Predictors of client retention in alternative -to -prison substance abuse programs

Increased treatment retention among substance abusing individuals has been associated with reduced drug use, fewer arrests, and decreased unemployment, as well as a reduction in health risk behaviors. This longitudinal study examined the predictors of client retention for alternative to prison substance abuse treatment programs through assessing the roles of motivational factors and the client-worker relationship. The sample was comprised of 141 male felony offenders who were legally mandated to community based long-term residential drug treatment programs. ^ The primary measures used in the study were the consecutive days a participant remained in treatment, Stages of Change Readiness Model and Treatment Eagerness Scale (SOCRATES), the Working Alliance Inventory (WAI), and The Readiness Ruler. Hierarchical multiple regression analysis was conducted for four hypotheses (a) participants who are more motivated to change at the time of entry will remain in treatment longer, (b) participants who have a strong therapeutic alliance will remain in treatment a greater number of consecutive days than participants who have weaker therapeutic alliance, (c) motivation to change, as measured at treatment entry, will be positively related to therapeutic alliance, (d) during the course of treatment variation in motivation to change will be predicted by the therapeutic alliance. ^ Results support the following conclusions: Among clients in alternative-to prison programs the number of days in treatment is positively related to their motivation to change. The therapeutic alliance is not a predictor of the number of days in treatment. Motivation to change, particularly recognition of a drug problem, is positively related to the therapeutic alliance. Changes in motivation to change in response to treatment are positively related to the therapeutic alliance among clients in an alternative to prison substance abuse treatment programs. These results carry forward prior research and have implications for social work practice, research, and social welfare policy. ^

The use of treatment process variables to differentiate between completers and dropouts for a guided self -change adolescent substance abuse intervention

This study documented differences between substance using adolescent participants who either completed or dropped out of a brief motivational intervention. Therapeutic alliance, working alliance and patient involvement were used to describe differences in treatment process ratings in a sample of majority Latino males who either (a) completed a adolescent substance abuse intervention called Alcohol Treatment Targeting Adolescents In Need (ATTAIN) or (b) dropped out after the first or second Guided Self-Change therapy session. Fifteen-minute segments were copied from the midpoint of previously recorded audio-tapes of Guided Self-Change therapy sessions. Raters were trained to a criterion level of interrater reliability for both the Working Alliance Inventory-Short and Vanderbilt Psychotherapy Process Scale. Correlations among Working Alliance Inventory- Short and Vanderbilt Psychotherapy Process Scale subscales reflected a general similarity in the assignment of ratings to client-therapist dyads. Findings underscore why these concepts are often used interchangeably in the treatment process literature. The Vanderbilt Psychotherapy Process Scale patient participation subscale demonstrated substantial empirical differentiation from overall therapeutic alliance. Discriminant function analysis demonstrated the Working Alliance Inventory-Short goal subscale and the Vanderbilt Psychotherapy Process Scale patient participation and therapist warmth and friendliness subscales as successful classifiers of groups of mostly Latino youth based on completion status. Follow-up logistic regression analyses confirmed major findings and successfully predicted group membership. Treatment process constructs can be used as clinical tools to identify participants who may be susceptible to dropping out of treatment services. Further investigation of treatment process may enhance understanding of the influence of alliance between clients and Guided Self-Change therapists. Investigating the role of treatment process as a critical component of brief motivational interventions for substance-using adolescents will inform both practitioners and researchers regarding the effectiveness of community-based substance abuse interventions for adolescents.

Predictors of client retention in alternative to prison substance abuse programs

Increased treatment retention among substance abusing individuals has been associated with reduced drug use, fewer arrests, and decreased unemployment, as well as a reduction in health risk behaviors. This longitudinal study examined the predictors of client retention for alternative to prison substance abuse treatment programs through assessing the roles of motivational factors and the client-worker relationship. The sample was comprised of 141 male felony offenders who were legally mandated to community based long-term residential drug treatment programs. The primary measures used in the study were the consecutive days a participant remained in treatment, Stages of Change Readiness Model and Treatment Eagerness Scale (SOCRATES), the Working Alliance Inventory (WAI), and The Readiness Ruler. Hierarchical multiple regression analysis was conducted for four hypotheses (a) participants who are more motivated to change at the time of entry will remain in treatment longer, (b) participants who have a strong therapeutic alliance will remain in treatment a greater number of consecutive days than participants who have weaker therapeutic alliance, (c) motivation to change, as measured at treatment entry, will be positively related to therapeutic alliance, (d) during the course of treatment variation in motivation to change will be predicted by the therapeutic alliance. Results support the following conclusions: Among clients in alternative-to prison programs the number of days in treatment is positively related to their motivation to change. The therapeutic alliance is not a predictor of the number of days in treatment. Motivation to change, particularly recognition of a drug problem, is positively related to the therapeutic alliance. Changes in motivation to change in response to treatment are positively related to the therapeutic alliance among clients in an alternative to prison substance abuse treatment programs. These results carry forward prior research and have implications for social work practice, research, and social welfare policy.

