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Sample records for abused older clients

  1. Self-Report Measure of Psychological Abuse of Older Adults

    ERIC Educational Resources Information Center

    Conrad, Kendon J.; Iris, Madelyn; Ridings, John W.; Langley, Kate; Anetzberger, Georgia J.

    2011-01-01

    Purpose: This study tested key psychometric properties of the Older Adult Psychological Abuse Measure (OAPAM), one self-report scale of the Older Adult Mistreatment Assessment (OAMA). Design and Methods: Items and theory were developed in a prior concept mapping study. Subsequently, the measures were administered to 226 substantiated clients by 22…

  2. Client perceptions of incest and substance abuse.

    PubMed

    Janikowski, T P; Bordieri, J E; Glover, N M

    1997-01-01

    Clients receiving substance abuse treatment from 35 treatment facilities throughout the United States were surveyed using the Substance Abuse and Incest Survey-Revised (SAIS-R). A total of 732 participants responded to the survey; 518 (71%) were males, 204 (28%) were females, and 10 (1%) did not indicate gender. Participants had a mean age of 33.8 years, were predominately Caucasian (61.6%), never married (45.2%), were currently unemployed (69.4%), and had completed an average of 11.7 years of education. Of the entire sample, 266 (36.3%) reported having been victims of incest; 151 were males and 113 were females (2 did not indicate gender). The group reporting incest histories had a significantly greater percentage of females that did the group not reporting incest histories (chi 2 = 48.1, p < .001). Participants with incest histories were asked about their perceptions regarding incest, substance abuse, and counseling. Item responses were examined using descriptive statistics and factor analysis. The factor analysis on SAIS-R perception items identified five factors that accounted for 68.9% of the variance; these factors were Stigma and Resistance to Counseling; Substance Abuse and Incest; Ambivalence; Fear and Anticipation; and Receptivity to Counseling. Results are presented and the implications for substance abuse treatment and counseling are discussed.

  3. Preventing abuse of older people.

    PubMed

    Fraser, Aileen

    2010-10-01

    The author travelled to the United States on a Florence Nightingale Travel Scholarship to study the systems in place to respond to and prevent elder abuse. She visited centres in Orange County, California, and New York City that are involved in dealing with the issue. This article provides a summary of her findings, with emphasis on education and training strategies for healthcare professionals working with older people, and provides recommendations for developments in safeguarding older people in the UK. The author also reviews models of service, models of evaluation and approaches to older people who self-neglect.

  4. [Substance abuse in older adults].

    PubMed

    Bitar, Raoul; Dürsteler, Kenneth M; Rösner, Susanne; Grosshans, Martin; Herdener, Marcus; Mutschler, Jochen

    2014-09-01

    In respect of demographic change, the number of older patients with substance abuse and addiction is on the raise. In this review we present important clinical and therapeutic aspects of substance abuse and addiction in the elderly and focus on alcohol, benzodiazepines and opioids. Daily and risky alcohol consumption is common among older people. They also have an increased risk getting alcohol-related complications. For early detection, laboratory parameters and questionnaires such as the AUDIT-C are suitable. Therapeutically brief interventions have been proved successful. Also, abuse of benzodiazepines, especially low-dose addiction, is widespread among older persons, although often overlooked, and patients often do not recognize their addiction. The physician has to know the correct indication, adequate dosage and pharmacological interactions. A slow-dose reduction is recommended in case of addiction. Thanks to opioid substitution therapy, patients with an opioidaddiction can reach a higher age. Age influences the effects of the substitute, which may require an adjustment of the dosage. Treatment of elderly patients should be based on their needs and resources and is usually very effective.

  5. Professional Value Conflicts in Forcing Services on Resistant Older Clients.

    ERIC Educational Resources Information Center

    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…

  6. Factors Associated with Illegal Drug Use among Older Methadone Clients

    ERIC Educational Resources Information Center

    Rosen, Daniel

    2004-01-01

    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…

  7. Acculturation and polysubstance abuse in Arab-American treatment clients.

    PubMed

    Arfken, Cynthia L; Kubiak, Sheryl P; Farrag, Mohamed

    2009-12-01

    Acculturation to U.S. culture by Latinos and Asian Americans has been associated with increased prevalence of substance abuse. However, little is known about the association between acculturation and substance use among Arab Americans, or more specifically, among Arab-American treatment clients. In 156 Arab-American male treatment clients, we found that higher levels of U.S. acculturation were positively associated with increased prevalence of polysubstance abuse. This first report on a large series of Arab-American clients also found considerable within-group variability. These results can be used to develop treatment plans and work-force training on the importance of U.S. acculturation and variability within Arab Americans.

  8. A Multimodal Approach in Dealing with Older Clients.

    ERIC Educational Resources Information Center

    Weikel, William J.

    1990-01-01

    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,…

  9. Preventing Elder Abuse and Neglect in Older Adults

    MedlinePlus

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  10. Adolescent Clients of Washington State's Division of Alcohol and Substance Abuse Services: A Descriptive Study.

    ERIC Educational Resources Information Center

    Andris, Lydia M.; And Others

    Many adolescent clients of the Division of Alcohol and Substance Abuse (DASA) in Washington come also with psychiatric problems, are involved with the legal system, live with someone who abuses drugs or alcohol, have poor social support networks, or live in poverty. This report describes a sample of adolescent clients who received treatment and/or…

  11. Changing Profile of Abused Substances by Older Persons Entering Treatment

    PubMed Central

    Lofwall, Michelle R.; Schuster, Alyson; Strain, Eric C.

    2009-01-01

    This study evaluated whether there were increasing admissions for illicit drug abuse treatment among older persons from 1992 to 2005 in the United States and describes the characteristics, number, and type of substances most commonly abused in this population over this 14-year period. Analyses used public data files from the Treatment Episode Data Set, which tracks federally and state funded substance abuse treatment admissions. From 1992 to 2005, admissions for illicit drug abuse increased significantly; in 2005, 61% of admissions age 50 to 54 years old and 45% of admissions age 55 years and older reported some type of illicit drug abuse, most commonly heroin or cocaine abuse. Criminal justice referrals for drug abuse admissions have increased over time and daily substance use remains high. Efforts to determine best practices for prevention, identification, and treatment of illicit drug abuse in older persons are indicated. PMID:19077857

  12. Abuses against Older Women: Prevalence and Health Effects

    ERIC Educational Resources Information Center

    Fisher, Bonnie S.; Zink, Therese; Regan, Saundra L.

    2011-01-01

    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…

  13. Sexual Abuse of Older Nursing Home Residents: A Literature Review

    PubMed Central

    Malmedal, Wenche; Iversen, Maria Helen; Kilvik, Astrid

    2015-01-01

    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

  14. Client-Provider relationship in comprehensive substance abuse treatment: differences in residential and nonresidential settings.

    PubMed

    Shin, Hee-Choon; Marsh, Jeanne C; Cao, Dingcai; Andrews, Christina M

    2011-12-01

    As the substance abuse service system shifts from primarily residential to primarily nonresidential settings, it becomes important to understand how substance abuse treatment processes and outcomes may vary across service setting. Research increasingly indicates that, along with specific treatment and service strategies, client-provider relationship is an important ingredient in effective substance abuse treatment. This study uses a moderator-mediator analysis of a comprehensive service model to examine how the relation between client-provider relationship and substance abuse treatment outcomes may differ in residential and nonresidential settings. The study used data collected for the National Treatment Improvement Evaluation Study, a prospective, cohort-based study of U.S. substance abuse treatment programs and their clients, with an analytic sample of 59 publicly funded service delivery units and 3,027 clients. Structural equation modeling is used to assess the structural relations and causal connections between treatment process and treatment outcome variables. Results indicate that for nonresidential settings, a better client-provider relationship is directly related to improved outcomes of treatment duration and reduced posttreatment substance use and is indirectly related to both outcomes through provision of services matched to client needs. In residential settings, the quality of the client-provider relationship is unrelated to process or outcome variables. The findings point to the importance of the client-provider relationship in all settings but particularly in outpatient settings where there are limited physical constraints on the treatment process.

  15. Evaluating and Training Substance Abuse Counselors: A Pilot Study Assessing Standardized Patients as Authentic Clients

    ERIC Educational Resources Information Center

    Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.

    2009-01-01

    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…

  16. Older people's conceptualization of elder abuse and neglect.

    PubMed

    Taylor, Brian J; Killick, Campbell; O'Brien, Marita; Begley, Emer; Carter-Anand, Janet

    2014-01-01

    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

  17. Personal resources supporting living at home as described by older home care clients.

    PubMed

    Eloranta, Sini; Routasalo, Pirkko; Arve, Seija

    2008-08-01

    This study describes the personal resources of older (> or = 75 years) home care clients in Finland and their perceptions of factors that enhance and constrain their ability to live independently at home. The data were collected by unstructured interviews with 21 older home care clients. Inductive content analysis were used to analyse the data. The resources of older people consisted of a sense of control over one's life and a determination to remain active. Factors enhancing older people's resources were their involvement in leisure activities and social networks, factors undermining their resources were conditions on living imposed by outsiders, declining health and loneliness. The results show that home care professionals do not yet have sufficient skills and abilities to identify and support older people's existing resources. As well as having access to necessary resources, it is also crucial that older people know how to use them.

  18. Prevalence and correlates of client-perpetrated abuse among female sex workers in two Mexico-U.S. border cities.

    PubMed

    Ulibarri, Monica D; Strathdee, Steffanie A; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L

    2014-04-01

    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

  19. Prevalence and correlates of client-perpetrated abuse among female sex workers in two Mexico-U.S. border cities.

    PubMed

    Ulibarri, Monica D; Strathdee, Steffanie A; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L

    2014-04-01

    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.

  20. PREVALENCE AND CORRELATES OF CLIENT-PERPETRATED ABUSE AMONG FEMALE SEX WORKERS IN TWO MEXICO-U.S. BORDER CITIES

    PubMed Central

    Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L.

    2011-01-01

    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

  1. The Effect of MSW Education on Students' Knowledge and Attitudes Regarding Substance Abusing Clients

    ERIC Educational Resources Information Center

    Senreich, Evan; Straussner, Shulamith Lala A.

    2013-01-01

    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,…

  2. The Influence of Rural and Urban Substance Abuse Treatment Counselor Characteristics on Client Outcomes

    PubMed Central

    Oser, Carrie B.; Biebel, Elizabeth P.; Pullen, Erin L.; Harp, Kathi L.H.

    2011-01-01

    Focus group data was collected from 28 substance abuse treatment counselors employed in rural and urban areas to examine their perceptions of factors influencing treatment outcomes. The influence of the counselor characteristics (i.e., education, experience, and recovery status) on client outcomes and geographic differences are explored. Focus group data was analyzed by three raters using line-by-line coding, focused coding, and memoing. This analytic approach revealed geographic differences in the counselors' perceptions of the effect of counselor education, experience, and recovery status on client outcomes. Recommendations for treatment planning and future research are provided. PMID:21927521

  3. The emerging role of the client in the delivery of primary care to older Americans.

    PubMed Central

    Counte, M A

    1998-01-01

    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

  4. Client-provider Relationship in Comprehensive Substance Abuse Treatment: Differences in Residential and Non-residential Settings

    PubMed Central

    Shin, Hee-Choon; Marsh, Jeanne C.; Cao, Dingcai; Andrews, Christina M.

    2011-01-01

    As the substance abuse service system shifts from primarily residential to primarily non-residential settings, it becomes important to understand how substance abuse treatment processes and outcomes may vary across service setting. Research increasingly indicates that, along with specific treatment and service strategies, client-provider relationship is an important ingredient in effective substance abuse treatment. This study uses a moderator-mediator analysis of a comprehensive service model to examine how the relation between client-provider relationship and substance abuse treatment outcomes may differ in residential and non-residential settings. The study uses data collected for the National Treatment Improvement Evaluation Study (NTIES), a prospective, cohort-based study of U.S. substance abuse treatment programs and their clients with an analytic sample of 59 publicly-funded service delivery units and 3,027 clients. Structural equation modeling (SEM) is used to assess the structural relations and causal connections between treatment process and treatment outcome variables. Results indicate that for non-residential settings, a better client-provider relationship is directly related to improved outcomes of treatment duration and reduced post-treatment substance use and indirectly related to both outcomes through provision of services matched to client needs. In residential settings, the quality of the client-provider relationship is unrelated to process or outcome variables. The findings point to the importance of the client-provider relationship in all settings but particularly in outpatient settings where there are limited physical constraints on the treatment process. PMID:21871770

  5. Medical and psychosocial services in drug abuse treatment: do stronger linkages promote client utilization?

    PubMed Central

    Friedmann, P D; D'Aunno, T A; Jin, L; Alexander, J A

    2000-01-01

    OBJECTIVE: To examine the extent to which linkage mechanisms (on-site delivery, external arrangements, case management, and transportation assistance) are associated with increased utilization of medical and psychosocial services in outpatient drug abuse treatment units. DATA SOURCES: Survey of administrative directors and clinical supervisors from a nationally representative sample of 597 outpatient drug abuse treatment units in 1995. STUDY DESIGN: We generated separate two-stage multivariate generalized linear models to evaluate the correlation of on-site service delivery, formal external arrangements (joint program/venture or contract), referral agreements, case management, and transportation with the percentage of clients reported to have utilized eight services: physical examinations, routine medical care, tuberculosis screening, HIV treatment, mental health care, employment counseling, housing assistance, and financial counseling services. PRINCIPAL FINDINGS: On-site service delivery and transportation assistance were significantly associated with higher levels of client utilization of ancillary services. Referral agreements and formal external arrangements had no detectable relationship to most service utilization. On-site case management was related to increased clients' use of routine medical care, financial counseling, and housing assistance, but off-site case management was not correlated with utilization of most services. CONCLUSIONS: On-site service delivery appears to be the most reliable mechanism to link drug abuse treatment clients to ancillary services, while referral agreements and formal external mechanisms offer little detectable advantage over ad hoc referral. On-site case management might facilitate utilization of some services, but transportation seems a more important linkage mechanism overall. These findings imply that initiatives and policies to promote linkage of such clients to medical and psychosocial services should emphasize on

  6. Informal Discussions in Substance Abuse Treatment Sessions with Spanish-speaking Clients

    PubMed Central

    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

    2010-01-01

    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

  7. Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual [and] Participant Workbook.

    ERIC Educational Resources Information Center

    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…

  8. Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes.

    PubMed

    Sirey, Jo Anne; Berman, Jacquelin; Salamone, Aurora; DePasquale, Alyssa; Halkett, Ashley; Raeifar, Elmira; Banerjee, Samprit; Bruce, Martha L; Raue, Patrick J

    2015-01-01

    The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice.

  9. Managing Opioid Abuse in Older Adults: Clinical Considerations and Challenges.

    PubMed

    Loreck, David; Brandt, Nicole J; DiPaula, Bethany

    2016-04-01

    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

  10. The role of the intermediate care team in detecting and responding to loneliness in older clients.

    PubMed

    Chana, Richard; Marshall, Paul; Harley, Clare

    2016-06-01

    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.

  11. The role of the intermediate care team in detecting and responding to loneliness in older clients.

    PubMed

    Chana, Richard; Marshall, Paul; Harley, Clare

    2016-06-01

    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

  12. Spanish language proficiency among providers and Latino clients' engagement in substance abuse treatment.

    PubMed

    Guerrero, Erick G; Khachikian, Tenie; Kim, Tina; Kong, Yinfei; Vega, William A

    2013-12-01

    Quality of care, such as provision of services in Spanish, is a common factor believed to improve treatment engagement among Spanish-speaking Latinos in health care. However, there is little evidence that Spanish language proficiency among providers increases treatment access and retention in publicly funded substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, California. An analytic sample of 1903 Latino clients nested within 40 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on days to initiate and spent in treatment. As hypothesized, Spanish language proficiency was negatively associated with client wait time and positively associated with retention in treatment, after controlling for individual and program characteristics. The path analysis models showed that Spanish language proficiency played a mediating role between professional accreditation and client wait time and retention. These preliminary findings provide an evidentiary base for the role of providers' Spanish language proficiency and Latino engagement in treatment for a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to enhance linguistically competent care, are discussed.

  13. [Abuse and neglect of older care recipients in domestic settings - a survey among nurses of in-home care services].

    PubMed

    Rabold, S; Görgen, T

    2007-10-01

    Although some anecdotal evidence for the phenomenon of abuse and neglect of community-dwelling older care recipients by in-home care services exists, there is an almost complete lack of data on this topic. In order to determine extent and risk factors of abuse and neglect of older care recipients by nurses, we conducted a self-report study among in-home care workers in the German city of Hanover. A total of 503 nurses took part in the study; the response rate was 43.3%. Nearly 40% of all respondents reported having abused or neglected at least one patient within the last 12 months. Psychological abuse/verbal aggression and neglect were most common. Serious problem behavior could be predicted by patients' aggressive behavior, the number of clients suffering from dementia, subjects' use of alcohol as a means of alleviating work-related stress, and nurses' general judgments of quality of care delivered by the respective in-home service. The results of this study show that the problem of abuse and neglect of care recipients is not limited to nursing homes and care by family members. Findings point at opportunities for prevention and accentuate the need for further research in this field.

  14. Using Personal Narratives for Curriculum Development about Substance Abuse and Older Adults

    ERIC Educational Resources Information Center

    Bial, Martha C.; Gutheil, Irene A.; Hanson, Meredith; White-Ryan, Linda

    2012-01-01

    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…

  15. Older persons' definitions and explanations of elder abuse in the Netherlands.

    PubMed

    Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

    2016-01-01

    In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semistructured interviews with 35 older persons who had no experience with abuse. Our findings show that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of, and explanation for, elder abuse may influence their detection and reporting behavior, as they may tend to acknowledge only severe cases of intentional physical violence that leave clear and therefore physically detectable evidence.

  16. Older persons' definitions and explanations of elder abuse in the Netherlands.

    PubMed

    Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

    2016-01-01

    In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semistructured interviews with 35 older persons who had no experience with abuse. Our findings show that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of, and explanation for, elder abuse may influence their detection and reporting behavior, as they may tend to acknowledge only severe cases of intentional physical violence that leave clear and therefore physically detectable evidence. PMID:26731491

  17. Identifying and responding to gaps in domestic abuse services for older women.

    PubMed

    Shiel, Rebecca

    2016-07-01

    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.

  18. Identifying and responding to gaps in domestic abuse services for older women.

    PubMed

    Shiel, Rebecca

    2016-07-01

    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

  19. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers

    PubMed Central

    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

    2016-01-01

    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

  20. Substance Abuse, Coping Strategies, Adaptive Skills and Behavioral and Emotional Problems in Clients with Mild to Borderline Intellectual Disability Admitted to a Treatment Facility: A Pilot Study

    ERIC Educational Resources Information Center

    Didden, Robert; Embregts, Petri; van der Toorn, Mirjam; Laarhoven, Nina

    2009-01-01

    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…

  1. Closing the Need–Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

    PubMed Central

    Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon

    2011-01-01

    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 outcome-targeted services on substance abuse treatment outcomes by using data collected from 1992 through 1997 for the National Treatment Improvement Evaluation Study, a prospective, cohort study of substance abuse treatment programs and clients. The analytic sample consists of 3,027 clients (1,105 women and 1,922 men) who reported needed services from 59 treatment facilities. Findings from the study indicate that overall programs have only limited success in targeting services to client needs, but when they do, receipt of substance abuse counseling and matched services predicts both remaining in treatment and reduced posttreatment substance use for both women and men, but especially for women. PMID:21566721

  2. The Relation of Secondary Traumatization to Therapists' Perceptions of the Working Alliance with Clients Who Commit Sexual Abuse

    ERIC Educational Resources Information Center

    Carmel, Melissa J. Sheehy; Friedlander, Myrna L.

    2009-01-01

    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,…

  3. Feasibility of Integrating Mental Health Screening and Services Into Routine Elder Abuse Practice to Improve Client Outcomes

    PubMed Central

    Sirey, Jo Anne; Berman, Jacquelin; Salamone, Aurora; DePasquale, Alyssa; Halkett, Ashley; Raeifar, Elmira; Banerjee, Samprit; Bruce, Martha L.; Raue, Patrick J.

    2015-01-01

    Objective The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and enrolling those victims into a brief psychotherapy useful with both depression and anxiety. Methods Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different mental health interventions concurrent with abuse resolution services. This design helped determine the acceptability of each intervention offered and thus the optimal format for service delivery. Results Staff were able to integrate mental health screening for 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was able to be implemented in two different formats, with collaboration between elder abuse and mental health staff workers. Discussion These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice. PMID:25611116

  4. Ageism and the abuse of older people in health and social care.

    PubMed

    Ward, D

    Ageing is a natural process and yet ageism, ageist practice and abuse of older people occur among not only the general public but also in health and social care settings. Recent media reports have highlighted delays in meeting the needs of older people, physical and psychological abuse and that decisions are being made about whether or not to resuscitate an older patient without consultation with the patient and his/her family (e.g. British Journal of Nursing, 2000). This article looks at ageism and the abuse of older people and discusses what can be done to achieve quality care for older people while dealing with obstacles such as poor collaboration between agencies, a lack of support for carers and the belief that the needs of older people are less important than those of the young.

  5. Depressed Skull Fractures: A Pattern of Abusive Head Injury in Three Older Children

    ERIC Educational Resources Information Center

    Lee, Anselm C. W.; Ou, Yvonne; Fong, Dawson

    2003-01-01

    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…

  6. To Stay or Not To Stay: Adolescent Client, Parent, and Counselor Perspectives on Leaving Substance Abuse Treatment Early

    PubMed Central

    Landrum, Brittany; Knight, Danica K.; Becan, Jennifer E.; Flynn, Patrick M.

    2013-01-01

    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

  7. Injection Drug Use as a Mediator Between Client-perpetrated Abuse and HIV Status Among Female Sex Workers in Two Mexico-US Border Cities

    PubMed Central

    Ulibarri, Monica D.; Strathdee, Steffanie A.; Ulloa, Emilio C.; Lozada, Remedios; Fraga, Miguel A.; Magis-Rodríguez, Carlos; De La Torre, Adela; Amaro, Hortensia; O’Campo, Patricia

    2009-01-01

    We examined relationships between client-perpetrated emotional, physical, and sexual abuse, injection drug use, and HIV-serostatus among 924 female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-US border cities. We hypothesized that FSWs’ injection drug use would mediate the relationship between client-perpetrated abuse and HIV-seropositivity. The prevalence of client-perpetrated emotional, physical, and sexual abuse in the past 6 months was 26, 18, and 10% respectively; prevalence of current injection drug use and HIV was 12 and 6%, respectively. Logistic regression analyses revealed that client-perpetrated sexual abuse was significantly associated with HIV-seropositivity and injection drug use, and that injection drug use was positively associated with HIV-seropositivity. Injection drug use partially mediated the relationship between client-perpetrated sexual abuse and HIV-seropositivity. Results suggest the need to address client-perpetrated violence and injection drug use when assessing HIV risk among FSWs. PMID:19636697

  8. Sexual Abuse of Older Residents in Nursing Homes: A Focus Group Interview of Nursing Home Staff

    PubMed Central

    Iversen, Maria Helen; Kilvik, Astrid; Malmedal, Wenche

    2015-01-01

    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

  9. Performance-Based Contracting Within a State Substance Abuse Treatment System: A Preliminary Exploration of Differences in Client Access and Client Outcomes

    PubMed Central

    Brucker, Debra L.; Stewart, Maureen

    2013-01-01

    To explore whether the implementation of performance-based contracting (PBC) within the State of Maine’s substance abuse treatment system resulted in improved performance, one descriptive and two empirical analyses were conducted. The first analysis examined utilization and payment structure. The second study was designed to examine whether timeliness of access to outpatient (OP) and intensive outpatient (IOP) substance abuse assessments and treatment, measures that only became available after the implementation of PBC, differed between PBC and non-PBC agencies in the year following implementation of PBC. Using treatment admission records from the state treatment data system (N=9,128), logistic regression models run using generalized equation estimation techniques found no significant difference between PBC agencies and other agencies on timeliness of access to assessments or treatment, for both OP and IOP services. The third analysis, conducted using discharge data from the years prior to and after the implementation of performance-based contracting (N=6,740) for those agencies that became a part of the performance-based contracting system, was designed to assess differences in level of participation, retention, and completion of treatment. Regression models suggest that performance on OP client engagement and retention measures was significantly poorer the year after the implementation of PBC, but that temporal rather than a PBC effects were more significant. No differences were found between years for IOP level of participation or completion of treatment measures. PMID:21249461

  10. The Extent and Frequency of Abuse in the Lives of Older Women and Their Relationship with Health Outcomes

    ERIC Educational Resources Information Center

    Fisher, Bonnie S.; Regan, Saundra L.

    2006-01-01

    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…

  11. Counselors' Role in Preventing Abuse of Older Adults: Clinical, Ethical, and Legal Considerations

    ERIC Educational Resources Information Center

    Forman, Julia M.; McBride, Rebecca G.

    2010-01-01

    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…

  12. Substance Abuse among Older Adults. Treatment Improvement Protocol (TIP) Series 26.

    ERIC Educational Resources Information Center

    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…

  13. Evidence-based and occupational perspective of effective interventions for older clients that remediate or support improved driving performance.

