Search results

1 – 10 of over 11000
To view the access options for this content please click here
Article

Richa Tripathi, Shalini Singh, Siddharth Sarkar, Rakesh Lal and Yatan Pal Singh Balhara

There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to…

Abstract

Purpose

There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to compare the pathways to care among patients with co-occurring disorder and those with only substance use disorders.

Design/methodology/approach

A cross-sectional observational study was carried out on male treatment seekers at a tertiary care substance use disorder treatment center in India. Participants were recruited in two groups, those with co-occurring psychiatric and substance use disorders and those with only substance use disorders. The two groups were matched for age and socio-economic status.

Findings

A total of 189 subjects with co-occurring psychiatric and substance use disorders and 197 subjects with substance use disorders only were recruited. Psychiatric services were the most common first point of care. However, a larger proportion of the subjects in the co-occurring disorder group received the first care from faith healers, while a greater proportion received first care from the therapeutic communities in substance use disorder only group. Initial care was sought mostly following suggestion from the family members in both the groups. The time to treatment for substance use disorders did not differ between the two groups, though the treatment seeking for substance use disorder was more delayed than that of psychiatric disorder in the co-occurring disorder group.

Research limitations/implications

The findings shed light on the pathway of care followed in India and is a matter of further research.

Practical implications

Expansion of services and dissemination of information about psychiatric disorders and substance use disorders can provide timely care to patients with substance use disorders and co-occurring disorders.

Social implications

The findings have a social implication as well. More awareness is needed currently in India for timely treatment of dual disorders.

Originality/value

The paper is an original research by the authors. The data were collected from the participants who reported to the dual diagnosis clinic. The findings are important as they tell us about the current understanding of dual diagnosis by the general public.

Details

Advances in Dual Diagnosis, vol. 14 no. 1
Type: Research Article
ISSN: 1757-0972

Keywords

To view the access options for this content please click here
Article

Caroline J. Easton, Cassandra M. Berbary and Cory A. Crane

The purpose of this paper is to review the research on the use of technology in mental health and addiction treatment, focusing on the use of technology-assisted treatment

Abstract

Purpose

The purpose of this paper is to review the research on the use of technology in mental health and addiction treatment, focusing on the use of technology-assisted treatment. Although initial research investigating technology-assisted treatment for substance use has demonstrated promising results, this paper highlights the need for treatment to address co-occurring substance use and intimate partner violence (IPV). This paper defines the benefits associated with the use of behavioral health avatar coaches in mental health treatment targeting substance use and IPV as well as providing preliminary research results regarding the use of avatar coaches in clinical settings.

Design/methodology/approach

A literature review of the research relating to the use of technology in mental health and addiction treatment is provided. Additionally, a preliminary study aimed to develop an interactive therapy platform that utilizes virtual avatars as therapy coaches to help clients with substance abuse and IPV is presented. In this preliminary study, male participants were shown videos of various technology-based coaches matched on length, gestures and content. Researchers investigated whether patients preferred a virtual reality health coach, a cartoon health coach or a human health coach; as well as patient satisfaction and preference between two versions of the avatar.

Findings

A review of the relevant literature suggests that a majority of research has focused on using technology to replace face-to-face therapy with little research focusing on technology-assisted or augmented mental health and addiction treatment. Although initial research investigating avatar-assisted treatment for substance use has demonstrated promising results, research suggests a high prevalence of co-occurring substance use and IPV, suggesting the need for treatment to address co-occurring substance use and IPV. A preliminary research study was conducted to obtain patient feedback for personalizing avatar development into behavioral health interventions that target addiction and IPV.

Research limitations/implications

Although results of the preliminary study combined with previous research on avatar-assisted treatment for substance use has demonstrated promising results, theory-based research needs to be expanded to focus on randomized controlled trials of avatar-assisted treatment for co-occurring substance use and IPV.

Practical implications

This paper provides an overview of the use of technology-assisted treatment for co-occurring substance use and IPV. The preliminary results regarding patient satisfaction led to the development of additional avatars for use in interactive therapy.

Originality/value

This paper is one of the first to explore the use of avatar-assisted treatment for male offenders with co-morbid substance use and IPV.

Details

Advances in Dual Diagnosis, vol. 11 no. 3
Type: Research Article
ISSN: 1757-0972

Keywords

To view the access options for this content please click here
Article

Albert M. Kopak, Steven L. Proctor and Norman G. Hoffmann

Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which…

Abstract

Purpose

Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which indicators have the greatest impact on treatment outcomes. The purpose of this paper is to determine which clinical indicators influenced the likelihood of rearrest among male drug-involved offenders.

Design/methodology/approach

This prospective longitudinal study examined indicators of 12-month post-treatment rearrest for male criminal justice-involved substance use treatment patients. Multinomial logistic regression results drawn from a sample of 1,531 adult male patients who were mandated to substance use treatment indicated that there were different factors related to the likelihood of one as well as multiple post-treatment arrests.

