Norton, E. Douglas
Substance-abuse problems among older adults, involving alcohol, medications, and illegal drugs may arise from such stress factors as unstructured time, relationships with friends, loss, side effects of medications, and irrational beliefs. (SK)
Morrissey, M; Biela, C
In this article, the authors examine the possible benefits of Snoezelen for older clients. The authors suggest that nurses can be instrumental in developing and creating innovative therapeutic environments for this vulnerable client group. PMID:9370672
Hayes, Christopher L.
Clinicians who work with at-risk older adults are often faced with the difficult decision to override their client's civil rights and force institutionalization. Many times the professional is pressured by police or a housing manager to "just do something" with the judgmentally impaired older client. Clinicians faced with these decisions may…
Stark, Michael J.; Kane, Barbara J.
Successful outcome in psychotherapy depends, in part, on clients' preconceptions and expectations. Research has shown that inaccurate expectations are more prevalent among lower socioeconomic status clients, who also represent the majority of substance abusers in community treatment programs. To investigate the effect of general and specific…
Purpose. The overall aims of this study are to describe the life stressors of, exposure to illegal drug use of, and illegal drug use by older methadone clients. Design and Methods. The current study focuses on a sub-sample of the larger administrative data of a methadone clinic that is limited to African American and White clients over the age of…
Weikel, William J.
Notes that older persons underuse community-based and outpatient mental health services, yet are overrepresented in inpatient facilities. Argues for increased programing targeted for elderly client. Advocates use of multimodal model as efficient method of service delivery and provides sample case study using BASIC ID (Behavior, Affect, Sensation,…
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Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana
Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse. PMID:24779540
Background Understanding client perspectives on treatment is increasingly recognized as key to improving care. Yet information on the perceptions and experiences of workers with private insurance coverage who receive help for substance use conditions is relatively sparse, particularly in managed behavioral health care organization (MBHO) populations. Furthermore, the role of several factors including prior service use has not been fully explored. Methods Employees covered by a large MBHO who had received substance abuse services in the past year were surveyed (146 respondents completed the telephone survey and self-reported service use). Results The most common reasons for entering treatment were problems with health; home, family or friends; or work. Prior treatment users reported more reasons for entering treatment and more substance use-related work impairment. The majority of all respondents felt treatment helped a lot or some. One quarter reported getting less treatment than they felt they needed. Discussion and conclusions Study findings point to the need to tailor treatment for prior service users and to recognize the role of work in treatment entry and outcomes. Perceived access issues may be present even among insured clients already in treatment. PMID:22251622
Teaster, Pamela B.; Roberto, Karen A.
Purpose: The purpose of this study was to develop a profile of sexual abuse cases among adults aged 60 and older receiving attention from Adult Protective Services units in Virginia over a 5-year period. Design and Methods: We used bivariate analysis to characterize older adults (n = 82) experiencing sexual abuse and the circumstances of the…
Fisher, Bonnie S.; Zink, Therese; Regan, Saundra L.
A clinical sample of 995 community dwelling women aged 55 and older were surveyed by telephone about their experience with psychological/emotional, control, threat, physical, and sexual abuse. Nearly half of the women experienced at least one type of abuse since turning 55. Sizable proportions were victims of repeated abuse, and many experienced…
Malmedal, Wenche; Iversen, Maria Helen; Kilvik, Astrid
Despite an increasing literature related to elder abuse, sexual abuse of older persons in general and of vulnerable adults living in nursing homes in particular is still sparsely described. The purpose of this study was to assess the state of knowledge on the subject of sexual abuse against older nursing home residents through a literature review. Systematic searches in reference databases including Cinahl, Medline, OVID Nursing Database, ISI Web of Science, PsycINFO, Cochrane Library, and SveMed + were conducted. Through several phases of selection of the articles, using strict inclusion and exclusion criteria, six articles were chosen for a deeper examination. Findings from the review show that sexual abuse occurs in nursing homes and that both older women and men are victims of sexual abuse. Perpetrators appear mainly to be staff and other residents and mainly to be men, but also women abuse both older men and older women. Findings from the literature review show that there is a need for knowledge and further research on the topic of sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step in seriously addressing sexual abuse against older persons. PMID:25642347
Atkins, Dianne; Loewenthal, Del
This paper presents the results of an heuristic study based on the research question: 'How do psychotherapists experience working with older clients?' The question came from the researchers' experience and interest in working with older clients in general practice. It started from the researchers' desire to examine more closely feelings and…
Flentje, Annesa; Heck, Nicholas C.; Sorensen, James L.
Objective This study evaluated whether sexual orientation-specific differences in substance use behaviors exist among adults entering substance abuse treatment. Method Admissions records (July 2007-December 2009) were examined for treatment programs in San Francisco, California receiving government funding. Lesbian, gay, and bisexual (LGB) persons (n=1441) were compared to heterosexual persons (n=11770) separately by sex, examining primary problem substance of abuse, route of administration, age of first use, and frequency of use prior to treatment. Results Regarding bisexual males, the only significant finding of note was greater prevalence of methamphetamine as the primary substance of abuse. When compared to heterosexual men, gay and bisexual men evidenced greater rates of primary problem methamphetamine use (44.5% and 21.8% respectively versus 7.7%, adjusted odds ratios [ORs] 6.43 and 2.94), and there was lower primary heroin use among gay men (9.3% vs. 25.8%,OR 0.35). Among LGB individuals, race and ethnicity did not predict primary problem substance, except that among LGB men and women, a non-White race predicted cocaine use (OR 4.83 and 6.40, respectively), and among lesbian and bisexual women, Hispanic ethnicity predicted lower odds of primary cocaine use (OR 0.24). When compared to heterosexual men, gay men were more likely to smoke their primary problem substance (OR 1.61), first used this substance at an older age (M = 23.16 versus M=18.55, p<.001), and used this substance fewer days prior to treatment (M=8.75 versus M=11.41, p<.001). There were no differences between heterosexual and lesbian or bisexual women. Conclusions There wereunique patterns of substance use for gay and bisexual men entering substance abuse treatment, but women did not evidence differences. Gay men evidenced unique factors that may reflect less severity of use when entering treatment including fewer days of use and a later age of initiation of their primary problem substances. The
Ganje-Fling, Marilyn A.; McCarthy, Patricia
Defines spirituality and discusses its relevance for counselors who work with childhood sexual abuse survivors. Describes the impact of abuse on client spirituality, and presents several suggestions for assessment and intervention approaches that address spiritual issues as part of the counseling process. (JPS)
Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.
Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…
Kedia, Satish; Sell, Marie A; Relyea, George
To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category-other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse. PMID:17996066
Taylor, Brian J; Killick, Campbell; O'Brien, Marita; Begley, Emer; Carter-Anand, Janet
This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as peer researchers. Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent: some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests. Preventing abuse requires a wide-ranging approach including rebuilding respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviors that have occurred. PMID:24779538
Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L.
History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence, psychological distress and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125
Ulibarri, Monica D; Strathdee, Steffanie A; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L
History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence (IPV), psychological distress, and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125
Knuuttila, Vesa; Kuusisto, Katja; Saarnio, Pekka; Nummi, Tapio
Background: The study examined the effect of the early working alliance on outcome in outpatient substance abuse treatment. Methods: A total of 327 clients and 33 therapists participated in the study. Data were collected in southern and western Finland in outpatient treatment units (N = 7). The dependent variables were percentage of days abstinent…
Senreich, Evan; Straussner, Shulamith Lala A.
Entering ("n"?=?475) and graduating ("n"?=?454) students at 3 master's of social work programs in the northeast were compared regarding their knowledge and attitudes concerning working with substance abusing clients. In comparison to entering students, graduating students demonstrated modestly higher levels of knowledge,…
Esposito-Smythers, Christianne; Walsh, Adam; Spirito, Anthony; Rizzo, Christie; Goldston, David B.; Kaminer, Yifrah
Substance use disorders and suicidal thoughts and behaviors commonly co-occur in adolescent and adult psychiatric populations and are often functionally interrelated. Although the evidence base for treatment of this population is sparse, integrated cognitive behavioral treatment (CBT) protocols, or those that rely heavily on CBT techniques, hold promise. In this paper, we provide an overview of the evidence-based literature for interventions that target suicidal behavior and substance use disorders with adults and adolescents. We then discuss the manner in which these behaviors may be functionally interrelated and offer a conceptual framework (S-O-R-C) to guide case conceptualization and treatment planning for clients with co-occurring suicidality and substance use disorders. Next, we provide a case example of a client with suicidal behavior and an alcohol use disorder and demonstrate how to apply an integrated CBT treatment protocol to this case. This case example is followed by a more general discussion about the potential advantages of integrated CBT protocols for suicidality and substance use disorders, guidelines for prioritizing treatment targets and skill selection for each individual client, and other important treatment considerations. We conclude with recommendations for future research in this area. PMID:23209362
McFarland, Bentson H.; Deck, Dennis D.; McCamant, Lynn E.; Gabriel, Roy M.; Bigelow, Douglas A.
Medicaid conversion from fee for service to managed care raised numerous questions about outcomes for substance abuse treatment clients. For example, managed care criticisms include concerns that clients will be undertreated (with too short and/or insufficiently intense services). Also of interest are potential variations in outcome for clients served by organizations with assorted financial arrangements such as for-profit status versus not-for-profit status. In addition, little information is available about the impact of state Medicaid managed care policies (including client eligibility) on treatment outcomes. Subjects of this project were Medicaid clients aged 18–64 years enrolled in the Oregon Health Plan during 1994 (before substance abuse treatment managed care, N = 1751) or 1996–1997 (after managed care, N = 14,813), who were admitted to outpatient non-methadone chemical dependency treatment services. Outcome measures were retention in treatment for 90 days or more, completion of a treatment program, abstinence at discharge, and readmission to treatment. With the exception of readmission, there were no notable differences in outcomes between the fee for service era clients versus those in capitated chemical dependency treatment. There were at most minor differences among various managed care systems (such as for-profit vs not-for-profit). However, duration of Medicaid eligibility was a powerful predictor of positive outcomes. Medicaid managed care does not appear to have had an adverse impact on outcomes for clients with substance abuse problems. On the other hand, state policies influencing Medicaid enrollment may have substantial impact on chemical dependency treatment outcomes. PMID:16215446
Counte, M A
OBJECTIVE: To address the likely influences, on options faced by older clients, of specific changes in the delivery system and several possible responses to these changes and the changed options, by older persons in the aggregate. STUDY DESIGN: Four specific topics are discussed at length: (1) the probable altered role for the older healthcare client brought on by organizational changes; (2) findings from research on elderly health maintenance behavior and reasons for the increased importance of this issue; (3) the effectiveness of the conventional approach to explaining health services utilization in population studies; and (4) recommendations for future research into the direct or indirect influence of organizational changes in the primary healthcare system on the health-related decisions and behaviors of older persons. PMID:9618677
Coon, David W.; Thompson, Larry W.; Gallagher-Thompson, Dolores
There is growing evidence that psychosocial treatments incorporating behavioral intervention strategies can be effective in the treatment of depression in older adults with cognitive impairment. However, less work with such cases has focused on the use of cognitive interventions in tandem with these behavioral intervention strategies. This case…
Knight, D K; Simpson, D D
Relationships with family and friends by 439 heroin addicts during the first 3 months of drug abuse treatment were examined in relation to behavioral improvements of clients. Family conflict and peer deviance were significant predictors of injection frequency and illegal activity during treatment, and reductions in family conflict were associated with lower drug use, injection frequency, and illegal activity during treatment. These results provide support for treatment emphasis on helping clients reduce conflict among family members, improve dysfunctional relationships with peers, and replace deviant friendships with others that encourage treatment participation and conformance to social norms. PMID:9058354
Knight, Danica K; Broome, Kirk M; Simpson, D Dwayne; Flynn, Patrick M
Objectives To examine organizational structural attributes associated with counselor–client contact. Data Sources Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. Study Design The study uses a naturalistic design to investigate organizational structure measures—ownership, accreditation, and supplemental services—as predictors of time in counseling and case management, and caseload size, controlling for geographic differences. Data Collection Directors at 116 outpatient drug-free treatment programs located in four regions across the U.S. (Great Lakes, Gulf Coast, Northwest, and Southeast) voluntarily completed a survey about program structure. Primary Findings Clients received more counseling hours in programs that were “intensive,” publicly owned, accredited, and had a lower proportion of recently hired counselors. More case management hours were offered in “intensive,” private-for-profit or publicly owned (versus private-nonprofit) programs, serving a lower proportion of dual-diagnosis clients, and providing more on-site supplemental services. Smaller caseloads were found in programs that were accredited and had a smaller average client census and a lower proportion of criminal justice referred clients. Conclusions Organizational attributes are related to counselor–client contact and may have implications for staff turnover and service quality. PMID:18370970
Stark, Susan; Landsbaum, Amanda; Palmer, Janice; Somerville, Emily K.; Morris, John C.
Background Remaining at home is a high priority for many older adults, but the capacity to “age in place” often is threatened by environmental barriers. Purpose To describe a client-centered occupational therapy, home modification intervention program and examine the impact of the intervention on daily activity performance over time. Methods Using a competence-environmental press framework, a client-centered home modification program for older adults was implemented. In this quasi-experimental, single group prospective study, participants’ subjective ratings of daily activity performance were evaluated before and after the intervention (baseline/post/post). Findings After home modification, participants’ perception of their daily activity performance at home improved significantly and was maintained 2 years post-modification. Implications Home modification may benefit older adults attempting to age in place. PMID:19757729
Bamatter, Wendy; Carroll, Kathleen M.; Añez, Luis M.; Paris, Manuel; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Suarez-Morales, Lourdes; Szapocznik, Jose; Martino, Steve
This study investigated the extent to which bilingual counselors initiated informal discussions about topics that were unrelated to the treatment of their monolingual Spanish-speaking Hispanic clients in a National Institute on Drug Abuse Clinical Trial Network protocol examining the effectiveness of motivational enhancement therapy (MET). Session audiotapes were independently rated to assess counselor treatment fidelity and the incidence of informal discussions. Eighty-three percent of the 23 counselors participating in the trial initiated informal discussions at least once in one or more of their sessions. Counselors delivering MET in the trial initiated informal discussion significantly less often than the counselors delivering standard treatment. Counselors delivering standard treatment were likely to talk informally the most when they were ethnically non-Latin. Additionally, informal discussion was found to have significant inverse correlations with client motivation to reduce substance use and client retention in treatment. These results suggest that informal discussion may have adverse consequences on Hispanic clients’ motivation for change and substance abuse treatment outcomes and that maintaining a more formal relationship in early treatment sessions may work best with Hispanic clients. Careful counselor training and supervision in MET may suppress the tendency of counselors to talk informally in sessions. PMID:20817381
Jonker, Irene E; Jansen, Carinda C J M; Christians, Milou G M; Wolf, Judith R L M
We conducted a concept mapping exercise to gain insight into the perspectives held by abused women and professionals with regard to appropriate care in Dutch women's shelters. Three brainstorming sessions generated 92 statements that were then rated by 56 clients and 51 professionals. A total of 11 clusters were identified. The three most important clusters were "help with finding a safe house if necessary," "safety and suitable care for the children," and "a personalized, respectful approach." The most important statement was "take women seriously and treat them with respect." The mapping exercise identified key practice-based elements of intervention that should better accommodate the needs of shelter-based abused women. We have used these elements in developing a new intervention for shelter-based abused women in the Netherlands. PMID:24686124
Reilly, Patrick M.; Shopshire, Michael S.; Durazzo, Timothy C.; Campbell, Torri A.
