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Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Extensão em Foco is the property of Universidade Federal do Parana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this article is to demonstrate the results of the dissertation research for a master's degree in Sciences of Religion at PUC GO (2012-2013) on the religious practices used in the rehabilitation process of drug addicts. Was it questioned whether Casa do Oleiro, a confessional recovery entity that received drug addicts, promotes the effective recovery of its inmates through religious means of therapy? In the data analysis, the recovery time, the statistics of those retrieved in the proposed time, were considered. It was exploratory bibliographical research with field research when the entity was visited, and inmates were interviewed through a questionnaire prepared by the researcher. The results obtained from the research allow us to infer that the religious practices used in the process in question provide conditions of social dignity and recovery, if the intern is willing to adhere to the religious practices worked on as a therapeutic proposal for abstinence that the entity offers. [ABSTRACT FROM AUTHOR]

Joseph A Carley, Tyler Oesterle Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USACorrespondence: Joseph A CarleyDepartment of Psychiatry and Psychology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USATel +1 507 284-2088Email carley.joseph@mayo.eduAbstract: Opioid use disorder is a frequent cause of suffering to communities worldwide. Therapeutic approaches to opioid use disorder include screening, appropriate assessment and diagnosis, consideration of level of care, acute management of overdose or withdrawal, treatment with medications, psychotherapeutic approaches, and community support. People who struggle with addiction to opioids often suffer deeply from direct and indirect consequences of use. Subsequently, it is critical that all medical providers understand the appropriate treatment options for opioid use disorder. This paper provides a comprehensive overview of the therapeutic options available for treatment of this chronic disease.Keywords: addiction, opioid, substance use, chemical dependency, primary care, medication-assisted treatment

Objective: To examine the extent to which there was any therapeutic relationship between Veterans and their initial buprenorphine provider and whether the presence of this relationship influenced treatment retention. Data Sources: National, secondary administrative data used from the Veterans Health Administration (VHA), 2008–2017. Study Design: Retrospective cohort study. The primary exposure was a therapeutic relationship between the Veteran and buprenorphine provider, defined as the presence of a previous visit or medication prescribed by the provider in the 2 years preceding buprenorphine treatment initiation. The primary outcome was treatment discontinuation, evaluated as 14 days of absence of medication from initiation through 1 year. Data Collection/Extraction Methods: Adult Veterans (age ≥ 18 years) diagnosed with opioid use disorder and treated with buprenorphine or buprenorphine/naloxone within the VHA system were included in this study. We excluded those receiving buprenorphine patches, those with documentation of a metastatic tumor diagnosis within 2 years prior to buprenorphine initiation, and those without geographical information on rurality. Principal Findings: A total of 28,791 Veterans were included in the study. Within the overall study sample, 56.3% (n = 16,206) of Veterans previously had at least one outpatient encounter with their initial buprenorphine provider, and 24.9% (n = 7174) of Veterans previously had at least one prescription from that provider in the 2 years preceding buprenorphine initiation. There was no significant or clinically meaningful association between therapeutic relationship history and treatment retention when defined as visit history (aHR: 0.99; 95% CI: 0.96, 1.02) or medication history (aHR: 1.03; 95% CI: 1.00, 1.07). Conclusions: Veterans initiating buprenorphine frequently did not have a therapeutic history with their initial buprenorphine provider, but this relationship was not associated with treatment retention. Future work should investigate how the quality of Veteran‐provider therapeutic relationships influences opioid use dependence management and whether eliminating training requirements for providers might affect access to buprenorphine, and subsequently, treatment initiation and retention. [ABSTRACT FROM AUTHOR]

Chemical dependencies are cognitive, social and neurological diseases caused by the abuse of any substance not produced by the organism that has properties to act on one or more of its systems. This Integrative Review searched for scientific literature that shows which changes can be evaluated through the use of protocols, in systematized approaches in music therapy, in the context of chemical dependency. Twenty-two texts were identified that pointed to a lack of standardization of the outcomes evaluated by the studies, limiting their comparability. Even so, it was possible to conclude some points about the action of music therapy on psychological aspects of patients affected by chemical dependence. [ABSTRACT FROM AUTHOR]