    PubMed

    Hunt, Linda A; Arbesman, Marian

    2008-01-01

    To assess the effectiveness of person-related interventions on driving ability in older adults, this literature review was completed as a part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. Nineteen articles were incorporated into the systematic review and include interventions in the following areas: visual, cognitive, and motor; educational; passengers; and medical. The results provide inconclusive evidence for the use of interventions such as the Useful Field of View training, home exercise programs, and passenger interactions. Conclusive evidence shows that older adults respond positively to programs stressing self-awareness of driving skills and that some medical interventions affect the ability to drive. Despite limitations, the studies reviewed provide useful information that deserves further exploration. Reading the literature provides therapists with knowledge that might improve client care. Learning about cutting-edge interventions and educating peers and students about evidence-based interventions may lead to safer community mobility for older adults.

  14. Representations of Attachment Security in the Bird's Net Drawings of Clients with Substance Abuse Disorders.

    ERIC Educational Resources Information Center

    Francis, Denille M.; Kaiser, Donna; Deaver, Sarah P.

    2003-01-01

    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…

  15. Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

    PubMed Central

    Rosen, Daniel; Engel, Rafael J.; Hunsaker, Amanda E.; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F.

    2014-01-01

    This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders. PMID:23731426

  16. Just say know: an examination of substance use disorders among older adults in gerontological and substance abuse journals.

    PubMed

    Rosen, Daniel; Engel, Rafael J; Hunsaker, Amanda E; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F

    2013-01-01

    This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders.

  17. An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

    PubMed Central

    2014-01-01

    Background Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. Methods A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation. Results Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. Conclusions Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion

  18. Therapeutic Components and Differential Treatment Outcomes among Clients of Israeli Services for Substance Abusers

    ERIC Educational Resources Information Center

    Schiff, Miriam; Katz, Katalin

    2007-01-01

    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…

  19. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China.

    PubMed

    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

    2016-05-01

    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

  20. The Incidence of Incest Histories among Clients Receiving Substance Abuse Treatment.

    ERIC Educational Resources Information Center

    Glover, Noreen M.; And Others

    1995-01-01

    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…

  1. Attitudes toward Substance Abuse Clients: An Empirical Study of Clinical Psychology Trainees.

    PubMed

    Mundon, Chandra R; Anderson, Melissa L; Najavits, Lisa M

    2015-01-01

    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.

  2. Attitudes toward Substance Abuse Clients: An Empirical Study of Clinical Psychology Trainees

    PubMed Central

    Mundon, Chandra R.; Anderson, Melissa L.; Najavits, Lisa M.

    2015-01-01

    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 is 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

  3. Substance abuse and personality disorders in homeless drop-in center clients: symptom severity and psychotherapy retention in a randomized clinical trial.

    PubMed

    Ball, Samuel A; Cobb-Richardson, Patricia; Connolly, Adrian J; Bujosa, Cesar T; O'neall, Thomas W

    2005-01-01

    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

  4. Substance abuse and personality disorders in homeless drop-in center clients: symptom severity and psychotherapy retention in a randomized clinical trial.

    PubMed

    Ball, Samuel A; Cobb-Richardson, Patricia; Connolly, Adrian J; Bujosa, Cesar T; O'neall, Thomas W

    2005-01-01

    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.

  5. Older people's perceptions of the term elder abuse and characteristics associated with a lower level of awareness.

    PubMed

    Naughton, Corina; Drennan, Jonathan; Lafferty, Attracta

    2014-01-01

    A national representative survey of 2,021 community-dwelling older people was carried out in 2010 using face-to-face interviews. The study examined how the term "elder abuse" was understood by this population and identified factors associated with lower levels of awareness. Over 80% of this population recognized the term elder abuse, and 56% demonstrated specific insight related to typologies, locations, and perpetrators of abuse. Less specific responses were given by 22% of participants, and a further 21% could not give a reply. Less specific or "don't know" responses were independently associated with age 80 years or older, a lower level of education, impaired physical health, and living in economically deprived communities. Despite ongoing public information campaigns, there remained a significant portion of older people who may be unaware of or have limited insight into elder abuse. This study suggests a need for more targeted education campaigns aimed at specific higher-risk groups. PMID:24329480

  6. "My older clients fall through every crack in the system": geriatrics knowledge of legal professionals.

    PubMed

    Soones, Tacara; Ahalt, Cyrus; Garrigues, Sarah; Faigman, David; Williams, Brie A

    2014-04-01

    With the number of older adult arrestees and prisoners increasing rapidly, 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 the ability of legal professionals 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 demographic characteristics, 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: educate legal professionals about age-related health, train professionals to identify cognitive and sensory impairment, develop checklists to identify those at risk of poor health or safety, and improve knowledge of and access to transitional services for older adults. These findings suggest that geriatrics knowledge gaps of legal professionals exist that may contribute to adverse medical or legal outcomes for older adults involved in the criminal justice system and that partnerships between healthcare and legal professionals are needed to address these challenges.

  7. Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders.

    PubMed

    Appel, Philip W; Ellison, Aletha A; Jansky, Hadley K; Oldak, Rivka

    2004-01-01

    Alcohol and other drug abuse (AOD) treatment is a major means of HIV/AIDS prevention, yet clients of street outreach programs (SOP) who are injection drug users (IDU), and outreach workers and staff as well, report various obstacles to enrolling clients in AOD programs. This study assessed the barriers to AOD enrollment facing high risk street outreach clients and obtained suggestions for reducing them. Data were obtained from semistructured field interviews with: 1) IDU outreach clients (N = 144) of the six SOPs in New York City (NYC) and northern suburbs supported by the Office of Alcoholism and Substance Abuse Services (OASAS), the single state agency in New York State for AOD prevention and treatment, 2) outreach workers and staff of the six SOPs (N = 55), 3) staff of detox and AOD treatment programs in major modalities treating IDUs (N = 71), and 4) officials and administrators (N = 11) in OASAS, the AIDS Institute of the Department of Health (addresses all aspects of the HIV/AIDS epidemic in New York State), and the agency for public assistance in New York City, the Human Resources Administration (HRA). Principal barriers for street outreach clients included personal-family issues, lack of insurance/Medicaid, ignorance, suspicion, and/or aversion to AOD treatment (methadone maintenance especially), "hassles" with Medicaid, lack of personal ID, lack of "slots," limited access to intake, homelessness, childcare-child custody issues. Further, about 18% had no desire for AOD services, reported no barriers, or were too enmeshed in addiction to enroll. Outreach staff cited prospective client's lack of ID and lack of Medicaid, lack of "slots," and stakeholder agency bureaucracy. Treatment staff cited lack of client readiness, "hassles" posed by welfare reform, AOD programs' own "red tape," waiting lists, and near exclusionary preference for the Medicaid-eligible. Finally, agency managers cited client factors, inadequate funding and lack of appropriate programs

  8. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    PubMed

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    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.

  9. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    PubMed

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    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

  10. A Client-Centered Community Engagement Project: Improving the Health and Wellness of Older Adults in an Assisted Living Facility.

    PubMed

    Ballantyne-Rice, Madeleine; Chopp, Kayla; Evans, Lisa; Ho, Vanessa; Hsiung, Wan Ping; Simon, Marian Alexandra; Wu, Kaiyu; Donnelly, Tam Truong

    2016-08-01

    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

  11. Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

    PubMed Central

    2011-01-01

    Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Discussion

  12. A Prevention Education Project on the Abuse and Mistreatment of Older Adults in Northern Saskatchewan. Final Report.

    ERIC Educational Resources Information Center

    Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.

    A project was designed to begin an Elder Abuse Prevention Education initiative specific to northern and Aboriginal needs in northern Saskatchewan, Canada. The key principle in every dimension of the project was getting to know one another and talking with Aboriginal older adults and those who work with them. In early 1993, LaRonge, Saskatchewan,…

  13. Closing the Need-Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon

    2009-01-01

    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…

  14. Condom Use, Sexual Risk, and Self-Reported STI in a Sample of Older Male Clients of Heterosexual Prostitution in the United States.

    PubMed

    Milrod, Christine; Monto, Martin

    2016-07-01

    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

  15. Abuse

    MedlinePlus

    ... 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 ...

  16. Abuse of Older Men in Seven European Countries: A Multilevel Approach in the Framework of an Ecological Model

    PubMed Central

    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.

    2016-01-01

    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

  17. Therapist and client race/ethnicity match: an examination of treatment outcome and process with rural older adults in the deep south.

    PubMed

    Presnell, Andrew; Harris, Grant; Scogin, Forrest

    2012-01-01

    This study investigated the effects of race/ethnicity (r/e) match in cognitive-behavioral therapy with rural older adults. Races/ethnicities represented in this study were African-American and White. Treatment followed a CBT treatment protocol and was provided by MSWs to clients in their homes. Results indicated little evidence of differences in outcome and process for matched and non-matched dyads for number of sessions attended, changes in quality of life and psychological symptoms, overall quality of therapy sessions, or the number of sessions considered of unsatisfactory quality. Our findings are consistent with recent research on r/e matching and extend these findings to a sample of rural older adults. PMID:22676430

  18. Alcohol Use among Abused and Non-Abused Older Persons Aged 60-84 Years: An European Study

    ERIC Educational Resources Information Center

    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

    2013-01-01

    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…

  19. An interprofessional team approach to fall prevention for older home care clients ‘at risk’ of falling: health care providers share their experiences

    PubMed Central

    Baxter, Pamela; Markle-Reid, Maureen

    2009-01-01

    Background Providing care for older home care clients ‘at risk’ of falling requires the services of many health care providers due to predisposing chronic, complex conditions. One strategy to ensure that quality care is delivered is described in the integrated care literature; interprofessional collaboration. Engaging in an interprofessional team approach to fall prevention for this group of clients seems to make sense. However, whether or not this approach is feasible and realistic is not well described in the literature. As well, little is known about how teams function in the community when an interprofessional approach is engaged in. The barriers and facilitators of such an approach are also not known. Purpose The purpose of this qualitative study was to describe the experiences of five different health care professionals as they participated in an interprofessional team approach to care for the frail older adult living at home and at risk of falling. Methodology This study took place in Hamilton, ON, Canada and was part of a randomized controlled trial, the aim of which was to determine the effects and costs of a multifactorial and interdisciplinary team approach to fall prevention for older home care clients ‘at risk’ of falling. The current study utilized an exploratory descriptive design to answer the following research questions: how do interprofessional teams describe their experiences when involved in a research intervention requiring collaboration for a 9-month period of time? What are the barriers and facilitators to teamwork? Four focus groups were conducted with the care-provider teams (n=9) 6 and 9 months following group formation. Results This study revealed several themes which included, team capacity, practitioner competencies, perceived outcomes, support and time. Overall, care providers were positive about their experiences and felt that through an interprofessional approach benefits could be experienced by both the provider and the

  20. Caregiver Abuse of Chicago Chinese Older Adults in a Community-Dwelling Population

    PubMed Central

    Dong, Xin Qi; Li, Ge

    2016-01-01

    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. PMID:27606358

  1. Seasonal Variation in Mortality, Medical Care Expenditure and Institutionalization in Older People: Evidence from a Dutch Cohort of Older Health Insurance Clients

    PubMed Central

    Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David; Westendorp, Rudi Gerardus Johannes

    2015-01-01

    Background The mortality rates of older people changes with the seasons. However, it has not been properly investigated whether the seasons affect medical care expenditure (MCE) and institutionalization. Seasonal variation in MCE is plausible, as MCE rises exponentially before death. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality. Methods Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer and were linked with data from the Netherlands Institute for Social Research, and Statistics Netherlands (n = 61,495). The Seasonal and Trend decomposition using Loess (STL) method was used to divide mortality rates, MCE, and institutionalization rates into a long-term trend, seasonal variation, and remaining variation. For every season we calculated the 95% confidence interval compared to the long-term trend using Welch’s t-test. Results The mortality rates of older people differ significantly between the seasons, and are 21% higher in the winter compared to the summer. MCE rises with 13% from the summer to the winter; this seasonal difference is higher for the non-deceased than for the deceased group (14% vs. 6%). Seasonal variation in mortality is more pronounced in men and people in residential care. Seasonal variation in MCE is more pronounced in women. Institutionalization rates are significantly higher in the winter, but the other seasons show no significant impact. Conclusions Seasonal changes affect mortality and the level of MCE of older people; institutionalization rates peak in the winter. Seasonal variation in MCE exists independently from patterns in mortality. Seasonal variation in mortality is similar for both institutionalized and community-dwelling elderly. Policy-makers, epidemiologists and health economists are urged to acknowledge and include the impact of

  2. Integrated client care for frail older adults in the community: preliminary report on a system-wide approach.

    PubMed

    Goldhar, Jodeme; Daub, Stacey; Dhalla, Irfan; Ellison, Philip; Purbhoo, Dipti; Sinha, Samir K

    2014-01-01

    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

  3. Child Abuse

    MedlinePlus

    ... 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.

  4. Growing Old With Ice: A Review of the Potential Consequences of Methamphetamine Abuse in Australian Older Adults.

    PubMed

    Searby, Adam; Maude, Phil; McGrath, Ian

    2015-01-01

    This review analyzes contemporary literature in the context of Australian aging methamphetamine users, service response, and challenges to provision of care to this population. The article focuses on Australian literature with comparisons made with trends arising from international scholarship. Searches of the CINAHL, ProQuest, and Scopus electronic journal databases were performed in early 2014 as part of a wider study investigating dual diagnosis in older adults. Methamphetamine abuse is common in individuals with comorbid mental illness. The literature presented in this review outlines potential neuropsychological and persistent psychiatric sequelae associated with the use of methamphetamine, along with a number of concerning behaviors prevalent in individuals with comorbid human immunodeficiency virus-positive status. Despite an abundance of literature discussing methamphetamine use in adult populations, this is the first review exploring methamphetamine use in the context of aging and older adult mental health. Contemporary literature suggests that methamphetamine dependence will be a significant challenge for services that cater to older adults, requiring further research to fully assess the impact this cohort will have on the healthcare system.

  5. Safety and Security of Older Persons in Tehran, Iran: A Sociological Appraisal of Elder Abuse

    ERIC Educational Resources Information Center

    Sheykhi, Mohammad Taghi

    2010-01-01

    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…

  6. Violence against older women.

    PubMed

    2016-07-01

    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

  7. When the struggle against dejection becomes a part of everyday life: a qualitative study of coping strategies in older abused people

    PubMed Central

    Sandmoe, Astrid; Hauge, Solveig

    2014-01-01

    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

  8. Safety and security of older persons in Tehran, Iran: a sociological appraisal of elder abuse.

    PubMed

    Sheykhi, Mohammad Taghi

    2010-01-01

    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 reflected. The research also aims to study the elder age-groups in order to find out how these people gradually lose their physical and mental reliance, and as a result, how their dependence on others and various services enhances. The method of research mainly being empirical, it is preceded by theoretical and literature review. Five hundred elderly people were randomly selected for the study. Findings suggest that the aging pyramid shrinks and narrows at the age of 65 or even before in the present study. Research reached the conclusion that the young elderly with new needs and expectations are highly different from those of their pervious generations.

  9. Considerations of prescription opioid abuse and misuse among older adults in West Virginia--An Under-Recognized Population at Risk.

    PubMed

    Grey, Carl; Hall, P Bradley

    2016-01-01

    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

  10. Considerations of prescription opioid abuse and misuse among older adults in West Virginia--An Under-Recognized Population at Risk.

    PubMed

    Grey, Carl; Hall, P Bradley

    2016-01-01

    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.

  11. Prevalence and correlates of elder abuse among older women in rural and urban communities in South Western Nigeria.

    PubMed

    Cadmus, Eniola O; Owoaje, Eme T

    2012-01-01

    Elderly women face the same health, economic, and social issues that all elderly people face, but often encounter more challenges compared with men and are more prone to abuse. Elder abuse has hitherto been uncharacterized among women in South Western Nigeria. A cross-sectional survey was conducted to describe the prevalence, patterns, and factors associated with elder abuse among elderly women in Nigeria. The abuse of elderly women is quite prevalent in the two communities studied, especially physical abuse. Positive predictors of elder abuse were urban dwelling, financial dependency, and a high level of educational attainment. Appropriate interventions should be targeted toward reducing the occurrence. PMID:22946597

  12. Using Prayer as an Intervention with Clients Who Are Substance Abusing and Addicted and Who Self-Identify Personal Faith in God and Prayer as Recovery Resources

    ERIC Educational Resources Information Center

    Juhnke, Gerald A.; Watts, Richard E.; Guerra, Norma S.; Hsieh, Peggy

    2009-01-01

    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.

  13. Possible barriers to enrollment in substance abuse treatment among a diverse sample of Asian Americans and Pacific Islanders: opinions of treatment clients.

    PubMed

    Masson, Carmen L; Shopshire, Michael S; Sen, Soma; Hoffman, Kim A; Hengl, Nicholas S; Bartolome, John; McCarty, Dennis; Sorensen, James L; Iguchi, Martin Y

    2013-03-01

    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.

  14. Client incentives versus contracting and staff incentives: how care continuity interventions in substance abuse treatment can improve residential to outpatient transition.

    PubMed

    Acquavita, Shauna P; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine

    2013-07-01

    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

  15. Client Incentives versus Contracting and Staff Incentives: How Care Continuity Interventions in Substance Abuse Treatment can improve Residential to Outpatient Transition

    PubMed Central

    Acquavita, Shauna P.; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine

    2013-01-01

    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 30 days 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% vs 52% in UC) and immediacy (1.0 vs 3.9 days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361

  16. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    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

  17. 42 CFR 483.420 - Condition of participation: Client protections.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Client protections. 483.420 Section 483.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND..., sexual or psychological abuse or punishment; (6) Ensure that clients are free from unnecessary drugs...

  18. 42 CFR 483.420 - Condition of participation: Client protections.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Client protections. 483.420 Section 483.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND..., sexual or psychological abuse or punishment; (6) Ensure that clients are free from unnecessary drugs...

  19. 42 CFR 483.420 - Condition of participation: Client protections.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Client protections. 483.420 Section 483.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND..., sexual or psychological abuse or punishment; (6) Ensure that clients are free from unnecessary drugs...

  20. Counselors, Confidentiality, and Life-Endangering Clients.

    ERIC Educational Resources Information Center

    VandeCreek, Leon; Knapp, Samuel

    1984-01-01

    Reviews the statutory and case law regarding release of client information in three life endangering situations: child abuse, protection of third parties, and suicide. Describes the general principles of confidentiality and some specific legal issues for each of these three areas. (LLL)

  1. Geriatric Alcoholism and Drug Abuse

    ERIC Educational Resources Information Center

    Schuckit, Marc A.

    1977-01-01

    This paper reviews the literature and presents new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates, inadvertent misusers, and deliberate abusers of nonopiates. Two to 10 percent of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. (Author)

  2. Physical Abuse

    MedlinePlus

    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 ...

  3. Sexual Abuse

    MedlinePlus

    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 ...

  4. Substance abuse treatment characteristics of probation-referred young adults in a community-based outpatient program.

    PubMed

    Sinha, Rajita; Easton, Caroline; Kemp, Kathleen

    2003-08-01

    Although rates of substance abuse continue to rise among young adults ages 18-25, there is little information on the clinical characteristics of young adults referred to treatment, their readiness to change substance use behaviors, and treatment outcomes. These aspects were examined in young (18-25 years old) and older adult (26-45 years old) substance abusers entering treatment at a large, urban, outpatient substance abuse treatment facility. All clients were referred for outpatient treatment by the local Offices of Adult Probation during 1998-1999. The demographic and substance use characteristics, motivation level/readiness to change substance use behaviors, treatment attendance, completion, and "drug-free" status based on patient self-report and urine/breathalyzer data were assessed. Results. Substance-abusing young adult probationers were more likely to be African-American, with a significantly earlier age of onset of primary substance use. They were more likely to have a marijuana use disorder as compared with older adults, who in turn, were more likely to meet criteria for alcohol use disorders. Furthermore, as compared with older adults, young adults had significantly higher scores on precontemplation, and significantly lower scores on contemplation, determination, action, and maintenance subscales of motivation/change readiness. A significantly higher number of young adults did not complete outpatient treatment and were "drug-positive" at discharge, as compared with older adults. Conclusions. Young adult probationers referred to substance abuse treatment show significantly different substance abuse and treatment characteristics as compared with their older adult counterparts. The findings suggest that specialized treatment approaches that focus on enhancing treatment readiness and motivation to change substance use behaviors may be of particular benefit to substance abusing young adults. PMID:14510042

  5. Addressing violence against older women.

    PubMed

    2016-07-01

    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

  6. Voluntary Testing for HIV Antibodies among Clients in Long-Term Substance Treatment.

    ERIC Educational Resources Information Center

    Galea, Robert P.; And Others

    1988-01-01

    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…

  7. Profile of Clients Attending a Methadone Clinic

    PubMed Central

    JACOB, Sabrina Anne; MOHAMMED, Fauziah; HASSALI, Mohamed Azmi Ahmad

    2015-01-01

    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

  8. Elder Abuse and Substance Abuse

    MedlinePlus

    ... 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/ ...

  9. Participation and power in care: exploring the "client" in client engagement.

    PubMed

    Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys

    2014-12-01

    Despite growing recognition in health and care services of the necessity for client engagement, it is still not easily put into practice. This is owing to a range of factors relating to participating staff and clients, as well as the broader institutional context. One of the central factors affecting client engagement is the challenge it poses to traditional power relations inherent in care relationships and contexts. This is particularly the case in aged care services, which have traditionally positioned older adults in passive roles as "recipients" of care, or as lacking capacity to participate in care decision making. This paper presents an exploration of client engagement practices within a large aged care service provider in Australia. Interviews and focus group discussions with clients and staff were analysed for the ways in which clients were positioned - by both themselves and by staff - in terms of the roles that they hold within engagement practices. Four positions were identified: "Passivity, disempowerment and bestowal of power", "Role of expert/consumer", "Resistance, compliance and manageability", and "Complexity, diversity and uniqueness". While clients were positioned at times in empowering roles, they were simultaneously limited by personal, relational, or organisational constraints, making opportunities for client engagement provisional. This reflects a tension between passive and empowered client roles in the context of aged care provision.

  10. Participation and power in care: exploring the "client" in client engagement.

    PubMed

    Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys

    2014-12-01

    Despite growing recognition in health and care services of the necessity for client engagement, it is still not easily put into practice. This is owing to a range of factors relating to participating staff and clients, as well as the broader institutional context. One of the central factors affecting client engagement is the challenge it poses to traditional power relations inherent in care relationships and contexts. This is particularly the case in aged care services, which have traditionally positioned older adults in passive roles as "recipients" of care, or as lacking capacity to participate in care decision making. This paper presents an exploration of client engagement practices within a large aged care service provider in Australia. Interviews and focus group discussions with clients and staff were analysed for the ways in which clients were positioned - by both themselves and by staff - in terms of the roles that they hold within engagement practices. Four positions were identified: "Passivity, disempowerment and bestowal of power", "Role of expert/consumer", "Resistance, compliance and manageability", and "Complexity, diversity and uniqueness". While clients were positioned at times in empowering roles, they were simultaneously limited by personal, relational, or organisational constraints, making opportunities for client engagement provisional. This reflects a tension between passive and empowered client roles in the context of aged care provision. PMID:25456629

  11. Rosalie Wolf Memorial Lecture: Reconsidering assumptions regarding men as elder abuse perpetrators and as elder abuse victims.

    PubMed

    Kosberg, Jordan I

    2014-01-01

    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

  12. Rosalie Wolf Memorial Lecture: Reconsidering assumptions regarding men as elder abuse perpetrators and as elder abuse victims.

    PubMed

    Kosberg, Jordan I

    2014-01-01

    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.

  13. Ethical dilemma: is this elder abuse?

    PubMed

    Turkoski, Beatrice B

    2003-08-01

    Elder abuse, neglect, and exploitation are major problems today (Marshall, Benton, & Brazier, 2000). Most elder abuse occurs at home and is committed by spouses, children, or other family members. Abuse may go undetected until observant professionals intervene ( AOA, 1998). Sometimes the abuse is a continuation of existing dysfunctional family dynamics. More often, however, the abuse is a result of changes brought about by an older person's growing dependency and need for increased care. PMID:12917522

  14. Psychotherapy and Memories of Childhood Sexual Abuse.

    ERIC Educational Resources Information Center

    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…

  15. 45 CFR 2551.81 - What type of clients are eligible to be served?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FOR NATIONAL AND COMMUNITY SERVICE SENIOR COMPANION PROGRAM Clients Served § 2551.81 What type of clients are eligible to be served? Senior Companions serve only adults, primarily older adults, who have... 45 Public Welfare 4 2011-10-01 2011-10-01 false What type of clients are eligible to be...

  16. 45 CFR 2551.81 - What type of clients are eligible to be served?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... FOR NATIONAL AND COMMUNITY SERVICE SENIOR COMPANION PROGRAM Clients Served § 2551.81 What type of clients are eligible to be served? Senior Companions serve only adults, primarily older adults, who have... 45 Public Welfare 4 2010-10-01 2010-10-01 false What type of clients are eligible to be...