This manual and workbook set focuses on anger management. The manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger programs. The manual describes a 12-week cognitive behavioral anger management group treatment. Each of the 12 90-minute…
Chana, Richard; Marshall, Paul; Harley, Clare
The intermediate care team supports patients in their own homes to manage complex needs. They are ideally placed in the community to identify older adults at risk of loneliness. However, little is known about how intermediate care team professionals perceive, detect or respond to loneliness in their clients. This study explores intermediate care team professionals' attitudes to loneliness in the context of perceived service priorities and their experiences of managing loneliness in their clients. Eight professionals (n=2 physiotherapists, n=3 occupational therapists, n=3 nurses) took part in semi-structured interviews. Data were analysed thematically using framework analysis, applying the theory of planned behaviour as an interpretive framework. Intermediate care team professionals see loneliness as a significant issue for many of their older clients but a low priority for intermediate care team services. They believe that loneliness often goes undetected because it is difficult to measure objectively. Barriers to managing loneliness included high workloads, unsatisfactory referral systems and lack of close working with social care and independent sector services. Brief but reliable loneliness assessments into routine practice, receiving training on detecting and managing loneliness, and improving working relationships with social care and independent sector services were highlighted as strategies that could improve the detection and management of loneliness in intermediate care team clients. PMID:27270197
Loreck, David; Brandt, Nicole J; DiPaula, Bethany
Opioid use disorder is a public health epidemic. There is increasing attention being given to opioid abuse and overdose in the United States. The overall use of illicit substances by older adults is on the rise and in part can be attributed to the aging of Baby Boomers. Furthermore, much attention is being given to prescription opioid drug overdose, but it is important to note that heroin-related deaths have also increased sharply. Heroin use is part of a larger substance abuse problem, with more than nine in 10 individuals who use heroin also using at least one other drug (e.g., cocaine, prescription opioid medication). The current article highlights treatment approaches, namely buprenorphine, buprenorphine/naloxone, and naltrexone; insurance considerations; and resources to aid in understanding and managing this public health crisis. PMID:27027362
Farber, Barry A; Feldman, Sarah; Wright, A Jordan
This study investigated the perceptions of adult clients (N=98; M age=32) with a history of childhood sexual abuse (CSA) of the costs and benefits of disclosure of this material. Significant benefits of disclosing included a sense of relief from sharing bottled-up emotions, and feeling more accepted and understood by one's therapist; significant negative consequences included feeling emotionally overwhelmed, and feeling uncomfortably vulnerable and exposed. Linear regressions indicated that CSA patients who generally disclose more have a greater tendency to experience both positive and negative effects of disclosure about abuse. In addition, a hierarchical regression analysis indicated that higher levels of symptomatology were predictive of higher levels of anxiety related to disclosure in therapy, suggesting that clinicians need to be cautious in encouraging disclosure about CSA with patients with severe pathology. PMID:23906369
Cannell, Michael B; Manini, Todd; Spence-Almaguer, Emily; Maldonado-Molina, Mildred; Andresen, Elena M
We describe the annual prevalence of sexual abuse among community-dwelling older adults in the United States. We also describe factors associated with experiencing sexual abuse. We used data from 24,343 older adults from the 2005 Behavioral Risk Factor Surveillance System pooled across 18 states. We estimated prevalence of sexual abuse, bivariate distributions, and odds ratio associations across demographic, health, and contextual factors. Our results show that 0.9% of older adults reported experiencing sexual abuse in the previous year. This represents approximately 90,289 community-dwelling older adults. We also report on factors associated with experiencing recent sexual abuse. There was a significant gender by binge drinking interaction, with a stronger association among women. There is a need for health promotion efforts targeted specifically toward older adults, encouraging them to seek services, if possible, after exposure to sexual abuse. PMID:24410194
Bial, Martha C.; Gutheil, Irene A.; Hanson, Meredith; White-Ryan, Linda
This article reports on a project to sensitize graduate social work students taking courses in substance abuse to the needs of older adults. Graduate social work students at a major urban school of social work in the Northeast were recruited and trained to interview older adults with a history of substance abuse problems regarding their life…
Domestic abuse is widespread and indiscriminate. Older women living with domestic abuse report more health-related concerns than any other group, and demonstrate a higher incidence of significant mental health issues. Research suggests that older women who have experienced domestic abuse are not having their psychological and physical support needs met by existing services. This article examines the physical and mental health issues that older women face as a result of abusive relationships, and the barriers to seeking help. Multidisciplinary healthcare professionals can facilitate the therapeutic engagement of older women living with domestic abuse. Refuges and related interventions are limited in terms of the support they can offer, however, research suggests that developing a stepped approach, tailored to suit older women's needs, could be beneficial. PMID:27353789
There is virtually no literature concerning the experiences of self-identified heterosexual clients in substance abuse treatment who have a history of same-gender sexual contact (HSGS). In a U.S. urban inpatient program in 2009-2010, 99 HSGS clients were compared to 681 other heterosexual and 86 lesbian, gay, and bisexual clients regarding background factors, program completion rates, and feelings about treatment. Male HSGS participants had lower completion rates than other male heterosexual participants. Qualitative data indicated that most male HSGS participants experienced difficult emotions regarding same-gender sexual encounters, particularly those involving trading sex for money or drugs. Implications for treatment are discussed. PMID:25364839
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous
Didden, Robert; Embregts, Petri; van der Toorn, Mirjam; Laarhoven, Nina
Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who…
Goldstein, R B; Powers, S I; McCusker, J; Mundt, K A; Lewis, B F; Bigelow, C
We examined gender differences in manifestations of DSM-III-R antisocial personality disorder in 106 male and 34 female drug abusers enrolled in residential relapse prevention/health education treatment. In childhood, compared to males, females had more often run away but less often used weapons in fights, been cruel to animals, and set fires. Females also reported less vandalism. In adulthood, women had more often been irresponsible as parents and in financial matters, engaged in prostitution, made money finding customers for prostitutes, been physically violent against sex partners and children, failed to plan ahead, and lacked remorse. Our findings suggest that addiction treatment programs need to consider gender differences in antisocial symptomatology in the development of individualized treatment programs for both male and female clients. PMID:8793308
Carmel, Melissa J. Sheehy; Friedlander, Myrna L.
The authors assessed burnout, compassion fatigue, secondary trauma symptoms, and compassion satisfaction in relation to experienced therapists' perceptions of the working alliance. Participants, 106 specialists in the treatment of clients who commit sexual abuse, completed the Working Alliance Inventory-Short Form (T. J. Tracey & A. M. Kokotovic,…
Ford, Chandra L.; Lee, Sung-Jae; Wallace, Steven P.; Nakazono, Terry; Newman, Peter A.; Cunningham, William E.
The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus (HIV) testing of every client presenting for services in venues where HIV prevalence is high. Because older adults (age>50 years) have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent (past 12 months) and ever HIV testing in a probability sample of at-risk adults (N=1,238) seeking services in needle exchange sites, sexually transmitted disease clinics and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category (<50 years vs. >50 years) and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months (OR=0.6; 95% CI=0.40–0.90) or ever (OR=0.6; 95% CI=0.40–0.90). Aging-related disparities in HIV testing exist in these high HIV prevalence venues, and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. PMID:25303208
Sachs-Ericsson, Natalie; Medley, Amanda N.; Kendall – Tackett, Kathleen; Taylor, John
Objectives Child abuse has negative consequences on health functioning and the self-concept. Prior studies have garnered support for these relationships in younger adults; yet few studies have looked at the effects of abuse on health in older adults and the psychosocial variables, specifically self-efficacy, that may influence the abuse-health relationship. Methods Data obtained from the Physical Health and Disability Study were used to explore the impact of child abuse on current medical problems among older adults who were screened on physical disability status (N=1396, Mean age = 67, SD = 10.2). The study was conducted in South Florida and employed a multiethnic sample that is representative of the general population in this area. Results Child abuse was associated with the number of current medical problems and disability. Child abuse was also related to lower self-efficacy, and self-efficacy explained the relationship between abuse and the number of health problems. Conclusions There are far reaching effects of child abuse on older adults' health and self-concept. Health care providers and gerontologists need to be aware that child abuse is a life-long risk factor for increased disability and specific health problems, especially among the elderly. Future research should examine treatments designed to increase self-efficacy, especially among those who experienced child abuse, and observe any positive effects on health functioning. PMID:21922052
Ziminski Pickering, Carolyn E; Rempusheski, Veronica F
One out of 10 older adults experiences elder abuse in their lifetime, though less than one third of these cases ever get reported. The purpose of this study was to describe older adults' perceptions of physical abuse (PA) as a type of elder abuse including reasons why they may or may not self-report. An author developed vignette scale was used to present three types of PA and three barriers to reporting for each of three living situations. Older adults (n = 76) rated perceptions of whether or not the situation is abusive, likelihood of reporting and likelihood of reporting when presented with each of three barriers. The study participants had a consistent perception of PA; however the barriers affected their likelihood of reporting, which varied across types and situations. The results provide further evidence that reporting abuse is multifactorial and have implications for educational interventions. PMID:24341952
Lee, Anselm C. W.; Ou, Yvonne; Fong, Dawson
Objective: To describe a pattern of abusive head injury in a series of children older than 4 years of age. Methods: A hospital chart review of abused children with skull fractures from 1999 to 2001 was carried out. The clinical features, social background, and subsequent outcome and management are described. Results: An 11-year-old girl and a pair…
Allers, Christopher T.; And Others
Presents case studies and discussions regarding 3 observed characteristics of unresolved childhood sexual abuse in adult survivors over 65 years of age. Specifically, chronic depression, elder abuse, and misdiagnosis of residual abuse trauma as dementia or mental illness are compared to parallel issues identified by researchers working with…
Landrum, Brittany; Knight, Danica K.; Becan, Jennifer E.; Flynn, Patrick M.
Increasing motivation and raising retention rates are considerable challenges for providers of adolescent substance abuse treatment. Research has shown that motivation for treatment, social influences (peers, family, counselors), and for some clients external pressure from the juvenile justice system, can serve as key factors in successful retention. To further understand influences on motivation and retention, focus groups were conducted in two residential treatment facilities. Adolescent clients, parents, and treatment staff were asked to describe their experiences with the treatment process focusing specifically on factors related to treatment attrition and retention. Qualitative data analysis revealed five themes affecting retention either positively or negatively. Themes included relationships (with family, peers, and counselors), responsibility (degree to which clients embrace jobs, roles, and rules), emotional regulation (ability to express feelings appropriately), thinking (identifying behavior patterns and recognizing consequences), and self-efficacy (feelings of empowerment). Implications for future research and for developing strategies aimed at increasing motivation and retention are discussed. PMID:26457049
Hirst, Sandra P; Penney, Tasha; McNeill, Susan; Boscart, Veronique M; Podnieks, Elizabeth; Sinha, Samir K
A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed. PMID:27086668
Brown, B. Bradford; Chiang, Chi-Pang
Compared 21 older clients of drug treatment facilities, 30 older abusers not in treatment, and 155 elderly nonabusers. Analyses suggested that age and gender affect the likelihood of receiving treatment more than the likelihood of being an abuser. Substance abuse appeared more prevalent among single elderly who lived alone. (JAC)
Erlingsson, Christen L
Doing violence and evil always indirectly or directly leads to making someone else suffer. Such is the dialogical structure of evil and it seems to be the dialogical structure of elder abuse as well. There is a perturbing sameness between definitions of evil and definitions of elder abuse. It is hard at times to see how or if there is any line of demarcation between the subjects. Two modern-day philosophers, Paul Ricoeur and Simone Weil have delved particularly into the concept of evil. The symbolism Ricoeur analyses in depth is that of defilement, sin, and guilt and the concept of the servile will. Integral in Weil's description of evil are the concepts of suffering and the special situation of extreme suffering, termed affliction. Grounded in the writings of Ricoeur and Weil, this paper is a series of reflections on the intersection of evil and elder abuse as exemplified in the narrative of an abused older woman. This woman provided around the clock care at home for her husband who had vascular dementia. She was also abused by her husband. This was witnessed by both family and others but no one intervened. In her narrative there were indications of defilement, sin, guilt, and true affliction as a servile will. This paper illuminates the evil of elder abuse that is harm and suffering, and the challenge of untangling issues of blame, free will, responsibility, and self-determinism. When engaging with abused, older persons it can be worthwhile for nurses to enter the encounter with non-judgemental compassion founded on the human to human connection and recognition of our mutual fallibility and potential for evil that is part of our human fragility. PMID:21906229
Iversen, Maria Helen; Kilvik, Astrid; Malmedal, Wenche
The objective of this study was to increase knowledge of sexual abuse against older residents in nursing homes. A qualitative approach was used. Through a focus group interview with staff in nursing homes, the aim was to reveal employees' thoughts, experiences, and attitudes. Findings from the focus group interview show that sexual abuse of older residents is a taboo topic among health professionals. Acts of sexual abuse are difficult to imagine; it is hard to believe that it occurs. The fact that staff are not aware that it could happen, or have a hard time believing that it actually happens, can amplify the residents' vulnerable position as potential victims of abuse, and it makes it even more challenging to report or uncover such acts. The study highlights the need for education of all health care workers in Norway as well as more research on sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step towards addressing sexual abuse of the aged in a more appropriate way. Further research must aim to reveal more about this taboo area. PMID:26078879
Fisher, Bonnie S.; Regan, Saundra L.
Purpose: This study assessed the extent of different types of abuse, repeated and multiple abuse experiences among women aged 60 and older, and their effects on the women's self-reported health. Design and Methods: A cross-sectional study of a clinical sample of 842 community-dwelling women aged 60 and older completed a telephone survey about type…
Schonfeld, Lawrence; Larsen, Rebecca G.; Stiles, Paul G.
Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims…
Forman, Julia M.; McBride, Rebecca G.
Mistreatment of older adults is commonplace. These individuals are subjected to abuse, financial exploitation, and neglect. The authors present an overview of the literature concerning mistreatment, with an emphasis on clinical, ethical, and legal considerations. Methods are proposed for prevention, including counselor education, advocacy, and…
Cook, Paddy; Davis, Carolyn; Howard, Deborah L.; Kimbrough, Phyllis; Nelson, Anne; Paul, Michelle; Shuman, Deborah; Brooks, Margaret K.; Dogoloff, Mary Lou; Vitzthum, Virginia; Hayws, Elizabeth
As alcohol and other drug disorders become acknowledged as major problems, the need increases for current information on the scope of the problem and appropriate treatment. This TIP serves to educate treatment providers with information about older adults who, in general, are more likely to hide their substance abuse, less likely to seek…
Francis, Denille M.; Kaiser, Donna; Deaver, Sarah P.
Presents results of a study of the graphic indicators in drawings by patients with substance abuse disorders. The Bird's Nest Drawing, an assessment task previously devised to elicit pictorial representations of attachment security, was used to examine attachment patterns of volunteers. Results showed that those with substance abuse diagnoses were…
Morgan, Betty D; Rossi, Anne P
Complex clients with comorbid HIV disease, other medical illness, psychiatric illness, and substance abuse problems present tremendous challenges to providers. Medication adherence and case management become vital issues in providing comprehensive care to this population. This report describes the practice of two advanced practice psychiatric registered nurses who worked collaboratively with each other and with nurse practitioners to provide care to such complex clients. Description of collaborative practices and the model of collaboration used by the two practitioners are highlighted through three case studies. Conclusions about the practice and its use with complex clients are provided. PMID:17991601
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous drug use. Clients
Schiff, Miriam; Katz, Katalin
Objective: This study is the first in a comprehensive examination of therapeutic components and outcome of interventions in a public, nonresidential service for drug addicts in Jerusalem (SHALEM). Method: Data were gathered from 153 clients (35 women, 128 men; 35 Arabs, 118 Jews; median age = 39) using clinical data mining. Results: Men who had…
Winogrond, Iris R.; Mirassou, Marlene M.
Compares adult and elderly clients of a Crisis Intervention Service in an urban metropolitan area, which included a telephone counseling/referral service and a mobile intervention team for home assessments. Findings indicated the importance of using a biopsychosocial model, particularly in the assessment of elderly persons. (JAC)
Senreich, Evan; Straussner, Shulamith Lala A.
This study compared 248 graduating seniors with 301 beginning juniors at 10 bachelor's-level social work programs in the Northeast concerning their knowledge and attitudes regarding working with substance-abusing clients. Graduating seniors demonstrated modestly higher levels of knowledge and only slightly more positive attitudes toward…
Glover, Noreen M.; And Others
Volunteer participants (n=77) enrolled in 8 substance abuse treatment facilities were surveyed in order to examine the prevalence and nature of incest contacts among the group. Results indicated that approximately 49 percent of the participants had reported histories of incest. Data are presented under various parameters. Also gives comparisons by…
Mundon, Chandra R; Anderson, Melissa L; Najavits, Lisa M
Despite the high prevalence of substance use disorder (SUD) and its frequent comorbidity with mental illness, individuals with SUD are less likely to receive effective SUD treatment from mental health practitioners than SUD counselors. Limited competence and interest in treating this clinical population are likely influenced by a lack of formal training in SUD treatment. Using a factorial survey-vignette design that included three clinical vignettes and a supplementary survey instrument, we investigated whether clinical psychology doctoral students differ in their level of negative emotional reactions toward clients with SUD versus major depressive disorder (MDD); whether they differ in their attributions for SUD versus MDD; and how their negative emotional reactions and attributions impact their interest in pursuing SUD clinical work. Participants were 155 clinical psychology graduate-level doctoral students (72% female). Participants endorsed more negative emotional reactions toward clients with SUD than toward clients with MDD. They were also more likely to identify poor willpower as the cause for SUD than for MDD. More than a third reported interest in working with SUD populations. Highest levels of interest were associated with prior professional and personal experience with SUD, four to six years of clinical experience, and postmodern theoretical orientation. PMID:26375324
Ball, Samuel A; Cobb-Richardson, Patricia; Connolly, Adrian J; Bujosa, Cesar T; O'neall, Thomas W
This study evaluated the psychiatric symptoms, psychosocial problems, and treatment response of personality-disordered substance abusers receiving services within a homeless drop-in center. Fifty-two homeless clients were assessed after program admission and randomly assigned to receive either individual psychotherapy focused on personality disorder and substance abuse relapse prevention (dual-focus schema therapy [DFST]) or standard group substance abuse counseling (SAC). Client functioning was assessed using measures of personality disorder, psychiatric symptoms, early maladaptive schemas, interpersonal problems, and addiction-related psychosocial impairment. Therapy retention (total weeks in treatment) and utilization (number of weeks in which sessions were attended) were the primary outcomes. Although rates of cluster B personality disorders were comparable to other substance dependent samples, clusters A and C disorders were disproportionately more common. Clients reported significant psychiatric symptoms, criminality, and psychosocial impairment, yet made limited lifetime use of mental health services. Overall, there was greater utilization of individual DFST than group SAC. However, clients with more severe personality disorder symptoms demonstrated better utilization of SAC than DFST. PMID:16122538
Most research on intimate partner violence to date has focused on young men. Although interest and research regarding older abused women has increased in recent years, research on the voices and experiences of older abusive men is still scarce. The purpose of this article is to present a typology of older battering men dwelling in lifelong intimate violence relationships. Fifteen older Israeli abusive men, aged 65 to 84 years, were interviewed in depth. Four types were identified: the "Non-quitter," the "Cover-up"-er, the "In-between"-er, and the "Normalizer." These types were constructed based on four dimensions: the construction of violence over the years, the perception of the spouse over the years, losses accompanying the violent relationship, and the meaning of violence in old age. The four types enable an in-depth look at the experiential world of older abusers and paint a complex picture of various ways in which abusive men live with violence over time. PMID:23339131
Schiff, Miriam; Levit, Shabtay; Cohen-Moreno, Rinat
This study investigated association between post-traumatic stress disorder (PTSD) and a 1-year follow-up heroin use among female clients in methadone clinics in Israel. Participants were 104 Israeli female clients from four methadone clinics (Mean age = 39.09, SD = 8.61) who reported victimization to childhood sexual abuse. We tested traces in urine of these female clients for heroin a year preceding and a year following the assessment of their PTSD. Results show that 54.2% reported symptoms that accedes the DSM-IV criteria for PTSD. We found that among childhood victimized women PTSD is associated with more frequent use of heroin at a 1-year follow-up even after controlling for duration of the stay at the clinic, background, other traumatic experiences and heroin use a year prior the assessment of their PTSD. This study shows the potential long-run negative consequences of childhood sexual abuse. Not only are these sexually abused women trapped into drug dependence and addiction, they cannot break the vicious cycle of continuing the use of illicit drugs even when treated for their addiction. One major practice implication is that treatment for PTSD proven efficacious will be provided in the methadone and other drug treatment services. PMID:20938876
Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer
The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. PMID:25092045
Ballantyne-Rice, Madeleine; Chopp, Kayla; Evans, Lisa; Ho, Vanessa; Hsiung, Wan Ping; Simon, Marian Alexandra; Wu, Kaiyu; Donnelly, Tam Truong
Central to nursing practice is the promotion of health and wellness practices. Drawing on the Community as Partner Model, nursing process, Nursing Interventions Classification, and Logic Model, second-year nursing students collaborated with staff and residents of an assisted living facility to promote health and wellness in the older adult population. Windshield surveys, resident surveys, key informant interviews, and focus group interviews were conducted to gain insight into the perceptions and experiences of staff and residents. The majority of residents indicated they were satisfied with life at the facility and their needs have been adequately met. Strengths and areas for improvement were identified in several aspects, including the facility atmosphere and location, quality of staff and health care services, recreational and dietary services, and social support networks. By partnering with community key stakeholders, valuing all different perspectives, and connecting theory to practice, a successful client-centered community clinical project was demonstrated. [Journal of Gerontological Nursing, 42(8), 44-51.]. PMID:27263539
Feeney, Joanne; Kamiya, Yumiko; Robertson, Ian H; Kenny, Rose Anne
Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early-life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population-based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self-rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding. PMID:24265204
Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon
Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and…
Milrod, Christine; Monto, Martin
While there is evidence of increasing rates of sexually transmitted infections (STIs) among older men in the United States, there has been little research on older male clients of female sex providers. The purpose of the current study was to understand the sexual risk behaviors and psychosocial correlates among older men hiring sex providers through provider review websites and discussion boards. A convenience sample of 208 male clients ages 60 to 84 completed online surveys about their sexual behavior and psychosocial factors. Participants indicated the most common sexual activities with providers in the past 12 months were receiving condomless fellatio (33.7%) and having penile-vaginal intercourse with a condom (31.7%). Although condomless penile-vaginal sex with a provider in the past 12 months was only reported by 2.9%, about half (51%) of the respondents indicated that they had experienced this at least once during their lifetime. This was associated with a preference for providers who do not require condoms, having been previously diagnosed with an STI, and perceiving one's HIV risk to be higher, as well as advancing age and having more emotional relationships with providers. Findings demonstrate the need for general and sexual health care practitioners to openly discuss protective measures and strategies for avoiding STIs among their older-to-elderly male patients. PMID:26739295
Melchiorre, Maria Gabriella; Di Rosa, Mirko; Lamura, Giovanni; Torres-Gonzales, Francisco; Lindert, Jutta; Stankunas, Mindaugas; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Macassa, Gloria; Soares, Joaquim J. F.
Background Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims. Methods The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal. Results Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused. Conclusions Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting
... also may fall prey to strangers who take advantage of their cognitive impairment. Types of abuse Signs ... property) to his or her disadvantage or the advantage of someone else Sexual abuse: touching, fondling or ...
Tredal, Ingrid; Soares, Joaquim J. F.; Sundin, Orjan; Viitasara, Eija; Melchiorre, Maria Gabriella; Torres-Gonzales, Francisco; Stankunas, Mindaugas; Lindert, Jutta; Ioannidi-Kapolou, Elisabeth; Barros, Henrique
Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression). Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60-84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with…
Dong, Xin Qi; Li, Ge
Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse.
... for adults 18-59 (21.6%), followed by physical abuse (19.5%), and caregiver neglect/abandonment (18.3%) ( ... third largest category for adults 18-59 was physical abuse (13.2%). Percentages of self-neglect appeared to ...
Goldhar, Jodeme; Daub, Stacey; Dhalla, Irfan; Ellison, Philip; Purbhoo, Dipti; Sinha, Samir K
The Toronto Central Community Care Access Centre is leading a collaborative local health integration network systemic change initiative to implement and evaluate a practical model of integrated care for older adults with complex needs. The approach is embedded in the community where older adults and their families live and is designed to first and foremost improve the quality of care while ultimately bending the cost curve. The model is leveraging and aligning existing system resources by bringing together sectors from across the health system to create ways of working that build capacity in the system to be more responsive to this population. Outcomes to date will be discussed and next steps described. The secondary goal was to understand the key elements of this integration that can be scaled locally and across the province. PMID:25591612
Soones, Tacara; Ahalt, Cyrus; Garrigues, Sarah; Faigman, David; Williams, Brie A.
With the rapid aging of the criminal justice population, legal professionals increasingly provide front-line identification and response to age-related health conditions (including cognitive and physical impairments) that may affect legal outcomes, such as the ability to participate in one's defense or stay safe in jail. The goals of this study were to assess legal professionals’ ability to recognize and respond to age-related conditions that could affect legal outcomes and to identify recommendations to address important knowledge gaps. This was a mixed quantitative-qualitative study. Legal professionals (N=72) in the criminal justice system were surveyed to describe their demographics, expertise and prior aging-related training, and to inform the qualitative interview guide. Those surveyed included attorneys (district attorneys (25%), public defenders and legal advocates (58%)), judges (6%), and court-affiliated social workers (11%). In-depth qualitative interviews were then conducted with a subset of 10 legal professionals who worked with older adults at least weekly. Results from the surveys and interviews revealed knowledge deficits in four important areas: age-related health, identification of cognitive impairment, assessment of safety risk, and optimization of services upon release from jail. Four recommendations to close these gaps emerged: (1) educate legal professionals about age-related health; (2) train professionals to identify cognitive and sensory impairment; (3) develop checklists to identify those at risk of poor health or safety; and (4) improve knowledge of and access to transitional services for older adults. These findings suggest that geriatrics knowledge gaps among legal professionals exist that may lead to adverse medical or legal outcomes for criminal justice-involved older adults and that partnerships between healthcare and legal professionals are needed to address these challenges. PMID:24611718
Lachs, Mark S; Pillemer, Karl A
Because older victims of abuse tend to be isolated, their interactions with physicians are important opportunities to recognize abuse and intervene. This review explores the manifestations of elder abuse and the role of multidisciplinary teams in its assessment and management. PMID:26559573
... or become violent. An older child may use drugs or alcohol, try to run away or abuse others. Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.
