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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]

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. [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]

• 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]

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]

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]

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]

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]

'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]

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]

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]

Florida men in nursing who are chemically dependent represent a greater percentage of the total number of male nurses than female nurses who are chemically dependent. This study identifies characteristics of 9 men who completed the Florida Intervention Project for Nurses. All participants were interviewed independently and data were analyzed to determine common themes in their behaviors and relationships and how they successfully manipulated professional nursing systems to remain professionally active for prolonged period of time while impaired. A model of caring for nurses with professional impairment graphically depicted the interaction of 2 overarching themes of person and profession. The person theme had 3 subthemes of predetermined risk, altered values, and sensation-seeking behaviors. The profession theme had 6 subthemes of masterminding, professional heteronomy, getting caught, rehabilitation, spirituality, and the nurse becoming the nursed. Findings imply that chemical dependency among male nurses starts in childhood in an abusive family environment and continues throughout the educational process and into the work environment. Findings supporting diversion success include a lack of awareness of the signs and symptoms of impairment by supervisors, poor compliance to drug control procedures, and a common acceptance by peers that impaired men are clinically competent and clinical leaders. When these 3 situations are present, there is greater success in masterminding daily events to maintain undetected drug access. [ABSTRACT FROM AUTHOR]

The issue of co-occurring disorders is of concern to the Criminal Justice field, including drug courts. To assess the potential co-occurrence of substance use- and mental health-related diagnoses, the Psychiatric Diagnostic Screening Questionnaire and similar instruments was administered to suburban drug court clients. Based on the screening, one quarter to one half of the 108 participants would be referred for follow-up for a mental health issue; women would be referred at a greater rate than men. There is a need to develop appropriate, brief mental health screening instruments for use in drug court settings so that clients can receive necessary services. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e,g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system. [ABSTRACT FROM AUTHOR]

Abstract: Most clients in substance abuse treatment are referred for continuing care. However, post-treatment services vary widely in their approaches to helping individuals achieve better substance use outcomes. This study examined the attitudes of outpatient treatment staff who refer clients exclusively to 12-Step groups (12-Step subgroup) and staff who refer clients both to 12-Step groups and to other continuing care options (Diversity subgroup) toward seven mutual-aid and professional psychosocial post-treatment options: Twelve-Step Programs (12-Step), Cognitive–Behavioral Therapy (CBT), Moderation Management (MM), Smart Recovery® (SMART), Psychodynamic-oriented Therapy (PSY), Secular Organizations for Sobriety (SOS), and Women for Sobriety (WFS). A large percentage of clinicians lacked knowledge about the effectiveness of all alternatives to 12-Step programs with the exception of CBT. Clinicians in the 12-Step subgroup were more likely than those in the Diversity subgroup to be unfamiliar with alternatives to 12-Step programs and to believe less strongly in the effectiveness of CBT and PSY. A logistic regression found beliefs about CBT effectiveness and clinician preference for the 12-Step model to be related to the likelihood of referring exclusively to 12-Step groups. Findings suggest that clinicians could benefit from information and training on assessing and referring clients to various options for continuing care. [Copyright &y& Elsevier]

This project gathered survey information from physicians, physician assistants, dentists and pharmacists in Arizona who, while enrolled or following a completion of a monitored aftercare program, had relapsed back to active chemical dependency. The findings suggest several subjective factors that contributed to the subjects' relapse included (1) dishonesty to self, (2) not working a 12 step program, and (3) denial of the problem. Factors reported to be helpful for future relapse prevention were (1) abstinence from substance use, (2) working a 12 step program, and (3) having spiritual beliefs. In general, survey respondents were male, averaged 52 years of age, had relapsed several times and started abusing illicit drugs and alcohol in high school or college. By identifying the specific causes of relapse, future studies may attempt to decrease the percentage of health care providers who relapse by recognizing signs of problematic behavior before they occur. [ABSTRACT FROM AUTHOR]

This article presents the results of a qualitative study on lesbians' recovery from addiction. The study involved semi-structured interviews with 20 lesbians in recovery from addiction and was analyzed using grounded theory method. The central theme that emerged was self-acceptance, both as a lesbian and as a recovering alcoholic/addict, with considerable interaction between the two. Categories that contributed to this theme were learning to recover, relationships with other people, and relationship with something bigger than self. The discussion addresses how this information can be used to assist lesbians trying to recover from addiction. [ABSTRACT FROM AUTHOR]

Unlabelled: This study examined whether an EEG biofeedback protocol could improve outcome measures for a mixed substance abusing inpatient population.Method: One hundred twenty-one volunteers undergoing an inpatient substance abuse program were randomly assigned to the EEG biofeedback or control group. EEG biofeedback included training in Beta and SMR to address attentional variables, followed by an alpha-theta protocol. Subjects received a total of 40 to 50 biofeedback sessions. The control group received additional time in treatment equivalent to experimental procedure time. The Test of Variables of Attention (TOVA), and MMPI, were administered with both tester and subject blind as to group placement to obtain unbiased baseline data. Treatment retention and abstinence rates as well as psychometric and cognitive measures were compared.Results: Experimental subjects remained in treatment significantly longer than the control group (p <0.005). Of the experimental subjects completing the protocol, 77% were abstinent at 12 months, compared to 44% for the controls. Experimental subjects demonstrated significant improvement on the TOVA (p<.005) after an average of 13 beta-SMR sessions. Following alpha-theta training, significant differences were noted on 5 of the 10 MMPI-2 scales at the p<.005 level.Conclusions: This protocol enhanced treatment retention, variables of attention, and abstinence rates one year following treatment. [ABSTRACT FROM AUTHOR]