  17. Quality of counselling of young clients in Zimbabwe.

    PubMed

    Kim, Y M; Marangwanda, C; Kols, A

    1997-08-01

    Researchers observed 418 consultations with clients aged 12-24 years at 38 health facilities throughout Zimbabwe and interviewed both the clients and providers. Less than one per cent of clients at these facilities were aged 12-14 years; between 5% and 20% were aged 15-19 years. Compared with older clients, those aged 12-16 years came more often for antenatal care and medical problems and less often for family planning. In sessions with 12-16 years, the most common topics were STDs (48%) and school (46%), while sessions with older clients focused more on family planning (56-68%). Providers rarely discussed adolescence or non-sexual problems such as alcohol and drugs. Younger clients were less likely than older clients to ask questions without prompting (16%), expressed their concerns (27%), and they were more likely to appear embarrassed (58%) and shy (64%). Most service providers believed that the parents should be notified if a young, unmarried client was pregnant (89%), had HIV/AIDS (74%), or engaged in sex at "an early" age (73%). The findings suggest that young people may be reluctant to seek advice at health facilities because of legitimate concerns about privacy, providers' attitudes, and narrow focus on reproductive health. PMID:9487418

  18. Substance Abuse in Rural Areas

    MedlinePlus

    ... 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 ...

  19. Reducing client waiting time.

    PubMed

    1992-01-01

    This first issues of Family Planning (FP) Manager focuses on how to analyze client waiting time and reduce long waits easily and inexpensively. Client flow analysis can be used by managers and staff to identify organizational factors affecting waiting time. Symptoms of long waiting times are overcrowded waiting rooms, clients not returning for services, staff complaints about rushing and waiting, and hurried counseling sessions. Client satisfaction is very important in order to retain FP users. Simple procedures such as routing return visits differently can make a difference in program effectiveness. Assessment of the number of first visits, the number of revisits, and types of methods and services that the clinic provides is a first step. Client flow analysis involves assigning a number to each client on registration, attaching the client flow form to the medical chart, entering the FP method and type of visit, asking staff to note the time at each station, and summarizing data in a master chart. The staff should be involved in plotting data for each client to show waiting versus staff contact time through the use of color coding for each type of staff contact. Bottlenecks become very visible when charted. The amount of time spent at each station can be measured, and gaps in client's contact with staff can be identified. An accurate measure of total waiting time can be obtained. A quick assessment can be made by recording arrival and departure times for each client in one morning or afternoon of a peak day. The procedure is to count the number of clients waiting at 15-minute intervals. The process should be repeated every 3-6 months to observe changes. If waiting times appear long, a more thorough assessment is needed on both a peak and a typical day. An example is given of a completed chart and graph of results with sample data. Managers need to set goals for client flow, streamline client routes, and utilize waiting time wisely by providing educational talks

  20. Aging and Alcohol Abuse: Increasing Counselor Awareness

    ERIC Educational Resources Information Center

    Williams, June M.; Ballard, Mary B.; Alessi, Hunter

    2005-01-01

    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.

  1. Perceptions of Elders' Substance Abuse and Resilience

    ERIC Educational Resources Information Center

    Kane, Michael N.; Green, Diane

    2009-01-01

    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…

  2. Directions in Substance Abuse Counseling, 2000.

    ERIC Educational Resources Information Center

    Cohen, Adam W., Ed.

    2000-01-01

    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.…

  3. Substance Abuse and Counseling: An Epilogue.

    ERIC Educational Resources Information Center

    Sales, Amos

    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…

  4. The complexities of elder abuse.

    PubMed

    Roberto, Karen A

    2016-01-01

    Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record

  5. Pattern of Child Sexual Abuse by Young Aggressors.

    ERIC Educational Resources Information Center

    Alert-Dancer, Claire; Halley, Nancy; Hamate, Maryam; Bernard-Bonnie, Anne-Claude

    1997-01-01

    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)

  6. The Impact of Organizational Stress and Burnout on Client Engagement

    PubMed Central

    Landrum, Brittany; Knight, Danica K.; Flynn, Patrick M.

    2011-01-01

    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

  7. Perceived Counselor Characteristics, Client Expectations, and Client Satisfaction with Counseling.

    ERIC Educational Resources Information Center

    Heppner, P. Paul; Heesacker, Martin

    1983-01-01

    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…

  8. Drug and Substance Abuse

    MedlinePlus

    ... 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 ...

  9. Elder abuse: speak out for justice.

    PubMed

    Olson, Jenna M; Hoglund, Barbara A

    2014-01-01

    It is estimated that 1 in 10 older adults experience abuse, but only 1 in 5 to as little as 1 in 24 cases are reported. Elder abuse is expected to increase as the population ages. Nurses are in a prime position to identify, assess, manage, and prevent elder abuse. This article explores elder abuse and its prevalence, potential causes, and risk factors offering case studies, assessment tools, resources, and interventions.

  10. Older women and intimate partner violence: effective interventions.

    PubMed

    Tetterton, Summer; Farnsworth, Elizabeth

    2011-09-01

    Women above the age of 60 who have experienced intimate partner violence (IPV) have specific needs compared with younger victims. More research is emerging that assists counselors and other helping professionals with identification of these needs and aids to promote the mental health and well-being of this population. Professionals must consider the generational values held by older IPV victims and understand how values may impact decision making. Integrating safety planning and risk assessment into the counseling process is vital. Older IPV victims may seek counseling for posttraumatic stress or depressive symptoms as a result of the abuse. Others may participate in counseling for issues unrelated to IPV. Therefore, a thorough assessment process should include questions related to relationship dynamics so that the counselor has a complete understanding of all factors impacting the client's functioning. Helping professionals must also have an understanding of available community resources, as well as barriers that these clients face as they take steps toward recovery from trauma. This research uses qualitative analysis of case studies to assist helping professionals in understanding the most effective interventions when working with this population.We found that a contextual approach focusing on the restoration of self-confidence is a constructive means of initiating recovery from trauma.

  11. Social Work Students' Attitudes about Working with Involuntary Clients

    ERIC Educational Resources Information Center

    Pope, Natalie D.; Kang, Byungdeok

    2011-01-01

    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…

  12. A Profile of Clients Entering Treatment for Alcohol Problems.

    ERIC Educational Resources Information Center

    Finkbiner, Richard

    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…

  13. Sophia Client Version 12

    SciTech Connect

    2012-08-09

    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.

  14. Vulnerable populations: drug court program clients.

    PubMed

    Speck, Patricia M; Connor, Pamela D; Hartig, Margaret T; Cunningham, Patricia D; Fleming, Belinda

    2008-09-01

    Substance abuse and addiction are chronic conditions characterized by an inability to control one's urge to use mood- or mind-altering drugs. Recognition of the association between addictions and crime to support the addiction, along with the relapsing nature of addictions, presents treatment and management challenges for clinicians and frustration for patients and their families. Pressures to reduce the burgeoning jail population have resulted in collaboration between the treatment community and the court--a diversion program called drug court. This article reviews the drug court programs, the clients, and the processes of accountability that direct the progress toward sobriety in the drug court clients. It also argues that the drug court clients have unique health needs requiring interventions best suited for the recovering addict enrolled in a diversion program within the criminal justice system. Nurses have the ability to influence these systems and provide safety-net clinics to drug court clients through outreach, case finding, and culturally and linguistically appropriate care that can ultimately help this population to reach a higher level of wellness.

  15. Acceptance and Commitment Therapy with Older Adults: Rationale and Considerations

    ERIC Educational Resources Information Center

    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    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…

  16. The cost of treating addiction from the client's perspective: results from a multi-modality application of the Client DATCAP.

    PubMed

    McCollister, Kathryn E; French, Michael T; Pyne, Jeffrey M; Booth, Brenda; Rapp, Richard; Carr, Carey

    2009-10-01

    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

  17. Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    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…

  18. Superpowers and client states

    SciTech Connect

    Efrat, M.; Bercovitch, J.

    1987-01-01

    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.

  19. Animal-assisted therapy for clients with dementia.

    PubMed

    Buettner, Linda L; Fitzsimmons, Suzanne; Barba, Beth

    2011-05-01

    The purpose of this article is to increase nurses' awareness of animal-assisted therapy as a treatment option for older adults with dementia. We describe the differences between animal visitation programs and goal-directed therapy. We also address credentials of human-animal teams and provide an overview of possible therapeutic outcomes for older adults with dementia. Step-by-step methods are outlined for nurses to advocate for clients with dementia to receive these services.

  20. Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: "You Only Get Things Done When Working in Concert with Clients".

    PubMed

    Coulourides Kogan, Alexis; Wilber, Kathleen; Mosqueda, Laura

    2016-01-01

    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.

  1. Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: "You Only Get Things Done When Working in Concert with Clients".

    PubMed

    Coulourides Kogan, Alexis; Wilber, Kathleen; Mosqueda, Laura

    2016-01-01

    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

  2. Counselors as Clients.

    ERIC Educational Resources Information Center

    Journal of Counseling and Development, 1988

    1988-01-01

    Contains four personal accounts of counselors' experiences as clients: (1) "The Heart of the Matter" (Paul Crowley); (2) "Empathic Intervention in Self-Psychology" (Jon Maaske); (3) "Moving toward a New Perspective on Depression and Myself" (John Rebillot); and (4) "My Journey from Despair to Hope" (Lawrence Rossiter). (NB)

  3. Psychotherapy for Suicidal Clients.

    ERIC Educational Resources Information Center

    Lester, David

    1994-01-01

    Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

  4. Abusive Relationships

    MedlinePlus

    ... 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 ...

  5. The National Treatment Improvement Evaluation Study (NTIES): Profile of Clients Age 45 and Over.

    ERIC Educational Resources Information Center

    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…

  6. The Effects of Incest on Therapist Assessment of Female Clients.

    ERIC Educational Resources Information Center

    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,…

  7. Psychotherapy with Older Dying Persons.

    ERIC Educational Resources Information Center

    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…

  8. Drug Abuse

    MedlinePlus

    ... 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 ...

  9. Domestic and institutional elder abuse legislation.

    PubMed

    Daly, Jeanette M

    2011-12-01

    Statutes pertinent to elder abuse vary widely. This article provides examples of organizational structure, dependency and age of the victim, definitions of abuse, classification of penalties, and investigation processes. Health care providers must learn their state's elder abuse laws and review any operating manuals produced from the statutes or regulations. All health care workers must know and implement the law to protect the welfare of older persons. PMID:22055906

  10. Domestic and institutional elder abuse legislation.

    PubMed

    Daly, Jeanette M

    2011-12-01

    Statutes pertinent to elder abuse vary widely. This article provides examples of organizational structure, dependency and age of the victim, definitions of abuse, classification of penalties, and investigation processes. Health care providers must learn their state's elder abuse laws and review any operating manuals produced from the statutes or regulations. All health care workers must know and implement the law to protect the welfare of older persons.

  11. Working with Potentially Assaultive Clients.

    ERIC Educational Resources Information Center

    Murdach, Allison D.

    1993-01-01

    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,…

  12. The Competitive Advantage: Client Service.

    ERIC Educational Resources Information Center

    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…

  13. Elder Abuse and Neglect: Considerations for Mental Health Practitioners

    ERIC Educational Resources Information Center

    Thompson, Heather; Priest, Ronnie

    2005-01-01

    Elder abuse and neglect are prevalent throughout the U.S. and are often unrecognized and untreated. It is projected that by the year 2030, the number of older adults (age 60 and older) will double, thereby increasing the likelihood that mental health practitioners will encounter instances of elder abuse and neglect. The authors address the…

  14. Solution-Focused Group Therapy for Level 1 Substance Abusers

    ERIC Educational Resources Information Center

    Smock, Sara A.; Trepper, Terry S.; Wetchler, Joseph L.; McCollum, Eric E.; Ray, Rose; Pierce, Kent

    2008-01-01

    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…

  15. Inclusion of Substance Abuse Training in CACREP-Accredited Programs

    ERIC Educational Resources Information Center

    Salyers, Kathleen M.; Ritchie, Martin H.; Luellen, Wendy S.; Roseman, Christopher P.

    2005-01-01

    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…

  16. Inclusion of Substance Abuse Training in CACREP-Accredited Programs

    ERIC Educational Resources Information Center

    Salyers, Kathleen M.; Ritchie, Martin H.; Cochrane, Wendy S.; Roseman, Christopher P.

    2006-01-01

    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…

  17. Interaction effects of treatment setting and client characteristics on retention and completion.

    PubMed

    Klein, Chris; di Menza, Salvatore; Arfken, Cynthia; Schuster, Charles R

    2002-01-01

    Client-treatment matching assumes treatment outcome will be improved if characteristics of clients are matched to specific elements of treatment. Few empirical studies, however, have examined matching across different types of treatment settings. The present research examined differences in demographics and substance-related problems in populations admitted to three substance abuse treatment settings--outpatient (n = 1132), intensive outpatient (n = 1190), and residential (n = 149)--and tested whether interactions between client characteristics and type of setting predicted rates of 30-day retention and treatment completion. In addition, three specific hypotheses based on prior theoretical and empirical investigations were tested. Client characteristics included demographic information (e.g., sex, age, race) and Addiction Severity Index (ASI) composite scores. Client-setting interactions were found for both retention and completion. All three hypotheses received at least partial support. Implications for client assignment and future research are discussed.

  18. Elder abuse and dementia: a review of the research and health policy.

    PubMed

    Dong, XinQi; Chen, Ruijia; Simon, Melissa A

    2014-04-01

    Older adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia. We found that psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent. Physical abuse was estimated to affect 3.5-23.1 percent of older adults with dementia. We also found that many older adults experienced multiple forms of abuse simultaneously, and the risk of mortality from abuse and self-neglect may be higher in older adults with greater levels of cognitive impairment. We summarize programs and policies related to the abuse of older adults with dementia, including adult protective services, mandatory elder abuse reporting, and the Long-Term Care Ombudsman Program. We also summarize aspects of the National Alzheimer's Project Act, the Older Americans Act, and the Elder Justice Act. In spite of a recent increase in research and policy developments on elder abuse, challenges such as insufficient funding, limited knowledge about elder abuse, a lack of funding for the implementation of federal and state programs relevant to elder abuse and dementia, and a lack of dementia-specific training for front-line health care staff persist. Stronger programs targeting the well-being of older adults with dementia are needed.

  19. Evaluation of Drug Abuse Treatment Effectiveness: Summary of the DARP Followup Research. Treatment Research Report.

    ERIC Educational Resources Information Center

    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…

  20. Cultural Diversity Among Older Adults: Addressing Health Education

    ERIC Educational Resources Information Center

    Haber, David

    2005-01-01

    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…

  1. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    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…

  2. Addressing Trauma in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  3. Spiritual abuse.

    PubMed

    Purcell, B C

    1998-01-01

    Spiritual abuse is the act of making people believe--whether by stating or merely implying--that they are going to be punished in this life and/or tormented in hell-fire forever for failure to live life good enough to please God and thus earn admission to heaven. Spiritual terrorism is the most extreme form of spiritual abuse and may cause serious mental health problems. Those people who have not been spiritually terrorized have not necessarily been spared from spiritual abuse and therefore may still be in need of competent, spiritual counseling. Spiritual abuse, which may be active or passive, can best be conceptualized on a continuum from terroristic to zero abuse. Severity is determined by intensity, age of onset, duration, and individual reaction. The underlying issue in all forms of abuse is control. PMID:9729974

  4. Client/server study

    NASA Technical Reports Server (NTRS)

    Dezhgosha, Kamyar; Marcus, Robert; Brewster, Stephen

    1995-01-01

    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.

  5. [Client centered psychotherapy].

    PubMed

    Werthmann, H V

    1979-01-01

    In the discussion concerning which psychotherapeutic methods should come under the auspices of the medical health system in West Germany, the question is raised regarding the client-centered therapy of Carl Rogers. Can it be considered a distinct psychotherapeutic method? A review of the scientific literature dealing with this method shows that it provides neither a theory of mental illness nor a theory of clinical application based on individual cases or specific neurotic disturbances, Therefore it should be categorized as a useful method of communication in the field of psychology and not as a therapeutic method for treating mental illness.

  6. [Client centered psychotherapy].

    PubMed

    Werthmann, H V

    1979-01-01

    In the discussion concerning which psychotherapeutic methods should come under the auspices of the medical health system in West Germany, the question is raised regarding the client-centered therapy of Carl Rogers. Can it be considered a distinct psychotherapeutic method? A review of the scientific literature dealing with this method shows that it provides neither a theory of mental illness nor a theory of clinical application based on individual cases or specific neurotic disturbances, Therefore it should be categorized as a useful method of communication in the field of psychology and not as a therapeutic method for treating mental illness. PMID:543319

  7. A proposed intergenerational model of substance abuse, family functioning, and abuse/neglect.

    PubMed

    Sheridan, M J

    1995-05-01

    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.

  8. New drugs of abuse.

    PubMed

    Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth

    2015-02-01

    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

  9. Talking about friends, drugs, and change: meanings of friendship in substance abusers' change talk.

    PubMed

    Sarpavaara, Harri

    2014-05-01

    This article explores the meanings of substance-abusing clients attach to friendships during motivational treatment sessions in Probation Service. Sessions (98) were videotaped in 12 probation service offices in Finland in 2007 to 2009. By using semiotic framework, this qualitative study examines client's change talk utterance about friendships as a symbolic sign. The findings indicate that the friendships play an important role in the substance-abusing clients' motivation to change and in their treatment outcome. The study suggests that the personal meanings of clients' utterances in motivational treatment sessions could be seen as potential predictors of their future behavior.

  10. Ten-year recovery outcomes for clients with co-occurring schizophrenia and substance use disorders.

    PubMed

    Drake, Robert E; McHugo, Gregory J; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara

    2006-07-01

    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

  11. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    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…

  12. Client Common Factors Represented by Client Motivation and Autonomy

    ERIC Educational Resources Information Center

    Scheel, Michael J.

    2011-01-01

    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…

  13. The Therapeutic Alliance: Clients' Categorization of Client-Identified Factors

    ERIC Educational Resources Information Center

    Simpson, Arlene J.; Bedi, Robinder P.

    2012-01-01

    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…

  14. Is managed care closing substance abuse treatment units?

    PubMed

    Wells, Rebecca; Harris Lemak, Christy; Alexander, Jeffrey A; Roddy, Brian L; Nahra, Tammie A

    2007-03-01

    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

  15. Women-focused treatment agencies and process improvement: Strategies to increase client engagement

    PubMed Central

    Wisdom, Jennifer P.; Hoffman, Kim; Rechberger, Elke; Seim, Kay; Owens, Betta

    2009-01-01

    Behavioral health treatment agencies often struggle to keep clients engaged in treatment. Women clients often have additional factors such as family responsibilities, financial difficulties, or abuse histories that provide extra challenges to remaining in care. As part of a national initiative, four women-focused drug treatment agencies used process improvement to address treatment engagement. Interviews and focus groups with staff assessed the nature and extent of interventions. Women-focused drug treatment agencies selected relational-based interventions to engage clients in treatment and improved four-week treatment retention from 66% to 76%. Process improvement interventions in women-focused treatment may be useful to improve engagement. PMID:20046914

  16. Vocational Indecision and Rehabilitation Clients.

    ERIC Educational Resources Information Center

    Strohmer, Douglas C.; And Others

    1984-01-01

    Assessed the vocational decision-making problems of rehabilitation clients (N=60). Revealed that decision-making problems of clients can be grouped into three areas: employment readiness, self-appraisal, and decision-making readiness. Suggested that vocationally decided and undecided subjects differ significantly in the extent to which they have…

  17. Using Clients to Monitor Performance.

    ERIC Educational Resources Information Center

    Molnar, Jack; Stup, Brenda

    1994-01-01

    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.…

  18. Fostering Clients' Cooperation with Rehabilitation.

    ERIC Educational Resources Information Center

    Dale, B.

    1996-01-01

    This paper examines common causes of visually impaired clients' noncooperation with activities recommended by rehabilitation professionals. Recent literature on effective strategies for increasing compliance is reviewed, and techniques such as contingency contracts, task analysis, and openness to client innovation and modification of activities…

  19. Group Work with Transgender Clients

    ERIC Educational Resources Information Center

    Dickey, Lore M.; Loewy, Michael I.

    2010-01-01

    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…

  20. Constructing Genograms with Lesbian Clients.

    ERIC Educational Resources Information Center

    Magnuson, Sandy; And Others

    1995-01-01

    The intergenerational family therapy method of genogram construction may be a useful technique for increasing levels of differentiation in clients with a lesbian sexual orientation. Provides a description, rationale, and illustration of how genogram construction may be used by family counselors to treat lesbian clients. (JBJ)

  1. Changing Social Work Students' Attitudes toward Substance Abusers through the Use of an Abstinence Assignment: A Pilot Study

    ERIC Educational Resources Information Center

    Spaid, Wanda M.; Squires, Stuart P.

    2005-01-01

    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…

  2. Accidents and Alcohol Abuse among Older Americans.

    ERIC Educational Resources Information Center

    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…

  3. Working with the Suicidal Client Who Also Abuses Substances

    ERIC Educational Resources Information Center

    Esposito-Smythers, Christianne; Walsh, Adam; Spirito, Anthony; Rizzo, Christie; Goldston, David B.; Kaminer, Yifrah

    2012-01-01

    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…

  4. Using Motivational Interviewing to Address College Client Alcohol Abuse

    ERIC Educational Resources Information Center

    Scholl, Mark B.; Schmitt, Dorothy M.

    2009-01-01

    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…

  5. Substance Abuse Treatment Outcomes for Coerced and Noncoerced Clients

    ERIC Educational Resources Information Center

    Burke, Anna C.; Gregoire, Thomas K.

    2007-01-01

    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…

  6. Client safety in assisted living: perspectives from clients, personal support workers and administrative staff in Toronto, Canada.

    PubMed

    Speller, Brittany; Stolee, Paul

    2015-03-01

    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

  7. Students as Clients in a Professional/Client Relationship.

    ERIC Educational Resources Information Center

    Bailey, Jeffrey J.

    2000-01-01

    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)

  8. Differences in the acceptability of non-abstinence goals by type of drug among American substance abuse clinicians.

    PubMed

    Rosenberg, Harold; Davis, Alan K

    2014-02-01

    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

  9. Risk taking among diabetic clients.

    PubMed

    Joseph, D H; Schwartz-Barcott, D; Patterson, B

    1992-01-01

    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

  10. A Descriptive Profile of Abused Female Sex Workers in India

    PubMed Central

    Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Zelaya, Carla; Solomon, Suniti; Go, Vivian F.; Celentano, David

    2010-01-01

    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

  11. The evaluation of the National Long Term Care Demonstration. 3. Recruitment and characteristics of channeling clients.

    PubMed

    Applebaum, R A

    1988-04-01

    The National Long Term Care Demonstration (channeling) was designed to provide coordinated community-based long-term care services to those older persons at high risk of nursing home placement. A key component of the program was the process established to accomplish this targeting effort. In this article, the outreach and eligibility procedures developed in the demonstration are described. Characteristics of channeling clients are compared to those of clients from other long-term care demonstrations, a national nursing home sample, and a simulated national sample of functionally impaired older persons. Results indicate that the channeling clients were quite frail, more so than the clients served in most of the other long-term care demonstrations, but were younger, slightly less disabled, and more likely to be married than a national sample of nursing home residents.

  12. Prevalence of Client Violence against Social Work Students and Its Effects on Fear of Future Violence, Occupational Commitment, and Career Withdrawal Intentions

    ERIC Educational Resources Information Center

    Criss, Pamela Myatt

    2009-01-01

    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,…

  13. Neurofeedback outcomes in clients with Asperger's syndrome.

    PubMed

    Thompson, Lynda; Thompson, Michael; Reid, Andrea

    2010-03-01

    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

  14. Neurofeedback outcomes in clients with Asperger's syndrome.

    PubMed

    Thompson, Lynda; Thompson, Michael; Reid, Andrea

    2010-03-01

    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

  15. Sexual abuse in childhood : a report of four cases.

    PubMed

    Cherian, A; Kuruvilla, K

    1996-04-01

    Sexual abuse of children and adolescents is prevalent across all cultures. Sexual abuse often begins in infancy or toddler stage for many children. A Child's developmental level influences the detection and disclosure of sexual abuse. Pre-school children very rarely make verbal disclosures, but may present with behavioural and physical symptoms. Older children may make a conscious decision to reveal the abuse, but often feel that they risk their safety in making a disclosure. This paper reports four cases of sexual abuse detected in a clinic during a period of 12 months. The age group of these children ranged between 4-12 years. PMID:21584153

  16. Developing, Implementing, and Evaluating a Treatment Protocol for Rural Substance Abusers.

    ERIC Educational Resources Information Center

    Clark, James J.; Leukefeld, Carl; Godlaski, Theodore; Brown, Cyndy; Garrity, John; Hays, Lon

    2002-01-01

    Evaluation of an innovative substance abuse treatment program designed for rural areas involved 45 clients, 10 clinicians, and 2 program directors from three sites. Most clients felt the program was beneficial, but stressful. Clinicians found the program demanding to learn and adopt. Program directors liked the rural-specific design and the…

  17. Completion rates of clients discharged from drug and alcohol treatment programs in Washington State.

    PubMed Central

    Wickizer, T; Maynard, C; Atherly, A; Frederick, M; Koepsell, T; Krupski, A; Stark, K

    1994-01-01

    OBJECTIVES. The primary goal of this study was to analyze completion rates of clients in drug and alcohol abuse treatment programs in Washington State and to assess the factors associated with treatment completion. A secondary goal was to examine the utility of a state information system as a source of evaluative data. METHODS. Analyses were conducted of 5827 client records contained in the Washington State Substance Abuse Monitoring System, representing a census of public clients discharged during the last quarter of 1990 from all state-funded alcohol and drug treatment programs in four treatment modalities. Logistic regression was performed to determine the independent predictors of treatment completion. RESULTS. Completion rates were highest for intensive inpatient alcohol treatment (75%) and lowest for intensive outpatient drug programs (18%). Factors associated with treatment completion included screening at a referral assessment center, education, age, ethnicity, and existence of a secondary drug problem. CONCLUSIONS. The fit between clients and treatment programs may be an important factor explaining why some clients complete treatment and others drop out. State client information systems are an important source of data for analyzing treatment completion and other outcomes. PMID:8296943

  18. HIV infection and contraceptive need among female Ethiopian voluntary HIV counseling and testing clients.

    PubMed

    Bradley, H; Tsui, A; Kidanu, A; Gillespie, D

    2010-10-01

    Despite political endorsement of voluntary HIV counseling and testing (VCT), and family planning integration in Ethiopia, little is known about the reproductive health needs of VCT clients. We estimated contraceptive prevalence and need among 646 Ethiopian female VCT clients. We compared socio-demographic characteristics of contracepting VCT clients to those with unmet need and examined how these characteristics are associated with having unmet contraceptive need and being HIV-positive using multinomial logistic regression. We also assessed the quality of VCT services from clients' reports of reproductive health topics discussed in VCT sessions. Nearly 34% of female VCT clients have unmet contraceptive need. Three socio-demographic characteristics are consistently associated with both risk for unintended pregnancy and HIV: older age, marriage, and lower education. In the multivariate analysis, older age, marriage, and belonging to a minority ethnic group are significantly associated with being both HIV-positive and having unmet contraceptive need. Conversely, higher education, larger families, and frequent sexual activity are associated with reduced likelihood of experiencing these two adverse health outcomes. VCT clients report infrequent reproductive health counseling, although HIV-positive women are more likely than HIV-negative women to have discussions about contraception with VCT counselors. At the time of this study, family planning was not offered as part of VCT programs, although VCT clients demonstrate considerable need for contraceptive services. PMID:20665282

  19. Measurement of Client Preferences for Therapist Behavior.

    ERIC Educational Resources Information Center

    Richert, Alphons J.

