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Substance abuse can have such a destructive impact on a family that it can both interrupt and transform the entire family's life. The impact of chronic illness on the family has been researched primarily from a stress-coping paradigm. Within the mental health literature, the impact of one family member's mental illness on other family members has begun to be investigated in a systema-tic and scientific manner. Within a stress-coping paradigm, the results of this empirical research have borne out the tremendous objective and subjective burdens placed on family caregivers (Biegel, Song, and Chakravarthy, 1994; Lefley, 1996). This article suggests that the impact of substance abuse on families may also be conceptualized within this paradigm and posits an evidence-based stress-coping model for conceptualizing this process. [ABSTRACT FROM AUTHOR]

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of "spiritual transformation" in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement. [ABSTRACT FROM AUTHOR]

The development of cultural competency skills is important for a clinician in any cross-cultural setting where a working knowledge of the client's culture is important to the delivery of services. This paper suggests that incorporating attendance at Twelve Step recovery programs may begin to facilitate cultural competency for students, or at the very least provide exposure to the culture through a cross-cultural experience. From the perspective of cultural competency, an understanding of the culture of Twelve Step groups is important to any clinician working with clients who may be referred to, and/or are members of a Twelve Step group. This article defines cultural competency, applies this to the culture that has developed around Twelve Step groups, and provides a model of integrating Twelve Step meeting attendance into addictions coursework as a mechanism for development of cultural responsiveness with addicted clients. [ABSTRACT FROM PUBLISHER]

The article focuses on spiritual mechanisms underlying substance abuse behavior change in faith-based substance abuse treatment. Several definitions of faith-based organizations are being discussed. An integrative conceptual framework articulating connections between spiritual intervention components, behavior change processes and substance abuse outcomes is presented. Faith-based substance abuse treatment programs concerns the distinction between religion and spirituality. The article states that the ecological perspective and the model of social work practice provide for the incorporation of the element of personal spirituality, and therefore spiritual change, in viewing any individual presenting for services. A number of human and social service organizations have been addressed by faith-based programs. It has been found that religious or spiritual involvement may serve as a protective factor against the development of substance abuse problems. During substance abuse treatment some spiritual changes occur and substance abuse interventions may be effective for those for whom religion or spirituality is salient.

A structured diagnostic interview (Practical Adolescent Diagnostic interview) designed to gather basic information about substance use disorders, other mental health conditions, and related experiences was used in a variety of clinical settings. Anonymous data from 279 adolescents interviewed as part of routine clinical assessments in a variety of clinical programs were analyzed to assess the ability of the questions to identify potential problem areas and to provide a preliminary exploration of interrelationships between those problems. Results demonstrated that the vast majority of individuals manifested indications of multiple problems. For a given diagnostic condition, the trend is for those meeting at least the minimal DSM-IV criteria to exhibit substantially more than the minimum number of symptoms. Internal consistencies for item groups defining the various conditions range from more than .700 to over .900 indicating adequate to excellent internal consistency and reliability. Utility of the instrument for routine clinical use is also discussed. [ABSTRACT FROM AUTHOR]