Copyright of Avances en PsicologÍa Latinoamericana is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective of this study is to systematically review randomized controlled trials (RCTs) and quasi-experiments that assess how music therapy affects the psychosocial outcomes of clients who are being treated for substance use concerns. This review includes all RCTs and quasi-experiments published in English-language peer-reviewed journals since 2006 that assess music therapy interventions for substance use. A search of bibliographic databases returned a list of 195 potential studies, which was narrowed to 14 for analysis. Current research supports the possibility that music therapy is an expressive intervention that can reduce depressive symptoms, as well as increase motivation for treatment and readiness to change patterns of substance use. Despite an increase in quantitative research on this topic in the last 10 years, an overall paucity of quantitative studies and lack of long-term research suggest that more primary studies are still needed before any conclusions can be made about the efficacy of music therapy for treating substance use. [ABSTRACT FROM AUTHOR]

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are approximately 3.1 million nurses in the Unites States (U.S. Census Bureau, 2016), and approximately 8% of them experience substance use disorders (Kunyk, 2015). Nurses with impaired practice are referred to peer assistance programs as they seek rehabilitation. As of 2016, 348 nurses in Texas Peer Assistance Program for Nurses were actively participating in the program for substance-abuse-related offenses. Over the last 6 years (2010–2016), 1,553 nurses were referred to Texas Peer Assistance Program for Nurses specifically for substance-abuse-related problems. These represent 2% of the population of nurses in Texas. The average age of participants was 40.1 years. Women represented 75% of participants, and 76% were registered nurses. About 41% successfully completed the program without relapsing, and 32% reported at least one relapse. Varieties of drugs were abused including prescription drugs and illegal drugs. Opioids were the most frequently abused class of drugs, followed by alcohol and stimulants. Most nurses obtained their drugs by diverting from patients. Contrary to what is in the literature, nurses working in long-term care, medical–surgical units, and home health care had the highest prevalence of impaired practice. Psychiatric comorbidity was not significantly associated with relapse, but self-report status was significantly associated with gender, age category, license type, relapse, and drug of choice. There was a significant inverse relationship between time it takes to enroll and number of abstinent days. Men were also more likely to be employed while in the program. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Taking into account the preferences of patients can provide relevant information when establishing therapeutic objectives. • Substance use disorder patients express desire to be involved in the decision-making process about their treatment. • More perceived control than desired might experience an excess of responsibility that could negatively influence retention or substance use. Patient-centered care in therapeutic processes has been associated with better clinical outcomes, however, it remains a poorly studied aspect in Substance Use Disorder (SUD). The study aimed to evaluate patient's preferences, perceived participation in treatment decisions and activation level; and how they predict retention, pharmacological adherence and substance use during one-year follow-up. Logistic regression models were used to analyze the association between independent variables, along with a wide number of sociodemographic and clinical covariates, and outcomes. Most patients prefer a shared or passive role when making decisions about their treatment, and showed concordance between their preferred and perceived roles. In the univariate models, perceiving more involvement than desired showed a higher likelihood of treatment discontinuation at 12 months, and substance use at 6 and 12 months. No significant associations were found between the remaining decisional variables or the degree of activation with the assessed outcomes. A majority of SUD patients prefer and perceive to be involved in the decision-making process about their treatment. Patients perceiving more involvement than desired might experience an excess of responsibility that could negatively influence treatment continuation and substance use. Limitations of the study preclude any definitive conclusion, and more research is needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Adolescent substance use (SU) remains a serious problem. Inpatient, primary care, and self-treatment models for chemical dependency (CD) yield varying degrees of success impacting the sequelae of chronic or episodic SU. Relational engagement among adolescent substance users is a long known influential factor in the development, maintenance and transformation of addictive behaviors. Objectives: Following tenets of Relational-Cultural Theory and using the Relational Health Indices for Youth (RHI-Y), a validated survey tool for adolescents, we sought to measure relational health (RH) during times of transitions during CD treatment. This article addresses use of the tool and its potential for improving addictions research and practice. Methods: During 2015-2017 we explored differences in RH scores in adolescent girls entering inpatient CD treatment at three points: 51 at admission, 39 at discharge, and 13 at 3 months post-discharge. Data were analyzed using a generalized linear mixed model to compare changes in domain scores of RH. Results: Changes in RH scores were significant in the friend domain, but not the mentor and community domains. The RHI-Y shows promise in discerning RH change during transitions in CD treatment. [ABSTRACT FROM AUTHOR]