    While past research has found conflicting results on the place for client role preferences in psychotherapy, none of this research has examined the client role preferences in an actual client population seeking outpatient therapy. This study involved the development of a measure of client role preferences which attempted to survey a wider range of…

  20. Substance abuse counselors' experiences with victims of incest.

    PubMed

    Glover-Graf, N M; Janikowski, T P

    2001-01-01

    Counselors delivering substance abuse treatment from within 39 treatment facilities throughout the United States were surveyed using the Substance Abuse Counselor Survey on Clients with Incest Histories (SACSCIH). The sample of 114 participants reported upon experiences and perceptions related to their incest-related training, identification of incest victims, prevalence of incest victims on their caseloads, and referral and treatment practices. Additionally, group comparisons provided information on differences based upon participants' gender, educational degree, recovery status, and experience with incest counseling.

  1. Detecting elder abuse and neglect: assessment and intervention.

    PubMed

    Hoover, Robert M; Polson, Michol

    2014-03-15

    Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is expected to increase. Although the U.S. Preventive Services Task Force found insufficient evidence that screening for elder abuse reduces harm, physicians in most states have professional and legal obligations to appropriately diagnose, report, and refer persons who have been abused. Screening or systematic inquiry can detect abuse. A detailed medical evaluation of patients suspected of being abused is necessary because medical and psychiatric conditions can mimic abuse. Signs of abuse may include specific patterns of injury. Interviewing patients and caregivers separately is helpful. Evaluation for possible abuse should include assessment of cognitive function. The Elder Abuse Suspicion Index is validated to screen for abuse in cognitively intact patients. A more detailed two-step process is used to screen patients with cognitive impairment. The National Center on Elder Abuse website provides detailed, state-specific reporting and resource information for family physicians.

  2. Drug Abuse and School Children: A Survey and Analysis.

    ERIC Educational Resources Information Center

    Roessler, Richard T.

    The purpose of this paper is twofold: (1) to survey the nature of the drug abuse problem among younger students; and (2) to determine whether profiles from abuse research on older student groups apply to a younger student sample. Subjects were 676 fifth graders in a semi-urban area. Incidence data on drug use and availability were gathered through…

  3. 78 FR 37427 - World Elder Abuse Awareness Day, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-20

    .... (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...

  4. Special Considerations for Substance Abuse Intervention with Latino Youth

    ERIC Educational Resources Information Center

    Goldbach, Jeremy T.; Thompson, Sanna J.; Holleran Steiker, Lori K.

    2011-01-01

    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…

  5. Gender Differences in Substance Dependence and Abuse. The NSDUH Report

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2004

    2004-01-01

    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…

  6. Countertransference with the Older Adult: The Importance of Mental Health Counselor Awareness and Strategies for Effective Management.

    ERIC Educational Resources Information Center

    Brockett, Daniel R.; Gleckman, Ari D.

    1991-01-01

    Defines the concept of countertransference and four dimensions of possible countertransference responses toward the older client. Three of these responses are based on Karen Horney's interpersonal styles: moving toward, moving away, and moving against. Discusses strategies for managing countertransference with older clients, with special emphasis…

  7. Ethical Dilemmas of Child Abuse Reporting: Implications for Mental Health Counselors.

    ERIC Educational Resources Information Center

    MacNair, Rebecca R.

    1992-01-01

    Explores effect of child abuse reporting on counselor-client relationship, mental health profession, and child protective services system. Uses ecological systems approach in exploration of interventions needed to help resolve child abuse reporting dilemma. Within ecosystems framework, discusses ethical guidelines and policymaking for reporting…

  8. Mental Health Providers and Child Abuse: An Analysis of the Decision to Report.

    ERIC Educational Resources Information Center

    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.…

  9. The Maine Approach: A Treatment Model for The Intellectually Limited Substance Abuser.

    ERIC Educational Resources Information Center

    Maine State Dept. of Mental Health and Mental Retardation, Augusta.

    The document presents Maine's model for providing substance abuse treatment to the client with mental retardation. Introductory information on retardation and substance abuse is followed by a discussion of this population's unique problems. Services offered in the Mental Retardation Alcoholism project are reviewed, and contracts and cooperative…

  10. Effects of Forgiveness of Perpetrators on Marital Adjustment for Survivors of Sexual Abuse.

    ERIC Educational Resources Information Center

    Holeman, Virginia Todd; Myers, Rita W.

    1998-01-01

    The effects of forgiveness on survivors' marital adjustment and the effects of childhood sexual abuse on forgiveness were examined. Self-report scales regarding abuse and forgiveness and demographic information were collected from clients (N=63). ANOVA produced significant main effects; forgiveness was negatively correlated with perceived…

  11. Psychosocial Characteristics of Drug-Abusing Women. Services Research Monograph Series.

    ERIC Educational Resources Information Center

    Burt, Marvin R.; And Others

    In recent years considerable attention has been paid to the status of women as drug abusers and as clients in drug treatment programs. A study of drug abusers' characteristics found a significantly higher history of non-medical psychotherapeutic drug use for females than for males; however, males had a higher prevalence of illicit drug use.…

  12. Experiences Associated with Intervening with Homeless, Substance-Abusing Mothers: The Importance of Success

    ERIC Educational Resources Information Center

    Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.

    2012-01-01

    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,…

  13. The Use of Family Therapy in Drug Abuse Treatment: A National Survey. Services Research Report.

    ERIC Educational Resources Information Center

    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…

  14. An Integrative Spiritual Development Model of Supervision for Substance Abuse Counselors-in-Training

    ERIC Educational Resources Information Center

    Weiss Ogden, Karen R.; Sias, Shari M.

    2011-01-01

    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.

  15. The Use of Adventure Programming in Traditional Substance Abuse Treatment Programs: An Exploratory Investigation.

    ERIC Educational Resources Information Center

    Moraes, Ricardo

    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…

  16. Psychosocial Characteristics of Pregnancy Women with and without a History of Substance Abuse.

    ERIC Educational Resources Information Center

    Marcenko, Maureen O.; And Others

    1994-01-01

    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…

  17. A Multivariate Examination of Explanations for the Occurrence of Elder Abuse

    ERIC Educational Resources Information Center

    Litwin, Howard; Zoabi, Sameer

    2004-01-01

    The goal of the study was to determine the relative strength of four major explanations for the rise of elder abuse among a population in transition from traditional to modern culture. The study compared a sample of 120 abused elderly Arab Israelis with a control group of 120 nonabused older adults from the same background. The abuse status…

  18. Psychiatric disorders, spouse abuse and child abuse.

    PubMed

    Bland, R C; Orn, H

    1986-01-01

    The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.

  19. Qualifications, training, and perceptions of substance abuse counselors who work with victims of incest.

    PubMed

    Janikowski, Timothy P; Glover-Graf, Noreen M

    2003-08-01

    The study was an initial investigation into substance abuse counselors' qualifications and their training related to providing counseling for incest. Perceptions regarding the incidence of incest and insights into the difficulties of serving this subpopulation were also gathered. A total of 121 practicing substance abuse counselors, randomly sampled from treatment facilities across the United States, completed the "Substance Abuse Counselor Survey on Clients with Incest Histories" (SACSCIH). Participants estimated that, on average, about 24% of their clients were victims of incest. They also suspected that, on average, an additional 14% of their clients were victims of incest but did not report this information to the treatment staff. Participants revealed how they collected incest-related information and the various challenges they face in treating these clients. Data are analyzed descriptively and recommendations for future research are presented.

  20. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

    The purpose of this paper was to elaborate on the definitions of child abuse in order to improve the understanding of child abuse. The definitions given by the U.S. House Joint Committee on Child Abuse in the Child Abuse Prevention and Treatment Act, and in research by Holden (1984), are cited. These definitions refer to the nature of abusive acts…

  1. Nutrition Education Needs Pantry Clients

    ERIC Educational Resources Information Center

    Wood, Dolores K.; Shultz, Jill Armstrong; Edlefsen, Miriam; Butkus, Sue N.

    2007-01-01

    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…

  2. Students: Customers, Clients or Pawns?

    ERIC Educational Resources Information Center

    Tight, Malcolm

    2013-01-01

    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…

  3. Understanding and Counseling Narcissistic Clients.

    ERIC Educational Resources Information Center

    Stevens, Michael J.; And Others

    1984-01-01

    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)

  4. Child abuse by drowning.

    PubMed

    Griest, K J; Zumwalt, R E

    1989-01-01

    Drowning as a form of subtle fatal child abuse is difficult to distinguish from accidental immersion or from sudden unexpected natural death when the circumstances of immersion are concealed. Homicidal drownings are unwitnessed, usually occurring in the home, and the victims are young, either infants or toddlers. Accidental drownings are more likely to involve toddlers or older children in public areas such as swimming pools, drainage ditches, lakes, and rivers. This is especially true in rural areas. In cities, bathtubs remain a major site of accidental childhood drownings. Perpetrators of deliberate drownings often fit the sociopathologic profile of a child abuser. Because there is often a survival interval between immersion and death, pathologic findings consistent with postimmersion syndrome suggest the cause of death. Foreign material in the lungs, if immersion was other than in clear tap water, and injuries of the face are other positive correlating factors. A thorough investigation of the circumstances and cooperation between the investigating agency and the pathologist are essential to determine the correct manner of death in these cases. PMID:2909975

  5. Child abuse by drowning.

    PubMed

    Griest, K J; Zumwalt, R E

    1989-01-01

    Drowning as a form of subtle fatal child abuse is difficult to distinguish from accidental immersion or from sudden unexpected natural death when the circumstances of immersion are concealed. Homicidal drownings are unwitnessed, usually occurring in the home, and the victims are young, either infants or toddlers. Accidental drownings are more likely to involve toddlers or older children in public areas such as swimming pools, drainage ditches, lakes, and rivers. This is especially true in rural areas. In cities, bathtubs remain a major site of accidental childhood drownings. Perpetrators of deliberate drownings often fit the sociopathologic profile of a child abuser. Because there is often a survival interval between immersion and death, pathologic findings consistent with postimmersion syndrome suggest the cause of death. Foreign material in the lungs, if immersion was other than in clear tap water, and injuries of the face are other positive correlating factors. A thorough investigation of the circumstances and cooperation between the investigating agency and the pathologist are essential to determine the correct manner of death in these cases.

  6. Relapse Prevention with Substance Abusers: Clinical Issues and Myths.

    ERIC Educational Resources Information Center

    Daley, Dennis C.

    1987-01-01

    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)

  7. Hope-Focused Interventions in Substance Abuse Counselling

    ERIC Educational Resources Information Center

    Koehn, Corinne; O'Neill, Linda; Sherry, John

    2012-01-01

    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…

  8. The Inspiration of Hope in Substance Abuse Counseling

    ERIC Educational Resources Information Center

    Koehn, Corinne; Cutcliffe, John R.

    2012-01-01

    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…

  9. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    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…

  10. When staff members sexually abuse children in residential care.

    PubMed

    Bloom, R B

    1992-01-01

    When an agency staff member is accused of sexually abusing a client, the administration is faced with the Solomonic task of balancing the necessity of protecting the child, supporting the staff, and maintaining the integrity and reputation of the agency. This article presents practical suggestions for managing the agency through such a crisis. PMID:1638902

  11. Process and Outcome: Evaluation of the Sexual Abuse Treatment Project.

    ERIC Educational Resources Information Center

    Love, Arnold J.

    1989-01-01

    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)

  12. Including Siblings in the Treatment of Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Baker, Juanita N.; Tanis, Heyley J.; Rice, Jennifer B.

    2001-01-01

    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)

  13. Methamphetamine Abuse and Manufacture: The Child Welfare Response

    ERIC Educational Resources Information Center

    Hohman, Melinda; Oliver, Rhonda; Wright, Wendy

    2004-01-01

    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…

  14. Does Steroid Abuse Cause--Or Excuse--Violence?

    ERIC Educational Resources Information Center

    Lubell, Adele

    1989-01-01

    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)

  15. Images from Purgatory: Art Therapy with Male Adolescent Sexual Abusers

    ERIC Educational Resources Information Center

    Mazloomian, Hoda; Moon, Bruce L.

    2007-01-01

    This article describes the clinical practice of two male art therapists and their work with male adolescent sex offenders in a residential treatment facility. The authors share experiences of working with clients who, in addition to being offenders, were diagnosed with a mental illness and were themselves victims of sexual abuse. The function of…

  16. Successful Instruction in Substance Abuse and Traffic Safety (SATS).

    ERIC Educational Resources Information Center

    Russell, J. Curtis; And Others

    1989-01-01

    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…

  17. Survivors in the Margins: The Invisibility of Violence Against Older Women.

    PubMed

    Crockett, Cailin; Brandl, Bonnie; Dabby, Firoza Chic

    2015-01-01

    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.

  18. Older Drivers

    MedlinePlus

    ... 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 ...

  19. A Female Therapist's Perspective on Growing Older.

    PubMed

    Fodor, Iris

    2015-11-01

    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

  20. Public managed care and service access in outpatient substance abuse treatment units.

    PubMed

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A

    2011-10-01

    The continued growth of public managed behavioral health care has raised concerns about possible effects on services provided. This study uses a national sample of outpatient substance abuse treatment units surveyed in 2005 to examine associations between public managed care and service access, measured as both the types of services provided and the amount of treatment received by clients. The percentage of clients funded through public managed care versus other types of public funding was positively associated with treatment units' odds of providing some types of resource-intensive services and with the odds of providing transportation to clients, but was negatively associated with the average number of individual therapy sessions clients received over the course of treatment. In general, public managed care does not appear to restrict access to outpatient substance abuse treatment, although states should monitor these contracts to ensure clients receive adequate courses of individual treatment. PMID:21184286

  1. Client services for geriatric pets.

    PubMed

    Hancock, G; Yates, J

    1989-01-01

    Some veterinarians have been reluctant to discuss the prospect of the death of a pet because of a sense of discomfort and a lack of understanding about how to respond to the client's grief reaction. It is essential to take the time for this important communication and help clients deal with fears about the process, any feelings of guilt and helplessness, and judgments about the medical aspects of a case. Clients must be encouraged to express grief over the loss of a pet, particularly a geriatric pet that has lived with them many years and to which they are deeply bonded. Veterinarians need to counsel clients about obtaining additional pets or another pet. The phrase "replacement pet" must be stricken from the veterinarian's vocabulary. One does not "replace" a deceased spouse, mother, father, or child. It is possible to have another child or find another spouse, but it is not possible to replace a person. Neither can a pet be "replaced," because each pet is a unique living being. It is disrespectful to the memory of deceased pets to belittle their uniqueness by suggesting that they can be replaced. Instead, the veterinarian has the capability and responsibility to help pet owners maintain fond and happy memories of an irreplacable pet, while finding room in their hearts for another new pet to create happiness for the future. Once the grief is resolved, clients will be thankful for having had the privilege of sharing their life with an animal and experiencing the joy of the bond between two unique individuals. PMID:2646816

  2. Client services for geriatric pets.

    PubMed

    Hancock, G; Yates, J

    1989-01-01

    Some veterinarians have been reluctant to discuss the prospect of the death of a pet because of a sense of discomfort and a lack of understanding about how to respond to the client's grief reaction. It is essential to take the time for this important communication and help clients deal with fears about the process, any feelings of guilt and helplessness, and judgments about the medical aspects of a case. Clients must be encouraged to express grief over the loss of a pet, particularly a geriatric pet that has lived with them many years and to which they are deeply bonded. Veterinarians need to counsel clients about obtaining additional pets or another pet. The phrase "replacement pet" must be stricken from the veterinarian's vocabulary. One does not "replace" a deceased spouse, mother, father, or child. It is possible to have another child or find another spouse, but it is not possible to replace a person. Neither can a pet be "replaced," because each pet is a unique living being. It is disrespectful to the memory of deceased pets to belittle their uniqueness by suggesting that they can be replaced. Instead, the veterinarian has the capability and responsibility to help pet owners maintain fond and happy memories of an irreplacable pet, while finding room in their hearts for another new pet to create happiness for the future. Once the grief is resolved, clients will be thankful for having had the privilege of sharing their life with an animal and experiencing the joy of the bond between two unique individuals.

  3. Quality focuses on clients' needs.

    PubMed

    Barnett, B

    1997-01-01

    This article discusses issues related to improving postpartum and postabortion quality of care for women in developing countries. Health workers and health care providers have a responsibility to provide high-quality care to postpartum and postabortion women that includes family planning counseling. Postabortion and postpartum women may have different needs. Quality of care means "helping women to identify their individual reproductive health needs and helping them make choices that will meet those needs." Choice belongs to the family planning client. Clients may view family planning quality as the ability to maintain reproductive health and satisfaction in sexual relations. Providers may view quality as prevention of unplanned pregnancies. Quality outcome measures are more than effectiveness and avoidance of complications. Quality means satisfaction of clients' personal preferences and lack of interference with women's everyday life. Clients need accurate information, empathetic counseling, and accessible services. Health workers need to consider how service delivery systems, providers' attitudes, and clients' views can affect women's access to postpartum and postabortion contraception and other reproductive health services. Providers must know that postpartum women need information about breast feeding, infant care, and nutrition. Women who were treated for incomplete abortions need emergency treatment for complications and information about symptoms that would warrant a return to the medical setting. The need for family planning is immediate for postabortion women, but providers should not offer women family planning information while women are under stress. Privacy is key to quality services. The Pan American Health Organization and the Judith Bruce framework identify essential features of quality services.

  4. Sociodemographic characteristics and drug abuse patterns of treatment-seeking illicit drug abusers in Finland, 1997-2008: the Huuti study.

    PubMed

    Onyeka, Ifeoma N; Uosukainen, Hanna; Korhonen, Maarit Jaana; Beynon, Caryl; Bell, J Simon; Ronkainen, Kimmo; Föhr, Jaana; Tiihonen, Jari; Kauhanen, Jussi

    2012-01-01

    The epidemiological part of the Huume tietokanta (HUUTI) consortium research project is the first large-scale longitudinal study of treatment-seeking illicit drug abusers in Finland. The objective of this report was to describe the sociodemographic characteristics and drug abuse patterns of treatment-seeking clients at their first visit. This study analysed baseline data of 4817 clients (3365 men and 1452 women) aged 11-65 years who sought treatment for drug abuse between 1997 and 2008 at Helsinki Deaconess Institute. Data were collected using a structured questionnaire. The majority (56%) of clients were between 15 and 24 years, educated at elementary school level (75%), and unemployed (57%). Opiates (30%) were the primary drugs of abuse. The primary drugs were mostly injected (45%) and were abused daily during the past month (44%). Cannabis was the most common secondary drug of abuse (34%). The secondary drugs were predominantly smoked (39%) or taken orally (38%) and were abused once per week or less frequently during the past month (33%). Age at initiation of illicit drug abuse ranged from 5 to 49 years. Polydrug abuse was common, with a mean consumption of 3.5 concurrent polydrug use, which were combined from 3 or more drug classes. The prevalence of lifetime/ever intravenous drug abuse was 64% and past month intravenous drug abuse was 64%, respectively, and 13% reported sharing injecting equipment during the past month. Early initiation, polydrug abuse, and risky consumption of illicit drugs were major areas of concern among the study population. Injecting drug use could place considerable burden on health services in view of complications and transmission of infectious diseases.

  5. A Social Network Approach to Working With Elderly Clients: Training Manual for Mental Health Professionals.

    ERIC Educational Resources Information Center

    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…

  6. Differential Perception of Life Crisis Events by Sex, Diagnosis and Ethnicity in Rural Mental Health Clients.

    ERIC Educational Resources Information Center

    Swanda, Rex M.; Kahn, Marvin W.

    1986-01-01

    Describes study in which 146 rural mental health clinic clients reported moderate to extreme stress levels for all demographic and diagnostic groupings. Indicates younger patients had higher stress levels than older and significantly different stress events differentiated alcoholic, male, and Hispanic-American patients. Discusses implications for…

  7. Elder abuse: a call to action.

    PubMed

    Bird, P E; Harrington, D T; Barillo, D J; McSweeney, A; Shirani, K Z; Goodwin, C W

    1998-01-01

    An estimated 2 million people a year are victims of elder abuse, which ranges from neglect and mistreatment to physical abuse. By the year 2020, a full 22% of the population will be aged 65 or older. This demographic explosion demands that we identify and protect those at risk. To investigate the incidence of elder abuse or neglect (EAN) and to determine clinician awareness of associated risk factors, we conducted a 1-year retrospective review of thermally injured patients aged 60 or older. Data included age, total body surface area burned, mechanism of injury, length of hospital stay, mortality, abuse or neglect risk factors, and referral to the appropriate social agency. We found that our elderly patients (n = 28) were poorly screened for EAN. While 64% to 96% of patients were screened for cognitive impairment, overall health, and financial resources, none were screened for risk factors of emotional isolation. None of the patient's caregivers, including any spouses, roommates, or guardians, were screened for risk factors of substance abuse, familial violence, dependency needs, or external stresses. With the use of available data, we were able to place 11 patients on the following levels of abuse or neglect: 1) low risk for abuse; 2) self-neglect; 3) neglect; and 4) abuse. By this scale, 7 patients (64%) were victims of self-neglect, 3 patients (27%) were victims of neglect, and 1 patient (9%) was a victim of abuse. Adult Protective Services intervened in 2 cases. Recognizing that all cases of EAN should be preventable, we cannot accept the socioeconomic impact of this entity. The 11 patients identified as victims of neglect, self-neglect, or abuse accounted for 135 hospital days and 8 fatalities. Before we can address EAN, health care personnel must be made aware of the problem and routine screening for risk factors must be implemented. The true incidence of EAN is likely underestimated because health care providers have difficulty recognizing its features. A

  8. Client Compliance with Homework Directives during Counseling.

    ERIC Educational Resources Information Center

    Worthington, Everett L., Jr.

    1986-01-01

    Investigated compliance as a function of counselor, client, and therapy variables. Results indicated that variables associated with the conduct of counseling more strongly influenced compliance with homework than did either counselor or client variables. (Author/BL)

  9. Clients' perceptions of their psychotherapists' multicultural orientation.

    PubMed

    Owen, Jesse J; Tao, Karen; Leach, Mark M; Rodolfa, Emil

    2011-09-01

    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

  10. Estimating Local Child Abuse.

    ERIC Educational Resources Information Center

    Ards, Sheila

    1989-01-01

    Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)

  11. Child Sexual Abuse

    MedlinePlus

    ... victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or ... can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, ...

  12. How to Handle Abuse

    MedlinePlus

    ... them. Another word for hurting someone is "abuse." Child abuse (say: ah-BYOOS) can affect all kinds of ... a babysitter, teacher, coach, or a bigger kid. Child abuse can happen anywhere — at home, school, childcare, or ...

  13. Mental health/psychiatric issues in elder abuse and neglect.

    PubMed

    Cooper, Claudia; Livingston, Gill

    2014-11-01

    Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. PMID:25439645

  14. Mental health/psychiatric issues in elder abuse and neglect.

    PubMed

    Cooper, Claudia; Livingston, Gill

    2014-11-01

    Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated.

  15. Evaluation of a Spiritually Focused Intervention with Older Trauma Survivors

    ERIC Educational Resources Information Center

    Bowland, Sharon; Edmond, Tonya; Fallot, Roger D.