The Effects of Peer Teaching of Infant Massage on General Self-Efficacy and Mother Infant Attachment Among Mothers in a Residential Rehabilitation Facility for Drug Addiction and Substance Abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children's school performance.

This study examined the intergenerational effects of parental conviction of a substance-related charge on children's academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. State administrative data from North Carolina courts, birth records, and school records were linked for 2005-2012. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics; for example, mother's educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. While the children of convicted parents fared worse on average, much--but not all--of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children.

Prefrontal cortical and striatal activity to happy and fear faces in bipolar disorder is associated with comorbid substance abuse and eating disorder

Background: The spectrum approach was used to examine contributions of comorbid symptom dimensions of substance abuse and eating disorder to abnormal prefrontal-cortical and subcortical-striatal activity to happy and fear faces previously demonstrated in bipolar disorder (BD). Method: Fourteen remitted BD-type I and sixteen healthy individuals viewed neutral, mild and intense happy and fear faces in two event-related fMRI experiments. All individuals completed Substance-Use and Eating-Disorder Spectrum measures. Region-of-Interest analyses for bilateral prefrontal and subcortical-striatal regions were performed. Results: BD individuals scored significantly higher on these spectrum measures than healthy individuals (p<0.05), and were distinguished by activity in prefrontal and subcortical-striatal regions. BD relative to healthy individuals showed reduced dorsal prefrontal-cortical activity to all faces. Only BD individuals showed greater subcortical-striatal activity to happy and neutral faces. In BD individuals, negative correlations were shown between substance use severity and right PFC activity to intense happy faces (p<0.04), and between substance use severity and right caudate nucleus activity to neutral faces (p<0.03). Positive correlations were shown between eating disorder and right ventral putamen activity to intense happy (p<0.02) and neutral faces (p<0.03). Exploratory analyses revealed few significant relationships between illness variables and medication upon neural activity in BID individuals. Limitations: Small sample size of predominantly medicated BD individuals. Conclusion: This study is the first to report relationships between comorbid symptom dimensions of substance abuse and eating disorder and prefrontal-cortical and subcortical-striatal activity to facial expressions in BD. Our findings suggest that these comorbid features may contribute to observed patterns of functional abnormalities in neural systems underlying mood regulation in BD. (C) 2009 Elsevier B.V. All rights reserved.

Digit Ratio (2D:4D) in Newborns: Influences of Prenatal Testosterone and Maternal Environment

Introduction: The 2D:4D digit ratio is sexually-dimorphic, probably due to testosterone action through the perinatal period. We characterize the 2D:4D ratio in newborn (NB) infants, in between the pre- and postnatal surges of testosterone, and relate it to the mother's 2D:4D and to testosterone levels in the amniotic fluid (AF). Subjects and methods: Testosterone was assayed in samples of maternal plasma and AF collected at amniocentesis. Shortly after birth, 106 NBs and their mothers were measured for 2D:4D ratio. Results: NB males had lower mean 2D:4D ratios than females but this dimorphism was significant only for the left hand (males: 0.927; females: 0.950; p=0.004). Mothers who had sons had lower 2D:4D ratios than those who had daughters and the mother's 2D:4D were higher than those of NBs regardless of sex. Both hands of NB females were negatively correlated with AF testosterone and positively correlated with the mother's 2D:4D, but males showed no significant associations. Maternal plasma testosterone also showed a negative weak correlation with NB's digit ratio in both sexes. Conclusions: Sexual dimorphism at birth was only significant for the left hand, in contrast with reports of greater right hand dimorphism, suggesting that postnatal testosterone is determinant for 2D:4D stabilization. The lower 2D:4D ratios in mothers who had sons support claims that hormone levels in parents are influential for determining their children's sex. NB female's digit ratio, but not males', was associated to the level of AF testosterone. The mother's 2D:4D ratios were positively correlated with their daughters' 2D:4D, but the same was not observed for male NBs, suggesting that prenatal testosterone levels in male fetus lead their 2D:4D ratios to stray from their mothers' with high individual variability.