Nurses constitute approximately 36% of all healthcare providers, and 2% of the labor force in the United States (American Nurses Association [ANA], 2016). However, about 8% of nurses suffer from substance use disorders ([SUD]; Kunyk, 2015) and must participate in peer assistance programs to maintain their licenses (Darbro & Malliarakis, 2012). The purpose of this study was to describe the lived experiences of nurses with SUD participating in peer assistance programs and the subsequent employment implications. A Phenomenological approach was used to answer the research questions. Ten nurses were recruited from local support meetings and a thematic inductive approach was utilized to develop four overarching themes, which included stress from restriction, guilt and shame, gratitude for being caught, and keeping up with recovery. Understanding the challenges recovering nurses face when being incorporated into the workforce is important in implementing policies that facilitate a smooth transition. [ABSTRACT FROM AUTHOR]

In his explanation of the brain as a control system, Glasser (1999) described the Quality World (QW) as a photo album that contained pictures of those things which we have or want and which fulfill our Basic Needs. The QW is differentiated from the Everything I Know World (EIKW) in that pictures in the QW are need fulfilling and relatively permanent, while pictures in the EWKW are transient and not Need fulfilling. While this analogy is useful in understanding the concepts of Choice Theory Psychology, it doesn't explain the biological workings that support the ideas. One of the criticisms of Choice Theory is that it lacks a research base to explain the physiological underpinnings of the theory. This paper addresses that concern and suggests a neurobiological explanation of how the QW is populated through dopamine/glutamate interactions. While the neurobiological explanation works for how any construct is fixed in the brain, chemical dependency (i.e., addiction) will be used as the primary example to illustrate the mechanism. [ABSTRACT FROM AUTHOR]

Adolescent substance use (SU) endures as a priority concern to communities. The increasing risk of SU in young women has been a rising concern, and the needs of young women may be unique. The importance of relationships and "connectedness" as aberrant behavior protective factors has been validated extensively in the literature of several disciplines over the past decade. Less well described are the components and qualities of relational engagement among adolescents involved in SU treatment. This multimethod study was a broad analysis of the nature of relational health in adolescent girls, so as to determine whether understanding components of relational health could inform SU treatment options. The survey tool, the Relational Health Indices (Liang et al., 2002), was used to measure dimensions and domains of relational health in adolescent girls and informed qualitative methods in the study. It is clear from this research that adolescent girls in SU treatment care deeply about but are confused regarding their relationships with others, particularly their romantic partners and their mothers. They have a desire to help others, specifically their siblings and others struggling with addiction. This article describes the multimethod study and implications for treatment, research, and education. [ABSTRACT FROM AUTHOR]

We discuss the features of development and implementation of programs of social and psychological support of adolescents in domestic and foreign practice. The priority in the field of prevention of social risks among young people is to provide systematic, comprehensive, accurate information about the consequences of substance use, adolescent training in self-care and self-regulation, the use of health-care technology, the formation of stable personal negative attitude to the problem of substance abuse. The effectiveness of preventive anti-drug programs is caused by the identification of the target group (including psychophysiological age characteristics), development of a set of preventive measures based on interagency cooperation with involvement of the minors’ parents (legal representatives).

This study aims to point out the role of spirituality/religiosity in the drug addiction situation. The method used was the integrative review, with a survey at CAPES Periodicals; SciELO and VHL. After examining the 281 collected studies, 39 empirical works were selected for analysis. They were categorized into two major themes: "epidemiology" and "treatment". The studies were developed predominantly in the area of Health Sciences. The majority, 69.2%, focuses on epidemiological issues. 30.7% deal with rehabilitation processes. The results indicate that spirituality/religiosity works as a protective, preventive and/or healing factor (treatment). It is suggested that longitudinal and interdisciplinary researches should be developed considering specific contributions from Bioethics, Psychology of Religion and Practical Theology, in order to investigate the mechanisms of action of spirituality/religiosity in the context of drug addiction. [ABSTRACT FROM AUTHOR]