    2012-01-01

    This study evaluated the effectiveness of an 11-session, spiritually focused group intervention with older women survivors (age 55 years and older) of interpersonal trauma (child abuse, sexual assault, or domestic violence) in reducing trauma-related depressive symptoms, posttraumatic stress, and anxiety. Forty-three community-dwelling women…

  16. County government resources associated with dependent-adult abuse investigations in Iowa.

    PubMed

    Jogerst, Gerald J; Daly, Jeanette M

    2008-01-01

    This study evaluated on a county level the association of Iowa's domestic dependent-adult abuse investigations with the location of adult protective services (APS) offices, rurality, government resources, felony charges and prosecutions, child abuse reports, and census demographics. In 2003, the rate of dependent-adult abuse investigations for Iowa was 0.70 per 1,000 population age 18 and older. Higher rates of child abuse investigations, felony prosecutions, sheriff's annual salary, and lower rates of child abuse substantiations are associated with higher rates of dependent-adult abuse investigations and substantiations.

  17. Comparison of clients of a mobile health van and a traditional STD clinic.

    PubMed

    Ellen, Jonathan M; Bonu, Sekhar; Arruda, Jaime S; Ward, Michael A; Vogel, Ruth

    2003-04-01

    The objective of this study was to determine if there were any demographic, behavioral, and clinical differences between clients seen aboard a mobile sexually transmitted disease (STD)/HIV clinic compared with those seen in a traditional municipal STD/HIV health clinic for receipt of STD/HIV services. Clients seen in the two different settings were interviewed about demographic characteristics, reasons for their visit, STD history, their HIV/STD risk factors, and the risk factors of their sex partners. Clients in both settings were also offered testing for syphilis, gonorrhea, chlamydia, and HIV. Results suggested that clients seen at the mobile clinic were older, more likely to be injecting drug users themselves and/or to have sex partners who were, or had engaged in prostitution for money or drugs. Over half (54.4%) of the mobile clinic clients sought testing for HIV, and they were far less likely to be seeking care for symptoms of an STD. In contrast, only 7.1% of municipal clinic clients indicated HIV testing as the reason for their visit, whereas nearly two thirds (64.5%) reported symptoms of disease. Two percent of municipal clinic clients and 5.4% of mobile clinic clients had a positive HIV test ( p<.001), and 17.8% of STD clinic clients and 5.6% of mobile van clients had a positive gonorrhea and/or test ( p<.001). These data suggest that a mobile STD/HIV clinic may be an effective strategy to reach individuals at high risk for HIV who are not being served by traditional municipal STD/HIV health clinics.

  18. The Costs and Benefits of Substance Abuse Treatment: Findings from the National Treatment Improvement Evaluation Study (NTIES).

    ERIC Educational Resources Information Center

    Koenig, Lane; Denmead, Gabrielle; Nguyen, Robert; Harrison, Margaret; Harwood, Henrick

    This study seeks to quantify the costs and benefits of alcohol and drug abuse treatment and the resulting economic benefits to society. Using data from the National Treatment Improvement Evaluation Study (NTIES), and client questionnaires, estimates were made of the average costs per client in terms of crime-related costs, health care costs, and…

  19. Client-Side Monitoring for Web Mining.

    ERIC Educational Resources Information Center

    Fenstermacher, Kurt D.; Ginsburg, Mark

    2003-01-01

    Discusses mining Web data to draw conclusions about Web users and proposes a client-side monitoring system that supports flexible data collection and encompasses client-side applications beyond the Web browser to incorporate standard office productivity tools. Highlights include goals for client-side monitoring; framework for user monitoring,…

  20. Bulimia: Book for Therapist and Client.

    ERIC Educational Resources Information Center

    Bauer, Barbara G.; And Others

    This book was written for practitioners working with bulimic clients and for clients themselves. Bulimia is presented as a multidimensional problem requiring a multidisciplinary team approach to treatment. An introductory chapter presents six treatment sessions with a bulimic client which provide an overview of the experiences and attitudes of the…

  1. Rehabilitation Counseling Student Perceptions of Obese Clients.

    ERIC Educational Resources Information Center

    Kaplan, Steven P.; Thomas, Kenneth R.

    1981-01-01

    Investigated whether stigmatization of obese persons has affected rehabilitation counseling students' perceptions of such clients. Results suggest that rehabilitation students perceive obese clients more negatively. If a counselor's first impression of an obese client is that he is less competent and less attractive, rehabilitation outcome could…

  2. Client Self-Disclosure in Psychotherapy.

    ERIC Educational Resources Information Center

    Stiles, William B.

    Psychotherapists of different theoretical persuasions use systematically different profiles of verbal response modes. However, clients tend to use very similar profiles, regardless of what their therapist does. Disclosure comprises the largest part of this common client profile, and it distinguishes the client role from other roles. Higher levels…

  3. Client and Therapist Variability in Clients' Perceptions of Their Therapists' Multicultural Competencies

    ERIC Educational Resources Information Center

    Owen, Jesse; Leach, Mark M.; Wampold, Bruce; Rodolfa, Emil

    2011-01-01

    This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated…

  4. Elder Abuse: Systematic Review and Implications for Practice.

    PubMed

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. PMID:26096395

  5. My Shield Will Protect Me against the ANTS: Treatment of PTSD in a Client with an Intellectual Disability

    ERIC Educational Resources Information Center

    Fernando, Kumari; Medlicott, Louisa

    2009-01-01

    Background: There are limited interventions for individuals with posttraumatic stress disorder (PTSD) who also have an intellectual disability. This paper reports the successful treatment of a client with an intellectual disability who experienced PTSD following abuse in an intimate relationship. We describe the use of an innovative coping…

  6. ANXIETY AND ITS CORRELATES AMONG OLDER ADULTS ACCESSING AGING SERVICES

    PubMed Central

    Richardson, Thomas M.; Simning, Adam; He, Hua; Conwell, Yeates

    2010-01-01

    Objectives To assess the characteristics of anxiety in aging services network (ASN) clients. Methods Interviews were conducted as part of an academic-community partnership for studying the mental health needs of community-dwelling older adults. Participants consisted of ASN clients in Monroe County, NY, that were aged 60 years and older and received an in-home assessment for care management services. The Goldberg Anxiety Scale screened for anxiety symptoms, and instruments covering the domains of associated mental health, physical health and disability, social support, negative life events, and other areas relevant to delivery of aging services were administered. Results Of 378 subjects enrolled, 27% had clinically significant levels of anxiety. In bivariate analyses anxiety was associated with having a current major depressive episode (MDE), five or more medical conditions, pain, younger age, less income, and negative life events. After controlling for MDE in multivariate analyses, medical conditions, pain, negative life events, and younger age were significant correlates of anxiety in ASN clients. Conclusions Anxiety was common among ASN clients who received in-home care management services. These anxious clients suffered from a combination of mental, medical, and social issues that suggests the need for multidisciplinary care. Because aging services providers work with their clients to ameliorate conditions that are highly correlated with anxiety, the ASN represents a promising venue for detecting, managing, and preventing anxiety among older adults. PMID:20066684

  7. The Impact of a Post-Master's Program in Substance Abuse on Social Work and Other Health Professionals

    ERIC Educational Resources Information Center

    Straussner, Shulamith Lala A.; Vairo, Elena

    2007-01-01

    Substance abuse is a major problem encountered by social workers in all settings. This study investigated the impact of a postmaster's program in the treatment of substance-abusing clients on the domains of "Attitudes and Values," "Knowledge and Skills," and "Behaviors" of its graduates. Overall, 91 percent of respondents found the program to be…

  8. Wicked problems or wicked people? Reconceptualising institutional abuse.

    PubMed

    Burns, Diane; Hyde, Paula; Killett, Anne

    2013-05-01

    Institutional abuse is a global issue, sometimes ascribed to the behaviour of a few wicked people. It persists despite regulatory measures, interventions from enforcement and protection agencies, organisational policies and procedures. Therefore, the accurate recognition and early detection of abuse and taking corresponding steps to deal with perpetrators are critical elements in protecting vulnerable people who live in institutions. However, research is less clear about why and how abuse (re)occurs. Using the tame and wicked problem analysis of Rittell and Webber (1973) as a lens, we examine the ways institutional abuse is formulated in care settings. Drawing on case study data from eight care homes for older people, we show how solutions seeking to reduce institutional abuse and improve care quality can cause additional problems. The article reconceptualises institutional abuse through the lens of wicked problem analysis to illustrate the multifaceted and recurring, wicked problem characteristics of residential care provision. PMID:22897625

  9. Wicked problems or wicked people? Reconceptualising institutional abuse.

    PubMed

    Burns, Diane; Hyde, Paula; Killett, Anne

    2013-05-01

    Institutional abuse is a global issue, sometimes ascribed to the behaviour of a few wicked people. It persists despite regulatory measures, interventions from enforcement and protection agencies, organisational policies and procedures. Therefore, the accurate recognition and early detection of abuse and taking corresponding steps to deal with perpetrators are critical elements in protecting vulnerable people who live in institutions. However, research is less clear about why and how abuse (re)occurs. Using the tame and wicked problem analysis of Rittell and Webber (1973) as a lens, we examine the ways institutional abuse is formulated in care settings. Drawing on case study data from eight care homes for older people, we show how solutions seeking to reduce institutional abuse and improve care quality can cause additional problems. The article reconceptualises institutional abuse through the lens of wicked problem analysis to illustrate the multifaceted and recurring, wicked problem characteristics of residential care provision.

  10. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

    A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily…

  11. Counseling Abused Children.

    ERIC Educational Resources Information Center

    McFadden, Emily Jean

    This guide on counseling abused children was written to help counselors meet the needs of children and adolescents and to provide ways of working with the child's family. Chapter 1 presents an overview of child maltreatment by identifying types of maltreatment (neglect, physical abuse, sexual abuse and exploitation, and emotional abuse or neglect)…

  12. The Program Environment Scale: assessing client perceptions of community-based programs for the severely mentally ill.

    PubMed

    Burt, M R; Duke, A E; Hargreaves, W A

    1998-12-01

    The Program Environment Scale (PES) was developed for use with clients of community-based programs for the severely mentally ill. It is intended to fill the gap in available tools for assessing clients' perceptions of program functioning as it affects their "quality of life" in a program. Formal pretests were conducted with 121 clients at 12 randomly selected programs near Washington, DC. The final field test used a revised form (29 domains; 129 items) with 221 clients in 22 programs selected randomly throughout the U.S., including Clubhouse, day treatment, psychosocial rehabilitation, and social club programs. Twenty-three subscales met at least five of eight psychometric criteria for internal consistency and discriminant validity. A 24th subscale was retained because of its substantive importance. Successful subscales cover program atmosphere and interactions (program cares about me, energy level, friendliness, openness, staff-client and client-client respect, reasonable rules, availability of positive physical contact, protection from bad touch, staff investment in their jobs, and confidentiality), client empowerment/staff-client equality (program and treatment empowerment, egalitarian space use), and service components (support for paid work, work importance, emergency access, family activities, housing, public benefits, community activities, medications, substance abuse, and continuity). Subscale validity is indicated by associations of specific service offerings with scores on scales measuring client perceptions of those services, and by an ability to differentiate among program models (i.e., Clubhouses, day treatment programs, and psychosocial rehabilitation programs look different from each other). Subscale scores were not influenced by client characteristics (gender, race, age, diagnosis, number of hospitalizations, length of time in program). The final scale has 97 items and takes about 25 minutes to complete. The PES succeeds in measuring different

  13. The Program Environment Scale: assessing client perceptions of community-based programs for the severely mentally ill.

    PubMed

    Burt, M R; Duke, A E; Hargreaves, W A

    1998-12-01

    The Program Environment Scale (PES) was developed for use with clients of community-based programs for the severely mentally ill. It is intended to fill the gap in available tools for assessing clients' perceptions of program functioning as it affects their "quality of life" in a program. Formal pretests were conducted with 121 clients at 12 randomly selected programs near Washington, DC. The final field test used a revised form (29 domains; 129 items) with 221 clients in 22 programs selected randomly throughout the U.S., including Clubhouse, day treatment, psychosocial rehabilitation, and social club programs. Twenty-three subscales met at least five of eight psychometric criteria for internal consistency and discriminant validity. A 24th subscale was retained because of its substantive importance. Successful subscales cover program atmosphere and interactions (program cares about me, energy level, friendliness, openness, staff-client and client-client respect, reasonable rules, availability of positive physical contact, protection from bad touch, staff investment in their jobs, and confidentiality), client empowerment/staff-client equality (program and treatment empowerment, egalitarian space use), and service components (support for paid work, work importance, emergency access, family activities, housing, public benefits, community activities, medications, substance abuse, and continuity). Subscale validity is indicated by associations of specific service offerings with scores on scales measuring client perceptions of those services, and by an ability to differentiate among program models (i.e., Clubhouses, day treatment programs, and psychosocial rehabilitation programs look different from each other). Subscale scores were not influenced by client characteristics (gender, race, age, diagnosis, number of hospitalizations, length of time in program). The final scale has 97 items and takes about 25 minutes to complete. The PES succeeds in measuring different

  14. The Affordable Care Act, Substance Use Disorders, and Low-Income Clients: Implications for Social Work.

    PubMed

    McCabe, Heather A; Wahler, Elizabeth A

    2016-07-01

    Social workers are leaders in the substance abuse services field and may often work in substance use disorder (SUD) education, prevention, assessment, treatment, or resource coordination and case management roles. As the Patient Protection and Affordable Care Act (ACA) (2010) drives changes in the fields of health and behavioral health, social workers have an opportunity to lead structural changes at the micro and macro levels that will have a positive impact on low-income clients with SUDs. In this article, authors examine the current state of SUDs and health care access, the impact of the ACA on the field, and implications for social work practice and education. Social workers should seek specialized education and credentialing in SUD services, know how to help clients apply for health care coverage, and advocate for integrated substance abuse treatment and health care programs and an expansion of Medicaid in their local communities. Social workers are well positioned to be a voice for clients to ensure that the current structural changes result in a better, integrated system of care that is able to respond to the needs of low-income clients with SUDs. PMID:27501640

  15. The Affordable Care Act, Substance Use Disorders, and Low-Income Clients: Implications for Social Work.

    PubMed

    McCabe, Heather A; Wahler, Elizabeth A

    2016-07-01

    Social workers are leaders in the substance abuse services field and may often work in substance use disorder (SUD) education, prevention, assessment, treatment, or resource coordination and case management roles. As the Patient Protection and Affordable Care Act (ACA) (2010) drives changes in the fields of health and behavioral health, social workers have an opportunity to lead structural changes at the micro and macro levels that will have a positive impact on low-income clients with SUDs. In this article, authors examine the current state of SUDs and health care access, the impact of the ACA on the field, and implications for social work practice and education. Social workers should seek specialized education and credentialing in SUD services, know how to help clients apply for health care coverage, and advocate for integrated substance abuse treatment and health care programs and an expansion of Medicaid in their local communities. Social workers are well positioned to be a voice for clients to ensure that the current structural changes result in a better, integrated system of care that is able to respond to the needs of low-income clients with SUDs.

  16. Treatment of childhood sexual abuse in anorexia nervosa and bulimia nervosa: a feminist psychodynamic approach.

    PubMed

    Kearney-Cooke, A; Striegel-Moore, R H

    1994-05-01

    In this article a parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by clients with eating disorders. In particular, we describe how sexual abuse has a significant and lasting effect on body image, identity, self-regulation, and interpersonal functioning. Treatment issues are outlined including the nature of the healing relationship, assessment of abuse, development of capacity for self-soothing, techniques for assisting in memory recall, sculpting of images, description and reenactment of abuse, dealing with shame, and ending the cycle of repeated victimization.

  17. Client perspectives on occupational therapy practice: are we truly client-centred?

    PubMed

    Rebeiro, K L

    2000-02-01

    In Canada, the guidelines for the practice of occupational therapy are named and framed as client-centred. Two in-depth interviews were conducted with clients of mental health services about their experiences with a hospital-based occupational therapy service. These occupational therapy clients described their experiences as prescriptive, and as less than client-centred. With the publication of Enabling occupation: A Canadian occupational therapy perspective (Canadian Association of Occupational Therapists [CAOT], 1997) and an increasingly refined focus on being client-centred, these interviews highlight the challenges of a client-centred practice within the current health care environment. These occupational therapy clients raise issues of importance for occupational therapy. The participants stated that the prescription of 'activity', a lack of choice, and a focus upon the illness as opposed to the individual, served to diminish any collaborative partnership with the client and eliminate the client from any decision-making process. This distancing from the client, in their opinion, served to greatly diminish any therapeutic value of occupation. The participants recommended a greater focus upon occupational choice, consideration of the individual within the client, providing accepting, supportive environments, and using professional expertise on occupation to guide the client towards participation in meaningful occupation. These recommendations are strikingly similar to the most recent guidelines for the client-centred practice of occupational therapy in Canada. A discussion of the implications of these findings for the client-centred practice of occupational therapy is offered. PMID:10695164

  18. Demographic consequences, client satisfaction, and reasons for selecting sterilization among vasectomy and tubectomy clients in Bangladesh.

    PubMed

    Swenson, I; Khan, A R

    1982-06-01

    A follow-up study of vasectomy and tubectomy clients in Bangladesh showed that the mean ages of vasectomy clients and their wives were significantly higher than the mean ages of tubectomy clients. These findings suggest that the number of births averted by vasectomy is less than what might be expected from tubectomy. Between 20-60% of tubectomy clients stated that they (or their husbands) had previously used contraception, while only 2% of vasectomy clients indicated that they or their wives had previously used contraception. More than 95% of tubectomy clients, compared to less than 48% of vasectomy clients, were satisfied with having a sterilization procedure. A large proportion of dissatisfied vasectomy clients indicated that they had chosen vasectomy rather than some other method of contraception primarily because of financial incentives. The small percentage of dissatisfied tubectomy clients indicated that their concern was about possibly having a child die and not being able to replace that child. Less than 30% of vasectomy clients compared to more than 70% of tubectomy clients indicated that they had recommended the procedure to another man (woman). While more than 80% of tubectomy clients cited themselves, their husbands, or a close family member as the most influential person in their decision to have a tubectomy, vasectomy clients never mentioned their wives, rarely another family member, and in less than 1/2 the cases, themselves. This study suggests that client satisfaction with tubectomy in Bangladesh can be attributed to the desire to terminate childbearing. Positive responses of tubectomy clients appear to be consistent in spite of urban-rural, religious, and socioeconomic differences as measured by education of clients and their husbands' occupation. On the other hand, lack of satisfaction of vasectomy clients can be attributed to use of incentives, causing recruitment of clients who were not primarily motivated by a desire to terminate childbearing

  19. CLIENT NARRATIVES: A THEORETICAL PERSPECTIVE

    PubMed Central

    Gale, Deborah Dysart; Mitchell, Ann M.; Garand, Linda; Wesner, Susan

    2010-01-01

    The role of subjective client narratives in health care represents a clinical and therapeutic tool, useful in complementing objective, scientific data. Of particular interest to mental health practitioners is the role narratives play as a therapeutic tool to guide clinical practice. This paper lays a foundation for understanding the importance of narrative in the psychotherapeutic process. It provides a brief overview of narrative theory and methods of structural analysis in order to provide a theoretical approach that can be utilized by nurses to address clients’ needs. PMID:12735076

  20. Abuse and neglect experienced by aging chinese in Canada.

    PubMed

    Lai, Daniel W L

    2011-10-01

    The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification. PMID:21978291

  1. Abuse and neglect experienced by aging chinese in Canada.

    PubMed

    Lai, Daniel W L

    2011-10-01

    The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.

  2. Relationships between Trauma, Posttraumatic Stress Disorder Symptoms, Dissociative Symptoms, and Lifetime Heroin Use among Individuals Who Abuse Substances in Residential Treatment

    ERIC Educational Resources Information Center

    Horton, E. Gail; Diaz, Naelys; Peluso, Paul R.; Mullaney, Donald; Weiner, Michael; McIlveen, John W.

    2009-01-01

    This study explored the relationships between trauma, posttraumatic stress disorder symptoms, dissociation, and lifetime heroin use among inpatient clients who abused substances. Results indicate important implications for practice and directions for future research. (Contains 1 figure and 1 table.)

  3. A case-comparison analysis of elder abuse and neglect.

    PubMed

    Godkin, M A; Wolf, R S; Pillemer, K A

    1989-01-01

    This study examines factors which contribute to elderly abuse and neglect by caregivers in a domestic setting. Methodological and conceptual variations and problems in previous studies have led to considerable confusion as to the determinants of this important social problem. A more rigorous research design was used in this study than has been previously employed. Fifty-nine abused elders from a model project site for the study of elderly abuse were compared with forty-nine non-abused clients from a home care program in the same agency. Using a research instrument designed by the authors, data related to the following aspects of the lives of the elders and their caregivers were collected: psychological status, stressful life events, social networks, mutual dependency, and the nature of their relationships. The study indicates that members of abusive families are more likely to have emotional problems which contribute to interpersonal difficulties. Abused elders are not more dependent on caregivers for many of their daily needs. However, the abused elderly and their caregivers have become increasingly interdependent prior to the onset of abuse because of the loss of other family members, increased social isolation, and the increased financial dependency of the perpetrator on the elderly person. PMID:2707901

  4. Iowa Case Management for Rural Drug Abuse.

    PubMed

    Hall, James A; Sarrazin, Mary S Vaughan; Huber, Diane L; Vaughn, Thomas; Block, Robert I; Reedy, Amanda R; Jang, Mijin

    2009-07-01

    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 (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. RESULTS: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. CONCLUSION: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.

  5. Iowa Case Management for Rural Drug Abuse

    PubMed Central

    Hall, James A.; Sarrazin, Mary S. Vaughan; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2011-01-01

    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 (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. Conclusion Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time. PMID:22065018

  6. Do client fees help or hurt?

    PubMed

    Barnett, B

    1998-01-01

    This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics. PMID:12293239

  7. Increasing hope by addressing clients' outcome expectations.

    PubMed

    Swift, Joshua K; Derthick, Annie O

    2013-09-01

    Addressing clients' outcome expectations is an important clinical process that can lead to a strong therapeutic alliance, more positive treatment outcomes, and decreased rates of premature termination from psychotherapy. Five interventions designed to foster appropriate outcome expectations are discussed, including presenting a convincing treatment rationale, increasing clients' faith in their therapists, expressing faith in clients, providing outcome education, and comparing progress with expectations. Clinical examples and research support are provided for each. PMID:24000836

  8. Prevent elder abuse--using a family systems approach.

    PubMed

    Hamilton, G P

    1989-03-01

    1. Family stressors occur when the adult child is caregiver for an elderly parent, particularly when care is intensive or protracted. Under certain circumstances of high risk, severe and unresolved strains in intergenerational relationships can develop into elder abuse. 2. Elder abuse is a non-accidental act or omission that causes physical, psychological, or financial harm to an older person. 3. Using a family systems perspective, an original validated instrument is presented that evaluates the risk of elder abuse in the home (REAH). Using this instrument, the nurse can construct two profiles of 1) the older person, including personal data and dependency needs, and 2) the caregiver, including personal data and family dynamics. 4. The instrument provides a simple method for recognizing family strains and noting changes over time within the family system. Appropriate interventions and referrals can be initiated that may avert the crisis of elder abuse. PMID:2926101

  9. Treating women drug abusers: action therapy and trauma assessment.

    PubMed

    Uhler, Ann S; Parker, Olga V

    2002-07-01

    The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors believe the use of unassisted clinical judgment for trauma assessment in first interviews may drive patients away by probing for painful information that clients are not yet ready to confront or divulge.

  10. Characteristics of family planning clients in Bangladesh.

    PubMed

    Swenson, I; Khan, A R

    1983-01-01

    The study objective was to establish a profile of family planning clients in Bangladesh to illustrate differences and similarities of the clients who obtain various types of contraceptives--oral contraceptives (OCs), injectables, tubal ligation, and vasectomy--in both urban and rural areas. The urban women receiving OCs attended the family planning clinics of 6 hospitals in Dacca during the 1974-77 period. The rural OC clients attended a government family planning clinic about 25 miles southeast of Dacca between 1975-77. Urban injectable clients all attended the family planning clinic of the model clinic in Dacca. Rural injectable clients attended the same family planning clinic in Matlab as did rural OC clients. Urban tubal ligation clients were randomly selected from 2 areas, Kalicakar and Kustia. Vasectomy clients were randomly sampled from the lists of vasectomy clients which attended mass vasectomy centers in Shibjuir and Shalna provinces 2 years prior to the survey follow-up. The higher mean ages of all rural contraceptive users, regardless of method, was consistent with their high parities and the small percentages of these women who desired more children. 15.6% of urban women choosing sterilization had never used contraception previously, but 93.2% of urban OC acceptors and 61.5% of the injectable clients were obtaining contraception for the 1st time. 62% of sterilization clients who had previously used contraception had been using OCs. Among the rural users of contraceptives, those using pills and vasectomy had the highest proportions of no prior use of contraception (94% and 95.7%, respectively). 42% of tubal ligation clients had never used contraception previously; 64.2% of the injectable clients indicated they had never used contraceptives. Among the OC acceptors the majority of previous users had IUDs inserted. Injectable and tubal ligation acceptors previously using contraception had primarily been OC users. In both the urban and rural areas the vast

  11. Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs

    PubMed Central

    2012-01-01

    Background Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems. Methods We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse. Results Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way. Few had a policy requiring assessment of potential clients, or monitoring of admitted clients, for violence perpetration; almost one-quarter did not admit potential clients who had perpetrated IPV, and only 20% had a component or track to address violence. About one-third suspended or terminated clients engaging in violence. The most common barriers to SUDPs providing IPV services were that violence prevention was not part of the program’s mission, staff lacked training in violence, and the lack of reimbursement mechanisms for such services. In contrast, BIPs tended to address substance abuse in a more formal and comprehensive way; e.g., one-half had a policy requiring potential clients to be assessed, two-thirds required monitoring of substance abuse among admitted clients, and almost one-half had a component or track to address substance abuse. SUDPs had clients with fewer resources (marriage, employment, income, housing), and more severe problems (both alcohol and drug use disorders, dual substance use and other mental health disorders, HIV + status). We found little evidence that services are centralized for individuals with both substance abuse and violence problems, even though most SUDP and BIP directors agreed that help for both problems should be obtained simultaneously in separate programs. Conclusions SUDPs may have difficulty addressing violence because they have a clientele with relatively few resources and more complex psychological and medical

  12. Cough and Cold Medicine Abuse

    MedlinePlus

    ... and Cold Medicine Abuse DrugFacts: Cough and Cold Medicine Abuse Email Facebook Twitter Revised May 2014 Some ... diverted for abuse. How Are Cough and Cold Medicines Abused? Cough and cold medicines are usually consumed ...

