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Sosiaali- ja terveydenhuollon suunniteltujen uudistusten myötä asiakkaiden ja palveluiden ohjaus on noussut esiin yhtenä keskeisenä kehittämisen kohteena. Ohjauksen käsitteitä on useita, ja niiden käyttö vaihtelee kontekstin mukaan. Tässä tutkimuksessa mielenkiinnon kohteena oli erityisesti osallisuuden näkyminen ohjauksen eri käsitteissä ja niiden sisällöllisissä kuvauksissa. Osallisuus liittyy keskeisesti sosiaali- ja terveysalalla sekä asiakaslähtöisyyteen että mielenterveys- ja päihdetyössä yhtenä lähtökohtana olevaan toipumisorientaatioon. Tutkimuksen tarkoituksena oli selvittää, mitä ohjauskäsitteitä suomalaisissa mielenterveys- ja päihdetyötä koskevissa raporteissa on käytetty, mitkä ovat näitä käsitteitä kuvaavat tekstisisällöt ja mitkä näkökulmat näissä sisällöissä kuvastuvat. Tutkimus toteutettiin dokumenttianalyysina, ja aineisto analysoitiin sekä määrällisesti että laadullisesti. Analyysin tuloksena tunnistettiin kolme käytettyä ohjauksen käsitettä sekä kolme näkökulmaa, joista työntekijän näkökulma painottui eniten ja asiakkaan näkökulma vähiten. Tulosten perusteella voidaan todeta, että mielenterveys- ja päihdetyön alueella ohjauksen käsitteitä tulisi sekä sisällöllisesti kuvata tarkemmin että edelleen kehittää, jotta ne mahdollistavat asiakkaan osallisuuden. Tätä kehittämistyötä tulisi toipumisorientaation lähestymistavan mukaisesti tehdä yhdessä mielenterveys- ja päihdepalvelujen käyttäjien kanssa. Abstract Concepts of guidance in the context of mental health and substance abuse care – is client involvement enabled? Changes in the social and health care services as well as the development and utilization of the new technological methods in the everyday practice of the social and health care, have revealed a need to increase the competence of staff in different guidance activities. This need was recognized in several studies especially in the planning phase of the social and health care reform. In practice, several concepts are nowadays used when describing guidance. In the presented study the main interest was on the concepts used in the context of mental health and substance abuse care, in which the recovery approach with strong emphasis on client involvement is the main approach today. With the document analysis the aim was to describe which concepts of guidance have been used in the Finnish reports on mental health and substance abuse care, the content of these concept descriptions and the perspectives their present. Data was gathered with stepwise PRISMA process. As a result, three concepts describing the guidance were found and the most common perspective in these concepts was the employee’s perspective, two others being the client’s and service perspectives. Client perspective was the least described in the contents of these concepts, which indicates that the participation of the client is not made visible or well-supported in practice. It should be noted that this study has certain limitations, but the results are suggesting a need to develop the concepts of guidance towards more client-inclusive descriptions. It is recommended to work together with people with lived experience on mental health and substance abuse problems in this development process. Keywords: guidance, involvement, mental health and substance abuse services, document analysis

In Sweden, trained social workers ultimately determine the right to social assistance (SA). This paper examines how a substance-abusing SA applicant’s gender and ethnicity affect assessments on eli ...

Background: Substance abuse problems can be described as developing through a set of progressive stages. The adolescent period, it self is more vulnerable for beginning of various substance abuse. Adolescents usually begin to use legal drugs like tobacco, alcohol and then cannabis and other illicit drugs. Objective: To determine the socio-demographic profile of substance using children and adolescents in a community setting. Methods: 150 families were selected using systematic sampling with random start from a well-defined community. The study was carried out in two phases. In phase I 74 families were identified who had children in this age group 10-19 yrs. There were total of 141 children in this age group. They were further screened for substance use through interview of parents and children. In Phase II, Children who had been found to have used some psychoactive substance were taken in the case study group. Similar number of children who were not using any psychoactive substance was selected for control group from the same 150 families. Both the study group children and control group children were evaluated in detail for Sociodemographic information & nature and extent of substance use by using ICD-10 Diagnostic Criteria For Research. Results: The mean age of the both groups was comparable and males predominated (60.5%) in both group. In both groups, educational level was similar but there was higher number of children who were currently attending school in the control group. Majority of school drop-outs were seen from the study group. (57.9% as compared to 28.9% in the control group). This was statistically significant. ). The prevalence of substance use was found to be around 27%. In our study the most commonly used substance was tobacco & Mishri was the most common form used. Chewing tobacco, cigarette and gutkha were various other tobacco containing products used. Further, Mishri was more commonly used by females, while cigarette and gutkha were more commonly used by males. Of the 23 tobacco dependent children 20 were above the age of 16 years. This finding was statistically significant. (P < 0.05). Only the males were found to use alcoholic beverages and all these boys were above the age of 16 years, Beer was the most common form used. Conclusion: Study findings can be used to generate awareness in the community regarding antecedents of substance abuse and the problems arising from it. Community based-longitudinal studies are needed to understand multiple factors influencing alcohol use and recommend targeted preventive measures.