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

One of the major social and health problems across the world is drug and alcohol abuse. It is endemic to many societies. This has been the case for thousands of years with the use of cocaine in ancient Egypt, alcohol in ancient Rome, opium in China in the 19th century, and a new plague of cheap recreational street drugs now flooding the modern world. Hypnosis in its different forms has also been used for many millennia in healing the body and mind, as well as changing behaviours and human experience. Historically, the use of hypnotic techniques has been prevalent in ancient Egyptian healing temples, Greek Asclepeion temples, the salons of Mesmer in Paris, American Pentecostal churches, and in the modernday practice of clinical hypnotherapy and medical hypnosis. Today, hypnotherapy is utilised as a potent treatment modality for many presenting problems and in particular has helped tens of thousands of patients in the field of substance abuse cessation. This paper examines four case studies of long-term drug abuse where all patients ceased their addiction after one two-hour session of the Clinical Hypnotherapy Stop Drugs and Alcohol 6 Step Program (6 Step Program) created by the author, with the patients transitioning from drug and alcohol dependency to becoming clean and sober. The first case was a long-term methamphetamine user. The second case is a daily cannabis (also known as and referred to in this paper as 'marijuana') user who imbibed through a pipe for 36 years. The third and fourth cases are two brothers who used marijuana three or four times a day for five years and enabled each other in their co-joint addiction. In all four cases, the clients attended one initial session, as well as follow-up sessions. [ABSTRACT FROM AUTHOR]

Background: Lyric analysis is a commonly utilized music therapy intervention for clients in substance abuse rehabilitation wherein participants interpret song lyrics related to their clinical objectives. For these patients, working alliance and trust in the therapist represent consequential factors that may influence outcomes. However, there is a lack of randomized controlled music therapy studies investigating working alliance and trust in the therapist within lyric analysis interventions for patients with addictions. Objective: The purpose of this study was to quantitatively differentiate live versus recorded and educational versus recreational music therapy interventions via measures of working alliance and trust with patients on a detoxification unit. Method: Participants (N = 130) were cluster randomized in a single-session posttest-only design to one of four conditions: Live educational music therapy, recorded educational music therapy, education without music, or recreational music therapy. Dependent measures included working alliance and trust in the therapist. Educational music therapy interventions were scripted lyric analyses. Results: There was no statistically significant between-group difference in any of the measures. Although not significant, a greater number of patients and research participants attended live educational music therapy sessions. Conclusions: Between-group descriptive data were consistently similar but attendance trends may have implications for engaging patients and billing. Implications for clinical practice, limitations of the study, and suggestions for future research are provided. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Educação, Sociedade & Culturas is the property of Centro de Investigacao e Intervencao Educativa (CIIE) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Comportamentalia is the property of Instituto de Psicologia y Educacion de la Universidad Veracruzana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chemical use and dependency is a prevalent problem in society and among the members of the nursing profession. Nursing students, as the novice representatives of the profession, may be particularly vulnerable to chemical use. Nursing leaders in both educational institutions and practice settings must recognize highly vulnerable individuals, which nursing activities are most vulnerable, and interventions to assist and support the vulnerable individual while assuring a safe practice environment. As nurses, it is our responsibility, both ethically and legally, to provide a safe working environment not only for our patients but also for ourselves by reporting the behaviors of nurses who may be impaired through the proper channels according to your state's Nurse Practice Act. Through a united approach, nurse leaders from both the academic and practice environments should provide a safe and effective rehabilitation approach. [ABSTRACT FROM AUTHOR]

Background: Treatment motivation is a key component in the early rehabilitative stages for people with substance use disorders. To date, no music therapy researcher has studied how lyric analysis interventions might affect motivation in a randomized controlled design. Objectives: The primary purpose of this study was to determine the effect of lyric analysis interventions on treatment motivation in patients on a detoxification unit using a single-session wait-list control design. A secondary purpose was to determine if there were between-group differences concerning two contrasting songs used for the lyric analyses. Methods: Participants (N = 104) were cluster randomized to a group lyric analysis condition or a wait-list control condition. Participants received either a "Hurt" or a "How to Save a Life" lyric analysis treatment. The Texas Christian University Treatment Motivation Scale--Client Evaluation of Self at Intake (CESI) (Simpson, 2008[2005]) was used to measure aspects of treatment motivation: problem recognition, desire for help, treatment readiness, pressures for treatment, and total motivation. Results: Results indicated significant between-group differences in measures of problem recognition, desire for help, treatment readiness, and total motivation, with experimental participants having higher treatment motivation means than control participants. There was no difference between the two lyric analysis interventions. Conclusions: Although the song used for lyric analysis interventions did not affect outcome, a single group-based music therapy lyric analysis session can be an effective psychosocial treatment intervention to enhance treatment motivation in patients on a detoxification unit. Limitations, implications for clinical practice, and suggestions for future research are provided. [ABSTRACT FROM AUTHOR]

