Early impact of the BEST intervention for parents stressed by adolescent substance abuse.

Youth involvement in substance abuse can be a source of considerable distress for their parents. Unilateral family interventions have been advocated as one means by which concerned family members can be supported to assist substance-abusing family members. To date there has been little research examining the impact of unilateral family interventions on the directly participating family members. In this study the early impact of an 8-week parent-group programme known as Behavioural Exchange Systems Training (BEST) was evaluated using a quasi-experimental, waiting list control design. The professionally led programme had been developed to support and assist parents in their efforts to cope with adolescent substance abuse. Subjects were 66 parents (48 families) accepted for entry into the programme between 1997 and 1998. Comparison was made between 46 parents offered immediate entry into the programme and 20 parents whose entry to the programme was delayed by an 8-week waiting list. At the first assessment 87% of parents showed elevated mental health symptoms on the General Health Questionnaire. Evidence suggested exposure to the intervention had a positive impact on parents. Compared to parents on the waiting list, parents entered immediately into the intervention demonstrated greater reductions in mental health symptoms, increased parental satisfaction, and increased use of assertive parenting behaviours.

Narcotics Anonymous participation and changes in substance use and social support

In Victoria (a southern Australian state) in 1995, Narcotics Anonymous had a small but growing membership providing an opportunity to study the early experience of new self-help members. Ninety-one new members were interviewed and 62 (68%) were reinterviewed after 12 months. Three measures of self-help participation were examined: service role involvement, step work, and stable meeting attendance. Lower prior involvement in treatment services and greater participation in self-help predicted subsequent self-help participation. Higher levels of secondary school education predicted service role involvement and longer periods in stable meeting attendance. Higher self-help participation through the 12 months prior to follow-up was associated with lower levels of hazardous alcohol use and higher emotional support at reinterview. Multivariate regression analysis suggested stable self-help meeting attendance and step work continued to predict reductions in hazardous alcohol use and improvements in social support, after controlling for a range of alternative predictors.

Change for the BEST: family changes for parents coping with youth substance abuse

This paper reports family changes for participants in a program for parents coping with youth substance abuse. The Behavioural Exchange Systems Training (BEST) program is a professionally-led, parent training intervention. During 1996 and 1997, six groups of parents participated in the program. High levels of depression were observed at intake and symptoms demonstrated a stable reduction in association with exposure to the program. Parents tended to achieve success in developing common strategies for assertively managing family problems, though couples from more complex blended families found this more difficult. Adolescent improvements were noted during the weeks observed. A two year follow up conducted with a subset of families revealed that parents continued to report that the intervention had helped them cope with youth drug abuse.

Factors influencing the relationship between sexual abuse and academic achievement

This study examined factors expected to influence the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. It was found that sexual abuse combined with either low intelligence, substance abuse, internalising behaviour problems or externalising behaviour problems predicted poor academic achievement. The supporting portfolio aims to discuss the proposed relationship between attachment and adolescent depression, highlighting the clinical relevance of this body of research with four cases of adolescent depression.

Readiness for substance abuse treatment amongst Victorian prisoners

The thesis examined treatment readiness in offender rehabilitation. Findings empirically refuted the notion that treatment readiness occurs in sequential progression through stages. Instead the study offered two treatment readiness models based on concurrent states of thought and behaviour. Furthermore, the treatment readiness models were found to be significantly predicted by offenders' cognitive styles and self-efficacy. The portfolio seeks to demonstrate, through four case studies, how different variables within the three-part ecological framework can either promote or constrain the reintegration process of ex-prisoners and ex-offenders.

An examination of a proposed DSM-IV pathological gambling hierarchy in a treatment seeking population: similarities with substance dependence and evidence for three classification systems

Toce-Gerstein et al. (Addiction 98:1661–1672, 2003) investigated the distribution of Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) pathological gambling criteria endorsement in a U.S. community sample for those people endorsing a least one of the DSM-IV criteria (n = 399). They proposed a hierarchy of gambling disorders where endorsement of 1–2 criteria were deemed ‘At-Risk’, 3–4 ‘Problem gamblers’, 5–7 ‘Low Pathological’, and 8–10 ‘High Pathological’ gamblers. This article examines these claims in a larger Australian treatment seeking population. Data from 4,349 clients attending specialist problem gambling services were assessed for meeting the ten DSM-IV pathological gambling criteria. Results found higher overall criteria endorsement frequencies, three components, a direct relationship between criteria endorsement and gambling severity, clustering of criteria similar to the Toce-Gerstein et al. taxonomy, high accuracy scores for numerical and criteria specific taxonomies, and also high accuracy scores for dichotomous pathological gambling diagnoses. These results suggest significant complexities in the frequencies of criteria reports and relationships between criteria.