Purpose The purpose of this paper is to explore, describe and interpret two research questions: How do persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging? How do residential support staff experience promoting a sense of belonging for persons with co-occurring mental health and substance abuse problems, living in a supportive housing? Design/methodology/approach Individual semi-structured interviews were conducted with five persons with co-occurring mental health and substance abuse problems living in supportive housing in a Norwegian district. In addition, one semi-structured focus group was conducted with nine residential support staff. All interviews were transcribed verbatim and analyzed using thematic analysis. Findings Analysis resulted in three main themes: “I do not go to sleep in my pajamas”, “Do I have a choice?” and “Be kind to each other”. Research limitations/implications More research on how inclusive practices that are commonly described in guidelines actually affect the experience of residents and residential support staff is needed. Practical implications Practices that incorporate a communal and contextual understanding when assigning supportive housing are warranted. Originality/value By paying attention to the components of social recovery, this paper provides a nuanced understanding of how persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging. In addition, residential support staffs’ experiences with promoting a sense of belonging for this group are explored.

This 17-year prospective study applied a social-developmental lens to the challenge of distinguishing predictors of adolescent-era substance use from predictors of longer term adult substance use problems. A diverse community sample of 168 individuals was repeatedly assessed from age 13 to age 30 using test, self-, parent-, and peer-report methods. As hypothesized, substance use within adolescence was linked to a range of likely transient social and developmental factors that are particularly salient during the adolescent era, including popularity with peers, peer substance use, parent–adolescent conflict, and broader patterns of deviant behavior. Substance abuse problems at ages 27–30 were best predicted, even after accounting for levels of substance use in adolescence, by adolescent-era markers of underlying deficits, including lack of social skills and poor self-concept. The factors that best predicted levels of adolescent-era substance use were not generally predictive of adult substance abuse problems in multivariate models (either with or without accounting for baseline levels of use). Results are interpreted as suggesting that recognizing the developmental nature of adolescent-era substance use may be crucial to distinguishing factors that predict socially driven and/or relatively transient use during adolescence from factors that predict long-term problems with substance abuse that extend well into adulthood.

Rehabilitating substance-abusing offenders is difficult. And while correctional interventions that target problematic attitudes and cognitions have proven to be successful at reducing recidivism, t...