  13. Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment.

    PubMed

    Cochran, Bryan N; Cauce, Ana Mari

    2006-03-01

    Previous research has suggested that lesbian, gay, bisexual, and transgender (LGBT) individuals enter treatment for substance abuse with more severe problems than heterosexual individuals. However, methodological difficulties, particularly the difficulty of obtaining a representative sample, have limited the ability to draw conclusions about LGBT individuals who receive services for substance abuse. This study took advantage of a unique opportunity to examine a representative sample of openly LGBT clients receiving publicly funded substance abuse treatment by using data gathered by treatment providers in Washington State. Baseline differences between openly LGBT and heterosexual clients were compared in a variety of domains. Results demonstrated that openly LGBT clients enter treatment with more severe substance abuse problems, greater psychopathology, and greater medical service utilization when compared with heterosexual clients. When the analyses were stratified based on sex, different patterns of substance use and associated psychosocial characteristics emerged for the LGBT clients. Implications for provision of appropriate services and recommendations to treatment agencies are discussed in this article. PMID:16490677

  14. Food Security in Older Adults: Community Service Provider Perceptions of Their Roles

    ERIC Educational Resources Information Center

    Keller, Heather H.; Dwyer, John J. M.; Edwards, Vicki; Senson, Christine; Edward, H. Gayle

    2007-01-01

    Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food…

  15. Self-Report Measure of Financial Exploitation of Older Adults

    ERIC Educational Resources Information Center

    Conrad, Kendon J.; Iris, Madelyn; Ridings, John W.; Langley, Kate; Wilber, Kathleen H.

    2010-01-01

    Purpose: This study was designed to improve the measurement of financial exploitation (FE) by testing psychometric properties of the older adult financial exploitation measure (OAFEM), a client self-report instrument. Design and Methods: Rasch item response theory and traditional validation approaches were used. Questionnaires were administered by…

  16. Students and Drug Abuse

    ERIC Educational Resources Information Center

    Todays Educ, 1969

    1969-01-01

    Introduction to "Students and Drug Abuse, prepared by the Public Information Branch and Center for Studies of Narcotic and Drug Abuse, National Institute of Mental Health, in cooperation with the staff of Today's Education.

  17. Cough & Cold Medicine Abuse

    MedlinePlus

    ... I Help a Friend Who Cuts? Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  18. Abuse during Pregnancy

    MedlinePlus

    ... depressed, eat unhealthy foods, or pick up bad habits such as smoking or drinking . An abusive partner may try to ... depressed, eat unhealthy foods, or pick up bad habits such as smoking or drinking . An abusive partner may try to ...

  19. Prescription Drug Abuse

    MedlinePlus

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include narcotic painkillers, ...

  20. Client Contact versus Paperwork: A Student Perspective.

    ERIC Educational Resources Information Center

    Strohmer, Douglas C.; And Others

    1979-01-01

    Surveys master's level rehabilitation counseling students and examines percentage of time students spend involved in client contact and paperwork during their internship. Time spent in client contact was nearly double that spent doing paperwork for this group. Data from a number of settings are discussed. (Author)

  1. Counselors' Accounts of Their Clients' Spiritual Experiences.

    ERIC Educational Resources Information Center

    Holden, Janice Miner

    2000-01-01

    Introduces a special section within this issue of Counseling and Values that focuses on counselors' accounts of their clients' transpersonal experiences. The eight articles in this special section discuss ten types of transpersonal experiences. Clients range in age from early 20s to early 80s. Experiences occurred in various settings and were…

  2. Experience-Seeking Characteristics of Methadone Clients.

    ERIC Educational Resources Information Center

    Kohn, Paul M.; And Others

    1979-01-01

    Methadone clients scored higher than controls on measures reflecting boredom, desire for change and attraction to physically thrilling activities. Correlations of these measures with length of most recent dependency before treatment, time on program, and time since initial dependency suggest peculiarities of methadone clients antedated involvement…

  3. Client Relations: More than Just "Business"

    ERIC Educational Resources Information Center

    Malloy, Courtney L.; Yee, Patricia A.

    2006-01-01

    In this chapter, the authors review the literature on partnership evolution to offer strategies for developing collaborative evaluator-client relationships. They begin with a brief introduction to partnerships and their approach to client relationships. A synthesis of the literature on partnership evolution is provided and applied to the…

  4. Vocational Evaluation of Severely Disabled Deaf Clients.

    ERIC Educational Resources Information Center

    Watson, Douglas

    Research and practice in deafness rehabilitation show that evaluation services for severely disabled deaf clients can best be provided within a "total adjustment environment" which incorporates a number of special program considerations associated with the evaluation of deaf clients. Four of these considerations are (1) a rehabilitation evaluation…

  5. Cut Costs with Thin Client Computing.

    ERIC Educational Resources Information Center

    Hartley, Patrick H.

    2001-01-01

    Discusses how school districts can considerably increase the number of administrative computers in their districts without a corresponding increase in costs by using the "Thin Client" component of the Total Cost of Ownership (TCC) model. TCC and Thin Client are described, including its software and hardware components. An example of a Thin Client…

  6. Training Therapists about Client Expectations of Psychotherapy.

    ERIC Educational Resources Information Center

    Soley, Georgia; Marshall, Renee; Chambliss, Catherine

    Research has indicated that premature termination of therapy is sometimes due to a conflict in goal and outcome expectations between therapists and family members of clients. The present study requested both therapists and parents of child clients to complete questionnaires to determine if there is congruence between therapist and parental…

  7. Client Verbal Response Category System: Preliminary Data.

    ERIC Educational Resources Information Center

    Meier, Augustine; Boivin, Micheline

    1986-01-01

    The Client Verbal Response Category System classifies client responses into Temporal, Directional and Experiential categories. The categories with their subcategories are defined, interjudge reliability data is presented, and the instrument's utility in psychotherapy process research is demonstrated. Initial results indicate that the instrument is…

  8. Employment Patterns of Methadone Maintenance Clients

    ERIC Educational Resources Information Center

    Bloch, Harriet I.; And Others

    1977-01-01

    Analysis of employment patterns of methadone maintenance clients had indicated that the majority were not employed at time of program admission. At time of evaluation, 70 percent of the sample were employed; 88 percent of these clients had previous work histories and brought marketable skills with them. (Author)

  9. Organizational and Client Commitment among Contracted Employees

    ERIC Educational Resources Information Center

    Coyle-Shapiro, Jacqueline A-M.; Morrow, Paula C.

    2006-01-01

    This study examines affective commitment to employing and client organizations among long-term contracted employees, a new and growing employment classification. Drawing on organizational commitment and social exchange literatures, we propose two categories of antecedents of employee commitment to client organizations. We tested our hypotheses…

  10. Writing about Clients: Ethical Considerations and Options

    ERIC Educational Resources Information Center

    Sperry, Len; Pies, Ronald

    2010-01-01

    Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case…

  11. Experiential Interventions for Clients with Genital Herpes.

    ERIC Educational Resources Information Center

    Cummings, Anne L.

    1999-01-01

    Explores potential benefits of incorporating concepts and interventions from experimental therapy to help clients with psychosocial difficulties in learning to live with genital herpes. Recommends experimental counseling of two-chair dialog, empty chair, and metaphor for helping clients with emotional sequelae of genital herpes. Presents case…

  12. 49 CFR 1103.23 - Confidences of a client.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Confidences of a client. 1103.23 Section 1103.23... Responsibilities Toward A Client § 1103.23 Confidences of a client. (a) The practitioner's duty to preserve his client's confidence outlasts the practitioner's employment by the client, and this duty extends to...

  13. 49 CFR 1103.23 - Confidences of a client.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Confidences of a client. 1103.23 Section 1103.23... Responsibilities Toward A Client § 1103.23 Confidences of a client. (a) The practitioner's duty to preserve his client's confidence outlasts the practitioner's employment by the client, and this duty extends to...

  14. 42 CFR 483.420 - Condition of participation: Client protections.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Inform each client, parent (if the client is a minor), or legal guardian, of the client's medical...) Provide each client with the opportunity for personal privacy and ensure privacy during treatment and care...) Ensure that clients have access to telephones with privacy for incoming and outgoing local and...

  15. Child Abuse: Educator's Responsibilities. Revised.

    ERIC Educational Resources Information Center

    California State Office of the Attorney General, Sacramento. Crime Prevention Center.

    This document presents the educator with a guide to child abuse. A section defining child abuse examines the issues of physical abuse, physical neglect, sexual abuse, and emotional maltreatment. Areas discussed for these types of abuse include abuse indicators, location of injury, history, behavioral indicators, and types of injury. Incestuous and…

  16. Characteristics of Sexual Abuse in Childhood and Adolescence Influence Sexual Risk Behavior in Adulthood

    PubMed Central

    Senn, Theresa E.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite

    2006-01-01

    Childhood and adolescent sexual abuse has been associated with subsequent (adult) sexual risk behavior, but the effects of force and type of sexual abuse on sexual behavior outcomes have been less well-studied. The present study investigated the associations between sexual abuse characteristics and later sexual risk behavior, and explored whether gender of the child/adolescent moderated these relations. Patients attending an STD clinic completed a computerized survey that assessed history of sexual abuse as well as lifetime and current sexual behavior. Participants were considered sexually abused if they reported a sexual experience (1) before age 13 with someone 5 or more years older, (2) between the ages of 13 and 16 with someone 10 or more years older, or (3) before the age of 17 involving force or coercion. Participants who were sexually abused were further categorized based on two abuse characteristics, namely, use of penetration and force. Analyses included 1177 participants (n=534 women; n=643 men). Those who reported sexual abuse involving penetration and/or force reported more adult sexual risk behavior, including the number of lifetime partners and number of previous STD diagnoses, than those who were not sexually abused and those who were abused without force or penetration. There were no significant differences in sexual risk behavior between nonabused participants and those who reported sexual abuse without force and without penetration. Gender of the child/adolescent moderated the association between sexual abuse characteristics and adult sexual risk behavior; for men, sexual abuse with force and penetration was associated with the greatest number of episodes of sex trading, whereas for women, those who were abused with penetration, regardless of whether the abuse involved force, reported the most episodes of sex trading. These findings indicate that more severe sexual abuse is associated with riskier adult sexual behavior. PMID:17192833

  17. Ageism and abuse in the workplace: a new frontier.

    PubMed

    Powell, Mebane

    2010-10-01

    The economic crisis in the United States has led to increased media coverage of older workers being laid off, forced to retire, or working longer than planned. Embedded in these reports are the intimations of workplace abuse. Social workers need to start taking into account ageism and abuse in the workplace as possible cooccurring issues to effectively implement policy, and organizational change that will address both issues. This brief article discusses ageism and abuse in the workplace using a human rights framework, the current state of the literature, and directions for future research. PMID:20865626

  18. Elder abuse and oppression: voices of marginalized elders.

    PubMed

    Walsh, Christine A; Olson, Jennifer L; Ploeg, Jenny; Lohfeld, Lynne; MacMillan, Harriet L

    2011-01-01

    The voices of elderly people from marginalized groups are rarely solicited, and the relationship between elder maltreatment and belonging to an oppressed group has not been adequately investigated. This article reviews the literature on oppression and elder abuse and describes findings from the secondary analysis of data from focus group discussions on elder abuse held with marginalized older adults and (quasi)professionals caring for them in two Canadian cities. Participants identified that increased vulnerability to elder abuse was related to oppression experienced as a consequence of ageism, sexism, ableism/disability, racism, heterosexism/homophobia, classism, and various intersecting types of oppression.

  19. Social pressure, coercion, and client engagement at treatment entry: a self-determination theory perspective.

    PubMed

    Wild, T Cameron; Cunningham, John A; Ryan, Richard M

    2006-10-01

    Research on coercion in addiction treatment typically investigates objective sources of social pressure among legally mandated clients. Little research has examined the impact of clients' perceptions of social pressures in generalist addiction services. Clients seeking substance abuse treatment (N=300; 221 males and 79 females; M age=36.6 years) rated the extent to which treatment was being sought because of coercive social pressures (external motivation; alpha=.89), guilt about continued substance abuse (introjected motivation; alpha=.84), or a personal choice and commitment to the goals of the program (identified motivation; alpha=.85). External treatment motivation was positively correlated with legal referral, social network pressures to enter treatment, and was inversely related to problem severity. In contrast, identified treatment motivation was positively correlated with self-referral and problem severity, and was inversely related to perceived coercion (ps<.05). Hierarchical multiple regression analyses showed that referral source (i.e., mandated treatment status), legal history, and social network pressures did not predict any of 6 measures of client engagement at the time treatment was sought. However, treatment motivation variables accounted for unique variance in these outcomes when added to each model (DeltaR(2)s=.06-.23, ps<.05). Specifically, identified treatment motivation predicted perceived benefits of reducing substance use, attempts to reduce drinking and drug use, as well as self (and therapist) ratings of interest in the upcoming treatment episode (betas=.18-.31, ps<.05). Results suggest that the presence of legal referral and/or social network pressures to quit, cut down, and/or enter treatment does not affect client engagement at treatment entry.

  20. Substance Abuse. Policy Statement.

    ERIC Educational Resources Information Center

    National Collaboration for Youth, Washington, DC.

    This paper presents the policy statement on substance abuse from the National Collaboration for Youth (NCY). The policy statement section lists programs and activities supported by the NCY. A section on background includes a statement of the issue of substance abuse. Areas examined in this section include alcohol abuse and drunk driving among…

  1. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Morrow, Marilyn J.; Doyle, Kathleen

    The Elder Abuse Awareness Project was developed to determine the incidence of abuse and neglect of elderly people in several rural counties in central Illinois. A primary purpose of the study was to survey service providers as to their actual encounters with elder abuse and neglect. Each provider was asked about warning signs or cues that were…

  2. Child Abuse and Neglect.

    ERIC Educational Resources Information Center

    International Children's Centre, Paris (France).

    A series of four documents address the definition and identification of child abuse and neglect. In the first, which is designed for professionals, a historical review is followed by discussion of clinical and social evidence of abuse. Resources for managing child abuse are described, and personnel functions are outlined. The second document,…

  3. Dynamics of Parental Abuse

    PubMed Central

    Hardin, Eugene; Schlater, Theodore L.

    1987-01-01

    The dynamics of the various categories of parental abuse are examined with special emphasis on abuse by adult offspring living in the same household or adults acting as caretakers or legal guardians for their elderly parents. Society's role in the dynamics of parental abuse is examined.

  4. Analysis of the Competency-Based High School Diploma Program for CETA Clients. Report III: Student/Client Completion Results.

    ERIC Educational Resources Information Center

    McMillan, Samuel H., Jr.

    A study examined the student/client completion of a competency-based high school diploma for CETA clients. Using follow-up forms, attendance records, correspondence, telephone calls, and client information sheets, researchers collected data from clients and staff pertaining to 102 of the 238 program clients from five sites in Texas (Abilene,…

  5. The Role of Home-Visiting Programs in Preventing Child Abuse and Neglect

    ERIC Educational Resources Information Center

    Howard, Kimberly S.; Brooks-Gunn, Jeanne

    2009-01-01

    Kimberly Howard and Jeanne Brooks-Gunn examine home visiting, an increasingly popular method for delivering services for families, as a strategy for preventing child abuse and neglect. They focus on early interventions because infants are at greater risk for child abuse and neglect than are older children. In their article, Howard and Brooks-Gunn…

  6. Developing a Peer Educator Program to Raise Awareness about Elder Abuse

    ERIC Educational Resources Information Center

    Weeks, Lori E.; Bryanton, Olive; McInnis-Perry, Gloria; Chaulk, Paul

    2015-01-01

    There continues to be lack of public awareness about elder abuse. To help address this issue, we developed and piloted an elder abuse peer educator training program from an educational gerontology and health empowerment perspective. We describe the process employed to train older adults as peer educators. We present evaluation results from data…

  7. Substance abuse and batterer programmes in California, USA: factors associated with treatment outcomes

    PubMed Central

    Timko, Christine; Valenstein, Helen; Stuart, Gregory L.; Moos, Rudolf H.

    2015-01-01

    The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. PMID:25470658

  8. Termination: Analytic Reflections on Client Contact after Counselor Relocation.

    ERIC Educational Resources Information Center

    Pistole, M. Carole

    1991-01-01

    Claims client posttermination contact with counselors who have relocated has been neglected as training and practice issue. Uses analytic reflections to explore counselor, client, and process variables relative to counselors' response to "following" clients. (Author/ABL)

  9. Screening for domestic violence in public welfare offices: an analysis of case manager and client interactions.

    PubMed

    Lindhorst, Taryn; Meyers, Marcia; Casey, Erin

    2008-01-01

    Despite a high prevalence of domestic violence among welfare clients, most studies of the implementation of the Family Violence Option (FVO) under welfare reform find that women rarely receive domestic violence services in welfare offices. This study reviews findings from current research on the factors that improve the likelihood that women will reveal their domestic violence experiences to service personnel, and uses the guidelines drawn from this review to evaluate domestic violence screening practices in welfare offices using 782 transcribed interviews between welfare workers and clients from 11 sites in four states. The analysis found that only 9.3% of case encounters involved screening for domestic violence. Screening rates differed by state, interview type, and length of worker employment. Qualitative analysis of the interviews showed that the majority of screening by workers was routine or consisted of informing clients of the domestic violence policy without asking about abuse. Only 1.2% of the interviews incorporated at least two of the procedures that increase the likelihood of disclosure among domestic violence survivors, suggesting deeply inadequate approaches to screening for abuse within the context of welfare offices, and a need for improved training, protocol, and monitoring of FVO implementation.

  10. Elder Abuse: Research, Practice, and Health Policy. The 2012 GSA Maxwell Pollack Award Lecture

    PubMed Central

    Dong, Xinqi

    2014-01-01

    Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults. PMID:24270215

  11. [Aggressive clients in Dutch veterinary practice].

    PubMed

    Barbonis, T S A E; Endenburg, N

    2007-05-15

    Aggressive clients seem to be becoming more common. This article describes a study in which questionnaires on client behaviour were sent to veterinary assistants and veterinarians in randomly selected practices in the Netherlands. Results showed that 26.4% of the veterinarians and 29.3% of the assistants had experienced aggressive clients in the last year. Age, experience, and sex of the veterinarian or assistant did not influence the frequency with which aggressive clients were encountered. The same was true for the type of veterinary practice (companion animals, farm animals, horses, etc). The risk of encountering aggressive clients was higher among practices in large towns and in practices with a small turnover Of the veterinarians who had encountered aggressive clients at least once in their career, 31% has taken some kind of action after the aggressive encounter Nearly a quarter (24.9%) of veterinary practices have adopted a Risk Inventarization and Evaluation (RI&E) approach to preventing client aggression and 26.6% of practices have adopted another approach. While veterinarians tend not to consider aggression a big problem, they are often open to the suggestion that more attention should be paid to aggression in veterinary practice. PMID:17578228

  12. Treatment and prevention of elder abuse and neglect: where knowledge and practice meet-a model for intervention to prevent and treat elder abuse in Israel.

    PubMed

    Alon, Sara; Berg-Warman, Ayelet

    2014-01-01

    Successful handling of elder abuse and neglect requires various interventions. This article presents findings from an evaluation study of a model for intervention implemented in three municipalities in Israel. Data from 558 older adults, exposed to abuse and treated through the program, and interviews with victims, abusers, and professionals revealed that improvement was achieved in 66% of the cases. In 20% of the cases, the abuse was stopped. The most widespread type of intervention consisted of individual counseling. Legal intervention yielded the highest rate of improvement (82%). Provision of supportive services for victims of neglect was found to be most effective (82% of improvement in the situation).

  13. APS logDaemon and client library

    SciTech Connect

    Saunders, C.; Kowalkowski, J.

    1995-12-13

    This document serves as a User`s Manual and Reference for the logDaemon and client library. This package provides a general distributed message logging system. A logDaemon may be started anywhere on a subnet. A client which has linked in the client library is provided functions to open a connection to the logDaemon, log messages, and close the connection. The logDaemon maintains one or more log files (in simple ASCII or SDDS format) and an e-mail list based on specifications in a configuration file. Incoming messages are logged to the appropriate file and/or result in e-mail being sent.

  14. Client and therapist variability in clients' perceptions of their therapists' multicultural competencies.

    PubMed

    Owen, Jesse; Leach, Mark M; Wampold, Bruce; Rodolfa, Emil

    2011-01-01

    This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated that therapists accounted for less than 1% of the variance in their clients' Cross-Cultural Counseling Inventory–Revised (CCCI-R; T. D. LaFromboise, H. L. K. Coleman, & A. Hernandez, 1991) scores, suggesting that therapists did not differ in terms of how clients rated their MCCs. Therapists accounted for approximately 8.5% of the variance in therapy outcomes. For each therapist, their clients' CCCI-R scores were aggregated to provide an estimate of therapists' MCCs. Therapists' MCCs, based on aggregate CCCI-R scores, did not account for the variability in therapy outcomes that were attributed to them. Additionally, clients' race/ethnicity, therapists' race/ethnicity, or the interaction of clients'–therapists' race/ethnicity were not significantly associated with clients' perceptions of their therapists' MCCs.

  15. Older People and HIV

    MedlinePlus

    ... Many older people believe that HIV only affects younger people Most older people get little training in ... diseases among older people, as they do for younger people. Physicians may not diagnose HIV infection in ...

  16. Preventing and Recognizing Prescription Drug Abuse

    MedlinePlus

    ... Abuse » Preventing and recognizing prescription drug abuse Prescription Drug Abuse Email Facebook Twitter Preventing and recognizing prescription drug abuse To ensure proper medical care, patients should discuss ...

  17. HAART Adherence Strategies for Methadone Clients Who Are HIV-Positive: A Treatment Manual for Implementing Contingency Management and Medication Coaching

    ERIC Educational Resources Information Center

    Haug, Nancy A.; Sorensen, James L.; Gruber, Valerie A.; Lollo, Nicole; Roth, Gregory

    2006-01-01

    Research demonstrates that injection drug users with HIV and/or AIDS have difficulty adhering to complex regimens of HIV medications. Because of the risk of increased viral resistance associated with irregular medication adherence, there is considerable clinical need to assist clients who abuse substances in taking their antiretroviral medications…

  18. Potential sources of reinforcement and punishment in a drug-free treatment clinic: client and staff perceptions.

    PubMed

    Roll, John M; Chudzynski, Joy E; Richardson, Gina

    2005-01-01

    Contingency management interventions are quite successful at initiating abstinence from drugs of abuse. However, these approaches to drug abuse treatment are often criticized because of their perceived cost. One way to reduce the cost of contingency management interventions would be to use nonmonetary sources of reinforcement or punishment. A number of reports have discussed the availability of potential sources of reinforcement in opiate replacement clinics. This report describes the availability of potential sources of reinforcement and punishment available in drug-free treatment programs. Both clients and clinic staff rated a number of items in terms of their potential reinforcing and punishing efficacy. Results suggest that there are several sources of reinforcement and punishment available in drug-free clinics, which could be used in contingency management programs. The results also suggest that the clinic staff perceives potential sources of punishment as more aversive than do the clients.

  19. Counselor Values and the Pregnant Adolescent Client.

    ERIC Educational Resources Information Center

    Kennedy, Bebe C.; And Others

    1984-01-01

    Reviews options counselors can suggest to pregnant adolescents, including abortion, adoption, marriage, and single parenthood. Discusses the need for counselors to be aware of their own values and help the client explore her values. (JAC)

  20. HAART adherence strategies for methadone clients who are HIV-positive: a treatment manual for implementing contingency management and medication coaching.

    PubMed

    Haug, Nancy A; Sorensen, James L; Gruber, Valerie A; Lollo, Nicole; Roth, Gregory

    2006-11-01

    Research demonstrates that injection drug users with HIV and/or AIDS have difficulty adhering to complex regimens of HIV medications. Because of the risk of increased viral resistance associated with irregular medication adherence, there is considerable clinical need to assist clients who abuse substances in taking their antiretroviral medications on time and as directed. This article outlines intervention strategies to improve medication adherence among clients who are in methadone maintenance. In this treatment manual, the authors delineate contingency management procedures, including voucher incentives and a fishbowl lottery prize system. They also describe intervention elements and adherence tools for medication coaching. The purpose of this manual is to describe the intervention procedures for clinicians and to serve as a resource for drug abuse treatment programs that serve clients who are HIV-positive.