Maladaptive patterns of substance use are serious social problems. Both pharmacological and nonpharmacological treatments are available, but nondrug options may be preferable because they avoid the expense and adverse side effects of psychotropic medication. Contingency management (CM) and nondrug social and recreational activities (NDSRAs) are based on operant conditioning principles and seek to decrease substance use by means of nondrug rewards. However, their efficacy may be hindered where brain reward circuitry is dysfunctional. Research shows that substance abuse biases neural reward systems in favor of drug-induced highs, while disrupting circadian-based rhythms. Circadian systems also have been found to influence human reward pathways. Possibly, a bidirectional relationship exists between circadian disturbance and substance abuse effects. If so, repair of abnormal circadian rhythms might help normalize reward response in substance abusers, with positive effects on CM or NDSRA treatment outcomes. Phototherapy has been effective in repairing circadian rhythms in persons with seasonal affective disorder and other chronobiological conditions. This article proposes that it similarly may repair circadian response in substance abusers, thereby normalizing brain reward systems. By doing so, it would enhance the efficacy of CM and NDSRA therapies and may also help prevent relapse. Given its low cost and ease of administration, phototherapy seems a promising avenue to pursue. [ABSTRACT FROM AUTHOR]

Self-efficacy is a component of Bandura's social cognitive theory and can lead to abstinence and a reduction of relapse potential for people who have substance abuse disorders. To date, no music therapy researcher has utilized this theoretical model to address abstinence and reduce the likelihood of relapse in people who have addictions. The purpose of this study was to determine the effects of music therapy on drug avoidance self-efficacy in a randomized three-group wait-list control design with patients on a detoxification unit. Participants (N = 131) were cluster randomized to one of three single-session conditions: music therapy, verbal therapy, or wait-list control. Music therapy participants received a group lyric analysis intervention, verbal therapy participants received a group talk therapy session, and wait-list control participants eventually received a group recreational music therapy intervention. Although there was no significant between-group difference in drug avoidance self-efficacy, participants in the music therapy condition tended to have the highest mean drug avoidance self-efficacy scores. Posttest written comments supported the use of both music therapy and verbal therapy sessions. Two music therapy participants specifically noted that their initial skepticism had dissipated after receiving music therapy. Despite a lack of significant differences, the theoretical support of self-efficacy for substance abuse rehabilitation suggests that this may be an area of continued clinical focus and empirical investigation. Clinical anecdotes, limitations of the study, and suggestions for future research are provided. [ABSTRACT FROM AUTHOR]

This study aimed to raise the scientific literature on the constructs of craving relating it to situations that stimulate the usage pattern of the crack, the repercussions on the lives of users and control strategies. We conducted a review of the literature through databases SciELO, LILACS and MEDLINE, using the keywords: craving, crack cocaine, and drug dependence. The survey period was from 1996 to 2012, totaling 39 studies. The results demonstrated that the concept of craving (or tear) most used is understood as a strong desire to use a substance, which may influence the user’s life in a negative way through relational ruptures and illicit activities. The craving management is through various strategies and techniques ranging from the use of other drugs to drug therapy. It is concluded that the craving because of its multifactorial etiology and on the way management becomes his peculiar understanding to help crack users in a unique way, involving social and psychological peculiarities of each. [ABSTRACT FROM AUTHOR]