Tässä teoksessa ollaan kotona. Tutkijat kuljettavat lukijan hyvinvointityön tekijöiden kotikäynneille ja asumisessaan tukea tarvitsevien asiakkaiden luokse. Hyvinvointityön tekijöillä viitataan sosiaali- ja terveysalan ammattilaisiin, joista kirjassa ovat edustettuina muun muassa sosiaalityöntekijä, sosiaaliohjaaja ja sairaanhoitaja. Koti, hyvinvointityö ja haavoittuvuus ovat kirjan pääkäsitteet, joita tarkastellaan eri tulokulmista. Hyvinvointityössä kohdataan eri tavoin haavoittavissa elämäntilanteissa olevia ihmisiä keskellä arkea. He saattavat tarvita tukea mielenterveyden hallintaan, fyysisiin sairauksiin, raitistumisen, toipumisen ja kuntoutumisen haasteisiin tai vaikkapa vanhuuden mukanaan tuomiin vaikeuksiin. Yhtäältä heidän toimijuutensa on rajallista ja heikkoa, mutta toisaalta heillä on myös monenlaisia vahvuuksia ja voimavaroja. Kirja kiinnittyy merkittävään hyvinvointipalveluiden ja -työn murrokseen, jossa yhteiskuntapoliittisiksi tavoitteiksi on määritelty jokaisen oikeus omaan kotiin ja kotona asumisen turvaaminen mahdollisimman pitkään. Monet yhteiskunnalliset tekijät ovat viimeisten noin viidenkymmenen vuoden aikana mahdollistaneet laitosten purkamisen, laitospaikkojen vähentämisen, laitoshoitojaksojen lyhentämisen, avohoidon kehittämisen, pienten asuin- ja hoitoyksiköiden rakentamisen sekä viimeisimpänä kotiin vietävien palveluiden kehittämisen. Tätä laitosten purkamisen viimeisintä vaihetta kirjassa kutsutaan kotikäänteeksi. Kotikäänne on yhteiskunnallisena muutossuuntana kompleksinen – ja sellaisena sitä myös kirjassa käsitellään. Kun koti on hyvinvointipolitiikan ja -työn keskeinen toteuttamisen paikka, on tärkeää tutkia lähemmin sitä, mitä kotikäynneillä konkreettisesti tapahtuu ja mitä erityiskysymyksiä näihin liittyy. Teos on ajankohtainen puheenvuoro hyvinvointipalveluiden kehittämisestä ja hyvinvointityön tekemisen arjesta. Siinä hyödynnetään etnometodologiaan ja ihmismaantieteeseen sitoutunutta vuorovaikutuksen tutkimusta. Aineistoina käytetään kotikäyntien nauhoituksia, tutkijan kenttäpäiväkirjoja sekä työntekijä- ja asiakashaastatteluja. Kokonaisuus sisältää sekä taustoittavia käsiteteoreettisia lukuja että empiirisiä tutkimuksia asiakkaan ja työntekijän kotikäyntikohtaamisista. Kotona tehtävään hyvinvointityöhön liittyy monia jännitteitä ja eettisiä kysymyksiä, joita teoksessa jäsennetään ja tehdään näkyväksi tutkimuksen keinoin. Painettu teos on tilattavissa verkkokaupoista (mm. Booky.fi, Suomalainen.com ja Adlibris.com). Sisällys 1 Johdanto: Koti hyvinvointityön ja haavoittuvuuden kohtaamisen ympäristönä / Suvi Raitakari, Kirsi Günther & Jenni-Mari Räsänen Osa I Koti käsitteellisenä ilmiönä 2 Kotikäänne: Hyvinvointipalveluiden ja -työn muutos / Suvi Raitakari & Kirsi Juhila 3 Koti asiakkaan ja työntekijän kohtaamispaikkana / Kirsi Juhila 4 Kotiin paikantuvan tutkimuksen metodologisia lähtökohtia / Kirsi Juhila, Johanna Ranta & Suvi Holmberg Osa II Kotona tehtävän hyvinvointityön käytäntöjä 5 Kotikäyntityön rajat ja rajattomuus mielenterveys- ja päihdekuntoutuksessa / Kirsi Juhila & Suvi Raitakari 6 Koti päihdetyön näyttämönä: Kotikäyntityön aloituksia ja päättämisiä ohjaavat kehykset / Kirsi Günther 7 Haittojen vähentäminen ja asunto ensin -malli huumeita käyttävien asumisen tuessa / Johanna Ranta & Riikka Perälä 8 Kotiin kietoutuva tiedonkeruu aikuissosiaalityössä / Jenni-Mari Räsänen 9 Riskit ja luottamus syrjäseudun aikuissosiaalityön kotikäynneillä / Suvi Raitakari, Henna Takala & Sirpa Saario Osa III Koti kuntoutumisen, hoivan ja sairastamisen paikkana 10 Kotona katkolla: Asiakkaan arki osana kotiin vietävää katkaisuhoitoa / Suvi Holmberg & Johanna Ranta 11 Neuvottelut toimijuudesta aikuissosiaalityön asiakkaiden kotikäynneillä: Selontekoja ja vastarintaa / Suvi Raitakari, Kirsi Günther & Ilkka Vuorinen 12 Vanhan ihmisen haavoittuvuus ja hoivateknologia kodissa / Hilla Kiuru, Marjo Outila & Heli Valokivi 13 Muuttuuko koti sairaalaksi? Potilaiden ja hoitajien käyttämät tavarat ja tilat kotona / Riikka Lämsä, Mia Niemi & Marjaana Seppänen 14 Kotikäänteen ja kotiympäristössä tehtävän hyvinvointityön kompleksisuus / Suvi Raitakari, Kirsi Günther & Jenni-Mari Räsänen In this edited volume the authors take the reader on welfare workers’ home visits to clients in need of support in their living. Welfare workers refer to professionals in health and social care who in the book are represented among others by social workers, social care workers and nurses. The main concepts of the book are home, welfare work and vulnerability and these are contemplated from different angles. Welfare work entails encountering people who are in vulnerable situations in the midst of their everyday lives. They may need support in coping with their mental health, with physical illnesses, with the challenges of achieving sobriety and recovery or perhaps with the difficulties accompanying old age. On the one hand their ability to act is limited and weak but on the other they have many kinds of strengths and resources. The book addresses a significant turning point in welfare services and work at which the objective is defined as the right of every individual to their own home and making living at home feasible for as long as possible. In the last fifty years or so many societal factors have made possible the dismantling of institutions, the reduction of places and the shortening of stays in institutions, the further development of care in the community, the construction of small residential and care facilities and most recently the further development of services to be taken into people’s homes. The last stage of this dismantling of institutions is referred to in the book as the “home turn”. As a societal change the home turn is complex – and that is how it is approached in the book. When one’s own home is the main place in which welfare policy and work are implemented, it is important to scrutinize more closely what actually occurs there and what special issues are connected to this given context. The book offers a timely point of view on the development of welfare services and the grass-root level welfare work done in the homes. It draws on interaction research based on ethnomethodology and human geography. Research data consist of recordings of home visits, researchers' field diaries and interviews with clients and workers. The volume includes both chapters providing conceptual and theoretical overviews and empirical research on the encounters between client and worker(s) on home visits. Welfare work accomplished in people’s homes entails many tensions and ethical issues which are analysed in the book and made visible through the means of research. Available in print from online bookstores (e.g. Booky.fi, Suomalainen.com and Amazon Europe).