  1. Substance Abuse by Elders and Self-Enhancement Bias

    ERIC Educational Resources Information Center

    Kane, Michael N.; Green, Diane

    2009-01-01

    Human service professionals regularly do not recognize the symptoms of substance abuse in older populations and are unlikely to provide intervention. In this study, human service students (N = 242) were given one of three vignettes in which the main character was an 80-year-old man, an 80-year-old woman, or they were asked to imagine themselves at…

  2. Nonoffending Caregiver and Youth Experiences with Child Sexual Abuse Investigations

    ERIC Educational Resources Information Center

    Jones, Lisa M.; Atoro, Kathryn E.; Walsh, Wendy A.; Cross, Theodore P.; Shadoin, Amy L.; Magnuson, Suzanne

    2010-01-01

    Qualitative responses by caregivers (n = 203) and youth (aged 8 and older; n = 65) about their experiences with sexual abuse investigations were analyzed in conjunction with quantitative ratings of satisfaction. Respondents described mostly high levels of satisfaction, although dissatisfaction was reported with some key aspects of investigations.…

  3. Cleaner fish Labroides dimidiatus recognise familiar clients.

    PubMed

    Tebbich, S; Bshary, R; Grutter, A S

    2002-09-01

    Individual recognition has been attributed a crucial role in the evolution of complex social systems such as helping behaviour and cooperation. A classical example for interspecific cooperation is the mutualism between the cleaner fish Labroides dimidiatus and its client reef fish species. For stable cooperation to evolve, it is generally assumed that partners interact repeatedly and remember each other's past behaviour. Repeated interactions may be achieved by site fidelity or individual recognition. However, as some cleaner fish have more than 2,300 interactions per day with various individuals per species and various species of clients, basic assumptions of cooperation theory might be violated in this mutualism. We tested the cleaner L. dimidiatus and its herbivorous client, the surgeon fish Ctenochaetus striatus, for their ability to distinguish between a familiar and an unfamiliar partner in a choice experiment. Under natural conditions, cleaners and clients have to build up their relationship, which is probably costly for both. We therefore predicted that both clients and cleaners should prefer the familiar partner in our choice experiment. We found that cleaners spent significantly more time near the familiar than the unfamiliar clients in the first 2 minutes of the experiment. This indicates the ability for individual recognition in cleaners. In contrast, the client C. striatus showed no significant preference. This could be due to a sampling artefact, possibly due to a lack of sufficient motivation. Alternatively, clients may not need to recognise their cleaners but instead remember the defined territories of L. dimidiatus to achieve repeated interactions with the same individual.

  4. Characteristics of Northern Plains American Indians seeking substance abuse treatment in an urban, non-tribal clinic: a descriptive study.

    PubMed

    Kropp, Frankie; Somoza, Eugene; Lilleskov, Maurine; Moccasin, Mabel Granados-Bad; Moore, Michelle; Lewis, Daniel; Boetel, Brenda; Smith, Corey; Winhusen, Theresa

    2013-12-01

    Because few data exist on substance abuse rates in American Indian (AI) communities, the Methamphetamine and Other Drug project was developed and implemented by five nodes within the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). This article presents findings from AI clients in a Northern Plains urban non-Native substance abuse treatment setting. Alcohol and marijuana were used earlier, longer, and by more clients, followed by stimulants and prescription opioids. Most regularly smoked tobacco. Differences in substance use patterns were associated with age of onset and victimization. Age of onset was correlated with victimization, gender, cognitive impairment, and suicidal behavior. Despite considerable health and economic disparities, most clients found support for recovery in relationships and elements of Native culture.

  5. Physical Abuse of Urban Native Americans

    PubMed Central

    Buchwald, Dedra; Tomita, Sue; Hartman, Suzanne; Furman, Richard; Dudden, Matthew; Manson, Spero M

    2000-01-01

    To ascertain the extent of, and risk factors for, physical abuse among older urban American Indian/Alaska Natives (AI/ANs), we conducted a chart review of 550 urban AI/AN primary care patients ≥50 years old seen during 1 year. Mistreatment was documented in 10%. A logistic regression found younger age (P < .001), female gender (P < .001), current depression (P < .001), and dependence on others for food (P < .05) to be significant correlates of physical abuse. In only 31% of instances of definite abuse were the authorities notified. We conclude that providers should be alert to the possibility of physical mistreatment among older urban AI/ANs. Improvements in detection and management are sorely needed. PMID:10940148

  6. Training Probation and Parole Officers to Provide Substance Abuse Treatment: A Field Test.

    ERIC Educational Resources Information Center

    Cunningham, John A.; Herie, Marilyn; Martin, Garth; Turner, Bonnie J.

    1998-01-01

    The results of field-testing a substance-abuse treatment protocol are reported. Ten probation and parole officers were trained in Structured Relapse Prevention, and 55 clients were treated. Incentives and barriers to treatment are highlighted. The use of this type of field test as a dissemination technique is discussed. (EMK)

  7. Statewide Adoption and Initial Implementation of Contingency Management for Substance-Abusing Adolescents

    ERIC Educational Resources Information Center

    Henggeler, Scott W.; Chapman, Jason E.; Rowland, Melisa D.; Halliday-Boykins, Colleen A.; Randall, Jeff; Shackelford, Jennifer; Schoenwald, Sonja K.

    2008-01-01

    Four hundred thirty-two public sector therapists attended a workshop in contingency management (CM) and were interviewed monthly for the following 6 months to assess their adoption and initial implementation of CM to treat substance-abusing adolescent clients. Results showed that 58% (n = 131) of the practitioners with at least one…

  8. Improving Session Attendance in Mental Health and Substance Abuse Settings: A Review of Controlled Studies

    ERIC Educational Resources Information Center

    Lefforge, Noelle L.; Donohue, Brad; Strada, Marilyn J.

    2007-01-01

    Patient nonattendance to scheduled sessions results in excessive costs to mental health and substance abuse providers and compromises the care of clients. This paper presents a comprehensive review of interventions that have been shown to increase session attendance rates in these settings. Unique to other review papers, reliability estimates were…

  9. Arab Parents' Reactions to Child Sexual Abuse: A Review of Clinical Records

    ERIC Educational Resources Information Center

    Abu-Baker, Khawla

    2013-01-01

    This paper addresses parents' reactions to sexual abuse cases in their families. The study analyzed the clinical records of individual and family therapy sessions with 35 cases of Arab Palestinian clients, citizens of Israel (27 individuals and 8 families). Families were categorized as either functional or dysfunctional. It was concluded that…

  10. Extrapyramidal Motor Dysfunction and Resultant Orofacial Dystonia Post-Cocaine Abuse: A Clinical Case Study

    ERIC Educational Resources Information Center

    McMicken, Betty L.; Ostergren, Jennifer A.; Vento-Wilson, Margaret

    2010-01-01

    This case study investigated the consequences of cocaine use and resultant extrapyramidal motor dysfunction. The study focused on a female client, post-long-term drug abuse with concomitant untreated head trauma, experiencing extraneous motor movements of the lips, tongue, jaw, and upper and lower extremities. The goals of this study were to (a)…

  11. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    ERIC Educational Resources Information Center

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

  12. Responding to Hidden Abuse: A Role for Social Work in Reforming Mental Health Systems.

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1991-01-01

    Studied 89 clients in case management program, most of whom were identified as heavy users of acute care and psychiatric emergency rooms. Findings revealed that 50% were adult children of alcoholics and that many had been sexually and physically abused as children or adults. None had been asked about or appropriately treated for these aspects of…

  13. Help-Seeking among Male Victims of Partner Abuse: Men's Hard Times

    ERIC Educational Resources Information Center

    Tsui, Venus; Cheung, Monit; Leung, Patrick

    2010-01-01

    Sixty-eight agency representatives in the United States completed a survey to identify issues of male victims in partner abuse: half referenced responses from male clients and the other half responses from male victims who were their family members, friends, colleagues, or themselves. Almost 25% revealed that male victims did not utilize social…

  14. Arrest and Conviction Histories before, during and after Participation in a Substance Abuse Treatment Program.

    ERIC Educational Resources Information Center

    Edwards, Elizabeth D.

    1978-01-01

    Arrest and conviction records were examined for clients who had participated in a methadone substance abuse program to determine the differences in criminal activity prior to entering the program, while in the program, and after program termination. Decreasing linear trends were found in amounts of misdemeanor convictions, felony arrests, and…

  15. Advancing the Field Elder Abuse: Future Directions and Policy Implications

    PubMed Central

    Dong, XinQi

    2012-01-01

    Elder abuse, sometime called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adult experiences some form of elder abuse, and only 1 of out 25 cases are actually reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow/Health and Aging Policy Fellow working with Administration on Community Living (ACL) (Previously known at Administration on Aging (AoA)) for the last two years, I will describe the major functions of the ACL; and highlight on two major pieces of federal legislation: The Older Americans Act (OAA) and the Elder Justice Act (EJA). Moreover, I will highlight major research gaps and future policy relevant research directions for the field of elder abuse. PMID:23110488

  16. Predictors of substance abuse treatment participation among homeless adults.

    PubMed

    Ibabe, Izaskun; Stein, Judith A; Nyamathi, Adeline; Bentler, Peter M

    2014-03-01

    The current study focuses on the relationships among a trauma history, a substance use history, chronic homelessness, and the mediating role of recent emotional distress in predicting drug treatment participation among adult homeless people. We explored the predictors of participation in substance abuse treatment because enrolling and retaining clients in substance abuse treatment programs is always a challenge particularly among homeless people. Participants were 853 homeless adults from Los Angeles, California. Using structural equation models, findings indicated that trauma history, substance use history and chronicity of homelessness were associated, and were significant predictors of greater recent emotional distress. The most notable result was that recent emotional distress predicted less participation in current substance abuse treatment (both formal and self-help) whereas a substance use history alone predicted significantly more participation in treatment. Implications concerning treatment engagement and difficulties in obtaining appropriate dual-diagnosis services for homeless mentally distressed individuals are discussed. PMID:24238716

  17. An interactive electronic instructional unit on substance abuse.

    PubMed

    Bonder, Bette R; Hulisz, Darrell; Marsh, Sybil; Bonaguro, John

    2006-01-01

    This paper describes an approach to instruction for allied health students in screening and brief intervention to assist children and adolescents living with adults who are abusing substances. Substance abuse is a major public health problem in the United States; among its outcomes is damage to children living in the home. Health professionals should screen child and adolescent clients to determine whether adults in the home are substance abusers, and provide help for children living with such adults. An interactive electronic instructional unit, suitable for either independent study or classroom use, was developed to provide this content to allied health students. The unit includes an introductory page, followed by pages focused on the scope of the problem, screening, and brief intervention. Evaluation by means of a pre and post-test suggested that the unit has the potential to increase occupational and physical therapy students' knowledge and modify attitudes regarding their role in providing screening, referral, and brief intervention for this population.

  18. Determining Prevalence and Correlates of Elder Abuse Using Promotores: Low Income Immigrant Latinos Report High Rates of Abuse and Neglect

    PubMed Central

    DeLiema, Marguerite; Gassoumis, Zachary D.; Homeier, Diana C.; Wilber, Kathleen H.

    2012-01-01

    Low-income Latino immigrants are understudied in elder abuse research. Limited English proficiency, economic insecurity, neighborhood seclusion, a tradition of resolving conflicts within the family, and mistrust of authorities may impede survey research and suppress abuse reporting. To overcome these barriers, we recruited and trained promotores, local Spanish-speaking Latinos, to interview a sample of Latino adults age 66 and older residing in low-income communities. The promotores conducted door-to-door interviews in randomly selected census tracts in Los Angeles to assess the frequency of psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. Overall, 40.4% of Latino elders experienced some form of abuse and/or neglect within the previous year. Nearly 25% reported psychological abuse, 10.7% indicated physical assault, 9% reported sexual abuse, 16.7% indicated financial exploitation, and 11.7% were neglected by their caregivers. Younger age, higher education, and experiencing sexual or physical abuse before age 65 were significant risk factors for psychological, physical, and/or sexual abuse. Years lived in the United States, younger age, and prior abuse were associated with increased risk of financial exploitation. Years spent living in the U.S. was a significant risk factor for caregiver neglect. Abuse prevalence was much higher in all mistreatment domains than findings from previous research on community-dwelling elders, suggesting that low-income Latino immigrants are highly vulnerable to elder mistreatment, or that respondents are more willing to disclose abuse to promotores who represent their culture and community. PMID:22697790

  19. Alternative drugs of abuse.

    PubMed

    Sutter, M E; Chenoweth, J; Albertson, T E

    2014-02-01

    The incidence of drug abuse with alternative agents is increasing. The term "alternative drugs of abuse" is a catch-all term for abused chemicals that do not fit into one of the classic categories of drugs of abuse. The most common age group abusing these agents range from 17 to 25 years old and are often associated with group settings. Due to their diverse pharmacological nature, legislative efforts to classify these chemicals as a schedule I drug have lagged behind the development of new alternative agents. The potential reason for abuse of these agents is their hallucinogenic, dissociative, stimulant, anti-muscarinic, or sedative properties. Some of these drugs are easily obtainable such as Datura stramonium (Jimson Weed) or Lophophora williamsii (Peyote) because they are natural plants indigenous to certain regions. The diverse pharmacology and clinical effects of these agents are so broad that they do not produce a universal constellation of signs and symptoms. Detailed physical exams are essential for identifying clues leading one to suspect an alternative drug of abuse. Testing for the presence of these agents is often limited, and even when available, the results do not return in a timely fashion. Intoxications from these agents pose unique challenges for health care providers. Physician knowledge of the physiological effects of these alternative agents and the local patterns of drug of abuse are important for the accurate diagnosis and optimal care of poisoned patients. This review summarizes the current knowledge of alternative drugs of abuse and highlights their clinical presentations. PMID:23636733

  20. [Sexual abuse of minors].

    PubMed

    Hayez, J Y

    1991-01-01

    The author gives a definition of sexual abuse on minors, emphasizing its more frequent occurrence inside the family (incest) than outside. He describes the countertransference reactions induced by this type of abuse, especially in professional teams who tend to put each other in a position of rivalry. Next, he sketches the pathogeny of sexual abuse, the clinical signs and the long term effects. The author deduces what should be the first signs of sexual abuse and proposes a pattern of diagnosis. Finally, he explains a management model, of the crisis and the follow-up of this difficult situation. PMID:1670411

  1. Elder physical abuse.

    PubMed

    Young, Lisa M

    2014-11-01

    Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse.

  2. Alternative drugs of abuse.

    PubMed

    Sutter, M E; Chenoweth, J; Albertson, T E

    2014-02-01

    The incidence of drug abuse with alternative agents is increasing. The term "alternative drugs of abuse" is a catch-all term for abused chemicals that do not fit into one of the classic categories of drugs of abuse. The most common age group abusing these agents range from 17 to 25 years old and are often associated with group settings. Due to their diverse pharmacological nature, legislative efforts to classify these chemicals as a schedule I drug have lagged behind the development of new alternative agents. The potential reason for abuse of these agents is their hallucinogenic, dissociative, stimulant, anti-muscarinic, or sedative properties. Some of these drugs are easily obtainable such as Datura stramonium (Jimson Weed) or Lophophora williamsii (Peyote) because they are natural plants indigenous to certain regions. The diverse pharmacology and clinical effects of these agents are so broad that they do not produce a universal constellation of signs and symptoms. Detailed physical exams are essential for identifying clues leading one to suspect an alternative drug of abuse. Testing for the presence of these agents is often limited, and even when available, the results do not return in a timely fashion. Intoxications from these agents pose unique challenges for health care providers. Physician knowledge of the physiological effects of these alternative agents and the local patterns of drug of abuse are important for the accurate diagnosis and optimal care of poisoned patients. This review summarizes the current knowledge of alternative drugs of abuse and highlights their clinical presentations.

  3. Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.

    PubMed

    Ball, Samuel A; Carroll, Kathleen M; Canning-Ball, Monica; Rounsaville, Bruce J

    2006-02-01

    Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.

  4. Moving beyond Consultation and into Action with a Client Project

    ERIC Educational Resources Information Center

    Ewing, Sara; Dover, Howard F.

    2012-01-01

    Attempting to implement client-based projects within a single semester often overwhelms students and underwhelms the client and grading professor. In this paper, we share results from a two-year pilot project in which the components of a client project were split between several classes. We discuss the client project model as a valuable teaching…

  5. Client Engagement Characteristics Associated with Problem Gambling Treatment Outcomes

    ERIC Educational Resources Information Center

    Dowling, Nicki A.; Cosic, Sanja

    2011-01-01

    Previous research examining the factors associated with problem gambling treatment outcomes has examined client factors and to date, treatment characteristics, therapist factors, and client-therapist interactions have essentially remained unexplored. This study aimed to investigate how client engagement variables (client-rated therapeutic…

  6. Pursuing Therapeugenic Consequences of Restricting Client Smoking during Counseling.

    ERIC Educational Resources Information Center

    Schneider, Lawrence J.; Dearing, Nancy

    Theorists and therapists have become increasingly attentive to the role of interpersonal behaviors that facilitate or hinder the ability of the counselor to exert influence over the client during counseling. A study was conducted to examine the impact of a counselor's preference that clients not smoke, client stress levels, client sex, and…

  7. Perceptions and views of self-neglect: a client-centered perspective.

    PubMed

    Day, Mary Rose; Leahy-Warren, Patricia; McCarthy, Geraldine

    2013-01-01

    Aging populations and chronic illness increase vulnerability of older people for self-neglect, which is a serious public health issue. Many referrals received by Elder Abuse Services (EAS) in Ireland are categorized as self-neglect. The aim of the research was to observe and describe the living circumstances of a purposive sample of eight older people who were deemed self-neglectful by senior case workers. An exploratory descriptive research design was used. The themes that emerged were early life experiences and lifestyle, disconnectivity, vulnerability, frugality, and service refusal. The majority of participants were content so decisions to live in this way must be respected. PMID:23289418

  8. Impact of substance abuse treatment on arrests among opiate users in Washington State.

    PubMed

    Campbell, Kevin M; Deck, Dennis; Krupski, Antoinette

    2007-01-01

    Administrative data from Washington State's Division of Alcohol and Substance Abuse drive this three-year prospective study of the impact of substance abuse treatment on arrests among 12,962 opiate users receiving publicly funded substance abuse services. Using survival analysis, the risk of arrest among opiate users who receive substance abuse treatment is compared to those who do not receive treatment. Propensity scores control for client characteristics associated with admission to substance abuse treatment. Overall, a reduction in the risk of arrest was found among subjects in treatment (Hazard Ratio = 0.59-0.78, p < .05) and subjects successfully completing treatment (Hazard Ratio = 0.75, p < .05). Risk of arrest was elevated among those with a negative outcome to treatment (Hazard Ratio = 1.23, p < .05).

  9. Abuse and neglect of elderly individuals: guidelines for oral health professionals.

    PubMed

    Glassman, Paul D; Chávez, Elisa M; Hawks, Doris

    2004-04-01

    The number of elderly individuals in our society is growing rapidly. This demographic change presents a number of challenges to our society and our health care systems. One of these is elder abuse and neglect, a serious and growing problem. In California, there are a number of state agencies responsible for oversight of care provided to elderly individuals and several systems for reporting suspected abuse and neglect depending on where the suspected abuse or neglect is occurring. Dental professionals are mandated reporters and therefore must understand how to recognize and--where possible prevent--abuse and neglect in their older patients and know how to report these suspicions.

  10. Understanding the medical markers of elder abuse and neglect: physical examination findings.

    PubMed

    Gibbs, Lisa M

    2014-11-01

    A specific foundation of knowledge is important for evaluating potential abuse from physical findings in the older adult. The standard physical examination is a foundation for detecting many types of abuse. An understanding of traumatic injuries, including patterns of injury, is important for health care providers, and inclusion of elder abuse in the differential diagnosis of patient care is essential. One must possess the skills needed to piece the history, including functional capabilities, and physical findings together. Armed with this skill set, health care providers will develop the confidence needed to identify and intervene in cases of elder abuse.

  11. Elder abuse and neglect vs. parricide: a letter from Russia.

    PubMed

    Jargin, Sergei V

    2014-01-01

    In Russia, elder abuse is rarely discussed in the professional literature and the media. However, it is posited that parricide can be considered a form of elder abuse in Russia, as the line between elder abuse and parricide can be vague. Instances of parricide can appear trivial, hardly realized as such by victims and the social environment. Borderline cases can include involving older people in binge drinking, denying them help, and manipulating them to commit suicide. The perpetrators are often nonpsychotic, although sometimes exhibiting abnormal personality traits. Anger toward the victim can be absent on the part of the perpetrator, with their actions often driven by economic desires. A concluding point is that for better prevention of parricide and, therefore, elder abuse, it should not be considered only an unusual horrific crime committed by the mentally ill. PMID:24779543

  12. Decision tool for clients with medical issues: a framework for identifying driving risk and potential to return to driving.

    PubMed

    Dickerson, Anne E; Bédard, Michel

    2014-04-01

    This paper offers occupational therapy generalists and specialists a new framework by which to consider clinical evaluation data and an older adult's driving risk and potential to resume this previously learned skill. Based on Michon's model describing the hierarchy of driving levels, clinical questions identify the factors that may affect a client's fitness to drive. The first part is intended to support clinical judgment of whether a client needs a driving evaluation by a driver rehabilitation specialist. The second part offers a framework to organize clinical data that are already known and determine what other evaluation information is justified and necessary to make a driving recommendation. Methods and rational for use are discussed.

  13. Analyses of client variables in a series of psychotherapy sessions with two child clients.

    PubMed

    Mook, B

    1982-04-01

    Studied the process of child psychotherapy by means of analyses of client verbal behaviors. Audio-video recordings were made of nine intermittent psychotherapy sessions with 2 child clients, aged 8 and 12. A randomized mastertape of 4-minute segments was rated for self-exploration by means of the Carkhuff scale. Transcripts were categorized by means of an extended Snyder system and a preliminary set of grammatical variables. Transcripts then were minutized, and all client variables were intercorrelated and factor-analyzed. According to the research expectations, a high level of interrater reliability for the Carkhuff scale and high levels of interjudge agreement for the extended Snyder system were found. Analyses of the client variables demonstrated the nature of each client's verbal responding as well as their pattern of change across successive therapy sessions. The overall verbal response behavior of each client was summarized best through the factor analyses. Communalities and individual differences between the clients were discussed. Future directions for the study of client variables in child psychotherapy process research were suggested.

  14. Client engagement in home and community care services: The client and care coordinator perspective.

    PubMed

    Kirst, Maritt; Elmi, Arij; Ray-Daniels, Mila; Foster, Jennifer

    2016-07-01

    A recent study of two Community Care Access Centres in Ontario was conducted to look at how clients can be involved in their own care while, at the same time, enhance their experience overall. This article describes that study and looks at ways of developing a new client engagement strategy moving forward. PMID:27270114

  15. Clinical Writing about Clients: Seeking Consent and Negotiating the Impact on Clients and Their Treatments

    ERIC Educational Resources Information Center

    Bridges, Nancy A.

    2010-01-01

    The author discusses her experiences seeking consent from 16 clients to use clinical material for publication. Sharing case examples from her practice, she elucidates her process with clients and focuses on the beneficial and detrimental effects on the therapeutic relationship. Seeking consent raises issues of confidentiality and stimulates…

  16. Measuring Client Engagement from the Client's Perspective in Nonvoluntary Child Protective Services

    ERIC Educational Resources Information Center

    Yatchmenoff, Diane K.

    2005-01-01

    Objective: This study reports on the development and test of a multidimensional measure of client engagement in child welfare services. Method: Five dimensions of engagement were identified and were based on a literature review and data from interviews with child welfare workers and clients. A pool of items generated to reflect these five…

  17. Addressing elder abuse: the Waterloo restorative justice approach to elder abuse project.

    PubMed

    Groh, Arlene; Linden, Rick

    2011-04-01

    The Community Care Access Centre (CCAC) of Waterloo Region, in partnership with a number of other social service agencies, designed and implemented a restorative justice model applicable to older adults who have been abused by an individual in a position of trust. The project was very successful in building partnerships, as many community agencies came together to deal with the problem of elder abuse. The program also raised the profile of elder abuse in the community. However, despite intensive efforts, referrals to the restorative justice program were quite low. Because of this, the program moved to a new organizational model, the Elder Abuse Response Team (EART), which has retained the guiding philosophy of restorative justice but has broadened the mandate. The team has evolved into a conflict management system that has multiple points of entry for cases and multiple options for dealing with elder abuse. The team has developed a broad range of community partners who can facilitate referrals to the EART and also can help to provide an individualized response to each case. The transition to the EART has been successful, and the number of referrals has increased significantly.