Annual Report of the Elder Abuse National Implementation Group, 2006

Annual Report of the Elder Abuse National Implementation Group, 2006 The specific function of the Elder Abuse National Implementation Group (EANIG) is to overview the implementation of Protecting Our Future (Department of Health and Children, 2002) by various government agencies and other bodies. Protecting our Future became official health policy in November 2002. The group met on four occasions during 2006. I would like to thank the following members who retired from the Group for their hard work and contribution to the elder abuse programme: Ms Mary McDermott, Cllr Eibhlin Byrne, Mr Shay Costello, Ms Anne-Marie Ross and Mr Tom Leonard. A full list of current members is provided at Appendix A. Click here to download PDF 157kb

Report Against Drugs- an action plan to combat substance abuse in Longford.

The Forum for Longford was started in 1997 to provide a co-ordinated inter-agency approach to identify and help tackle social problems in Longford. A survey was carried out with 1,331 post-primary students to ascertain attitudes and behaviours towards alcohol, smoking and drug use. Of the pupils interviewed, 64% had taken an alcoholic drink at age 15 or younger; of these 73% had their first drink between the ages of 12 to 15. Of those that had experience of alcohol, 51% drank several times a week or daily. For smoking, 67% had smoked a cigarette; of these 8% smoked 5 or more daily. Of those that smoked, 47% began between the ages of 11 to 14. With regard to illegal drugs 27% had used cannabis, 20% had used inhalants, 10% hallucinogens, 9% amphetamines and 7.4% had used ecstasy. Following on form these findings, the report makes several recommendations, including the formation of a community task force, Garda/ neighbourhood watch response, schools prevention and information. Also among these key areas are the role of parents, the needs of young people and facilities for young people.This resource was contributed by The National Documentation Centre on Drug Use.

Substance abuse treatment for persons with co-occurring disorders.

This TIP, Substance Abuse Treatment for Persons With Co-Occurring Disorders, revises TIP 9, Assessment and Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug Abuse. The revised TIP provides information about new developments in the rapidly growing field of co-occurring substance use and mental disorders and captures the state-of-the-art in the treatment of people with co-occurring disorders. The TIP focuses on what the substance abuse treatment clinician needs to know and provides that information in an accessible manner. The TIP synthesizes knowledge and grounds it in the practical realities of clinical cases and real situations so the reader will come away with increased knowledge, encouragement, and resourcefulness in working with clients with co-occurring disorders. Contents: Executive Summary â?¢ 1 Introduction  2 Definitions, Terms, and Classification Systems for Co-Occurring Disorders  3 Keys to Successful Programming  4 Assessment  5 Strategies for Working With Clients With Co-Occurring Disorders  6 Traditional Settings and Models  7 Special Settings and Specific Populations  8 A Brief Overview of Specific Mental Disorders and Cross-Cutting Issues 9 Substance-Induced Disorders Appendix A: Bibliography Appendix B: Acronyms  Appendix C: Glossary of Terms Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor  Appendix E: Emerging Models â?¢ Appendix F: Common Medications for Disorders  Appendix G: Screening and Assessment Instruments  Appendix H: Screening Instruments  Appendix I: Selected Sources of Training  Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Consumers and Providers  Appendix K: Confidentiality  Appendix L: Resource Panel  Appendix M: Cultural Competency and Diversity Network Participants Appendix N: Field ReviewersThis resource was contributed by The National Documentation Centre on Drug Use.

Licensed Substance Abuse Treatment Programs, 2003

Addresses and information for licensed substance abuse programs in the state of Iowa.

L'adolescent consommateur de substances face au réseau de soins [Substance abuse adolescents and the health care network]

Substance user adolescents were asked to report on each contact they had had with any type of care providers since they had begun to use alcohol or illegal drugs regularly. Primary care doctors and social workers represent the main access to the care network. In one out of two contacts substance use was not discussed.

State of Iowa Substance Use Epidemiological Profile, February 2008.

A report by the Iowa Epidemiological Outcome Workgroup showing the substance use epidemiological profile for the state of Iowa. The data shows the consumption patterns and consequences of adults and youths, males and females in Iowa.

Iowa Substance Abuse Brief; Alcohol: Binge Drinking, May 2009, Issue 2

Binge drinking by Iowans is a serious problem. Binge drinking is commonly defined as five or more drinks of alcohol on the same occasion for men and four or more for women. The 2006 National Survey on Drug Use and Health (NSDUH) estimated that 11% (approximately 28,000) of Iowans 12-17 years of age and 51% (approximately 177,000) of Iowans ages 18-25 had engaged in binge drinking during the past month. Favorable community and peer norms about alcohol use and easy access both contribute to this problem. Consequences of binge drinking can be immediate, like alcohol poisoning or injury, or much more delayed such as an increased risk for stroke or alcoholism. In either case the results can be severe.