Multimodal treatment package for substance abuse treatment programs.

Describes a multimodal treatment design for a short-term, residential, hospital-based program for drug abusers. Each patient is expected to attend all program services with the intent that one or several will provide the corrective emotional experience facilitating change. Services included medical care, individual counseling/psychotherapy, group counseling, health education seminars, milieu/recreational therapy, Narcotics Anonymous meetings, linkage with aftercare components, and ancillary services (vocational rehabilitation, court liaison, and 90-day follow-up). Psychology interns and students are utilized. Results of internal follow-up show that 40% of Ss admitted over 3 yrs stated they were drug-free at 90 days and 1.5 yrs. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcomes of the treatment climate in psychiatric and substance abuse programs

This study examines how key aspects of the treatment climate are related to program differences in the aggregate behaviors of patients residing in 89 psychiatric or substance abuse facilities. More active support, personal expression, and practical orientation were related to better patient functioning, more patient activity in the facility and in the community, and more use by patients of the program's health-treatment services and social-recreational activities. These results held for both patients' and staff members' consensual perceptions of the treatment climate. On the whole, these aspects of the treatment milieu were especially beneficial for groups of patients with greater psychiatric impairment.     

Relapse prevention strategies in outpatient substance abuse treatment.

Reviews the use of relapse prevention (RP) strategies in the treatment of substance abuse disorders. The work of G. A. Marlatt and J. R. Gordon (1980, 1985) provided the cognitive-behavioral base of RP models and numerous techniques. Specific protocols for the treatment of alcoholism, cocaine abuse, marijuana abuse, and heroin addiction are described. This body of knowledge has given the drug-free outpatient treatment of substance abuse a clear focus and direction. The techniques used in the RP include 7 groups of strategies: psychoeducation, identification of high-risk situations for relapse, development of coping skills, development of new-life behaviors, increased self-efficacy, dealing with relapse and avoiding the abstinence violation effect, and drug and alcohol monitoring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of key informants, parents, and teenagers for planning adolescent substance abuse prevention programs.

Surveyed 102 key informants about their knowledge of adolescent substance abuse in their community. Results were compared to findings from similar surveys administered to 402 teenagers and 266 parents in the same geographic area. Key informants matched teenagers' judgments about the prevalence of alcohol and marijuana use, but overestimated other drug use. Parents greatly underestimated all drug use. Key informants, parents, and teenagers differed on attitudes toward resources for prevention and alternatives to drug use. Implications for the use of community resources in primary prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance abuse treatment for pregnant women: a window of opportunity?

Determination of the crystal structure of the human TBP-associated factor (hTAF(II))28/hTAF(II)18 heterodimer shows that these TAF(II)s form a novel histone-like pair in the TFIID complex. The histone folds in hTAF(II)28 and hTAF(II)18 were not predicted from their primary sequence, indicating that these TAF(II)s define a novel family of atypical histone fold sequences. The TAF(II)18 and TAF(II)28 histone fold motifs are also present in the N- and C-terminal regions of the SPT3 proteins, suggesting that the histone fold in SPT3 may be reconstituted by intramolecular rather than classical intermolecular interactions. The existence of additional histone-like pairs in both the TFIID and SAGA complexes shows that the histone fold is a more commonly used motif for mediating TAF-TAF interactions than previously believed.     

Child care and parenting education within drug treatment programs for pregnant and parenting women

A new method to detect the identity of unexpected antibodies in the sera of prospective transfusion recipients is presented. The method is based on a macroscopic hemagglutination inhibition assay. In this assay, incubation of phenotypically defined test red blood cells with patient sera containing non-agglutinating antibodies to one or more specific antigen systems block monoclonal IgM induction of red cell agglutination. Since the specificities of the IgM antibodies are known, the identity of the patient's antibody(ies) can be directly determined. This method, which uses only reagents that are commercially available, is specific and eliminates the use of the indirect antiglobulin test (IAT) and the use of elimination panels.     