In a treatment facility in Nigeria community meeting has been an effective strategy in substance abuse management for identifying and addressing motivation in the treatment, insight and judgment, self-esteem, psychotic symptoms, readiness for treatment etc. The components of community meeting significantly facilitate effective transition in stages of change. This research utilised information from various meetings, individual interviews and Focus Group Discussion. The study also obtained information about substance use from files of 211 participants previously admitted from 2014 – 2020, descriptive statistics using SPSS version 20 was utilized in the analysis. The analysis show that male were predominant at 91.9% with a mean of 1.08, 24.6% primary substance of abuse is alcohol and the most common substance abused at 29%. Clients admitted with psychotic symptoms were 47.9% and 29% common problematic substance is cannabis and 65% of them are within the ages of 21-30 years, while 45% of them have used other psychoactive substances like opioids and cocaine. The qualitative study reveals that all the components of community meeting significantly contributed positively in the management of clients. Consequently, community meeting gives people experiencing addiction the opportunity to self-examine, express, and adapt to techniques of living a substance free life effectively. This gathering allows all categories of clients interact freely and respectfully given way to teaching, learning and mentoring. The researchers therefore, suggest that though substance abuse problems may not vary, however, the approach to addressing this problem should be tailored in a ways that reflects the people and their culture.

Much has been written about intimate partner homicide (IPH), but empirical examinations have been less rigorous and mostly descriptive in nature. The purpose of this paper is to provide an exploration of the characteristics of fatal intimate partner violence (IPV) cases.,A direct comparison of fatal IPHs with both a matched sample of non-fatal IPV cases and a random selection of non-fatal IPV cases is made on a number of offence, offender, victim characteristics and risk-relevant variables.,Despite assertions that domestic homicide is different than domestic violence, in general, few notable differences emerged among the groups. Prior domestic incidents differed between the matched fatal and non-fatal cases, where a greater proportion of the homicide perpetrators had a prior domestic incident. Other differences that were found revealed that more non-fatal perpetrators had substance abuse problems, younger victims and been unemployed at the time of the offence. However, differences were minimal when fatal and non-fatal IPV perpetrators were matched on demographic features and criminal history.,This study highlights that there may be few features that distinguish IPH and non-fatal violence. Rather than be distracted with searching for risk factors predictive of fatality, we should evaluate IPV risk using broad-based approaches to determine risk for reoffending and overall severity of reoffending.