Background: Songwriting is a commonly utilized music therapy technique for clients in substance abuse rehabilitation. For these patients, motivation and readiness for treatment remain two key treatment areas. Moreover, there is a lack of randomized and controlled music therapy studies systematically investigating how group songwriting can affect patients on a detoxification unit Objective: The purposes of this study were to measure the effects of a single group songwriting session on motivation and readiness for treatment and determine emerging themes from patient-composed songs with patients on a detoxification unit. Methods: Participants (N = 99) were randomized to experimental (posttest only) or wait-list control (pretest only) conditions to provide treatment to all participants in an inclusive single session design. Results: There were significant between-group differences in motivation and readiness for treatment, with experimental participants having higher means than control participants. Code categorizations from patients' composed song lyrics concerned "action," "emotions and feelings," "change, " "reflection, " "admission, " and "responsibility. " Conclusion: From the results of this study, it seems that a single group songwriting session can be an effective intervention concerning motivation and readiness for treatment in patients on a detoxification unit. Implications for clinical practice, suggestions for future research, and limitation are provided. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: to explore the extent to which a specialist clinic meets the needs of chemically dependent women. Design: a critical ethnography informed by theorists such as Habermas and feminists'' interpretation of Foucault. Setting: a specialist antenatal clinic for chemically dependent pregnant women at a major metropolitan women''s hospital in Melbourne, Australia. Participants: a purposive sample of twenty (20) chemically dependent pregnant women who attended the clinic. Data collection and analysis included three taped interviews (two preceding the birth and one post birth), observation of the interactions between the women and the clinic staff over a 25-month period and chart audits. Findings: similar to other studies there were multiple factors influencing development and maintenance of chemical dependency in this group of women, including family instability, family history of drug and alcohol abuse, childhood sexual abuse, having a chemically dependent partner and having a dual diagnosis of both drug addiction and mental illness. Initially there was considerable variation between the women and the clinic staff''s expectations with regard to attending for antenatal care and conforming to a set regime as the women struggled with the contradictions inherent in their lifestyle and that of the ‘normal’ expectant mother. Aspects of that struggle included their belief that their opinions and knowledge of their lives was largely ignored, leading to episodes of resistance. Several women alleged the clinics staff''s relationship with them was influenced by a belief that the women were ‘hopeless addicts in need of expert medical and midwifery care'' and that the clinic staff exercised control in an authoritarian manner. However, as they explored possibilities for collaboration, they realised they could exercise power and work towards a more equal relationship with staff. The quality of relationships in most instances improved over time, and if not always strictly collaborative, was situated at various points along a continuum from minimal to full co-operation, with concomitant varying levels of success in terms of outcomes. It was often the attitude of individual staff members, particularly midwives, that was the key to the way in which the women responded to care. Key conclusions and implications for practice: comprehensive history-taking and engaging women as early as possible in pregnancy; providing continuity of care – particularly midwife care – to assist in developing a collaborative approach to care; provision of an extended period of postnatal support to at least six months for those women able to parent their children was a key recommendation. [Copyright &y& Elsevier]

'Contingency Management programs (CMP) and non-drug social and recreational activities (NDSRA) are interventions premised on behavior theory that rely on external sources of reinforcement alternative to drug-based forms to decrease drug use. CMP usually employs vouchers as reinforcement for negative toxicologies. Despite research support, CMP alone may be insufficient to achieve abstinence. Although evidence supporting NDSRA is limited, it is promising because it assists patients to employ 'fun' real world activities (e.g. films, plays, circus) as alternative sources of reinforcement. Both CMP and NDSRA are currently used at Coney Island Hospital's Outpatient Chemical Dependency Services (CIHCDS) in New York City. The NDSRA program is fairly extensive (>40 events per year) and includes group excursions (868 patient participants in 2009) under the supervision of one or more therapists. A description of program design and clinical observations of its impact follows a brief review of relevant research.' [ABSTRACT FROM AUTHOR]

This exploratory and quantitative study presents a model of treatment success of the nation's oldest and largest chemical dependency treatment provider for the gay, lesbian, bisexual, and transgender (GLBT) population. The main purpose is to examine the potential ability of the predictor variables' degree of affiliation with Alcoholics Anonymous (AA), the severity of chemical use, the strength of a higher power relationship, attitudes about sexual orientation, and length of time in treatment to predict length of time clean and sober. The proposed model demonstrated the ability to explain 29% of the variance in time clean and sober. Results lend tentative support for culturally competent treatment and include specific intervention recommendations for professionals, including social workers, chemical dependency counselors, and therapists. [ABSTRACT FROM AUTHOR]

Abstract: Withdrawal symptoms are one of the primary reasons people enter a detoxification facility while internal locus of control has been associated with maintenance of sobriety and relapse prevention. The purpose of this study was to determine if a music therapy lyric analysis intervention could affect withdrawal symptoms and locus of control in patients who were in detoxification. Participants (N =118) were randomized into a music therapy lyric analysis condition or a verbal therapy condition by group. After the session, participants completed a posttest with established psychometric instruments measuring symptoms of withdrawal and locus of control. Although there were no significant differences between groups, results indicated that patients in detoxification facility tended to have slightly less severe withdrawal symptoms after a music therapy session than after a verbal psychotherapy session. Participants in the experimental group tended to have slightly higher mean external of control scores. A greater number of inpatients attended the music therapy sessions than the verbal therapy control sessions, potentially providing implications for funding and billing. Most participants indicated they thought the music therapy (experimental) or relapse prevention (control condition) was most helpful/therapeutic program in which they had participated on the unit. Concerning free response written comments on the posttest, participants in the experimental condition made more comments categorized into the “positive change” category than participants in the control condition. Limitations, implications for clinical practice, and suggestions for future research are provided. [Copyright &y& Elsevier]

