Empowered and self-managing users in methadone treatment?

Empowerment is a keyword in treatment. Users should have the means and possibilities to influence their treatment and become self-managing. Drawing on ethnographic fieldwork in a Danish methadone treatment project, we find that the practices of users and staff are often not carried out in accordance with governmental intentions. We identify a gap between the official notions of treatment and practices. We analyse the notions and practices of empowerment by applying two analytical perspectives. First, we apply a constructionist perspective in which empowerment is analysed as wanting to set users ‘free’ but also as ways to govern. We elaborate the analysis by applying a more practice-oriented focus. Drawing on this perspective, we analyse the ways in which staff and users constantly produce, construct and negotiate institutional practices that differ from the governmental intentions for treatment.     

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.     

孙中山的人学思想及其现实意义

孙中山的人学思想产生于19世纪末20世纪初的近代中国,是在其"致力国民革命四十年,求中国之自由平等"的斗争实践中逐渐形成的。它内涵丰富、意蕴深远,涉及互助人性论、民生观、自由平等观、"生元"说以及人生观等方面的内容。探讨发掘孙中山的人学思想中蕴含的积极合理成分,在当代无疑具有重要的现实意义。     

Confidence Corridors for Multivariate Generalized Quantile Regression

We focus on the construction of confidence corridors for multivariate nonparametric generalized quantile regression functions. This construction is based on asymptotic results for the maximal deviation between a suitable nonparametric estimator and the true function of interest, which follow after a series of approximation steps including a Bahadur representation, a new strong approximation theorem, and exponential tail inequalities for Gaussian random fields. As a byproduct we also obtain multivariate confidence corridors for the regression function in the classical mean regression. To deal with the problem of slowly decreasing error in coverage probability of the asymptotic confidence corridors, which results in meager coverage for small sample sizes, a simple bootstrap procedure is designed based on the leading term of the Bahadur representation. The finite-sample properties of both procedures are investigated by means of a simulation study and it is demonstrated that the bootstrap procedure considerably outperforms the asymptotic bands in terms of coverage accuracy. Finally, the bootstrap confidence corridors are used to study the efficacy of the National Supported Work Demonstration, which is a randomized employment enhancement program launched in the 1970s. This article has supplementary materials online.     

A Multi-Dimensional Conceptual Framework for Trauma-Informed Practice in Addictions Programming

Previous research has conceptualized trauma-informed practice in relation to five key values: safety, trust, choice, collaboration, and empowerment. This research identifies key organizational, programmatic, and interpersonal characteristics in community-based residential addictions treatment programming that exemplify each of these principles. Utilizing qualitative research methods, involving open-ended, one to one interviews with clients in residential substance misuse treatment (n = 41), respondents identified the importance of experiencing “safety” in relation to physical safety, confidentiality, reassurance, rule enforcement, and peer relationships. “Trust” was manifested in sharing, staff availability, nonjudgmental interactions, positive relationship dynamics, and caring. “Choice” was articulated in relation to individual needs, participation, opportunities, and focus of efforts. “Collaboration” was characterized in relation to opportunities for feedback, planning, goal setting, specificity, and support. Finally, “empowerment” was characterized by comfort in sharing, trigger management, trauma awareness, and understanding. The findings provide a conceptual framework for a trauma-informed social services organizational practice environment. Findings can inform adaptations to social service delivery processes and programs to become aligned with the values of trauma-informed practice. Future research can build on this framework by testing the study findings with quantitative methods along with replicating current methods in other social service delivery sectors.     

试从课堂提问探究大学英语课堂中的“平等交际”

调查分析苏州某一院校的两位英语教师的课堂提问模式,从提问的类型、提问后的等候时间、反馈形式以及回答问题的方式总结归纳了两位教师的课堂提问情况,提出了大学英语课堂中四种有利于师生“平等交际”的途径。     

Examining implementation and preliminary performance indicators of veterans treatment courts: The Kentucky experience

Veterans’ Treatment Courts (VTCs) are posited as a solution to offer rehabilitation for veterans involved in the criminal justice system. Despite the pervasive implementation of VTCs, there is little research focused specifically on VTC implementation and outcomes, which are based on other problem-solving court models such as drug court. The current study presents qualitative process evaluation data from key stakeholders (n = 21) and veteran participants (n = 4) to show accomplishments, challenges, and lessons learned during first-year implementation at two VTC sites. Quantitative performance data is also presented on veteran participants (n = 19) served during the first year to show: types of services, monitoring, judicial interaction, sanctions/therapeutic responses, and rewards, as well as preliminary data on recidivism. Qualitative data, from both key stakeholders and veteran participants, suggests that offering rehabilitation via various program components, services/referrals, and accountability are critical to the success of the VTC. Data also provides valuable lessons learned for VTC implementation including communication, collaboration, information/protocols, and resources. Performance data shows that a variety of services are utilized and that frequent judicial interaction, drug testing, and sanctions are cornerstones of the VTC. Implications and future directions for research are discussed.     

How can context and discourse affect teachers’ and mental health professionals’ interactions with adults with mental illness?

Patients with severe mental illness may have needs different from those of patients with more limited illnesses and might benefit from other types of intervention than traditional treatment. We interviewed health care professionals from two open, short-term psychiatric wards and teachers from two schools for adults with psychiatric diagnoses. The focus was to explore how differences in contextual factors such as time, tasks, and organizational demands might affect the actions and attitudes of health care professionals and teachers, as well as the potential consequences for patients and students. Data were collected through qualitative interviews. Participants included 14 health care professionals and 14 teachers. The informants worked with patients and students with similar diagnoses and illness durations. All interviews were conducted during the informants’ work time. Findings and interpretations showed that both teachers and health care professionals were engaged in their work and in the wellbeing of students and patients. However, they described marked differences in practice, including the amount of time spent with students/patients, the organization of their work, main tasks, amount of control over their tasks, and social structure. These differences seemed to affect relationships with students/patients, attitudes toward students/patients, norms and values, and opportunities for patient empowerment. Our findings suggest that while existing psychiatric health care might be appropriate for limited short-term problems such as single-episode depression, a model with a supportive environment, based on stable relations and possibility for learning, may improve personal development and mental health for persons with severe mental illness and disturbances in self-experience.     

工业共生研究综述

工业共生作为工业生态系统的重要特征和实现途径已经引起学者们的关注。然而,目前工业共生的理论研究仍处于起步阶段,侧重于相关概念的阐释和理论平台的搭建,大致形成了工业共生链网结构、形成动因、网络治理和评价研究等几个方面。未来的研究应综合运用产业生态学、管理学、经济学相关理论及分析方法深入研究工业共生形成机理和稳定运行的规律性问题,由此为我国发展循环经济、建设生态工业园提供必要的理论支持。