The incarcerated population has been substantially burdened by syndemic productions involving mental health illness and substance abuse problems. The present analysis describes the mental health symptoms of a nonprobability sample of 225 formerly incarcerated men and establishes the types of perceived support they received during incarceration as predictors of their psychological well-being upon release. The men were between 35 and 67 years of age; the mean age was 47.27 ( SD = 6.64), and Blacks and Latinos were about equally represented. Most respondents did not finish high school, were unemployed, convicted of a nonviolent crime, and were housed in a New York state prisons. The majority were also single (never married) and had children. The findings indicate that greater social, community, and spiritual support were correlated with lower mental health scores. The strongest predictor was perceived social support. Access and use of social resources, including social support, are important factors in influencing the psychological functioning among formerly incarcerated men.

Objectives: To explore the association of family-related adversities with physical fighting, and whether this association is mediated by hopelessness.Methods: The sample consisted of 3712 Slovak adolescents (mean age: 13.9, 50.7% girls). Participants answered questions regarding experienced family-related adversities, involvement in physical fighting in the last 12 months and the Hopelessness Questionnaire. First, the association of family adversities in general with fighting and of each of family-related adversity separately was assessed using linear regression models and second, mediation was assessed using the a*b product method with bootstrapped 95% confidence intervalsResults: Adolescents who had experienced at least one family adversity reported more frequent fighting. Similarly, each of reported family adversities (death of a parent, substance abuse problems of a parent, conflicts/physical fights, divorce) was associated with more frequent fighting among adolescents. The mediation effect of hopelessness was found in each association of family-related adversity with fighting.Conclusion: These findings suggest that interventions to support adolescents who had experienced family adversities could among other things be directed at better coping with hopelessness.

BACKGROUND: Suicide rates in the United States have been consistently increasing since 2005 and increasing faster among females than among males. Understanding circumstances related to the changes in suicide may help inform prevention programs. This study describes the circumstances associated with suicides among females in the United States using the National Violent Death Reporting System. METHODS: We analyzed the circumstances of suicides occurring from 2005 to 2016 in 16 states (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin) among females aged 10 years and above. We compared the percentages of circumstances reported for the entire sample, by age group, and by race/ethnicity. Trends in changes in the leading circumstances were analyzed using Joinpoint regression. RESULTS: From 2005 to 2016, there were 27,809 suicides among females 10 years and older in the 16 states. Overall, the 2 leading precipitating circumstances were current mental health problem and ever treated for mental health problem. The leading circumstances differed by demographics. Joinpoint analysis showed inflection points in reports of job problems, financial problems, and non—intimate partner relationship problems during 2005–2009. During 2010–2016, downward inflections were seen in reports of job problems and financial problems and upward inflections in substance abuse problems and a recent or impending crisis. CONCLUSIONS: These findings show changes by age group and race/ ethnicity in the circumstances associated with suicides among females in the 16 states have occurred. Studying these shifts and identifying the most salient circumstances among female suicide decedents may help prevention programs adapt to different needs.

Att ta hand om patienter som är aktivt missbrukande är en utmaning. För att bättreförstå de svåra relationer som kan uppstå i mötet mellan patienter som harmissbruksproblem och sjuksköterskan är det viktigt att identifiera dessarelationsproblem. Ett av de stora problemen är misstro till patienter när de har smärta.Syftet med litteraturstudien var att identifiera faktorer som påverkar sjuksköterskan imötet med patienter som har missbruksproblem. Metoden var en allmänlitteraturstudie med åtta vetenskapliga artiklar som analyserades med hjälp av femsteg för analys av kvalitativ forskning. Resultatet presenteras i tre kategorier;sjuksköterskans kompetens, sjuksköterskans kulturella bakgrund och erfarenhet samtsjuksköterskans hjälpmedel. Faktorer som påverkar sjuksköterskan i mötet medpatienter som har missbruksproblem är sjuksköterskans kompetens, kulturellabakgrund och erfarenhet men också vilka hjälpmedel som finns tillgängligt försjuksköterskans omvårdnad. Konklusionen är att när sjuksköterskan visarengagemang och icke-dömande stöd i mötet med patienter som har missbruksproblemkan en god vårdrelation med öppen kommunikation och god smärtlindring uppnås. Taking care of patients who are actively abusive is a challenge. To better understandthe difficult relationships that can arise in the meeting between patients who havesubstance abuse problems and the nurse, it is important to identify these relationshipproblems. One of major problem is mistrust of the patients when they are in pain. Thepurpose of this literature study was to identify factors that affect the nurse's in theencounter with patientes who have substance abuse problems. The method was ageneral literature study with eight scientific articles that were analyzed using fivesteps for analysis of qualitative research. The results were presented in threecategorie's; the nurse´s competence, the nurse´s cultural background and experienceand the nurse´s aids. Factors that affect the nurse in the meeting with patients whohave substance abuse problems are the nurse´s competence, cultural background andexperience also what aids are available for the nurse’s nursing. The conclusion is thatwhen the nurse shows commitment and non-judgemental support in the meeting withpatients who have substance abuse problems, good care relationship with open communication and good pain relief can be achieved.