Using a retrospective quasi-experimental design, this study evaluated the effectiveness of prison-based chemical dependency (CD) treatment by examining recidivism outcomes among 1,852 offenders released from Minnesota correctional facilities during 2005. Because recidivism data were collected on the 1,852 offenders through the end of 2008, the average follow-up period was 42 months. To minimize the threat of selection bias, propensity score matching was used to create a comparison group of 926 untreated offenders who were not, for the most part, significantly different from the 926 treated offenders. Results from the Cox regression analyses revealed that participating in prison-based CD treatment significantly reduced the hazard ratio for recidivism by 17–25%. Although dropping out of treatment did not increase the risk of recidivism, completing treatment significantly lowered it by 20–27%. The findings also suggest that long-term treatment programs were not as effective as short- or medium-term programs in reducing the risk of recidivism. The study concludes by discussing the implications of these findings. [ABSTRACT FROM AUTHOR]

This article addresses the use of group work in a community-based outpatient children's mental health agency to respond to financial threats by county and state government during the economic downturn of 2008-2009. Three specific threats that came within months of one another are discussed: (1) the threat to close down a chemical dependency treatment service for youth, (2) severe funding cuts to an outreach program for immigrant youth and their families, and (3) a state government plan to restructure/reform reimbursement for outpatient mental health services that promises to reduce access to care for underinsured families. Group work was used to organize, educate, and activate staff, board, community, and consumer groups, in large and small groups, to counter the threats and build a culture of advocacy. Lending a vision, empowering advocates, managing polarity, and shaping the advocacy message were essential elements of the advocacy process. [ABSTRACT FROM AUTHOR]

Caffeine is probably the most frequently ingested pharmacologically active substance in the world. It is found in common beverages (coffee, tea, soft drinks), in products containing cocoa or chocolate, and in medications. Because of its wide consumption at different levels by most segments of the population, the public and the scientific community have expressed interest in the potential for caffeine to produce adverse effects on human health. Reproductive-aged and pregnant women are ‘at risk’ subgroups of the population who may require specific advice on moderating their daily caffeine intake. This article highlights the implications of caffeine intake in pregnancy, reviews the latest evidence-based information available on this subject, and offers recommendations (practical advice) for the obstetrician–gynecologists proving peripartum care to these potentially complicated pregnancies. [ABSTRACT FROM AUTHOR]

Introduction: This paper explores the use of machine learning and Bayesian classification models to develop broadly applicable risk stratification models to guide disease management of health plan enrfollees with substance use disorder (SUD). While the high costs and morbidities associated with SUD are understood by payers, who manage it through utilization review, acute interventions, coverage and cost limitations, and disease management, the literature shows mixed results for these modalities in improving patient outcomes and controlling cost. Our objective is to evaluate the potential of data mining methods to identify novel risk factors for chronic disease and stratification of enrollee utilization, which can be used to develop new methods for targeting disease management services to maximize benefits to both enrollees and payers. [ABSTRACT FROM AUTHOR]

Abstract: The First Step Series (FSS) is a protocol of five art therapy directives designed for the initial stages of substance abuse treatment. These directives target denial to facilitate client identification of ambivalence and eventual acceptance of lifestyle changes necessary for recovery. Motivational Interviewing (MI) [Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing: Preparing people to change (2nd ed.). New York: Guilford Press] informs a conceptualization of denial as normal ambivalence that occurs during any change process. Normalizing ambivalence sets the stage for the related therapeutic tasks of matching the client''s attitude toward treatment, promoting trust in the therapeutic relationship, and gently supporting the client''s internal desire for change. [Copyright &y& Elsevier]

This column traces the history of the efforts of the American Association of Nurse Anesthetists to provide assistance to members struggling with addiction. The work of the Ad Hoc Committee on Chemical Dependency, the Peer Assistance Advisors, Anesthetists in Recovery, the Council on Public Interest in Anesthesia, and the Wellness Program are examined. [ABSTRACT FROM AUTHOR]