Adolescents' perceptions of substance abuse prevention strategies

As part of a 3-year evaluation of substance abuse prevention strategies (Harding, Safer, Kavanagh, Bania, Carty, Lisnov, & Wysockey, 1996), this study examined the perceptions of 719 sixth- through ninth-grade Chicago public school students. School-based programs were rated as significantly more effective on six prevention objectives than were television ads, testimonials by famous people, billboards, and print ads displayed on public transportation. Students perceived the two school-based programs, Project DARE (a national program conducted through local police departments) and Captain Clean (an intense live theater program coordinated with student participation), as being equally effective overall, although the interactive theater program was rated as significantly better at encouraging students to talk about their feelings concerning substance abuse issues and at relating to the students' ethnic/racial backgrounds. When students were categorized according to frequency of alcohol use, nonusers, infrequent users, and frequent users differed significantly in their ratings of the school-based programs.     

Handwriting in assessing treatment for substance abuse

Analysis of Mathematics and Language Arts scores for 11,438 fourth- and 8,972 seventh-grade students in compensatory education programs on the performance assessments for the Iowa Test of Basic Skills indicated the students performed poorly, particularly in mathematics.     

Group treatment for substance abuse in schizophrenia

OBJECTIVES: A review of the relevant research suggests a need to develop an appropriate, effective, and replicable treatment to help individuals with schizophrenia and substance abuse problems. This pilot study describes a biweekly group specifically designed to help the individual with both schizophrenia and substance abuse. The components of the group were support, psychoeducation, and skills training. Attention was also paid to the stage of recovery. METHOD: Eighteen subjects attended the group and were assessed pregroup. Thirteen subjects completed a 1-year follow-up, and 5 subjects were assessed between 3 and 6 months. RESULTS: At the follow-up assessment, 8 subjects (44%) were abstinent. CONCLUSIONS: This type of treatment appears to be effective for reducing substance abuse in this population.     

Computer-assisted strategies for substance abuse prevention: Opportunities and barriers.

This article presents an analysis of the potential role that computer-assisted strategies could play in substance abuse prevention efforts in the future. Four primary areas are addressed. First, substance abuse prevention is discussed within the context of adolescent development. Second, computer-assisted instruction (CAI) is defined in terms of the opportunities it represents for substance abuse prevention. Third, a variety of barriers are described that must be addressed if the potential of CAI for enhancing substance abuse prevention efforts is ever to be realized. Finally, recommendations are made for coordinating research and development efforts, now and in the future, so that the potential of new technology for improving substance abuse prevention efforts will be adequately evaluated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting training for women in residential substance abuse treatment. Results of a demonstration project

This paper presents findings on the impact of implementing a parenting component in two urban residential treatment programs in Massachusetts for pregnant and parenting chemically-dependent women. The parenting component consisted of multiple services for both women and their infants while they were in residential treatment as well as aftercare services after discharge from treatment. Findings presented focus on: (a) the characteristics of the 170 pregnant and parenting women who participated in the parenting component during its 48 months of implementation; (b) changes in the parenting skills and self-esteem of women who completed parenting training; (c) the quality of mother-child interaction; and (d) the participants' perceptions about the impact of the parenting training. Women in both programs made dramatic improvements in self-esteem and experienced significant gains in parenting knowledge and attitudes. The participants were also overwhelmingly positive about the impact of the parenting training on their lives. Study findings underline the importance of parenting services for pregnant and parenting women in residential substance abuse treatment.     

Maternal mental health and integrated programs for mothers with substance abuse issues.

To examine the impact of integrated treatment programs (those with substance use treatment and pregnancy-, parenting-, or child-related services) on maternal mental health, we compiled a database of studies of integrated programs published between 1990 and 2007 with outcome data on maternal mental health. There were 18 cohort studies, 3 randomized trials, and 2 quasi-experimental studies. Of the five studies comparing integrated to nonintegrated programs, three studies provided enough information to allow for them to be combined in a meta-analysis. The average effect size was 0.23 (95% CI = 0.15 to 0.31, SE = 0.04), p Q = 5.66, p = .059. This meta-analysis is the first systematic quantitative review of studies evaluating the impact of integrated programs on maternal mental health. Findings suggest that integrated programs may be associated with a small advantage over nonintegrated programs in improving maternal mental health. This review highlights the need for further research with improved methodology, study quality, and reporting to improve our understanding of how best to meet the mental health needs of mothers with substance abuse issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cost-effectiveness of inpatient substance abuse treatment