Prison-based therapeutic communities (TCs) are a widespread, effective way to help incarcerated individuals address substance abuse problems. The TC philosophy is grounded in an explicitly relational paradigm that entails building community and conditioning residents to increasingly take responsibility for leadership therein. Although TCs are based on cultivating a network that continuously integrates new residents, many common structural features can jeopardize TC goals and are hence discouraged (e.g., clustering, homophily). In light of this tension, analyzing the TC from a network perspective can offer new insights to its functioning, as well as to broader questions surrounding how networks integrate new members. In this study we examine a men’s TC unit in a Pennsylvania prison over a 10-month span. Using data on residents’ informal networks, we examine: (1) how well individuals integrate into the TC network across time, (2) what predicts how well residents integrate into the TC, and (3) how well the TC network structure adheres to theoretical ideals. Results suggest that individual integration is driven by a range of hypothesized factors and, with limited exceptions, the observed TC is able to foster a network structure and integrate residents consistent with TC principles. We discuss the implications of these results for evaluating TCs and for understanding the process of network integration.

Recovery, a prominent concern in mental health care worldwide, has been variously defined, requiring further clarification of the term as processual. Few studies have comprehensively addressed the nature of recovery processes. This study aims to explore the nature and characteristics of experiences of recovery as processual. The method used is a form of qualitative meta-synthesis that integrates the findings from 28 qualitative studies published during the past 15 years by one research group. Three meta-themes were developed: (a) recovery processes as step-wise, cyclical, and continuous, (b) recovery as everyday experiences, and (c) recovery as relational. These themes describe how recovery is intertwined with the way life in general unfolds in terms of human relationships, learning, coping, and ordinary everyday living. This meta-synthesis consolidates an understanding of recovery as fundamental processes of living in terms of being, doing, and accessing. These processes are contextualized in relation to mental health and/or substance abuse problems and highlight the need for support to facilitate the person’s access to necessary personal, social, and material resources to live an ordinary life in recovery.

Aim: There is a lack of knowledge about how adolescents with substance abuse problems manage after taking part in treatment. It is also difficult to perform traditional follow-up studies with this group. This article presents the outcome of a prospective study of 455 adolescents who underwent outpatient treatment, based on data taken from official registers. It aims to describe and analyse indications of continued use of substance (CUS) and how various risk and protective factors predict outcomes after initiated treatment at a Maria clinic in Sweden. Design: The study is based on structured interviews at intake, and the data that indicated CUS were taken from several different national registers. The analyses included descriptive data and bivariate associations, logistic regressions and a CHAID analysis. Results: Almost two thirds of the adolescents have no indication of CUS at one-year follow-up. The ten studied risk factors independently were weak predictors of CUS and it was instead the accumulation of risk factors that were linked to a negative outcome. Conclusion: The majority of adolescents who start outpatient treatment for substance abuse problems return to a lesser extent in registers that may indicate a continued problem with alcohol and drugs one year later. A concentration of more than five risk factors appears to be associated with a registration. The study also provides an example of an alternative method for following up adolescents with alcohol and drug abuse problems.

During the coronavirus pandemic, many behavioral health professionals providing psychotherapeutic services, including couple/marriage and family therapists (C/MFTs), quickly changed from providing in-person services to telebehavioral health (TBH) services, with specific reliance on teleconferencing. Many therapists were thrust into telehealth with minimal or no prior telebehavioral health experience, education, or training. Although TBH services have been shown to be effective and efficient with mental health and substance abuse problems, the teaching and learning of telebehavioral competencies have generally not been included in the formal education and training received by C/MFTs. This article presents an existing interprofessional telebehavioral health competencies framework not before published in C/MFT journals. This article will also demonstrate how those competencies are applicable to the education, training, and practice of telebehavioral health by C/MFTs. Implications for educational, service, and regulatory organizations are presented.

