevention are discussed.     

城市老年人社区参与的现状及原因探析

在社区参与的实践中,老年人已成为积极而重要的力量。在社区自治程度较高、社区居委会等社区组织能够发挥核心组织力量的社区,老年人社区参与的积极性较高,而且社区参与的形式也丰富多样,主要包括文体娱乐性参与、志愿性参与和自治性参与。老年人社区参与的积极性较高,其中存在多方面原因。可以从老年人的社区参与所具备的个人条件、社区参与的收益以及社区认同感与归属感等角度进行分析。     

Malaria in Pacific populations: seen but not heard?

Most Pacific Island countries are located in the tropics, where there is an abundance of mosquitoes with the potential to carry debilitating or life-threatening vector-borne diseases. This article examines three Melanesian countries in which malaria is endemic—Papua New Guinea, Solomon Islands and Vanuatu—but the threat posed by the spread of malaria gives the issues a broader significance to the Pacific region. After discussing the spatial distribution and prevalence of malaria in the Pacific, the article examines a number of health interventions through which people have sought to control malaria. Although the disease was nearly eradicated in the Pacific in the 1970s, it is no longer in retreat. The article concludes by examining why there are still grounds for cautious optimism, and the challenges that Pacific Island countries face in reducing the impact of malaria on their populations. There is a need for prompt and concerted action on malaria at the national, regional and international levels if the public health concerns arising from the disease are to be adequately addressed.     

Clarifying the Association Between Mother–Father Relationship Aggression and Parenting

Although much research examines the association between fathers' relationship aggression and mothers' parenting, little attention is given to mothers' aggression, mutual aggression, or fathers' parenting. Using a sample of coresiding couples from the Fragile Families and Child Wellbeing Study (N = 973), the authors examine the association between mothers' and fathers' relationship aggression, measured as frequency and perpetration–victimization types (mutual, mother only, father only), and mothers' and fathers' parenting. Fixed effects regression models show that fathers' aggression is positively related to mothers' parenting stress, whereas father‐only or mother‐only aggression is related to fathers' stress. For both parents, aggression perpetration is negatively related to their own engagement with children. Mother‐only aggression is negatively related to mothers' spanking and positively related to fathers' spanking. These findings suggest the importance of examining both parents' aggression and perpetrators' as well as victims' parenting to better understand the link between relationship aggression and parenting.     

‘Do you want to do some arm wrestling?’: children's strategies when experiencing domestic violence and the meaning of age

The aim of this study is, by analysing children's and young people's discourses, to investigate their strategies in response to domestic violence episodes, in relation to their age. The empirical data come from individual interviews with children and young people (ages 8–20 years) who had experienced domestic violence and lived at refuges for abused women. The thematic analysis shows that the children describe a wide range of strategies before, during and after a violent episode, that all children act regardless of age and that strategies vary according not only to age but also to situation and context. The theoretical framework used is the sociology of childhood, and the analysis engages with theoretical concepts of age, agency and positioning.     

Peer violence in foster care: a review of the research evidence

Whilst a small amount of research has been undertaken on peer violence in residential settings, very little is known about peer violence in foster care. This paper reviews the published research since 1995 about the nature and extent of peer violence in foster care and interventions for preventing and managing these negative peer interactions. The evidence indicates that young people in foster care can be the instigators and recipients of peer violence, but the limited number of studies found means that conclusions cannot be drawn about the extent of the problem. There is some evidence about the impact of this type of violence on young people and fostering households. However, there remain gaps in the evidence about the full extent of all forms of exploitation and violence that are experienced and instigated by young people in foster care, the circumstances in which it takes place, the young people affected and its co‐occurrence with other difficulties. Critically, young people's views were largely absent from included studies, an important area that requires further research.