Sheykhi, Mohammad Taghi
The article explores and evaluates the quality of life, safety, and security of elderly people in Tehran City in Iran. In that, different dimensions of material and social well-being, and abuse of people of the age 65 and above, are assessed. Besides the human rights, the dignity, and the gradual decline of the elderly's social security are…
Domestic abuse is widespread and indiscriminate. Older women living with domestic abuse experience a number of health-related concerns and significant mental health issues. Research suggests that the needs of older women experiencing domestic abuse are not being met by existing services. This article examines the issues that older women face as a result of abusive relationships and the barriers to seeking help. Research suggests that a stepped approach, tailored to suit older women's needs, could be beneficial. PMID:27384810
Sandmoe, Astrid; Hauge, Solveig
Background Abuse of older people is a serious issue and is associated with an increased risk of morbidity and mortality, and professionals will encounter elderly victims of abuse in all areas of the health care system. An important health determinant is behavioral factors, including coping style, which will impact on how older people manage stress and maintain control in their lives, and thereby protect themselves from abuse. The aim of this study was to explore the coping strategies elderly people abused by their offspring used to manage everyday life. Methods A qualitative approach was used and 14 elderly victims of abuse were interviewed. The interviews were recorded, transcribed, and subjected to qualitative content analysis. Results Five main coping strategies were identified. The main strategy was linked to the role of parent. Another prominent strategy was attitude towards being victimized. Further strategies were associated with hope for a better relationship with offspring in the future, while others felt that they had done the best they could, or that their offspring were no longer their responsibility. The results are discussed in light of theoretical perspectives related to coping and resilience. Conclusion Abuse of older people by their offspring imposes severe stress on victims and challenges the values and beliefs about the caring nature of families. The findings of this study indicate that victims of abuse use a wide range of coping techniques to manage everyday life, and that some strategies help them to maintain their self-respect in their role as parents and find some sort of resilience. PMID:25045272
Abath, Marcella de Brito; Leal, Márcia Carréra Campos; Melo Filho, Djalma Agripino de; Marques, Ana Paula de Oliveira
This cross-sectional study aimed to determine the profile of physical abuse against older people who underwent forensic examination at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. The cases, with data from 1,027 forensic reports, were described according to characteristics of the incident, victim, and aggressor. Most cases of violence were produced by mechanical energy, either with blunt objects or by empty-handed attack; the most common day of the week was Sunday, most frequently in the evening, and in the victim's home; typical cases involved mild injuries on more than one part of the victim's body. The majority of the victims were men, 60 to 69 years of age, brown (mixed-race), married or living with a partner, and retirees/pensioners. The majority of the aggressors were men, known to the victim, and attacking alone. The social transcendence of violence against older people clearly calls for investment in programs to deal with the problem in order to ensure better quality of life for the elderly. PMID:20877940
Maxwell, Colleen J; Kang, Jian; Walker, Jennifer D; Zhang, Jenny X; Hogan, David B; Feeny, David H; Wodchis, Walter P
Background The heterogeneity evident among home care clients highlights the need for greater understanding of the clinical and social determinants of multi-dimensional health-related quality of life (HRQL) indices and of potential sex-differences in these determinants. We examined the relative contribution of social and clinical factors to HRQL among older home care clients and explored whether any of the observed associations varied by sex. Methods The Canadian-US sample included 514 clients. Self-reported HRQL was measured during in-home interviews (2002-04) using the Health Utilities Index Mark 2 (HUI2). Data on clients' sociodemographic, health and clinical characteristics were obtained with the Minimum Data Set for Home Care. The relative associations between clients' characteristics and HUI2 scores were examined using multivariable linear regression models. Results Women had a significantly lower mean HUI2 score than men (0.48, 95%CI 0.46-0.50 vs. 0.52, 0.49-0.55). Clients with distressed caregivers and poor self-rated health exhibited significantly lower HRQL scores after adjustment for a comprehensive list of clinical conditions. Several other factors remained statistically significant (arthritis, psychiatric illness, bladder incontinence, urinary tract infection) or clinically important (reported loneliness, congestive heart failure, pressure ulcers) correlates of lower HUI2 scores in adjusted analyses. These associations generally did not vary significantly by sex. Conclusion For females and males, HRQL scores were negatively associated with conditions predictive or indicative of disability and with markers of psychosocial stress. Despite sex differences in the prevalence of social and clinical factors likely to affect HRQL, few varied significantly by sex in their relative impact on HUI2 scores. Further exploration of differences in the relative importance of clinical and psychosocial well-being (e.g., loneliness) to HRQL among female and male clients
Grey, Carl; Hall, P Bradley
Opioid abuse, misuse and overdose is now a public health epidemic receiving political, medical, and media attention at all levels. Despite the fact that many people know someone suffering from addiction, there is very little research focusing on this issue in older adults. Chronic pain, a highly prevalent affliction for the aging population, has been accompanied by a significant increase in opioid use. This, along with some unique aspects of older adults (increased susceptibility to illness, higher likelihood of altered presentation of illness, and impaired recovery), means that great care needs to be taken when considering opioids for treatment. Prudent prescribing is possible, but universal precautions should be taken to reduce the risk of opioid abuse, misuse, and addiction. This review provides education, summarizes current literature, and gives guidance in universal precautions for prescribing opioids. PMID:27301154
Juhnke, Gerald A.; Watts, Richard E.; Guerra, Norma S.; Hsieh, Peggy
This article describes how the authors use prayer with clients who self-identify their personal faith in God and who have used prayer as a helpful recovery agent or who believe prayer would be helpful to their personal recovery.
Masson, Carmen L.; Shopshire, Michael S.; Sen, Soma; Hoffman, Kim; Hengl, Nicholas; Bartolome, John; McCarty, Dennis; Sorensen, James L.; Iguchi, Martin
This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. PMID:22985677
Acquavita, Shauna P; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine
Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; n=114) was referral to a preferred outpatient program with advance appointment optional. Client incentive (CI; n=97) offered up to $100 in gift cards for intake and attendance during the first 30days of treatment. Contracting with staff incentives (CSI; n=49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92 versus 52% in UC) and immediacy (1.0 versus 3.9days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361
Gooden, Lauren; Metsch, Lisa R; Pereyra, Margaret R; Malotte, C Kevin; Haynes, Louise F; Douaihy, Antoine; Chally, Jack; Mandler, Raul N; Feaster, Daniel J
HIV counseling with testing has been part of HIV prevention in the U.S. since the 1980s. Despite the long-standing history of HIV testing with prevention counseling, the CDC released HIV testing recommendations for health care settings contesting benefits of prevention counseling with testing in reducing sexual risk behaviors among HIV-negatives in 2006. Efficacy of brief HIV risk-reduction counseling (RRC) in decreasing sexual risk among subgroups of substance use treatment clients was examined using multi-site RCT data. Interaction tests between RRC and subgroups were performed; multivariable regression evaluated the relationship between RRC (with rapid testing) and sex risk. Subgroups were defined by demographics, risk type and level, attitudes/perceptions, and behavioral history. There was an effect (p < .0028) of counseling on number of sex partners among some subgroups. Certain subgroups may benefit from HIV RRC; this should be examined in studies with larger sample sizes, designed to assess the specific subgroup(s). PMID:26837631
Schiamberg, Lawrence B; von Heydrich, Levente; Chee, Grace; Post, Lori A
Few empirical investigations of elder abuse in nursing homes address the frequency and determinants of resident-on-resident abuse (RRA). A random sample of 452 adults with an older adult relative, ≥65 years of age, in a nursing home completed a telephone survey regarding elder abuse experienced by that elder family member. Using a Linear Structural Relations (LISREL) modeling design, the study examined the association of nursing home resident demographic characteristics (e.g., age, gender), health and behavioral characteristics (e.g., diagnosis of Alzheimer's Disease, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), types of staff abuse (e.g., physical, emotional), and factors beyond the immediate nursing home setting (e.g., emotional closeness of resident with family members) with RRA. Mplus statistical software was used for structural equation modeling. Main findings indicated that resident-on-resident mistreatment of elderly nursing home residents is associated with the age of the nursing home resident, all forms of staff abuse, all ADLs and IADLs, and emotional closeness of the older adult to the family. PMID:26026215
Storck, Michael; Black, Laura; Liddell, Morgan
Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. PMID:27338970
Billips, Kathleen; And Others
Researchers surveyed 78 clients in drug abuse treatment facilities to determine their perceptions regarding factors related to their use and abuse of drugs. About 40% of the sample began using drugs between 11 and 15 years of age. Males tended to begin using drugs at an earlier age than did females. Over 90% of participants reported using drugs…
Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...
Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...
Domestic abuse is widespread and indiscriminate, causing health-related concerns and mental health issues in older women. Research suggests their needs are not met by existing services. This article examines physical and mental health issues faced by older women as a result of abusive relationships, and the barriers that exist to seeking help. Healthcare professionals can facilitate therapeutic engagement of older women living with domestic abuse. Refuges and related interventions are limited, but developing a stepped approach, tailored to older women's needs, could help. PMID:27369732
Galea, Robert P.; And Others
Describes voluntary testing for human immunodeficiency virus (HIV) in a residential substance abuse treatment program; highlights discussion group involving 5 clients who tested positive for HIV. Notes that clients in HIV groups dropped out of treatment at significantly lower percentages than clients in general, indicating HIV identification…
Burnes, David P R; Rizzo, Victoria M; Courtney, Erin
Little is known about conditions associated with favorable elder mistreatment (EM) case outcomes. The fundamental goal of EM protective service programs is to alleviate risk associated with substantiated cases of elder abuse and neglect. Using the EM socio-cultural model, this study examined victim, perpetrator, victim-perpetrator relationship, social embeddedness, and socio-cultural factors predicting risk alleviation of EM cases. Data from a random sample of EM protective social service cases (n = 250) at a large community agency in New York City were collected and coded by multiple, independent raters. Multinomial and binary logistic regression were used to examine undifferentiated risk alleviation for the entire sample of EM cases as well as differentiated financial, emotional, and physical abuse sub-types. Undifferentiated EM risk alleviation was associated with male victim gender, older victim age, previous community help-seeking, and victim-perpetrator dyads characterized by a separate living arrangement and shorter term abuse longevity. Financial abuse cases with younger perpetrators were less likely to have risk reduction. Physical abuse risk reduction was less likely when the perpetrator was male and the victim-perpetrator dyad included different genders. Distinct findings across EM sub-types suggest a need to develop targeted practice strategies with clients experiencing different forms of EM. Findings highlight a need to develop EM protective service infrastructure around perpetrator rehabilitation. PMID:24407144
JACOB, Sabrina Anne; MOHAMMED, Fauziah; HASSALI, Mohamed Azmi Ahmad
Background: Client characteristics provide useful information for designing programs that target individuals with risk factors for substance use and for determining client retention. Therefore, this study examined the profiles of clients attending a methadone clinic. Methods: A cross-sectional analysis of clients of a methadone clinic was conducted through a survey to obtain a profile of methadone clients. Results: Of the 51 patients who responded (response rate: 66.2%), the mean (SD) age at which they started substance use was 19.8 (5.1) years. Friends were cited as the most regular source of drugs (82.4%), and heroin was the most commonly used drug (98%). Daily substance use was reported by 72.5% of the respondents; 23.5% admitted to having stolen money to purchase drugs; 92.2% tried quitting substance use on their own and 98% stated that the main reason for registering at the clinic was that they wanted to stop their drug dependence. Approximately 60% of clients were receiving methadone doses of less than 60 mg/day. Conclusion: Heroin is still the most popular drug of abuse and most clients still receive methadone doses below the recommended level, despite evidence of poor patient retention rates associated with these low doses. PMID:25892951
... Additional Resources Return to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified ... the most frequently cited risk factor associated with elder abuse and neglect. It may be the victim and/ ...
Kedia, Satish; Williams, Charles
Identifies and analyzes several variables important in predicting the likelihood of abstinence among substance abuse clients. Data was collected from 1,350 clients treated for alcohol or drug abuse in residential, halfway house, or outpatient facilities. Analyzing 22 variables as possible treatment outcome predictors, results found one…
Kosberg, Jordan I
From research findings and practice experiences, it is concluded that abuse of older men is especially invisible and underreported, compared to abuse of older women. It is proposed that attention should be directed not to gender, but to those conditions in different countries and cultures leading to abuse of both older men and women, including (but not limited to) economic problems, few alternatives to family care of the elderly, violence, changing characteristics of the family, ageism, and sexism. Advocates for the prevention of elder abuse should work together in combating, reducing, and eliminating the problem of elder abuse of both older men and older women. PMID:24779537
Lindsay, D. Stephen
This conference address examines the question of whether "memory work"--using therapeutic techniques to help clients recover suspected hidden memories of childhood sexual abuse--has led some clients to develop illusory memories or false beliefs. Prospective research on memory for childhood trauma indicates that the gist of traumatic childhood…
Hirschel, J. David; Keny, Janet R.
Discusses trend towards involving criminal offenders in substance abuse programs and utilizing outpatient settings in treatment. Appraises the treatment performance of both court-referred and voluntary clients and the impacts criminal-justice-referred clients may have upon other persons in treatment programs to which they are admitted. Discusses…
... of death from overdose and suicide. Rural and Urban Substance Abuse Rates (ages 12 and older, unless ... among rural youth aged 12-13 than among urban youth the same age. This study suggests that ...
Kane, Michael N.; Green, Diane
Human service students' (social work, criminal justice, public administration, psychology) were surveyed (N = 242). Their perceptions about older persons' resilience and recovery from substance abuse were investigated. Overall, respondents did not agree that treating older persons for a substance abuse problem was wasteful of resources or older…
Williams, June M.; Ballard, Mary B.; Alessi, Hunter
Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.
Cohen, Adam W., Ed.
This volume of six lessons provides expert information on a variety of issues in substance abuse counseling. The lessons, which may be applied toward continuing education credits, are: (1) "Ethics in Substance Abuse Rehabilitation" (Robert L. Hewes); (2) "Addressing the Needs of Clients with Traumatic Injury and Alcoholism" (Charles H.…
This chapter discusses current issues and future perspectives in relation to substance abuse counseling. Current issues include: abstinence versus controlled use; coercive versus voluntary treatment; and career development and counseling with clients with substance abuse problems. Future perspectives include: the impact of managed care; the…
Alert-Dancer, Claire; Halley, Nancy; Hamate, Maryam; Bernard-Bonnie, Anne-Claude
Medical evaluation of 316 children, mean age 6 years, found 39 perpetrators of sexual abuse were less than 16 years old and 15 were between 16 and 19. Young aggressors were more likely to abuse older female children. Adolescent aggressors appeared to engage in more genital/genital and genital/anal sexual abuse than older aggressors. (Author/DB)
Landrum, Brittany; Knight, Danica K.; Flynn, Patrick M.
This paper explores the impact of organizational attributes on client engagement within substance abuse treatment. Previous research has identified organizational features, including small size, accreditation, and workplace practices that impact client engagement (Broome, Flynn, Knight, & Simpson, 2007). The current study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the U.S. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, while engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress, but was not related to participation. Two additional organizational measures – workload and influence – moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are discussed. PMID:22154029
Ellis, Thomas E.; Patel, Amee B.