‘I think it’s recognised that everybody wants a crack and one of the key things is having a club that reflects our community, and decision-making mechanisms that represent our community.’ Phil Duncan is a member of the Gomeroi Nation and elected representative of the Gomeroi Nation Native Title Claimant Group. He has a long history working in Aboriginal Affairs across a number of portfolios, including organisational reconciliation, cultural safety training, and natural resource management. He is the president of the Pearlers Netball Club and has had representative coaching roles with the Lloyd McDermott Rugby Union Development Team, NSW Rugby League Koori U16’s and Redfern All Blacks Women’s Team. Phil recently co-founded the Soapy Rowe Aboriginal Rugby League team, a Moree-based community sports program which uses sport to help young people with substance abuse problems.

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18-25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.

Aim: The article describes similarities and differences regarding various risk factors between girls and boys with substance abuse problems who begin outpatient treatment at the Maria clinics in Sweden. Potential hypotheses and some implications are also discussed. Methods: This cross-sectional study was based on interview data from 2169 adolescents obtained over three years from outpatient clinics in 11 Swedish cities. Results: Girls appear to consistently have more difficult family and childhood environments than boys, and are more likely to have problems related to school, more serious substance abuse problems, and more severe mental health problems. Criminal activity is significantly higher among boys. Conclusions: The study shows that girls entering treatment generally have significantly more risk factors than boys and thus more extensive problems in several aspects of life, which in turn increases the risk of developing serious drug and alcohol problems in adulthood. The study supports the gender-paradoxical relationship in which a smaller proportion of girls than boys enter treatment for substance abuse, even though girls tend to have more problematic life situations.

We describe a 26-year-old man who underwent Metacognitive-Focused Occupational Therapy for his substance abuse problems.

Although research indicates significant associations between exposure to certain types of media and men’s participation in high-risk behaviors, less is known about the potential mediating role of masculinity ideology, which is also linked to risk behaviors. Accordingly, the purpose of the present study was to investigate the relation between multiple forms of media, masculinity ideology, and participation in high-risk behaviors among a sample of 449 undergraduate men from a U.S. Midwestern university. Survey results indicated that overall television use, sports television, and movie viewing were significantly associated with stronger endorsement of masculinity ideology. Masculinity ideology, in turn, was associated with sexual risk-taking, alcohol use, drug use, and speeding while driving. Furthermore, masculinity ideology was found to mediate the relation between these media formats and risk outcomes. These findings highlight several ways in which various media formats and traditional masculine norms promote behaviors that put men at increased risk for sexually transmitted diseases, substance abuse problems, and physical injury.

The importance of examining positive aspects of youth development has been emphasized across disciplines involved in the care of youth with substance abuse problems. However, little is known about the strengths of adolescents with substance abuse problems, especially youth entering residential treatment. Utilizing the Strengths Assessment Inventory, a measure assessing psychological and social strengths, we examined patterns of strengths across groups of age- and gender-matched youth who reported no substance use, frequent substance use, and those entering treatment for severe substance use. Each group consisted of 43 participants ranging in age from 14 to 18 years. Results indicated that, on average, individuals entering treatment scored lower on personal strengths. However, through the use of more sophisticated statistical approaches, it was found that certain strengths were predictive of individuals belonging to the treatment group. Results are discussed in terms of their relevance to the treatment of adolescent substance abuse problems.

Families that have had to cope with the drink or drug problems of one or more of its members could no doubt agree that substance abuse problems generally make for very unhappy families. And when de...

Background: Mothers of adolescents with substance abuse problems experience significant distress as a result of the adolescent’s behaviours. Methods: Using an interpretative phenomenologica...

Parental incarceration impacts millions of children in the United States and has important consequences for youths’ adjustment. Children of incarcerated parents are at risk for a host of negative psychosocial outcomes, including substance abuse problems. Using data from a statewide survey of youth behavior, the effect of present and past parental incarceration on youths’ report of their substance use behaviors was examined. Present and past parental incarceration was significantly associated with use of alcohol, tobacco, marijuana, and prescription drugs, as well as substance abuse and dependence. Implications for practice and research are discussed.

Prior research on the consequences of imprisonment for the family suggest that incarceration of so-called petty offenders is most harmful for families, yet few studies provide a clear description of who is and is not a petty offender and how best to make such distinctions. We compare various ways of categorizing inmates (using preprison family involvement and characteristics related to criminality and child well-being) to better understand heterogeneity in the consequences of paternal incarceration for children. In our analysis, we find that differentiating between “harmful” and “helpful” fathers is rather difficult, and reform efforts that are overly reliant on criminal offense categories may not be the most gainful policy approach in terms of benefit to children. We also describe a small population of children who appear to benefit from paternal incarceration: children of fathers with severe substance abuse problems. The pattern of results suggests that providing alternative interventions to incarceration, rather than no intervention at all, is critical to improving outcomes for all children of incarcerated parents.