Is access to alcohol associated with alcohol/substance abuse among people diagnosed with anxiety/mood disorder?

To investigate the relationship between access to off-license alcohol outlets and areas with dual treatment for alcohol/drug abuse and anxiety/mood disorder compared to areas with anxiety/mood disorder only in an urban setting in New Zealand.

Patients with substance use and personality disorders: a comparison of patient characteristics, treatment process, and outcomes in Swiss and U.S. substance use disorder programs

Cross-cultural comparisons may increase our understanding of different models of substance use treatment and help identify consistent associations between patients' characteristics, treatment conditions, and outcomes.

The role of substance abuse treatment in preventing human immunodeficiency virus transmission among injecting drug users

This exploratory study assesses the utility of substance abuse treatment as a strategy for preventing human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs). Data analyzed in this study were collected in San Antonio, TX, 1989 through 1995 using both qualitative and quantitative methods. Qualitative data included ethnographic interviews with 234 active IDUs; quantitative data included baseline risk assessments and HIV screening plus interviews follow-up interviews administered approximately six months later to 823 IDUs participating in a Federally-funded AIDS community outreach demonstration project.^ Findings that have particularly important implications for substance abuse treatment as an HIV prevention strategy for IDUs are listed below. (1) IDUs who wanted treatment were significantly more likely to be daily heroin users. (2) IDUs who want treatment were significantly more likely to have been to treatment previously. (3) IDUs who wanted treatment at baseline reported significantly higher levels of HIV risk than IDUs who did not want treatment. (4) IDUs who went to treatment between their baseline and follow-up interviews reported significantly higher levels of HIV risk at baseline than IDUs who did not go to treatment. (5) IDUs who went to treatment between their baseline and follow-up interviews reported significantly greater decreases in injection-related HIV risk behaviors. (6) IDUs who went to treatment reported significantly greater decreases in sexual HIV risk behaviors than IDUs who did not go to treatment.^ This study also noted a number of factors that may limit the effectiveness of substance abuse treatment in reducing HIV risk among IDUs. Findings suggest that the impact of methadone maintenance on HIV risk behaviors among opioid dependent IDUs may be limited by the negative manner in which it is perceived by IDUs as well as other elements of society. One consequence of the negative perception of methadone maintenance held by many elements of society may be an unwillingness to provide public funding for an adequate number of methadone maintenance slots. Thus many IDUs who would be willing to enter methadone maintenance are unable to enter it and many IDUs who do enter it are forced to drop out prematurely. ^

Towards a new model of care: integrating mental health, substance use, and somatic care

Although research and clinical interventions for patients with dual disorders have been described since as early as the 1980s, the day-to-day treatment of these patients remains problematic and challenging in many countries. Throughout this book, many approaches and possible pathways have been outlined. Based upon these experiences, some key points can be extracted in order to guide to future developments. (1) New diagnostic approaches are warranted when dealing with patients who have multiple problems, given the limitations of the current categorical systems. (2) Greater emphasis should be placed on secondary prevention and early intervention for children and adolescents at an increased risk of later-life dual disorders. (3) Mental, addiction, and somatic care systems can be integrated, adopting a patient-focused approach to care delivery. (4) Recovery should be taken into consideration when defining treatment intervention and outcome goals. (5) It is important to reduce societal risk factors, such as poverty and early childhood adversity. (6) More resources are needed to provide adequate mental health care in the various countries. The development of European guidance initiatives would provide benefits in many of these areas, making it possible to ensure a more harmonized standard of care for patients with dual disorders.

The development and implementation of a new data collection instrument for the 1994 National Household Survey on Drug Abuse /

"April 1996"--T.p. verso.

Alcohol and drug abuse in medical education /

"Proceedings of the National Conference on Medical Education in Alcohol and Drug Abuse, jointly sponsored by the Association for Medical Education and Research in Substance Abuse and the Career Teacher Program in Alcohol and Drug Abuse (ADAMHA) November 5-6, 1977, Washington, D.C.": p. 75-131.

Policy report of the Physician Consortium on Substance Abuse Education, 1991 /

Shipping list no.: 91-780-P.

Learning factors in substance abuse /

Mode of access: Internet.