The loss of a client to suicide is a painful personal and professional experience for mental health providers. Whether trainee or experienced professional, the affected clinician often reports feeling overwhelmed and unprepared for the experience of client suicide, together with significant emotional distress and diminished work performance. In…
Heppner, P. Paul; Heesacker, Martin
Examined interpersonal influence process within counseling including relationship between perceived counselor expertness, attractiveness, and trustworthiness and client satisfaction; between client expectations on perceived counselor expertness, attractiveness, trustworthiness, and client satisfaction; and effects of actual counselor experience…
Heck, Lauri; Gillespie, Gordon L
Abuse of senior citizens should be paradoxical in a civilized society; however, the U.S. Government Accountability Office reports that 14.1% of noninstitutionalized older adults experienced some type of abuse within the previous year. This is suspected to be an underestimation of the number of abuses reported. In a society where the older population is predicted to increase significantly, it is likely that the number of cases for abused elders will increase proportionately. Through the success of advocacy groups to raise awareness of child and domestic partner abuse, funding has been channeled to shelter these abuse victims. The same cannot be said for elders who are abused. Providing shelter in a safe, secure, medically appropriate environment, free from violence, for an older adult is essential. This article describes a community's collaborative health planning process to respond to elder abuse and develop a program to shelter elders experiencing abuse or suspected abuse. PMID:23636048
... Latest Research Getting More Help Related Topics Anxiety COPD Delirium Depression Pain Management Prevention Related News Older Adults Who Drink Alcohol at Risk for Drug Interactions Monday, November 23, 2015 Join our e-newsletter! Aging & Health A to Z Drug and Substance Abuse ...
Krowchuk, H V
This article reports the results of an investigation of nurses' stereotypes of child abusers. Ninety-four registered nurses completed a questionnaire that measured subjects' knowledge of child abuse; professional contact with perpetrators and victims of abuse; knowledge of the causes of child abuse; and child abuser stereotypes. Results reveal a consensus among the subjects as to the stereotypes associated with child abusers. This study supports the notion that nurses stereotype individuals on the basis of demographic characteristics. This study also raises questions regarding the bias that may result from the use of child abuser stereotypes. Clinical decision-making processes could become compromised if biased judgements are used in planning nursing care for clients diagnosed as child abusers. PMID:2930179
Ghetti, Simona; Goodman, Gail S.; Eisen, Mitchell L.; Qin, Jianjian; Davis, Suzanne L.
A study investigated the consistence of 222 children's (ages 3-16) reports of sexual and physical abuse. Older children were more consistent, children were more consistent when reporting sexual abuse, and girls were more consistent in sexual abuse reports. Consistency in sexual abuse reports was predicted by measures of memory. (Contains…
Pope, Natalie D.; Kang, Byungdeok
Social workers employed in areas such as public child welfare, substance abuse, and corrections often provide services to involuntary clients. These individuals do not seek social work services on their own volition and may be actively opposed to the services they are receiving. This study explores social work students' attitudes about working…
Large numbers of clients entering publicly-funded substance abuse treatment facilities cite problems with alcohol as one reason for seeking treatment. This report presents the results of a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES) data set. It profiles the treatment experiences of three study groups that…
Carone, Stacia S.; LaFleur, N. Kenneth
Examines judgment of counseling students, with history of sexual or physical abuse, about their attitudes towards counseling adolescent sex offenders. Reports sexually abused counselors desired to see physically abused offenders as clients over sexually abused offenders. Presents implications for counseling, including ways in which nonabused…
Sophia Client Version 12 offers command line access to the Sophia Daemon and the Sophia database files. It provides print, fingerprint, acknowledge, color coding and status access to these other resources.
Dworkin, S H
Therapists, having recently come to terms with treating gay and lesbian clients, now must consider the issues that bisexual clients face. This article reviews the literature on what it means to identify as bisexual in a world where sexual identity is viewed as dichotomous, heterosexual at one end and gay or lesbian at the other end. The article explores sexual identity and its biological versus social origins, internalized biphobia, coming out, relationship patterns, and therapist issues. Two cases illustrate issues that might arise when a therapist is treating a bisexual client. The first case is a 17-year-old young woman who is accepting of her bisexual identity, and the second case is a 56-year-old woman, heterosexually identified and married, who suddenly fell in love with a woman. Concluding remarks focus on some future directions for research and work with bisexual clients. PMID:11304706
Yaffe, Mark J.; Tazkarji, Bachir
Abstract Objective To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse. Sources of information MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed. Main message Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index. Conclusion Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions. PMID:23242889
... Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs ... may be a sudden change in the person's financial situation. Elder abuse will not stop on its ...
... facilities or nursing homes. The mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, ...
... puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...
Petkus, Andrew J.; Wetherell, Julie Loebach
Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…
... abuse References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Weiss RD. Drugs of abuse. In: Goldman ...
McCollister, Kathryn E; French, Michael T; Pyne, Jeffrey M; Booth, Brenda; Rapp, Richard; Carr, Carey
There is a considerable disparity between the number of individuals who need substance abuse treatment and the number who actually receive it. This is partly due to the fact that many individuals with substance use disorders do not perceive a need for formal treatment. Another contributing factor, however, is a discrepancy between the real and perceived cost of services. Although many cost evaluations of substance abuse treatment have been conducted from the treatment provider perspective, less is known about the client-specific costs of attending treatment (e.g., lost work and leisure time, transportation, out-of-pocket and in-kind payments). Concerns about financial and other barriers to participating in treatment have encouraged addiction researchers to more carefully consider these previously unmeasured costs. To address this information gap, we administered the Client Drug Abuse Treatment Cost Analysis Program (Client DATCAP) to 302 clients (representing a total of 302 outpatient and 142 inpatient treatment episodes) as part of a larger study examining the cost-effectiveness of interventions designed to improve treatment linkage and engagement in Dayton, Ohio. The value of a client's time accounted for the largest component of total cost (more than 59%). The cost per visit for outpatient clients ranged from $19 for outpatient methadone to $38 for intensive outpatient/aftercare treatment. The average cost per day of treatment for inpatient clients was $235. Policy makers and treatment providers now have a broader view of the opportunity cost of addiction treatment and can use this information to support initiatives for improved treatment access and delivery. PMID:19574000
Greener, Jack M; Joe, George W; Simpson, D Dwayne; Rowan-Szal, Grace A; Lehman, Wayne E K
This study focused on the relationship between organizational functioning factors measured in a staff survey using the Texas Christian University (TCU) Organizational Readiness for Change assessment and client-level engagement measured by the TCU Client Evaluation of Self and Treatment in drug treatment programs. The sample consisted of 531 clinical and counseling staff and 3,475 clients from 163 substance abuse treatment programs located in nine states from three regional Addiction Technology Transfer Centers. Measures of client engagement in treatment (rapport, satisfaction, and participation) were shown to be higher in programs with more positive staff ratings of organizational functioning. In particular, these programs had fewer agency needs and more favorable ratings for their resources, staff attributes, and climate. These findings help establish the importance of addressing organizational factors as part of an overall strategy for improving treatment effectiveness. PMID:17433863
Efrat, M.; Bercovitch, J.
Throughout the world the two superpowers often conduct their global conflict by proxy, taking different sides in regional disputes. An important question of international relations is where the balance of power lies in the superpower client state relationship-how far are the interests of the superpower subordinated to those of the client state or vice versa. Taking the two case studies of the US-Israel relationship and the Soviet-Syrian relationship, this book explores the perceptions by each side of the relationship and the reality. It goes on to make general conclusions about superpower-client state relationships. Contents: Introduction; In Search of a Theoretical Framework; Client-States in Superpower Perception; Superpowers in Client States' Perception; The Case of US-Israel Relations; Israel in US Perspective; The USA in Israeli Perspective; Flows of US Civilian and Military Resources to Israel; The Case of Soviet-Syrian Relations; Syria in Soviet Perspective; The USSR in Syrian Perspective; Flows of Soviet Civilian and Military Resources to Syria; Comparative Analysis and Conclusions; Overview of the two cases studies and conclusions.
Myers, Bronwyn; Fakier, Nuraan
To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…
Koder, Deborah-Anne; Helmes, Edward
Despite the growing number of older adults that implies an increasing need for psychological services, few psychologists choose to specialize in working with older clients. The present cross-sectional research examined predictors of student interest in working with older clients in an effort to understand factors that may influence future…
True holistic care requires attention to spiritual as well as physical needs, but many health care providers do not feel comfortable discussing spiritual matters with clients. Although recognized by national nursing groups as a standard of care, nurses are not well prepared or rewarded for spiritual care efforts. There are several spiritual assessment tools available and many suggestions for interventions, but little research-based evidence on the effectiveness of spiritual care assessments or interventions. Nurses are well positioned by their continued intimate contact with clients and the importance of caring to nursing to lead the health care profession in developing spiritual care theory and practices. PMID:17544683
Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G
Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. PMID:25550167
Coulourides Kogan, Alexis; Wilber, Kathleen; Mosqueda, Laura
Specialized, fragmented acute care is not aligned optimally to serve older adults. Person-centered care (PCC) has emerged as an evidence-based solution that involves enlisting patients as partners in treatment planning. Although several efforts have captured person-centered voices in outpatient care, more information is needed at the organizational and provider level to better understand the feasibility, challenges, and effect of PCC in community-based and social services settings. To assess themes and emerging trends, researchers conducted telephone interviews with leaders at nine organizations providing PCC for older adults. Questions were focused on the legacy of PCC services, whether and how PCC was connected to better quality care, and what tools were used for measuring PCC. Three themes on PCC for older adults emerged. (1) Each organization ascribed to a unique definition and operational structure for PCC. (2) Despite these differences, all organizations specified a strong commitment to PCC. Most noted financial resources and staffing as challenges and opportunities affecting feasibility. (3) Terms such as "patient-centered" care and other PCC synonyms may warrant greater clarification, because ideological differences set these classifications apart. Results from this analysis indicate the lack of a single, established definition for PCC. As interest in and support for PCC mounts, organizations in outpatient medical and community-based settings clearly have undertaken individual efforts to interpret what PCC is and how to provide it. Interview responses reflect this inconsistency, highlighting how staff and financing in particular can bolster or burden the PCC paradigm and what a consensus definition could do for the field. PMID:26626544
Smiley, Elizabeth B.
Provides a brief conceptual statement about bisexuality. Offers a review of existing research studies, and suggests issues to consider when counseling bisexual clients. Defines bisexuality and discusses prevalence studies, identity development, and implications for counseling. Claims that bisexuality challenges traditional rules about sexual…
Contends both Afghan refugee children and adults perceive school as the primary resource for their successful transition into American society. Claims the school counselor is in a position to guide clients by providing them with necessary educational and career information. Describes aspects of Afghan culture relevant to counselors. (Author/ABL)
A study was conducted of 262 training providers in Malaysia, where providers must be government approved. Government regulation, client demands for high quality, and an economic downturn that focused attention on training costs have all influenced evaluation in a positive direction. (SK)
Thompson, Nikki; Renninger, Salina
Counseling survivors of sexual abuse requires acknowledgment of the legitimacy of the client's ego defenses while helping the client abandon those defenses which have become obstacles to leading a fulfilling life. Such defenses may also impede the therapeutic process, as survivors are less likely to trust other people. Clients can arrive at a…
Caliber Associates, Fairfax, VA.
This paper summarizes similarities and differences between two cohorts of the National Treatment Improvement Evaluation Study (NTIES) clients, those age 45 or older and those younger than 45. Results reveal the following: Clients in the 45+ cohort were considerably more likely to be treated for problems with alcohol or with heroin, and they were…
Meiselman, Karin C.; Sheehy, Nancy
The occurrence of incest in which a female child is molested by an older male family member may be increasing as the number of stepfamilies increases, because previous evidence suggests that girls living with stepfathers are at greater risk for molestation. If psychotherapists will be seeing more incest-history clients as a result of this trend,…
Dye, Carol J.
Psychotherapy with older dying patients can lead to problems of countertransference for the clinician. Working with dying patients requires flexibility to adapt basic therapeutics to the institutional setting. Goals of psychotherapy must be reconceptualized for dying clients. The problems of countertransference arise because clinicians themselves…
Murdach, Allison D.
Examines potentially assaultive or preassaultive client and suggests some ways to minimize the risk of assault by such clients. Data for the article are from author's 10-year experience in providing social work services on acute psychiatric ward in large public medical center. Reviews potentially assaultive client conditions of panic, rage,…
Leffel, Linda G.; DeBord, Karen B.
The adult education literature contains a considerable amount of research on and discussion of client service in the marketing process, management and staff roles in service- and product-oriented businesses, and the importance of client service and service quality to survival in the marketplace. By applying the principles of client-oriented…
Kindsvatter, Aaron; Osborn, Cynthia J.; Bubenzer, Donald; Duba, Jill D.
The authors suggest that when counselors have a rich understanding of pretreatment changes, they are better able to assist clients in capitalizing on such changes. The current study examined client perceptions of pretreatment changes. Thirty-six clients completed Q-sorts pertaining to pretreatment changes they experienced. Four factors pertaining…
Greene, G.; Plante, R.
The registry is a central component for the development of astronomical tools and applications requiring search and discovery. It contains standard descriptions for a variety of astronomical resources and services, including methods for remote invocation. Using web service technology, programmatic interfaces to the registry offer a powerful and robust mechanism for extracting specific sets of services and also a framework for combining a variety of astronomical resources into complex applications, for example, Datascope, Open SkyQuery, and WESIX. While the legacy of the NVO does not extend far back into history, we present here the current state of interfaces that client applications and tools have been built on, yet also extend the concepts to the new standard Registry Interface which will provide a uniform client interface protocol throughout the IVOA registry network. We explore this technology and discuss several implementations that exist in the current VO framework using JAVA, C#, Python, and IDL.
Fourteen children from seven families are reported for whom false allegations of abuse were made by the mother. Twelve children were alleged to have incurred sexual abuse, one both sexual and physical abuse, and one physical abuse alone. Thirteen of the children had incurred, or were currently victims of, factitious illness abuse invented by the mother. The one child with no history of factitious illness abuse had a sibling who had incurred definite factitious illness abuse. The false allegations of abuse did not occur in the context of parental separation, divorce, or custody disputes concerning the children. They occurred in the context of Munchausen syndrome by proxy abuse. The age of the children, 3 to 9 years, was older than the usual age for Munchausen syndrome by proxy abuse. The mother was the source of the false allegations and was the person who encouraged or taught six of the children to substantiate allegations of sexual abuse. PMID:8503664
... relationships and friendships. Emotional abuse (stuff like teasing, bullying, and humiliating others) can be difficult to recognize ... How to Break Up Respectfully Abuse Dealing With Bullying Date Rape Getting Over a Break-Up Posttraumatic ...
... as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug ...
Rowe, Cynthia L.; Liddle, Howard A.
Liddle and Dakof's (1995) comprehensive review of the status of family-based treatment for drug abuse concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using…
Thomas, Connie S.; Schandler, Steven L.
Discusses research on adolescent substance abuse risk factors and their role in the management of adolescent substance abuse disorders. A selective literature review suggests specific intervention strategies; no generic approach fits all adolescent substance-use clients. Effective techniques require individual assessments, including the context in…
Salyers, Kathleen M.; Ritchie, Martin H.; Cochrane, Wendy S.; Roseman, Christopher P.
Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational…
Salyers, Kathleen M.; Ritchie, Martin H.; Luellen, Wendy S.; Roseman, Christopher P.
Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational…
Smock, Sara A.; Trepper, Terry S.; Wetchler, Joseph L.; McCollum, Eric E.; Ray, Rose; Pierce, Kent
The present study compared solution-focused group therapy (SFGT) with a traditional problem-focused treatment for level 1 substance abusers. Outcome research on the effectiveness of solution-focused group therapy is minimal, especially in treating substance abusers. In the present study, clients were measured before and after treatment to…
The diversity of the older adult population is increasing, and health professionals need to learn new knowledge and skills to improve the adherence of older ethnic clients to their health recommendations. Much of the existing research literature on diversity in gerontology concludes that ethnic older adults are at a health disadvantage. Few if any…
Miller, Judith Droitcour; And Others
This 1982 national survey on drug abuse is the seventh in a series of surveys since 1971 sponsored by the National Institute on Drug Abuse. To investigate the current prevalence of drug abuse in a nationwide sample, 5,624 randomly selected Americans (aged 12 and older) were personally interviewed in their homes using a specially designed answer…
... misconduct involving the abuse of the spouse or dependent child pursuant to 10 U.S.C. 1408(h), are eligible... abuse occurred. 5. Yes, if the child: a. Is older than 18 years old and is enrolled in a full-time... offense involving physical or emotional abuse of the spouse or child, or was administratively...
Simpson, D. Dwayne; Sells, S. B.
The Drug Abuse Reporting Program (DARP) was initiated in 1969 as a federally supported client reporting system for community-based drug abuse treatment programs. Posttreatment follow-up interviews were conducted with over 4,000 persons from 34 treatment agencies to describe major findings from the drug abuse treatment research of the DARP relating…
Dezhgosha, Kamyar; Marcus, Robert; Brewster, Stephen
The goal of this project is to find cost-effective and efficient strategies/solutions to integrate existing databases, manage network, and improve productivity of users in a move towards client/server and Integrated Desktop Environment (IDE) at NASA LeRC. The project consisted of two tasks as follows: (1) Data collection, and (2) Database Development/Integration. Under task 1, survey questionnaires and a database were developed. Also, an investigation on commercially available tools for automated data-collection and net-management was performed. As requirements evolved, the main focus has been task 2 which involved the following subtasks: (1) Data gathering/analysis of database user requirements, (2) Database analysis and design, making recommendations for modification of existing data structures into relational database or proposing a common interface to access heterogeneous databases(INFOMAN system, CCNS equipment list, CCNS software list, USERMAN, and other databases), (3) Establishment of a client/server test bed at Central State University (CSU), (4) Investigation of multi-database integration technologies/ products for IDE at NASA LeRC, and (5) Development of prototypes using CASE tools (Object/View) for representative scenarios accessing multi-databases and tables in a client/server environment. Both CSU and NASA LeRC have benefited from this project. CSU team investigated and prototyped cost-effective/practical solutions to facilitate NASA LeRC move to a more productive environment. CSU students utilized new products and gained skills that could be a great resource for future needs of NASA.
Callahan, James J. Jr.
Claims elder abuse is not clearly defined, affects relatively small numbers of older persons, is an under-funded area of social service and has weak political support. Recommends a broad-based service strategy for older persons. (Author/ABL)
Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin
Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…
Land, Helen M.
Assesses the relationship between treatment intensity and rehabilitation of 89 child abusers whose MMPI (Minnesota Multiphasic Personality Inventory) profiles revealed high levels of psychological distress. The relationship was positive and statistically significant. The client receiving intense weekly treatment for longer durations was assessed…
Mangrum, Laurel F
The study examines client and service characteristics of addiction treatment completers and non-completers with co-occurring disorders (COD). On demographic variables, completers were more likely to be male and homeless. In the psychiatric domain, a greater proportion of completers received diagnoses of depression and generalized anxiety disorder, whereas non-completers were more often diagnosed with bipolar disorder and posttraumatic stress disorder. No group differences were found in client-reported psychiatric symptom severity; however, non-completers were rated by clinicians as having more severe symptoms in the areas of interpersonal sensitivity, depression, and hostility. In the area of substance use patterns, no differences were found in primary substance of abuse but completers reported more days of use during the month prior to treatment. Completers also had a greater history of both prior detox and non-detox treatment. At discharge, completers achieved higher rates of past month abstinence and AA attendance, but no differences were found in length of stay in treatment. Examination of recovery support services utilization revealed that completers more often received peer mentoring services. Greater proportions of the non-completer group received educational support, clothing, medical care, and employment assistance. These results suggest that future studies are needed in examining possible differential treatment response by diagnostic category and the potential role of peer mentoring in enhancing addiction treatment completion of COD clients. PMID:19303219
Drake, Robert E; McHugo, Gregory J; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara
The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 "recovery outcomes," identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non-substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients. PMID:16525088
Drake, Robert E.; McHugo, Gregory J.; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara
The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 “recovery outcomes,” identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non–substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients. PMID:16525088
Sheridan, M J
Although the link between substance abuse and child maltreatment has been relatively well established, there is a general recognition that this is not a simple cause-effect relationship. The current study explored the relationships among substance abuse, family functioning, and abuse/neglect in a sample of incarcerated substance abusers. Data were gathered on the earlier life experiences of 81 men and women serving sentences in two maximum security prisons, including assessments of their parents' substance abuse problems; levels of family competence within their families-of-origin; their exposure, as children and adults, to physical, emotional, and sexual abuse and physical/emotional neglect; and their own levels of substance abuse. Results showed generally high percentages of parental substance abuse and abuse/neglect, and relatively low levels of family competence. Correlational analyses revealed significant direct and indirect relationships among parental substance abuse, family dynamics, and exposure to both child and adult maltreatment. These four variables were also significantly associated with respondents' own substance abuse in later life, suggesting the potential for continuation of these patterns into successive generations. An intergenerational model of these family and personal functioning variables is presented and implications for service delivery with correctional clients is discussed. PMID:7664133
Scheel, Michael J.
Ryan and colleagues are applauded for elevating client factors in the form of motivation and autonomy to equal status with the alliance as common factors in psychotherapy. Next, client motivation and autonomy are explained to be inextricably linked with one promoting the other. Motivational methods are summarized for the major approaches, making…
Simpson, Arlene J.; Bedi, Robinder P.
Clients' perspectives on the therapeutic alliance were examined using written descriptions of factors that clients believed to be helpful in developing a strong alliance. Fifty participants sorted previously collected statements into thematically similar piles and then gave each set of statements a title. Multivariate concept mapping statistical…
Hayes, Jeffrey A.; Erkis, Andrew J.
Analyses revealed that therapists responded with less empathy, attributed less responsibility to client for problem solving, assessed client's functioning to be worse, and were less willing to work with client when the client's source of HIV infection was from something other than drugs, when the client was gay, and when the therapist was more…
Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.
This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists, experiences related to managing the chaotic nature of the client's lives, wanting to manage the client's lives, and frustration with client's life trajectories are reviewed. Observations related to the therapeutic process include the client's relationship to the therapist, balancing the client's independence and need for assistance, and unrealistic expectations among the clients. Recommendations for successfully approaching these clinical situations and experiences are offered. The purpose of this article is to document these therapy experiences to facilitate the work of future teams seeking to intervene in the lives of homeless families through homeless shelters or other settings. PMID:23285834
van Mulligen, E.; Timmers, T.
Computer scientists working in medical informatics have to face the problem that software offered by industry is more and more adopted for clinical use by medical professionals. A new challenge arises of how to combine commercial solutions with typical medical software that already exists for some years and proved to be reliable with these off-the-shelf solutions . With the HERMES project, this new challenge was accepted and possible solutions to integrate existing legacy systems with state-of-the-art commercial solutions have been investigated. After a period of prototyping to assess possible alternative solutions, a system based on an indirect client-server model was implemented with help of the industry. In this paper, its architecture is described together with the most important features currently covered. Based on the HERMES architecture, both systems for clinical data analysis and patient care (cardiology) are currently developed. PMID:7949988
Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth
Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases. PMID:25471045
Molnar, Jack; Stup, Brenda
This article describes an ongoing survey that illustrates how evaluators, working with program managers, have effectively used client-based data to monitor performance in the Social Security Administration. The value of client-based data outweighs the limitations and problems collecting it. Customer perceptions are a critical barometer of quality.…
Dickey, Lore M.; Loewy, Michael I.
Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…
Magruder, Kathryn M; Ouyang, Bichun; Miller, Scott; Tilley, Barbara C
We excluded those of multi-race/ethnicity and those from minority groups other than Hispanic or African American due to small numbers. Additionally, only three therapy types were represented among the six studies. Some potential variables that would influence retention, such as client housing, and client comorbidities, the race/ethnicity and gender of the staff who conducted study follow-up assessments, and reasons for loss to follow-up, were not collected by the CTN. Conclusions Although in our client model older African Americans and Caucasians had the greatest odds of retention and younger African Americans the lowest, in our final model, only age was significantly related to study retention. Additionally, primary drug of abuse, having HIV risk screening as a program benefit, and lower percentages of female admissions were significantly related to study retention. Efforts should be made to increase the study retention of younger participants to improve the validity and generalizability of drug abuse treatment study results. PMID:19528134
Wells, Rebecca; Harris Lemak, Christy; Alexander, Jeffrey A; Roddy, Brian L; Nahra, Tammie A
Despite high levels of unmet need for outpatient substance abuse treatment, a significant percentage of outpatient units have closed over the past several years. This study drew on 1999-2000 and 2005 national surveys to determine if managed care was associated with outpatient substance abuse treatment units' likelihood of surviving. Each substance abuse unit director was asked about the presence of any managed care contracts, percentage revenues from managed care, percentage of clients for whom prior authorization was required, and percentage of clients for whom concurrent review was required. A multiple logistic regression revealed that none of these factors was associated with substance abuse treatment unit survival. At this point, neither the presence nor the structure of managed care appears to affect the survival of outpatient substance abuse treatment units. Given the need for these facilities, however, and their vulnerability to closure, continued attention to managed care's potential influence is warranted. PMID:17458479
Milner, Joel S.; Gold, Ruth G.
Investigated the ability of the Child Abuse Potential Inventory to screen for child abuse in a group of spouse abusers. The completed, valid protocols revealed that 36.5 percent of the spouse abusers had elevated child abuse scores, while only 9.1 percent of the nonabusers had elevated abuse scores. (Author/BL)
Discusses factors inhibiting open talk around a client's history of abuse including gender, age and diagnosis. * Evaluates the helpfulness of a training course designed to reduce and overcome these factors. * Aim of the evaluation is to help replicate the training nationally, following the positive impact found. Abstract Despite the high prevalence of sexual abuse among users of mental health services, it appears that mental health professionals are frequently unaware of clients' abuse histories. In order to address this, a Mental Health Trusts Collaboration Project of nine trusts was formed, which piloted delivering the Department of Health's Victims of Violence & Abuse Prevention Programme one-day education and training course regarding enquiring about histories of sexual abuse to various mental health practitioners. This hoped to educate practitioners in factors associated with victims and offenders, improve confidence and competence in asking about client's history of abuse and to increase awareness of the importance of asking. The purpose of this paper is to describe the impact of this course on mental health professionals' practice and attitudes in one of these nine trusts. It was found that since the delivery of the course, 44% (n= x) of professionals had been asking about abuse in 75-100% of cases. Gender, age and diagnosis of both the service users and the practitioners were all identified as factors potentially affecting practitioners' willingness to ask about abuse. Most importantly, 93% (n= x) of participants were found to feel they have the skills and knowledge to enquire about abuse and respond to disclosure in the appropriate way and 77% (n= x) of participants felt that this training had changed their clinical practice. The aim of this evaluation is to prove the effectiveness of the Department of Health's education and training course, which will help towards replicating the project nationally. PMID:20100302
Kent, Lindsey; And Others
Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…
Abel, G G; Rouleau, J L
The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator. PMID:7761302
Daub, Stacey; Goldhar, Jodeme; Purbhoo, Dipti
This article examines the implementation of the strategy and Integrated Client Care Program, a multi-level health system strategy to break down the barriers in a solid health system and a program to integrate care for populations with the most complex needs. Specific reference is made to two specialized programs, older adults with complex care needs and a palliative care program whose goal is to meet the needs of patients and their families in a community setting. PMID:27365383
Tosi, Donald J.
Different levels of counselor and client dogmatism combined additively in terms of their effect on client ratings of the relationship. Client ratings of the relationship were progressively higher as more openness occurred in the dyad. (Author)
Spaid, Wanda M.; Squires, Stuart P.
Per se, increased knowledge about substance abuse has not been effective in altering social workers' negative attitudes towards substance abusers or their failure to recognize or address substance abuse problems among clients. In this paper, we describe an experiential abstinence assignment integrated with the content of an elective substance…
Speller, Brittany; Stolee, Paul
As the population ages, the demand for long-term care settings is expected to increase. Assisted living is a suitable and favourable residence for older individuals to receive care services specific to their needs while maintaining their independence and privacy. With the growing transition of older individuals into assisted living, facilities need to ensure that safe care is continually maintained. The purpose of this study was to determine the gaps and strengths in care related to safety in assisted living facilities (ALFs). A qualitative descriptive research design was used to provide a comprehensive understanding of client safety from the perspectives of clients, administrative staff and personal support workers. Interviews were conducted with 22 key informants from three ALFs in Toronto, Ontario throughout July 2012. All interviews were semi-structured, audio-recorded and transcribed verbatim. Initial deductive analysis used directed coding based on a prior literature review, followed by inductive analysis to determine themes. Three themes emerged relating to the safety of clients in ALFs: meaning of safety, a multi-faceted approach to providing safe care and perceived areas of improvement. Sub-themes also emerged including physical safety, multiple factors, working as a team, respecting clients' independence, communication and increased education and available resources. The study findings can contribute to the improvement and development of new processes to maintain and continually ensure safe care in ALFs. PMID:25175102
Chayes, D. N.; Arko, R. A.
We are actively developing a collection of open source example clients that demonstrate use of our "back end" data management infrastructure. The data management system is reported elsewhere at this meeting (Arko and Chayes: A Scaleable Database Infrastructure). In addition to their primary goal of being examples for others to build upon, some of these clients may have limited utility in them selves. More information about the clients and the data infrastructure is available on line at http://data.ldeo.columbia.edu. The available examples to be demonstrated include several web-based clients including those developed for the Community Review System of the Digital Library for Earth System Education, a real-time watch standers log book, an offline interface to use log book entries, a simple client to search on multibeam metadata and others are Internet enabled and generally web-based front ends that support searches against one or more relational databases using industry standard SQL queries. In addition to the web based clients, simple SQL searches from within Excel and similar applications will be demonstrated. By defining, documenting and publishing a clear interface to the fully searchable databases, it becomes relatively easy to construct client interfaces that are optimized for specific applications in comparison to building a monolithic data and user interface system.