"This book is well timed and critically needed because it is a unique focus specifically working with the individual drug abuser which is written within the Carl Rogers’ person-centered approach. This book is matchless and deeply insightful. Bryant-Jefferies offers critical wisdom from his many years of counseling persons with substance abuse problems and brings into the text the guidance and skill of an experienced supervisor. No doubt this book will remain a reference for a long time to come for all of us working in the field of counseling persons with drug abuse problems."— Dana Murphy Parker, in her Foreword, Professor of Nursing, Arizona Western College, Board of Directors, The International Nurses Society on Addictions "Counselling a Recovering Drug User has a story line that gripped me like a magnet from cover to cover. The reader will come away with a heightened awareness and increased knowledge of the complexities of dealing with people who have a drug-related problem. Many people will benefit from this book. The lay reader will find the book an engaging read whilst gaining some insight into the world of drug users and the counselling process. Actual and potential clients may need this and gain encouragement about the benefits of person-centred counselling. Health professionals will find this book provides an easy-to-follow explanation of Carl Roger’s counselling model and a unique view on how the counselling relationship allows a troubled client to grow and heal. I enjoyed this book immensely. I highly recommend this book to anyone who has an interest in drug users’ problems and the therapeutic relationship."— Dr Peter C Robinson, in his Foreword General Practitioner, Surrey; GP with a Special Interest in Substance Misuse, Guildford, Surrey

Title from PDF of title page (University of Missouri--Columbia, viewed on October 24, 2012).

Individuals with mental health and/or substance abuse problems experience disparities in health care utilization. While previous studies have focused on individual and social determinants of health care use in these populations, few have investigated the role of residential stability, especially in relation to different types of service use (i.e., inpatient vs. outpatient treatment). The present study examined the relationship between residential mobility, defined as the number of residential relocations in the past year, and past-year use of four types of behavioral services (i.e., inpatient and outpatient mental health services, inpatient and outpatient substance abuse services) among a national sample of adults with mental health and/or substance abuse problems.Data were drawn from the 2011-2014 National Survey of Drug Use and Health (unweighted N = 43,411). Based on prior literature and theory, we hypothesized that individuals who frequently relocate are more likely to use inpatient services and are less likely to use outpatient services. Logistic regression analyses were conducted and all models controlled for predisposing, need, and enabling factors.Compared to individuals who did not move in the past year, those who moved three or more times were more likely to report using inpatient mental health and substance abuse services. The relationship between residential mobility and outpatient mental health and substance use service use is not significant.The findings highlight the importance of understanding housing stability as a predictor factor of service use and access. Future research is needed to shed light on the pathway through which residential mobility affects behavioral health service utilization.

Aims: This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. Methods: Data set includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. Results: The excess morbidity associated with shelter use is substantially lower than in studies that did not include an extensive control. Approximately 80% of excess morbidity amongst shelter users is attributed to other risk factors. A large part of the excess morbidity is explained by substance abuse problems and lack of employment, whilst mental illness, low income, low education, civil status and ethnic minority background explain only a limited part. However, when conducting an extensive control for confounding, a significantly higher morbidity was identified amongst shelter users for infectious diseases, lung, skin, blood and digestive diseases, injuries, and poisoning. Conclusions: Ill health amongst homeless shelter users is widely explained by substance abuse problems and other risk factors. Nonetheless, for many diseases homelessness poses an additional risk to the health.

This chapter considers whether the two types of offenders are in fact different by looking at the relationship of the victim-offender relationship to recidivism, versatility, and specialization in a sample of prisoners incarcerated for violent crimes. It aims to increase public knowledge about offenders who commit violent crimes and how they differ from general criminal offenders. Such offenders’ reports of their motives, methods, and self-perceptions can help us understand the circumstances in which crimes are committed and the probable effects of criminal justice policies on crime. The chapter also considers the connection between the victim-offender relationship and the offenders’ criminal record. It is expected that offenders who victimize strangers will have longer, more extensive juvenile and adult criminal records, more motor vehicle accidents, and more serious substance abuse problems than offenders who victimize nonstrangers. The chapter examines variability and patterns in committing crimes.

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