Research suggests that gender-specific treatment for women with chemical dependency issues might be more effective than dual-gender programs. Several authors have posited that this might be due to the fact that women in treatment have differing sets of presenting problems than men. The purpose of this exploratory qualitative study was to investigate women's experiences in a single-gender, holistically focused chemical dependency treatment program. Results based on focus group interviews with 23 women suggest that the variables of empowerment, holistic services, children in treatment, domestic violence services, cohesion, and staff characteristics have distinct effects on women's experiences in chemical dependency treatment. Questions for further study are offered. [ABSTRACT FROM AUTHOR]

Women are subject to high rates of interpersonal violence. One frequent co-occurring issue is substance abuse, which may arise posttrauma as a way to cope. In this article, psychosocial therapies for co-occurring trauma and substance abuse are reviewed. Description of empirically studied models is provided, as well as results of the empirical studies. Overall, this area of work suggests positive growth in the availability of new models but very limited empirical work thus far for all but one model. Directions for the future include the need for greater study of treatments in this area, as well as the need to address issues beyond specific models (e.g., workforce issues, access to care, and changing the culture of treatment systems). Policy implications are also offered. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this descriptive study was to examine music therapists working with consumers in treatment for substance abuse with the intention of using these data to design realistic and practical research studies and inform future music therapists of what to expect as a Board-Certified Music Therapist working with this population. The secondary purpose of this study was to assess job environment factors of music therapists and their perception of influence on clinical effectiveness within the substance abuse population. Participants reported that communication, coping skills, emotional expression, decision making, and self-esteem were the most frequently addressed clinical objectives. The 12 Step, cognitive behavioral, and dual disorders were the most frequently utilized treatment approaches while lyric analysis and music assisted relaxation were the most utilized music therapy interventions. Participants had been working with the substance abuse population for a mean of 11.69 years, enjoyed their work, and felt they had a positive impact upon treatment. A significant relationship was found between years as an MT-BC and perception of positive impact of music therapy, possibly indicating that therapists who had practiced longer felt they were more effective. There was a significant relationship between the music therapists’ enjoyment of clinical practice and their perception of positive influence upon their consumers’ treatment, possibly indicating that the more a music therapist enjoyed their work, the more impact they felt they had upon their consumers. Finally, a significant relationship existed between the music therapists’ perception of treatment influence on their consumers and the percentage of consumers who had met their clinical objectives during the last week. Suggestions for additional research, implications for treatment, potential biases, and limitations of the study are provided. [Copyright &y& Elsevier]

Introduction. This study is a long-term follow-up of an early replication of the Peniston EEG biofeedback (EEG-BFB) Protocol for chemical dependency (Peniston & Kulkosky, 1989, 1990). Method. This clinical trial included 16 chemically dependent adult participants treated with the Peniston Protocol in a university outpatient clinic between 1993 and 1995. Ten participants were probationers classified as high risk for rearrest. Treatment effects were assessed using pre/posttreatment measures (Beck Depression Inventory, Minnesota Multiphasic Personality Inventory-2) and long-term follow-up of abstinence and rearrest rates. Probationer rearrest rates were compared to an equivalent probation sample (n = 24) that did not receive EEG-BFB. Results. Initial Beck Depression Inventory scores indicated mild/moderate depression but were significantly reduced posttreatment to within normal limits. Substantial differences were noted posttreatment on 7 Minnesota Multiphasic Personality Inventory-2 clinical scales suggesting less psychopathology following treatment. Long-term (74-98 months) follow-up indicated that 81.3% (n = 13) participants were abstinent. Rearrest rates and probation revocations for the probationer subgroup were lower than the comparison group (40% vs. 79.16%). Conclusion. This study provides evidence of the durability of Peniston Protocol results over time but has the usual limitations of a clinical trial with a small sample, nonrandomized, and uncontrolled design. Implications for further research are discussed including the relevance of recent modifications to the Peniston Protocol and qEEG-based protocols in treating substance abuse. [ABSTRACT FROM AUTHOR]

Abstract: Using artwork in group treatment of chemically dependent minority women can enhance introspection and involvement during the recovery process. This paper examines the use of 14 reproductions to help women identify feelings evoked by the art and to reconnect with feelings that chemical dependency can dampen. Art reproductions were used during the last 4 sessions of a 12-session experiential group therapy program with 17 minority women who were being treated for chemical dependency. Participants’ responses to the reproductions and effects of this visual processing modality on the women''s recovery from their addictions were the focus of this study. As the women learned to verbalize their feelings and reflect on their situations through interpretative interactions with visual art, they gained insight into their feelings and issues they faced in their recovery from chemical dependency. [Copyright &y& Elsevier]