Findings

Demographic risk factors, such as age and unemployment, were associated with significant increases in the probability of experiencing an arrest within 12-months of treatment discharge. Substance use relapse was also a significant indicator of the likelihood of rearrest and contributed to an increase in the odds of one post-treatment rearrest as well as multiple rearrests. A drug dependence diagnosis, relative to a diagnosis for alcohol dependence, was associated with an increased likelihood of rearrest. Participation in outpatient treatment was associated with a lower likelihood of rearrest.

Practical implications

These findings emphasize the need for treatment providers to concentrate heavily on demographic risk reduction to minimize the chance that male patients are rearrested after treatment. Relapse prevention, on the other hand, is critical in the effort to minimize the number of post-treatment rearrests in this population.

Originality/value

The results from this study provide evidence to empirically support the refinement of substance treatment programs for male patients involved in the criminal justice system.

Details

Journal of Criminological Research, Policy and Practice, vol. 2 no. 1
Type: Research Article
ISSN: 2056-3841

Keywords

To view the access options for this content please click here
Article

Cassandra Berbary, Camila Fernandes, Cory A. Crane and Caroline J. Easton

Research suggests that homework compliance within cognitive behavioral therapy is associated with treatment adherence and positive treatment outcomes through…

Abstract

Purpose

Research suggests that homework compliance within cognitive behavioral therapy is associated with treatment adherence and positive treatment outcomes through generalization of learned skills. The purpose of this paper is to determine whether there were differences in aggression and substance use between participants who did and did not complete therapy homework assignments.

Design/methodology/approach

Secondary analyses were conducted using data from Easton et al.’s (2017) randomized controlled trial of substance abuse domestic violence (SADV) treatment among substance dependent intimate partner violence (IPV) offenders. Analyses of covariance were conducted in order to determine whether homework completion had a significant effect on aggression and substance use. Correlational analyses were conducted to determine the association between quality of homework and outcomes.

Findings

Participants (n=63) who completed at least two homework assignments had fewer days of alcohol use during treatment compared to those who did not complete any assignments, p=0.03. There was not a difference in the number of days participants engaged in violence based on homework completion. Analyses indicated that those who displayed aggression proximal to alcohol use during treatment completed significantly fewer homework assignments compared to those who did not display aggression proximal to alcohol use (p=0.04).

Research limitations/implications

This research was limited to a sample of male substance using offenders of IPV within the US additional research utilizing a larger sample size in order to investigate differences in homework completion across treatment groups is needed. Further analysis of the barriers to and predictors of homework compliance among this population is recommended.

Originality/value

This research highlights the need for incorporation of homework and further exploration of methods and treatment modalities to ensure homework compliance among substance using male offenders of IPV.

Details

Advances in Dual Diagnosis, vol. 11 no. 4
Type: Research Article
ISSN: 1757-0972

Keywords

To view the access options for this content please click here
Article

Sixtus Dane Asuncion Ramos

The Philippines’ nationwide campaign on drugs has been under the limelight due to its controversial approaches in dealing with the problem of addiction. Despite the…

Abstract

Purpose

The Philippines’ nationwide campaign on drugs has been under the limelight due to its controversial approaches in dealing with the problem of addiction. Despite the government’s current efforts, substance use disorders continue to persist within the population. The purpose of this paper is to provide recommendations for addressing the issue of substance use disorder treatment through a modification of the therapeutic community (TC) in the Philippine context.

Design/methodology/approach

This conceptual paper reviews the existing facts about the Philippines’ campaign against drugs, the approaches implemented by the government, current state and research developments of TCs, and its resulting impact on contemporary evidence-based treatment for addiction in the country.

Findings

A treatment framework outlining a recovery-oriented therapeutic community (ROTC) is presented. The ROTC aims to address addiction as a chronic, relapsing disease. This alternative approach for addiction treatment in the Philippines is based on the concept of recovery, principles of effective substance use disorder treatment, and recent developments in TC best practices from the international community.

Originality/value

This paper discusses different recommendations for policy development, interventions and research, aimed at improving the odds of securing recovery for people suffering from addiction.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 40 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

To view the access options for this content please click here
Article

Cassandra M. Berbary, Cory A. Crane and Caroline J. Easton

The purpose of this paper is to investigate whether aggression and substance use assessed during treatment differ based on risk level for substance-using male offenders of…

Abstract

Purpose

The purpose of this paper is to investigate whether aggression and substance use assessed during treatment differ based on risk level for substance-using male offenders of intimate partner violence (IPV).

Design/methodology/approach

Secondary analyses were conducted using data from Easton et al.’s (2017) study on substance-dependent IPV offenders. A cluster analysis was utilized in order to classify participants into typology groups. Analyses of covariance were conducted in order to determine group differences in aggression and substance use during treatment.

Findings

The paper provides results-related response to treatment based on offender typology. Results appear to reflect two typology groups with significant differences in psychopathy among groups. High-risk offenders demonstrated higher rates of violence throughout treatment compared to moderate- and low-risk offenders; however, no differences in substance use outcomes were found.

Research limitations/implications

A limitation of the study is the extent to which the results can be generalized beyond substance using IPV offenders. Further investigation of treatment outcomes including alternate measures is needed in order to better translate theoretical typologies to clinical settings.