Esposito-Smythers, Christianne; Walsh, Adam; Spirito, Anthony; Rizzo, Christie; Goldston, David B.; Kaminer, Yifrah
Substance use disorders and suicidal thoughts and behaviors commonly co-occur in adolescent and adult psychiatric populations and are often functionally interrelated. Although the evidence base for treatment of this population is sparse, integrated cognitive behavioral treatment (CBT) protocols, or those that rely heavily on CBT techniques, hold…
Scholl, Mark B.; Schmitt, Dorothy M.
Motivational Interviewing (MI; W. R. Miller & S. Rollnick, 2002) is presented as a potentially effective counseling strategy for assisting traditionally aged college students in reducing their problematic, heavy alcohol use. MI's congruence with two developmental theories--Self-Determination Theory (R. M. Ryan & E. L. Deci, 2000) and…
Burke, Anna C.; Gregoire, Thomas K.
This study provides new evidence regarding the relation of coerced care to posttreatment substance use and addiction severity while controlling for two important factors: readiness to change and addiction severity at admission to treatment. The initial study sample consisted of 289 people who agreed to participate in a prospective study of…
Bailey, Jeffrey J.
Proposes the metaphor of professional/client rather than student-as-customer to characterize the relationship between professors and students. Uses examples of fitness trainer, management consultant, accounting service, and mountain guide to illustrate faculty and student roles. (SK)
Blai, Boris, Jr.
Rising life expectancies, reductions in disease, and the ability of the elderly to care for themselves and cope with life stresses all attest to the fact that Americans are learning how to maintain and improve their health. However, experts have noted that greater knowledge about the health problems of the elderly is needed. The elderly are prone…
Helmes, E; Lewis, V E; Allan, A
Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions. PMID:15386560
O'Leary, Patrick; Coohey, Carol; Easton, Scott D
This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy. PMID:20509077
Joseph, D H; Schwartz-Barcott, D; Patterson, B
Diabetic clients must make daily decisions about their health care needs. Observational and anecdotal evidence suggests that vast differences exist between the kinds of choices diabetic clients make and the kinds of chances they are willing to take. The purpose of this investigation was to develop a diabetic risk-assessment tool. This instrument, which is based on subjective expected utility theory, measures risk-prone and risk-averse behavior. Initial findings from a pilot study of 18 women clients who are on insulin indicate that patterns of risk behavior exist in the areas of exercise, skin care, and diet. PMID:1729123
Costa, A J
Elder abuse is a tragedy both for the individual and for society because it occupies a pivotal position in the family life cycle of violence. Great variety exists among victims, abusers, and situations; thus, no single model is adequate to explain cause and direct treatment. Primary care physicians must be alert to the possibility of elder abuse in their patients and aware of resources within their community for managing cases once identified. Federal laws and regulations must take a proactive, long-term approach to the solution of this problem and must respect the autonomy of competent elderly patients. PMID:8356158
Criss, Pamela Myatt
Social work literature has documented that social workers may be the victims of client violence. However, to date, no studies have documented the nationwide prevalence of client violence towards social work students. This study examined direct and indirect incidents of physical assault, threats of physical harm, verbal abuse, threats of lawsuit,…
Thompson, Lynda; Thompson, Michael; Reid, Andrea
This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting. The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS. An earlier paper (Thompson et al. 2009) reviews the symptoms of AS, highlights research findings and theories concerning this disorder, discusses QEEG patterns in AS (both single and 19-channel), and details a hypothesis, based on functional neuroanatomy, concerning how NFB, often paired with biofeedback (BFB), might produce a change in symptoms. A further aim of the current report is to provide practitioners with a detailed description of the method used to address some of the key symptoms of AS in order to encourage further research and clinical work to refine the use of NFB plus BFB in the treatment of AS. All charts were included for review where there was a diagnosis of AS or ASD and pre- and post-training testing results were available for one or more of the standardized tests used. Clients received 40-60 sessions of NFB, which was combined with training in metacognitive strategies and, for most older adolescent and adult clients, with BFB of respiration, electrodermal response, and, more recently, heart rate variability. For the majority of clients, feedback was contingent on decreasing slow wave activity (usually 3-7 Hz), decreasing beta spindling if it was present (usually between 23 and 35 Hz), and increasing fast wave activity termed sensorimotor rhythm (SMR) (12-15 or 13-15 Hz depending on assessment findings). The most common initial montage was referential placement at the vertex (CZ) for children and at FCz (midway between FZ and CZ) for adults, referenced to the right ear. Metacognitive strategies relevant to social understanding, spatial
Coll, Kenneth M.; Stewart, Roger A.; Morse, Renee; Moe, Amber
This study assessed the effectiveness of building partnerships with community resources and systems for court-referred clients and their families through a participant outcome evaluation. Specific variables studied included change in substance abuse patterns, family well-being, child safety, and recidivism. Results from pre-post testing revealed…
Rosenberg, Harold; Davis, Alan K
To assess whether acceptability of non-abstinence outcome goals varied depending on the specific drug a client consumes (alcohol, cannabis, amphetamine, heroin, cocaine, MDMA/ecstasy, polydrug), severity of diagnosis (DSM-IV Abuse vs. Dependence), and finality of outcome goal (intermediate vs. final), we recruited 432 clinicians to complete a web-based questionnaire. More respondents rated non-abstinence acceptable as an intermediate goal for clients diagnosed with alcohol abuse (44%) or cannabis abuse (43%) than for clients diagnosed as abusing the other listed drugs (23 to 31%). Similarly, larger proportions of respondents rated non-abstinence as acceptable as a final goal for clients diagnosed with alcohol abuse (30%) or cannabis abuse (24%) than for clients diagnosed as abusing the other drugs (11 to 13%). Only 9 to 13% of respondents rated non-abstinence as an acceptable final goal for clients diagnosed with dependence, but 20% to 30% rated non-abstinence as acceptable as an intermediate goal for clients diagnosed as dependent. PMID:23953169
Friedman, A S; Glickman, N W
The relationship to treatment outcome, as measured by reduction in drug use, of specific characteristics and elements of 30 drug-free outpatient programs for adolescents is reported. Admission and discharge data were obtained from National Institute on Drug Abuse-Client Oriented Data Acquisition Process on 5789 adolescents in the 30 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual clients, was the unit of analysis. While controlling for differences between programs on their client populations, multiple regression analysis indicated that the following characteristics of programs were found to predict the outcome criterion variable, to a statistically significant degree: treat a large number of adolescent clients; have a special school for school dropouts; have a relatively large budget; employ counselors or therapists who have at least 2 years' experience in working with adolescent drug abusers; provide special services such as vocational counseling, recreational services, and birth control services; use such therapy methods as crisis intervention, gestalt therapy, music/art therapy, and group confrontation; and be perceived by the clients as allowing and encouraging free expression and spontaneous action by clients. There was a high degree of replication of these findings across the two annual subsamples of clients; and the amount of variance in the treatment outcome criterion variable accounted for by the above-listed program characteristics was quite impressive. PMID:3772356
Abood, Sarah K
The successful ability to efficiently collect diet histories, convey appropriate health messages, and discuss client concerns about the safe feeding of pets requires excellent communication skills. In addition to understanding what the client wants for their pet, thorough nutritional interviewers gather information pertaining to animal factors, dietary factors, and feeding management factors. With the expansion of the Internet, increasing advances in medical care, and the health concerns associated with pet food recalls, small animal clients are looking to veterinarians for guidance and information on dietary recommendations in ever increasing numbers. Evaluating current information on changes in the pet food industry should be a periodic learning objective for all members of the veterinary health care team. Consistent, effective communication between veterinarians, their staff, and their clients can improve compliance, increase satisfaction levels, and improve patient outcomes. PMID:18656842
... to watch or be part of sexual acts. Money Matters: Financial Abuse and Healthcare Fraud After Victor’s ... the past 6 months, Victor has been taking money from their account for his own use. He ...
Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Zelaya, Carla; Solomon, Suniti; Go, Vivian F.; Celentano, David
This descriptive study presents the profiles of abused female sex workers (FSWs) in Chennai, India. Of 100 abused FSWs surveyed using a structured questionnaire, severe forms of violence by intimate partners were reported by most (98%) respondents. Of the total sample, 76% experienced violence by clients. Sexual coercion experiences of the FSWs included verbal threats (77%) and physical force (87%) by intimate partners and forced unwanted sexual acts (73%) by clients. While 39% of the women consumed alcohol before meeting a client, 26% reported that their drunkenness was a trigger for violence by clients. The findings suggest that there is an urgent need to integrate services, along with public-health interventions among FSWs to protect them from violence. Recognition of multiple identities of women in the contexts of intimate relationships versus sex work is vital in helping women to stay safe from adverse effects on health. PMID:20635631
Brank, Eve M; Wylie, Lindsey E
Informal older adult caregiving allows older adults to stay in their homes or live with loved ones, but decisions surrounding older adult care are fraught with complexities. Related research and case law suggest that an older adult's need for and refusal of help are important considerations; the current study is the first to examine these factors experimentally. Two samples (potential caregivers and care recipients) provided responses regarding anticipated emotions, caregiver abilities, and allocation of daily caregiving decision making based on a vignette portraying an older adult who had a high or low level of autonomy and who accepted or refused help. Study findings suggest differing views about caregiving; potential caregivers may not be as well prepared to take on caregiving as the potential care recipients anticipate and potential caregivers may allocate more decisional responsibility to older adults than the care recipients expect. Implications for older adult abuse are discussed. PMID:24652926
Raitakari, Suvi; Günther, Kirsi; Juhila, Kirsi; Saario, Sirpa
Professionals in human service work are at the centre of complicated client cases. The ways client cases are constructed and the problems explained form the basis for professionals' assessments, decisions, actions and interventions. In this article the ways professionals make sense of dual-diagnosis client cases are examined. Applying the concept of causal accounting, it is argued that 'theories of cause' are embedded in professional discourse and profoundly shape professionals' understandings of social and health problems, as well as of their own roles and responsibilities and of what interventions and outcomes are possible. The data consist of 48 tape-recorded weekly team meetings among professionals in a supported housing unit targeted for clients with both mental health and substance abuse problems. It was found that professionals reason about the relationship between these two problems in four different ways: (1) substance abuse causes or makes mental health problems worse; (2) substance abuse eases mental health problems; (3) mental health problems cause or make substance abuse worse; or (4) good mental health reduces substance abuse. Causal account research makes visible the ways professionals do institutional work by categorizing clients, accounting for responsibilities as well as assessing their work and clients' achievements according to moral expectations of a 'good'professional and a worthy client. PMID:25233561
Lottman, Thomas J.
Investigated access to generic substance abuse services for persons with mental retardation. Telephone survey of chemical dependency treatment agencies revealed that agencies accepting mentally retarded clients differed significantly from nonaccepting agencies in their perceived difficulty in integrating these clients and in their acceptance of…
Rubenzahl, Samuel A.; Gilbert, Brenda O.
Surveys of agencies specializing in treating victims of child sexual abuse indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not…
Dowd, E. Thomas; Sanders, Daniel
Describes effect of client resistance and reactance in counseling and methods for assessing these phenomena. Conceptualizes client symptoms as ego-syntonic, where symptom is consonant with client's self-image, or ego-dystonic, where it is not. Uses concepts in deriving counseling strategies for working with difficult clients according to model…
Salomone, Paul R.
A client centered placement approach for handicapped people is proposed as an alternative to the traditional selective placement method. The client centered placement is based on client responsibility and counselor direction and requires the counselor to have an unrealistic but optimistic attitude that the client will get a suitable job.…
Keller, S; Finger, W R
Clients need both skill and motivation to effectively use natural family planning (NFP). Thus, NFP services must provide adequate counseling and training to clients. A good teacher of NFP does not need formal health care training but she/must have good communication skills. A teacher usually needs to meet with a client four times over a period of several months to teach NFP. Fertility awareness comprises the first step in NFP training. This involves helping couples to understand the reproductive system, menstrual cycles, and fertile periods. The NFP Training and Medical Services Center in Nairobi, Kenya, provides clients, many of whom live in slums and are illiterate, with an exercise book with small squares that they color so they can track their fertility signs. They tend to use the cervical mucus method rather than the basal temperature method which requires a thermometer. In Los Angeles, California, clients of one NFP program attend group sessions and individual counseling sessions to learn about the menstrual cycle, fertile period, and rules of NFP and how to apply them. The Twin Cities NFP Center in Minnesota found that individual counseling was 50% more expensive than group sessions and it affected changes in neither the pregnancy nor NFP continuation rates. Group training here involved more men. Catholic groups in Bangladesh, India, Kenya, South Korea, and the US conducted a study of NFP programs and found that client's willingness or ability to discuss NFP were not associated with socioeconomic status, previous family planning experiences, and education. Another study of the same users did find an association between higher education and lower unplanned pregnancy rate. The same was true for previous family planning use. Since limited resources prevent some family planning programs from training staff in NFP, the programs can refer clients to existing NFP services, sending one staff member to be trained in NFP, or having one staff member providing NFP
Otiashvili, D; Djordjevic, A; Morales, D; Parsons, A; Platt, E; Stempliuk, V
Numerous studies have demonstrated the effectiveness of drug abuse treatment. Yet many drug abusers do not enter treatment, many who do enter leave prematurely, and relapse following treatment is common. Understanding motivation for change and treatment readiness is key to understanding how to induct and engage drug users in treatment. To the extent that treatment programs focus initially on reducing drug use, rather than psychosocial problems that motivate individuals to seek treatment, treatment programs may fail to meet the primary needs of users and thus fail to attract or engage them. Outcomes of substance abuse treatment programs historically have been measured by successful program completion, reduced drug use and illegal activity, and improved social functioning (employment, education etc). There is minimal reference to client expectations of treatment and factors that influenced treatment-seeking behavior. Studies that have assessed client dropout from substance abuse treatment have generally focused upon quantitative measures that attempt to determine what types of clients drop out or stay, or what types of characteristics best predict client dropout. Qualitative methods are the most appropriate to fill these gaps in substance abuse treatment research. PMID:15988078
Humphreys, K; Noke, J M; Moos, R H
This study of 329 substance abuse treatment staff assessed how recovery status, in combination with other variables, influences beliefs about the causes and treatment of substance abuse. About 15% (n = 47) of participants were "in recovery" from substance abuse problems; these staff members were not significantly different than nonrecovering staff members on education, age, race/ethnicity, years of clinical experience, or amount of client contact. When examined in a multiple regression equation that also included age, education, and treatment program goals and activities, staff members' recovery status was not associated with endorsement of disease and psychosocial models of substance abuse. However, being in recovery was associated with endorsing an eclectic approach to substance abuse treatment. The importance of recognizing the diversity of beliefs about substance abuse among recovering staff and of acknowledging that multiple influences affect all staff members viewpoints on treatment is discussed. PMID:8699546
Martino, Steve; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Carroll, Kathleen M.