This article examines racial/ethnic differences in a sample of 51 dually diagnosed women who received chemical dependency treatment. Comparisons are made between Anglo and racial/ethnic minority women at admission to the inpatient treatment program and at follow-up where data are available. Findings from a repeated measures design showed significant decreases in several problem domains for the overall sample. Significant racial/ethnic differences were found only for the other drugs domain. Anglo women reported greater decreases than racial/ethnic minority women in the majority of the domains. Findings suggest continued investigations to inform culturally competent treatment for all dually diagnosed women. [ABSTRACT FROM AUTHOR]

This study reports rates of domestic violence for women with posttraumatic stress disorder (PTSD) and substance dependence. The Conflict Tactics Scale-Revised (CTS2) was used to assess the rates of both physical and psychological aggression, lifetime and current, by self and partner. Results showed substantial rates, both lifetime and current by both partner and self and, for a substantial number in the sample, for multiple events within the past year. Consistent with prior studies, analyses indicated that the correlation between self and partner negative relationship behaviors was high. A significant association was found between past-month substance use and increased self and partner negative relationship behaviors. The complex dynamics of women as both recipients and enactors of negative relationship behaviors are discussed. [Copyright &y& Elsevier]

Substance abuse has crossed social, economic, and geographic borders and—throughout the world–remains one of the major problems facing society today. The prevalence of substance abuse in young adults (including women) has increased markedly over the past 20 years. Nearly 90% of drug-abusing women are of childbearing age. Consequently, it is not unusual to encounter pregnant women who abuse illicit drugs, as numerous case reports of drug abuse in pregnancy confirm. The diverse clinical manifestations of drug abuse combined with physiologic changes of pregnancy, and pathophysiology of coexisting pregnancy-related disease may lead to life-threatening complications and significantly impact the practice of obstetrical anesthesia. Regardless of the drug(s) ingested and clinical manifestations, it is always difficult to predict the exact anesthetic implications in chemically dependent patients. [Copyright &y& Elsevier]

This paper describes the development and utilization of a performance measurement system installed in the case management program for chronic substance abusers who are committed for chemical dependency treatment in Hennepin County, Minnesota. The system (operational for over four years) produces quarterly management reports which display client characteristics at program entry as well as client outcomes achieved during and following the six-month commitment period. Institutionalization of the system within the program and the associated measurement of client characteristics and outcomes have helped to standardize case planning and to sensitize program staff to both client needs and the outcomes toward which staff and client efforts should be directed. Finally, the paper describes the special studies that have been generated from the performance measurement system's database. These include the development of caseload difficulty indices, and multivariate investigations of the relationship between client characteristics and outcomes. The paper seeks to add to the knowledge of the ways in which performance measurement systems might be designed, implemented, and used. [ABSTRACT FROM AUTHOR]

The dual diagnosis of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is reported to be both highly prevalent and highly challenging. In this study, 147 clinicians were surveyed on their degree of difficulty and gratification in working with each disorder (PTSD, SUD) and their combination; specific types of difficulties and gratifications; and personal and professional characteristics. The dual diagnosis was perceived as more difficult than either disorder alone; but, interestingly, gratification in the work was higher than its difficulty. Areas of greatest difficulty were clients'' self-destructiveness, case management, and dependency; areas of greatest gratification were teaching new coping, developing expertise, and helping clients achieve abstinence. In general, difficulty and gratification appeared to be separate constructs, rather than simply opposites. Those finding the work most difficult were more likely to be in a mental health setting and to have no personal history of trauma. Clinical implications are discussed. © 2002 Elsevier Science Inc. All rights reserved. [ABSTRACT FROM AUTHOR]

The adult version of the Substance Abuse Subtle Screening Inventory-2 (SASSI-2) has proven effective in identifying chemically dependent individuals. This research examines whether adult SASSI-2 scores can change significantly from pre- to post-test administration. In the course of this research, subjects completed the SASSI-2 prior to receiving treatment and again after the completion of the treatment phase. A shift in scores was found from pre- to post-test administration for treatment subjects on both global scores, as well as on three subscales. Though limited in generalizability due to a sample size of 20, the results suggest that the adult SASSI-2 may be helpful in detecting recovery. [ABSTRACT FROM AUTHOR]

This article focuses on lesbians in later midlife who are in recovery (for at least six months) from chemical dependency and on the ways the traumatic effects of their chemical dependency affect and influence the issues they face, the decisions they make, the actions they take, and, most especially, the relationships they have with both self and others. Although earlier midlife (from 40 to 50) is an important time, we will focus on the later years (from 50 to 60) because they seem to comprise the critical decade, the time when "old selves are lost and new ones come into being" (Stein, 1983, p. 3). [ABSTRACT FROM AUTHOR]