Practical implications

Results provide support for differentiating treatment for substance-using male offenders of IPV based on typology as those with low/moderate risk level appear to be distinctly different and have different treatment outcomes compared to high risk level offenders.

Originality/value

Although the relationship between risk level and treatment outcomes has been researched with Drug Court Offenders, treatment outcomes based on typology has not been evaluated among substance using male offenders of IPV.

Details

Advances in Dual Diagnosis, vol. 11 no. 4
Type: Research Article
ISSN: 1757-0972

Keywords

To view the access options for this content please click here
Article

Stacey B Daughters, Jessica F Magidson, Carl W. Lejuez and Yun Chen

Substance use disorders (SUDs) often co-occur with major depressive disorder (MDD), yet treatments targeting this comorbidity are limited, especially in resource limited…

Abstract

Purpose

Substance use disorders (SUDs) often co-occur with major depressive disorder (MDD), yet treatments targeting this comorbidity are limited, especially in resource limited settings where individuals with SUDs often receive treatment.

Design/methodology/approach

Based upon principles of reinforcement and behavioral economic models of substance use, as well as the Brief Behavioral Activation Treatment for Depression (BATD; Lejuez et al., 2011), the Life Enhancement Treatment for Substance Use (LETS ACT; Daughters et al., 2008) was developed to meet the unique needs of patients with MDD-SUD comorbidity.

Findings

The current manuscript presents a summary of the theoretical foundations and key components of LETS ACT.

Originality/value

A specific focus on increasing dissemination via the flexible delivery dependent on patient and treatment setting characteristics is provided throughout.

Details

Advances in Dual Diagnosis, vol. 9 no. 2/3
Type: Research Article
ISSN: 1757-0972

To view the access options for this content please click here
Article

Etienne Maffli and Mariana Astudillo

The purpose of this paper is to estimate the share of multiple substance disorders among clients entering treatment for substance-related problems, to identify the most…

Abstract

Purpose

The purpose of this paper is to estimate the share of multiple substance disorders among clients entering treatment for substance-related problems, to identify the most frequent combinations of the substances involved and to investigate the profiles of the clients involved.

Design/methodology/approach

Data were taken from the Swiss treatment monitoring system act-info applied among inpatient and outpatient facilities (reporting years 2013–2015). All cases with information on multiple substance disorders, according to a definition close to the diagnosis F19 from the ICD-10 classification of disease were included. The measurements comprised designated primary substance, existing multiple substance use disorder, substances involved and basic socio-demographics.

Findings

From 10,009 clients included in the study, 1,653 (16.5 per cent) were reported as having multiple substance use disorders. A great variety of substance combinations was identified and alcohol was found in the majority of them.

Practical implications

Treatment strategies targeting accurately substance-related disorders as a whole complex should be promoted. In particular the alcohol-related aspect of the disorder should not be neglected when the focus is on illegal drugs.

Originality/value

Multiple substance use was until recently not sufficiently documented in treatment monitoring systems. A recent version of the European treatment demand indicator (TDI) has introduced the notion of “polydrug use problem” as complementary information to the primary substance, which remains the key variable for reporting treatment demand. This study represents a first attempt to explore systematically this new data.

Details

Drugs and Alcohol Today, vol. 18 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

To view the access options for this content please click here
Article

Jennifer E. Johnson, Yael Chatav Schonbrun, Jessica E. Nargiso, Caroline C. Kuo, Ruth T. Shefner, Collette A. Williams and Caron Zlotnick

The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use

Abstract

Purpose

The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use and major depressive disorders (MDDs) as they return to the community from prison.

Design/methodology/approach

The paper used qualitative methods to evaluate the perspectives of 15 women with co-occurring substance use and MDDs on the circumstances surrounding their relapse and recovery episodes following release from a US prison. Women were recruited in prison; qualitative data were collected using semi-structured interviews conducted after prison release and were analyzed using grounded theory analysis. Survey data from 39 participants supplemented qualitative findings.

Findings

Results indicated that relationship, emotion, and mental health factors influenced women's first post-prison substance use. Women attributed episodes of recovery to sober and social support, treatment, and building on recovery work done in prison. However, they described a need for comprehensive pre-release planning and post-release treatment that would address mental health, family, and housing/employment and more actively assist them in overcoming barriers to care.

Practical implications

In-prison and aftercare treatment should help depressed, substance using women prisoners reduce or manage negative affect, improve relationships, and obtain active and comprehensive transitional support.

Originality/value

Women with co-occurring mental health and substance use disorders are a high-risk population for negative post-release outcomes, but limited information exists regarding the processes by which they relapse or retain recovery after release from prison. Findings inform treatment and aftercare development efforts.

Details

International Journal of Prisoner Health, vol. 9 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

To view the access options for this content please click here
Article

Lynne Magor-Blatch, Navjot Bhullar, Bronwyn Thomson and Einar Thorsteinsson

The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment

Abstract

Purpose

The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes.

Design/methodology/approach

A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues.

Findings

Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed.

Research limitations/implications

Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts.

Practical implications

Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al., 2012; De Leon et al., 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al., 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances.

Originality/value

The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 35 no. 4
Type: Research Article
ISSN: 0964-1866

Keywords

1 – 10 of over 11000