OBJECTIVE: To identify the characteristics of cost-effective inpatient substance abuse treatment programs. DATA SOURCES/STUDY SETTING: A survey of program directors and cost and discharge data for study of 38,863 patients treated in 98 Veterans Affairs treatment programs. STUDY DESIGN: We used random-effects regression to find the effect of program and patient characteristics on cost and readmission rates. A treatment was defined as successful if the patient was not readmitted for psychiatric or substance abuse care within six months. PRINCIPAL FINDINGS: Treatment was more expensive when the program was smaller, or had a longer intended length of stay (LOS) or a higher ratio of staff to patients. Readmission was less likely when the program was smaller or had longer intended LOS; the staff to patient ratio had no significant effect. The average treatment cost $3,754 with a 75.0% chance of being effective, a cost-effectiveness ratio of $5,007 per treatment success. A 28-day treatment program was $860 more costly and 3.3% more effective than a 21-day program, an incremental cost-effectiveness of $26,450 per treatment success. Patient characteristics did not affect readmission rates in the same way they affected costs. Patients with a history of prior treatment were more likely to be readmitted but their subsequent stays were less costly. CONCLUSIONS: A 21-day limit on intended LOS would increase the cost-effectiveness of treatment programs. Consolidation of small programs would reduce cost, but would also reduce access to treatment. Reduction of the staff to patient ratio would increase the cost-effectiveness of the most intensively staffed programs.     

Overview of substance abuse acupuncture treatment research

The research on the efficacy of acupuncture substance abuse treatment is generally still in an early stage. The methodological weaknesses found in the acupuncture research can be found in most substance abuse research. Sufficient early trial, empirical findings suggest that there are positive treatment effects. Certainly, use of the treatment is popular and widespread. Overall, the research has progressed beyond early clinical trials, and the method has been documented to be safe and potentially useful.     

Comorbidity of schizophrenia and substance abuse: Implications for treatment.

The problem of substance abuse disorders in schizophrenia patients is reviewed, including the prevalence of comorbid disorders, assessment, hypothesized mechanisms underlying abuse, and the clinical effects of abuse on the course of illness and cognitive functioning. The principles of treatment for dual-diagnosis schizophrenia patients are outlined, and the limitations of existing interventions are noted. Gaps in current knowledge about the impact of substance abuse on schizophrenia and its treatment are identified, and suggestions are made regarding promising avenues of research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression prevalence and incidence among inner-city pregnant and postpartum women.

A sample of 192 financially impoverished, inner-city women was assessed for clinical depression twice during pregnancy and once postpartum. At the first and second antepartum interviews, respectively, 27.6% and 24.5% of the women were depressed, controlling for pregnancy-related somatic symptoms. Postpartum depression was found among 23.4% of women. These rates are about double those found for middle-class samples. Particularly heightened risk for antepartum depression was found among single women who did not have a cohabiting partner. African American and European American women did not differ in rates of depression. Antepartum depression was a weak but significant risk factor for postpartum depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent substance abuse treatment outcome: The role of substance abuse problem severity, psychosocial, and treatment factors.

A structural equation model incorporating substance abuse problem severity, psychosocial risk and protection, and treatment variables examined adolescent drug abuse treatment outcome pathways across 6- and 12-month follow-up points. Findings on resiliency factors and an empirical method adapted from previous research were used to select and assign 10 psychosocial factors to either a multiple protective factor index or a risk factor index. Gender, substance abuse problem severity, treatment modality, treatment length, and aftercare participation were also examined as outcome predictors. The findings suggest that treatment intensity decisions may be better informed by pretreatment psychosocial risk level rather than by substance abuse problem severity. The present study also suggests that drug-abusing adolescents who receive sufficiently long treatment, participate in aftercare, and possess at least 1 individual or interpersonal protective factor during their recovery process have the best chance to maintain gains made during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)