This study evaluated the extent to which counselors initiated informal discussions (i.e., general discussions and self-disclosures about matters unrelated to treatment) with their clients during treatment sessions within two National Institute on Drug Abuse Clinical Trial Network protocols involving adaptations of motivational interviewing (MI). Sixty counselors across the two protocols had 736 sessions independently rated for counselor treatment fidelity and the occurrence of informal discussions. The results showed that 88% of the counselors initiated informal discussions in their sessions and that the majority of these discussions involved counselors sharing personal information or experiences they had in common with their clients. The major finding was that counselor training in MI was associated with significantly less informal discussion across sessions. A higher frequency of informal discussion was related to less counselor MI proficiency and less in-session change in client motivation, though unrelated to client program retention and substance use outcomes. The findings suggest that while some informal discussion may help build an alliance between counselors and clients, too much of it may hinder counselors' proficient implementation of MI treatment strategies and the clients' motivational enhancement process. PMID:18835679
Goldbach, Jeremy T.; Thompson, Sanna J.; Holleran Steiker, Lori K.
Nearly 10% of Latino youth who are twelve and older are in need of substance abuse treatment for alcohol or illicit drug use. Ethnic differences exist with regard to susceptibility to drug use, attitudes regarding drugs, and drug resistance strategies. The failure of some substance abuse prevention programs can be traced in part to their lack of…
.... (Presidential Sig.) [FR Doc. 2013-14969 Filed 6-19-13; 11:15 am] Billing code 3295-F3 ... Documents#0;#0; ] Proclamation 8995 of June 14, 2013 World Elder Abuse Awareness Day, 2013 By the President..., it takes a devastating toll on millions of older Americans each year. On World Elder Abuse...
US Department of Health and Human Services, 2004
Males are more likely to use, abuse, and be dependent on alcohol or illicit drugs than females. The 2003 National Survey on Drug Use and Health (NSDUH) asked questions of persons aged 12 or older to assess their use of alcohol and illicit drugs, as well as their symptoms of substance dependence or abuse during the past year. NSDUH defines "any…
Cook, Paddy; Dogoloff, Mary Lou; Harteker, Linda; Nelson, Anne E.; Paul, Michelle M.; Shuman, Deborah J.; Mjoseth, Marcia; Vitzthum, Virginia; Hayes, Elizabeth; Gilbert, Max; Smith, Cara; Nguyen, Y-Lang
This TIP contains information on the best practice guidelines on case management for substance abuse treatment providers. It serves to educate program coordinators and facilitators about the factors to consider as they decide to modify or implement case management activities. Many substance abuse clients arrive for treatment with a number of other…
Wanlass, Janine; Moreno, J. Kelly; Thomson, Hannah M.
Although group therapy for abused and neglected youth is a viable and efficacious treatment option, facilitation is challenging. Group leaders must contain intense affect, manage multiple transferences, and advocate for their clients within the larger social welfare system. Using a case study of a group for sexually abused girls, this paper…
As a valuable addition to substance abuse treatment, adventure programming can have positive impacts on clients' self-efficacy, social behavior, and problem solving. A study explored the extent to which traditional substance abuse treatment programs use adventure programming, the level of adventure training and experience among substance abuse…
Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.
This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists,…
Crenshaw, Wesley B.; Lichtenberg, James W.
When deciding to report cases of child abuse, Mental Health Providers (MHPs) must confront legal mandates, concerns for client welfare, and a series of systemic and ethical issues. All 51 jurisdictions in the United States require MHPs to report suspected or known child abuse to appropriate authorities, with criminal penalties for noncompliance.…
George Washington Univ. Medical Center, Washington, DC.
A survey sought to determine the nature and extent of family therapy practiced in treatment and rehabilitation agencies serving drug abuse clients. Questionnaire responses to a three-phase study were on a voluntary basis. Phase I, with a 60% response rate, gathered information on the number of drug abuse treatment agencies providing family…
Weiss Ogden, Karen R.; Sias, Shari M.
Substance abuse counselors who address clients' spiritual development may provide more comprehensive counseling. This article presents an integrative supervision model designed to promote the spiritual development of substance abuse counselors-in-training, reviews the model, and discusses the implications for counselor education.
Budge, Stephanie L
Interpersonal therapy (IPT) is a particularly useful approach to use when working with clients who identify as transgender or gender nonconforming. All transgender individuals will experience changes and adjustment throughout their identity process, often referred to as transitioning. IPT offers specific interventions for psychotherapists to use with clients whose presenting concerns are specifically related to transitions. The current article outlines a case example of a transgender man who is experiencing difficulty with "role transitions" and offers four transgender-specific clinical intervention strategies derived within the traditional IPT framework. PMID:24000851
Although the registered nurse is not expected to have expert knowledge in all areas of practice, clients do ask questions in one health service area that might normally be handled in the context of another service area. When these sorts of 'surprising questions' arise, it is important for registered nurses to determine the nature of the question and to provide as much beginning assistance and guidance as possible to help the client to clarify the issues/concerns. Clearly, the nurse should do all she can to assist Sarah to access nurses and other health professionals who could provide more complete information and counselling for Sarah. PMID:12046496
Afifi, Tracie O.; MacMillan, Harriet L.; Boyle, Michael; Taillieu, Tamara; Cheung, Kristene; Sareen, Jitender
Background: Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts. Methods: We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%). Results: The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose–response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men. Interpretation: We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts. PMID:24756625
Marcenko, Maureen O.; And Others
Examined psychosocial characteristics and service needs of pregnant women with substance abuse histories. Interviewed 225 pregnant women defined as having high-risk pregnancies for psychosocial reasons. Compared to non-substance-abusing women, those with admitted history of substance abuse were significantly older, had more children, were more…
As an older woman therapist, I find that my life experience grounds me in my work with people of all ages and backgrounds as they deal with life crises, aging issues, and loss. People with whom I work in therapy appreciate the fact that I am older and have had varied life experiences. Gender issues are still central to my work with clients whether I am working with a man or a woman. I am an integrative therapist, with a background in cognitive-behavioral therapy and gestalt therapy. Therapists need to help clients to identify less with their aging bodies and our culture's view of attractiveness, shifting instead to a paradigm that values life experience and the cultivation of wisdom. We need to find ways of embracing what we have learned about life instead of extolling youthful values. As I get older, I more fully appreciate a constructivism framework and life-cycle perspective, focusing on making sense of clients' life narratives. Storytelling and memoirs have both provided a framework for working with clients on coping with the many changes and challenges of life that bring them to therapy and added another layer to my integrative therapeutic work. PMID:26394219
Stevens, Michael J.; And Others
Provides counselors with an overview of narcissism and its treatment. In the first section, dysfunctional narcissism is described, drawing on the diagnostic indicators presented in the DSM-III and the contemporary object relations theories of Heinz Kohut and Otto Kerberg. The second section focuses on counseling narcissistic clients. (Author/JAC)
Wood, Dolores K.; Shultz, Jill Armstrong; Edlefsen, Miriam; Butkus, Sue N.
Two food pantries were surveyed for nutrition education (NE) interests and experiences. One site provided nutrition education classes; the comparison site was utilized to assess client interest in class topics. "Fixing low cost meals," "fixing quick and easy recipes," and "stretching food and food dollars" were topics rated highly by nutrition…
The metaphor of the student as a consumer or customer is widely used within contemporary higher education, and impacts on the ways in which students, academics and institutions behave. These, and a number of alternative metaphors for the student, are critically reviewed. The alternatives considered include both contemporary (student as client or…
Crockett, Cailin; Brandl, Bonnie; Dabby, Firoza Chic
Violence against older women exists in the margins between domestic violence and elder abuse, with neither field adequately capturing the experiences of older women survivors of intimate partner violence (IPV). This commentary explores this oversight, identifying how the lack of gender analysis in the elder abuse field exacerbates older survivors' invisibility when the wider violence against women (VAW) field lacks a lifespan approach to abuse. Examining the impact of generational and aging factors on how older women experience IPV, we assert that the VAW field may be overlooking a wider population of survivors than previously thought. PMID:26371877
... Affects Driving Tips for Safe Driving Making Your Vehicle Safe Regulations Affecting Older Drivers When Driving Skills ... Like drivers of any age, they use their vehicles to go shopping, do errands, and visit the ...
Paley, Evelyn S., Ed.; Dea, Timothy Patrick, Ed.
This manual, geared for mental health professionals, demonstrates that social network intervention provides an excellent framework and set of tools for working with the multiple problems of older adults. Social networks are "family" groupings of client, family members, friends and other community supports. The intervention focusses on bonding and…
The number of elderly women is growing in absolute numbers and in proportion to the U. S. population. Current epidemiologic research indicates that the most frequent psychiatric disorders among older women are phobias, severe cognitive impairment, dysthymia, and major depressive episode without grief. The rates of all of these disorders, except for cognitive impairment, are lower for older than for younger women. The rates of psychiatric disorders in older women are higher than in older men, except for alcohol abuse-dependence, which is higher in men. Depression is a common psychiatric problem in older women. The differential diagnosis includes other medical disorders, drug effects, normal grief, and early dementia. Older depressed women may present with physical complaints rather than complaints of depression, and thus be misdiagnosed. Treatment consists of psychotherapy, antidepressant medication, and activities to improve self-esteem. Dementia affects 4 percent of elderly women over age 65, and 20 percent of those over age 85. The most common cause is Alzheimer's disease. Current research is focusing on abnormalities in the cholinergic system in the brain. A careful psychiatric evaluation may identify medical conditions, including depression, which can be treated and can lead to improvements in the patient's functioning. PMID:3120218
Baker, J N; Tanis, H J; Rice, J B
Siblings are often not included in treatment programs for children who have been sexually abused. This article describes the necessity of including siblings in the treatment of victims of child sexual abuse. Including siblings in treatment permits families to realize the maximum benefits of therapy for the victim as well as each family member. Theoretical and practical reasons to include siblings in treatment are discussed (i.e., preventing future abuse, providing support for siblings, teaching siblings to refrain from victim-blaming). Case examples using a particular intervention approach at The Family Learning Program and results of client satisfaction surveys are described. PMID:17521997
Reinhart, M A
Male victims of child sexual abuse have received inadequate attention in the literature. This article is a retrospective review of the reports of 189 boys evaluated during 1983-85. This population was younger than those previously reported. Comparison to an age- and race-matched group of girl victims seen during the same period revealed many similarities in patterns of disclosure and perpetrator characteristics. The acts perpetrated against the boys included a wide array of invasive acts at all ages, but sodomy was more frequently reported in the older victims. Abnormal anogenital findings were seen more often in younger children, but the findings were often nonspecific. An examiner experienced with young children and infants is essential. PMID:3594283
Owen, Jesse J; Tao, Karen; Leach, Mark M; Rodolfa, Emil
The current retrospective study examined whether clients' (N = 176) perceptions of their psychotherapists' multicultural orientation (MCO) were associated with their psychological functioning, working alliance, and real relationship scores. Moreover, we tested whether clients' perceptions of the working alliance and the real relationship mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. The results showed that clients' perceptions of their psychotherapists' MCO were positively related to working alliance, real relationship, and psychological functioning. Only clients' ratings of the working alliance mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. Thus, because clients perceive their psychotherapists as being more oriented toward cultural issues, they may view the therapist as being more credible and may gain a sense of comfort in the therapeutic process. In turn, clients' strong alliance facilitates improvement in psychological well-being. PMID:21639652
Love, Arnold J.
Assesses the feasibility and effectiveness of the Sexual Abuse Treatment Project used in a child welfare setting in Canada. Also evaluates the therapeutic process, which was based on an intensive psychodynamic model, and assesses its effectiveness for child and adult clients. (RJC)
Cazenave, Noel A.
Existing evidence on family violence rates by age and race as well as the available data on race and physical elder abuse incidence rates suggests that because such data are not based on random or representative samples and tend to reflect a "sampling artifact" of the particular client populations served by the professionals surveyed, there are no…
Baker, Juanita N.; Tanis, Heyley J.; Rice, Jennifer B.
Describes the necessity of including siblings in the treatment of victims of child sexual abuse. Theoretical and practical reasons to include siblings in treatment are discussed. Case examples using a particular intervention approach and results of client satisfaction surveys are described. (Contains 18 references.) (GCP)
Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.
Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…
Use of anabolic steroids is believed to increase the odds of violent antisocial behavior, thus posing risks to consumers and the general public. Some research shows the danger of steroids in inducing severe adverse psychiatric effects. Certain lawyers use this abuse to plead insanity for their clients. (SM)
Daley, Dennis C.
Discusses the problems of relapse with alcoholics and other drug abusers from three perspectives: client-related variables, common erroneous beliefs and myths held by professionals regarding relapse, and treatment system problems that may contribute to relapse. Offers proposed solutions and describes a relapse prevention model. (Author/ABB)
Koehn, Corinne; Cutcliffe, John R.
This study used a grounded theory method to explore how counselors inspire hope in clients struggling with substance abuse. Findings from 10 participants revealed that hope inspiration occurred in 3 phases and consisted of several categories of hope-inspiring processes. Implications for counseling practice, counselor education, and research are…
Koehn, Corinne; O'Neill, Linda; Sherry, John
Hope is a vital component of psychological healing and plays a critical role in counselling. With despair so prominent for individuals with serious substance abuse problems, the question arises as to how to foster hope in such clients. There are recent suggestions in the general counselling literature that some of the work in counselling involve…
Hohman, Melinda; Oliver, Rhonda; Wright, Wendy
Methamphetamine abuse is on the rise, particularly by women of child-bearing age. This article describes the history and effects of methamphetamine use. The authors examine the ways exposure to the manufacture of this drug affects clients and social workers in the course of their work. Because children are frequently found at the scene of a…
Russell, J. Curtis; And Others
Evaluated effectiveness of instruction and presentation format of course on alcohol consumption and safe driving given to individuals convicted of first offense of driving while under the influence. Results showed that instructional information significantly increased clients' knowledge of alcohol and drug abuse and safe driving; course did not…