  18. Domestic partner abuse treatment programs and cultural competence: the results of a national survey.

    PubMed

    Williams, O J; Becker, R L

    1994-01-01

    Partner abuse literature reveals that treatment is less effective with minorities than with their white counterparts. Our survey of partner abuse programs (N = 142) indicates that, for the most part, little or no special effort is being made to understand or accommodate the needs of minority populations. This colorblind approach lacks the effectiveness of a culturally competent approach, which fosters an environment that helps minority groups succeed in treatment. Do partner abuse programs make efforts to be culturally competent? The major characteristics of an organizational transformation towards cultural competence occur when these programs do the following: (a) network with the minority community, (b) locate outside consultants with expertise in working with minority clients, (c) obtain information concerning service delivery and programming for minority clients, and (d) have at least one bilingual counselor. These four characteristics accounted for .58 of the variance in the minority-focused activities. PMID:7647049

  19. Racial/Ethnic Differences in Substance Abuse Treatment Initiation and Engagement

    PubMed Central

    Acevedo, Andrea; Garnick, Deborah W.; Lee, Margaret T.; Horgan, Constance M.; Ritter, Grant; Panas, Lee; Davis, Steve; Leeper, Tracy; Moore, Rebecca; Reynolds, Mark

    2012-01-01

    This study examined variations by race/ethnicity in initiation and engagement, two performance measures of treatment for substance use disorders, which focus on the timely receipt of services during the early stage of treatment. Administrative data from the Oklahoma Department of Mental Health and Substance Abuse Services were linked with facility-level information from the National Survey of Substance Abuse Treatment Services. We found that Black clients were less likely to initiate treatment, but we found no differences in treatment engagement by race/ethnicity. Most client and facility characteristics’ association with initiation or engagement did not differ across racial/ethnic groups. Increased attention is needed to understand what may contribute to the differences found and how to address them. This study also offers an approach that state agencies may implement for monitoring treatment quality and examining racial/ethnic disparities in substance abuse treatment services. PMID:22381120

  20. Let’s talk about sex: helping substance abuse counsellors address HIV prevention with men who have sex with men

    PubMed Central

    Spector, Anya Y.; Pinto, Rogério M.

    2012-01-01

    Integrating HIV prevention into substance abuse counselling is recommended to ameliorate the health outcomes of men who have sex with men. However, culture-based countertransferences (CBCs) may hamper this effort. Using a case illustration, this paper will explain the manifestation of CBCs held among substance abuse counsellors and how they hinder counsellors’ work with men who have sex with men. The following CBCs will be explored: distancing, topic avoidance, heteronormativity, assumptions and denying client strengths. These CBCs allow counsellors to avoid discussions about sexual practices and curtail HIV prevention counselling, while undermining the counsellor-client relationship. Based on the empirical literature on HIV and substance abuse prevention with men who have sex with men, we provide recommendations to help counsellors overcome CBCs and integrate HIV prevention consistently with men who are in treatment for substance abuse. PMID:21308577

  1. Sexual abuse in children - what to know

    MedlinePlus

    Sexual abuse - children ... are sexually abused before they turn 18. Sexual abuse of children is any activity that the abuser ... or vagina Tongue kissing Oral sex Intercourse Sexual abuse can also happen without physical contact, such as: ...

  2. Antitussives and substance abuse

    PubMed Central

    Burns, Jarrett M; Boyer, Edward W

    2013-01-01

    Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. PMID:24648790

  3. Defining Child Abuse.

    ERIC Educational Resources Information Center

    Giovannoni, Jeanne M.; Becerra, Rosina M.

    In seeking to clarify the meaning of the terms "child abuse" and "child neglect" it has been assumed that, like other forms of social deviance, they are socially defined phenomena. Interviews were conducted with those professionals (lawyers, pediatricians, police officers, and social workers) who daily handle the problems of abuse and neglect for…

  4. Substance Abuse and Disability.

    ERIC Educational Resources Information Center

    Sales, Amos

    A review of the literature provides the conclusion that individuals with a disability versus those without a disability are more likely to have a substance abuse problem and less likely to get effective treatment. Data suggest 10-40% of all individuals in treatment for substance abuse have a coexisting physical or mental disability. Alcohol rates…

  5. Antitussives and substance abuse.

    PubMed

    Burns, Jarrett M; Boyer, Edward W

    2013-01-01

    Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. PMID:24648790

  6. Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Thorne, Craig R.; DeBlassie, Richard R.

    1985-01-01

    Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)

  7. Telematics-based online client-server/client collaborative environment for radiotherapy planning simulations.

    PubMed

    Kum, Oyeon

    2007-11-01

    Customized cancer radiation treatment planning for each patient is very useful for both a patient and a doctor because it provides the ability to deliver higher doses to a more accurately defined tumor and at the same time lower doses to organs at risk and normal tissues. This can be realized by building an accurate planning simulation system to provide better treatment strategies based on each patient's tomographic data such as CT, MRI, PET, or SPECT. In this study, we develop a real-time online client-server/client collaborative environment between the client (health care professionals or hospitals) and the server/client under a secure network using telematics (the integrated use of telecommunications and medical informatics). The implementation is based on a point-to-point communication scheme between client and server/client following the WYSIWIS (what you see is what I see) paradigm. After uploading the patient tomographic data, the client is able to collaborate with the server/client for treatment planning. Consequently, the level of health care services can be improved, specifically for small radiotherapy clinics in rural/remote-country areas that do not possess much experience or equipment such as a treatment planning simulator. The telematics service of the system can also be used to provide continued medical education in radiotherapy. Moreover, the system is easy to use. A client can use the system if s/he is familiar with the Windows(TM) operating system because it is designed and built based on a user-friendly concept. This system does not require the client to continue hardware and software maintenance and updates. These are performed automatically by the server.

  8. Gender Abuse and Major Depression Among Transgender Women: A Prospective Study of Vulnerability and Resilience

    PubMed Central

    Bockting, Walter; Rosenblum, Andrew; Hwahng, Sel; Mason, Mona; Macri, Monica; Becker, Jeffrey

    2014-01-01

    Objectives. We examined the social and interpersonal context of gender abuse and its effects on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depression among transgender women. Methods. We conducted a 3-year prospective study (2004–2007) among 230 transgender women aged 19 to 59 years from the New York City Metropolitan Area. Statistical techniques included generalized estimating equations (logistic regression). Results. We observed significant associations of psychological and physical gender abuse with major depression during follow-up. New or persistent experiences of both types of abuse were associated with 4- to 7-fold increases in the likelihood of incident major depression. Employment, transgender presentation, sex work, and hormone therapy correlated across time with psychological abuse; the latter 2 variables correlated with physical abuse. The association of psychological abuse with depression was stronger among younger than among older transgender women. Conclusions. Psychological and physical gender abuse is endemic in this population and may result from occupational success and attempts to affirm gender identity. Both types of abuse have serious mental health consequences in the form of major depression. Older transgender women have apparently developed some degree of resilience to psychological gender abuse. PMID:24328655

  9. Take a Multidisciplinary, Team-based Approach on Elder Abuse.

    PubMed

    2016-07-01

    While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem. Providing great care to a victim of elder abuse requires time and setting up a circumstance whereby one can actually communicate with the patient reliably and alone. While most states require providers to report suspected cases of elder abuse to Adult Protective Services, there is little evidence this requirement has incentivized more reports in the same way a similar requirement has prompted providers to report cases of suspected child abuse. Investigators advise ED leaders to train and empower every member of their team to identify potential signs of elder abuse. PMID:27439225

  10. Ethnic identity, spirituality, and self-efficacy influences on treatment outcomes among Hispanic American methadone maintenance clients.

    PubMed

    Wong, Eunice C; Longshore, Douglas

    2008-01-01

    There is increasing concern over whether standard health care services, such as substance abuse treatment, adequately account for important cultural influences, yet studies focusing on the impact of cultural influences on substance abuse treatment continue to be limited. The current study prospectively examined the effects of two cultural factors (ethnic identity and spirituality) on substance abuse treatment outcomes among Hispanic American clients (N=114) enrolled in methadone maintenance treatment. In addition, this study examined whether a commonly studied treatment factor (i.e., self-efficacy) significantly influenced treatment outcomes. Higher levels of self-efficacy at intake were related to increased odds of reported heroin abstinence and a lower number of drugs used at 1-year follow-up. Greater levels of ethnic identity were related to a greater number of drugs used at follow-up. No significant effects were found for spirituality.

  11. Midwifery care: reflections of midwifery clients.

    PubMed

    Doherty, Mary Ellen

    2010-01-01

    The purpose of this study was to describe the lived experience of midwifery clients throughout the life span. A qualitative study using a phenomenological approach was employed. In-depth interviews were conducted with a purposive sample of 12 midwifery clients. The research question was: What has been your experience with midwifery care? Interviews were audio-recorded and transcribed verbatim. Data saturation was achieved and analysis procedures from Colaizzi were used. Five themes emerged from the data: 1) decision to seek midwifery care; 2) working together in a therapeutic alliance; 3) formulating a birth plan; 4) childbirth education; and 5) nurse-midwives as primary health-care providers throughout the life span. There is much to learn from listening to the voices of midwifery clients.

  12. Midwifery Care: Reflections of Midwifery Clients

    PubMed Central

    Doherty, Mary Ellen

    2010-01-01

    The purpose of this study was to describe the lived experience of midwifery clients throughout the life span. A qualitative study using a phenomenological approach was employed. In-depth interviews were conducted with a purposive sample of 12 midwifery clients. The research question was: What has been your experience with midwifery care? Interviews were audio-recorded and transcribed verbatim. Data saturation was achieved and analysis procedures from Colaizzi were used. Five themes emerged from the data: 1) decision to seek midwifery care; 2) working together in a therapeutic alliance; 3) formulating a birth plan; 4) childbirth education; and 5) nurse-midwives as primary health-care providers throughout the life span. There is much to learn from listening to the voices of midwifery clients. PMID:21085519

  13. Gendered policies and practices that increase older men's risk of elder mistreatment.

    PubMed

    Thompson, Edward H; Buxton, William; Gough, P Casey; Wahle, Cara

    2007-01-01

    We aim to detail some of the ways that social policy and gendered practices put older men at risk of elder mistreatment. Research on the abuse and neglect that older adults experience has often focused on the characteristics of the victims and the dynamics within families, emphasizing factors such as the likelihood of an intergenerational cycle of violence, substance abuse and dependency, and older men's financial status as key risks in elder abuse. The effect on men from this type of analysis is that elder mistreatment remains an individual or family problem rather than being viewed as a larger societal concern. This article challenges the individualistic focus by outlining the importance of societal forces affecting older men's risk of mistreatment. PMID:18077274

  14. Preliminary Investigation of the Abuse of Girls in Zimbabwean Junior Secondary Schools. Education Research Paper. Knowledge & Research.

    ERIC Educational Resources Information Center

    Leach, Fiona; Machakanja, Pamela

    This study found that the abuse of girls in the coeducational schools where the research took place was widespread and took the form of aggressive sexual behavior, intimidation and physical assault by older boys, sexual advances by male teachers, and corporal punishment and verbal abuse by both female and male teachers (on boys as well as girls).…

  15. 76 FR 24901 - Request for Input To Inform a Possible Surgeon General Action on Prescription Drug Abuse in Youth

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ... stubbornly steady among persons 12 or older during recent years. Most abusers are between the ages of 18 and 25, but younger age groups are also a major concern. \\1\\ Prescription drug abuse is defined here as... media messages for a wide range of stakeholders; and possible roles for health care...

  16. Cultural considerations and the Hispanic cardiac client.

    PubMed

    Knoerl, Ann Marie

    2007-02-01

    This article examines the cultural influences of the Hispanic patient, such as health beliefs, communication styles, family and religious values, and time perception. In order to design and deliver individualized comprehensive care with the client and family, these assessment factors must be explored to create a plan of care that is tailored to meet the individualized needs of the patient and family. Understanding cultural influences that are important to the Hispanic cardiac client in the home care setting will have a positive impact on the nurse-patient relationship, the plan of care, and the management of the cardiac disease.

  17. Treatment effectiveness for legally coerced versus voluntary methadone maintenance clients.

    PubMed

    Brecht, M L; Anglin, M D; Wang, J C

    1993-01-01

    Analyses examined whether addicts reporting themselves coerced into drug abuse treatment by actions of the criminal justice system differed from voluntary admissions in their response to treatment, and whether such responsiveness varied across gender or ethnicity. Six hundred eighteen methadone maintenance clients admitted to programs in six southern California counties were categorized into high, moderate, and low legal coercion levels. Multivariate analysis of variance procedures for repeated measures (before, during, and after initial treatment episode) were used to test relevant hypotheses. Dependent variables included criminal justice system contact, criminal activities, drug and alcohol involvement, and measures of social functioning. Few differences within any measured domain were found among the three groups. All groups were similar in showing substantial improvement in levels of narcotics use, criminal activities, and most other behaviors during treatment with some regression in these behaviors posttreatment. Results support legal coercion as a valid motivation for treatment entry; those coerced into treatment respond in ways similar to voluntary admissions regardless of gender or ethnicity. PMID:8438834

  18. Physical abuse in pregnancy.

    PubMed Central

    Stewart, D E; Cecutti, A

    1993-01-01

    OBJECTIVES: To determine the prevalence of physical abuse during late pregnancy and to investigate how abused and nonabused pregnant women differ in demographic characteristics, health habits, psychologic distress and attitudes about fetal health. DESIGN: Survey of women attending for prenatal health care or admitted to hospital for delivery. The information was obtained on one occasion from self-report questionnaires, completed with the option of anonymity. SETTINGS: Community-based prenatal clinic, private obstetricians' offices in a large city, private family physicians' offices in a large city, family physicians' offices in a small town, and a university teaching hospital. PATIENTS: English-speaking women at 20 weeks' or more gestation attending or admitted consecutively. INTERVENTIONS: Three self-report questionnaires: the General Health Questionnaire (GHQ), the Fetal Health Locus of Control (FHLC) and the study questionnaire. RESULTS: Thirteen women (2.4%) refused to participate in the survey. Of the 548 women who completed the questionnaires 36 (6.6%) reported physical abuse during the current pregnancy and 60 (10.9%) before it. There were no significant differences in rates of abuse between settings. Of the women abused during the pregnancy 23 (63.9%) reported increased abuse during the pregnancy, and 28 (77.8%) remained with the abuser. Twenty-four pregnant women (66.7%) received medical treatment for abuse, but only 1 (2.8%) told her prenatal care provider of the abuse. Factor analysis revealed three factors associated with physical abuse in pregnancy: "social instability" (comprising low age, unmarried status, lower level of education, unemployment and unplanned pregnancy), "unhealthy lifestyle" (comprising poor diet, alcohol use, illicit drug use and emotional problems) and "physical health problems" (comprising health problems and prescription drug use). The GHQ scores showed that the abused women were significantly more emotionally distressed than the

  19. Older Adults and Substance-Related Disorders: Trends and Associated Costs

    PubMed Central

    Heberlein, Emily; Engel, Rafael J.

    2013-01-01

    Purpose. The aim of this study is to examine the changing service profile of older adults receiving substance abuse services over the past decade and the increased costs of treating this population. Design and Methods. Medicaid claims for mental health and substance abuse services data from a medium sized county in an eastern state were analyzed for individuals aged 50 years and older in calendar year 2000 or 2009. Univariate statistics are presented to describe the substance abuse and mental health services used by older adults in these two years. Results. The number of low-income older adults who accessed services for treatment and who had a substance-related diagnosis grew from 545 individuals in 2000 to 1,653 individuals in 2009. Costs for services utilized by older adults with a substance-related diagnosis rose by 358% from $2.1 million in 2000 to $9.5 million in 2009. Implications. The increase in the number of low-income older adults with a substance-related disorder and the concomitant rise in total spending for Medicaid reimbursed services indicate that local and state social service providers need to prepare for an older adult population who will need appropriate substance abuse prevention and treatment programs. PMID:25938120

  20. Older adults and substance-related disorders: trends and associated costs.

    PubMed

    Rosen, Daniel; Heberlein, Emily; Engel, Rafael J

    2013-01-01

    Purpose. The aim of this study is to examine the changing service profile of older adults receiving substance abuse services over the past decade and the increased costs of treating this population. Design and Methods. Medicaid claims for mental health and substance abuse services data from a medium sized county in an eastern state were analyzed for individuals aged 50 years and older in calendar year 2000 or 2009. Univariate statistics are presented to describe the substance abuse and mental health services used by older adults in these two years. Results. The number of low-income older adults who accessed services for treatment and who had a substance-related diagnosis grew from 545 individuals in 2000 to 1,653 individuals in 2009. Costs for services utilized by older adults with a substance-related diagnosis rose by 358% from $2.1 million in 2000 to $9.5 million in 2009. Implications. The increase in the number of low-income older adults with a substance-related disorder and the concomitant rise in total spending for Medicaid reimbursed services indicate that local and state social service providers need to prepare for an older adult population who will need appropriate substance abuse prevention and treatment programs.

  1. Client engagement in psychotherapeutic treatment and associations with client characteristics, therapist characteristics, and treatment factors.

    PubMed

    Holdsworth, Emma; Bowen, Erica; Brown, Sarah; Howat, Douglas

    2014-07-01

    Client engagement has been associated with positive psychotherapeutic outcomes, yet it is relatively under-theorized. The aims of this review were to establish how client engagement with psychotherapeutic interventions targeting psychological or behavioral change has been operationally defined and assessed, and the associated client characteristics, therapist characteristic, and treatment factors. Seventy-nine studies were selected for review, revealing inconsistent definitions and assessments of engagement and a broad array of client characteristics and treatment factors investigated. Attendance was frequently used as a proxy for engagement, but may not be reliable. Participation or involvement in conjunction with homework compliance which reflects clients' efforts within and between sessions may more reliably reflect engagement. The findings of associations between client characteristics and engagement variables were equivocal, although clients' capacities to address their problems tended to be positively associated with engagement. Nearly all therapist characteristics, particularly therapists' interpersonal skills, and most treatment factors, particularly strengths-based approaches and the therapeutic relationship, were positively associated with engagement. A theory of engagement that characterizes the function and inter-relations of variables across different psychotherapeutic settings is needed. PMID:25000204

  2. Aspects of abuse: abusive head trauma.

    PubMed

    Hinds, Tanya; Shalaby-Rana, Eglal; Jackson, Allison M; Khademian, Zarir

    2015-03-01

    Abusive Head Trauma (AHT) is a form of child physical abuse that involves inflicted injury to the brain and its associated structures. Abusive Head Trauma, colloquially called Shaken Baby Syndrome, is the most common cause of serious or fatal brain injuries in children aged 2 years and younger. The American Academy of Pediatrics recommends the term Abusive Head Trauma, as opposed to Shaken Baby Syndrome, as the former term encompasses multiple forms of inflicted head injury (inertial, contact, and hypoxic-ischemic) and a range of clinical presentations and radiologic findings and their sequelae. Children diagnosed with AHT are 5 times more likely to die compared with accidentally head-injured children, yet signs and symptoms are not always obvious, and therefore the diagnosis can be overlooked. Therefore, the American Academy of Pediatrics has tasked pediatricians with knowing how and when to begin an evaluation of children with signs and symptoms that could possibly be due to AHT. Overall, a detailed history of present illness and medical history, recognition of physical and radiological findings, and careful interpretation of retinal pathology are important aspects of formulating the differential diagnoses and increasing or decreasing the index of suspicion for AHT.

  3. Understanding emotional abuse.

    PubMed

    Rees, C A

    2010-01-01

    Emotional abuse lacks the public and political profile of physical and sexual abuse, despite being at their core and frequently their most damaging dimension. Difficulties in recognition, definition and legal proof put children at risk of remaining in damaging circumstances. Assessment of the emotional environment is necessary when interpreting possible physical or sexual abuse and balancing the risks and benefits of intervention. This article considers factors contributing to professional difficulty. It is suggested that understanding emotional abuse from the first principles of the causes and implications of the dysfunctional parent-child relationships it represents can help prevention, recognition and timely intervention. It may facilitate the professional communication needed to build up a picture of emotional abuse and of the emotional context of physical and sexual abuse. Doing so may contribute to the safety of child protection practice. The long-term cost of emotional abuse for individuals and society should be a powerful incentive for ensuring that development of services and clinical research are priorities, and that the false economy of short-term saving is avoided.

  4. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  5. When Caregivers Sexually Abuse Children.

    ERIC Educational Resources Information Center

    Tully, Fred

    1998-01-01

    A veteran child therapist reflects on the distressing problem of adults who sexually violate children and youth in their care. Discusses changes in society that may be the cause of increased child sexual abuse. Offers three "truths" concerning child sexual abuse. Presents the account of an abuser and discusses what happens when an abuser is…

  6. Encountering Child Abuse at Camp.

    ERIC Educational Resources Information Center

    Durall, John K.

    1997-01-01

    Defines child abuse, including the three categories: physical, sexual, and psychological. Presents characteristics and behaviors of each type of abuse, and long-term effects. Discusses how to handle abuse that occurs at camp, and the effects on the camp. Sidebars present abuse statistics, 15 activities that promote psychological wellness, and 8…

  7. Workplace abuse: finding solutions.

    PubMed

    Christmas, Kate

    2007-01-01

    The atmosphere within the work setting speaks volumes about your culture, and is often a primary factor in recruitment and retention (or turnover) of staff. Workplace tension and abuse are significant contributing factors as to why nurses are exiting workplaces--and even leaving the profession. Abuse can take many forms from inappropriate interpersonal communication to sexual harassment and even violence. Administrators should adopt a zero tolerance policy towards abusive communication. Addressing peer behavior is essential, but positive behavior must also be authentically modeled from the CNO and other nursing leaders. Raising awareness and holding individuals accountable for their behavior can lead to a safer and more harmonious work environment.

  8. Prediagnostic Commentary in Veterinarian-Client Interaction.

    ERIC Educational Resources Information Center

    Stivers, Tanya

    1998-01-01

    A study investigated the form of diagnostic talk occurring between veterinarian and client before or during the physical examination and before the clinical diagnosis. Data are from six cases from a corpus of veterinary consultations. Analysis focuses on use of qualifiers, hedges, and evidential mitigators in communicating both good news and bad…

  9. Three-Dimensional Audio Client Library

    NASA Technical Reports Server (NTRS)

    Rizzi, Stephen A.

    2005-01-01

    The Three-Dimensional Audio Client Library (3DAudio library) is a group of software routines written to facilitate development of both stand-alone (audio only) and immersive virtual-reality application programs that utilize three-dimensional audio displays. The library is intended to enable the development of three-dimensional audio client application programs by use of a code base common to multiple audio server computers. The 3DAudio library calls vendor-specific audio client libraries and currently supports the AuSIM Gold-Server and Lake Huron audio servers. 3DAudio library routines contain common functions for (1) initiation and termination of a client/audio server session, (2) configuration-file input, (3) positioning functions, (4) coordinate transformations, (5) audio transport functions, (6) rendering functions, (7) debugging functions, and (8) event-list-sequencing functions. The 3DAudio software is written in the C++ programming language and currently operates under the Linux, IRIX, and Windows operating systems.

  10. Brain Damage in Deaf Vocational Rehabilitation Clients.

    ERIC Educational Resources Information Center

    Getz, Marc; Vernon, McCay

    1986-01-01

    Screening of 54 deaf vocational clients by the Bender-Gestalt and other tests indicated the likely presence of significantly more brain damage than among the hearing population with a particularly high correlation between low IQ and brain damage in the deaf population. (DB)

  11. Attracting Clients to Service-Oriented Programs.

    ERIC Educational Resources Information Center

    Disney, Diane M.

    One of a series of manuals developed by the Home and Community-Based Career Education Project, the outreach component publication describes how the project went about attracting clients for its adult vocational counseling services. Sections include: creating a publicity campaign, using an advertising agency, creating products for the mass media,…

  12. A "client perspective" helps improve services.

    PubMed

    1998-01-01

    Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed. PMID:12321856

  13. Client-Centered Employee Assistance Services.

    ERIC Educational Resources Information Center

    Bayer, Darryl Lee

    This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

  14. Spiritual care and chronically ill clients.

    PubMed

    Sterling-Fisher, C E

    1998-04-01

    Today's high-technology, fast-paced healthcare system has left many providers and consumers feeling a void in the care provided. Home care nurses play pivotal roles in the delivery of spiritual care for chronically ill clients, who are usually confined to their homes. This article provides the nurse with interventions and techniques to integrate spiritual care into daily practice. PMID:9592425

  15. Individualized Client Planning for Work Adjustment Services.

    ERIC Educational Resources Information Center

    Esser, Thomas J.

    To assist work adjustors, evaluators, and counselors in learning how to write individualized work adjustment plans, this publication describes one method of developing individual client plans--the Materials Development Center Individualized Work Adjustment Plan. The detailed description of this plan explains the two basic parts of its format: (1)…

  16. Counselor-Client Similarity and Referral Bias

    ERIC Educational Resources Information Center

    Kunce, Joseph; Anderson, Wayne

    1970-01-01

    Based on ratings by classmates, counselors were dicotomized according to probability of being referred agitated or constrained clients. Counselors to whom the former were referred had higher MMPI scores on D and Pt scales and lower scores on Es scales. (Author)

  17. Borderline Clients: Practice Implications of Recent Research.

    ERIC Educational Resources Information Center

    Johnson, Harriette C.

    1991-01-01

    Reviews current research on treatment of borderline clients with medication, individual counseling, and family interventions. Notes that recent studies indicate that borderline personality is heterogeneous condition in which different underlying disorders (affective, schizotypal, and neurological) may be present. Reviews effectiveness of various…

  18. Client Confidentiality in Police Social Work Settings.

    ERIC Educational Resources Information Center

    Curtis, Patrick Almond; Lutkus, Anita M.

    1985-01-01

    Results of a survey that questioned police social workers regarding the protection of client confidentiality in police settings revealed several problems related to the unique character of the setting and to the identification of social workers with the goals and practices of police. Results raise questions about the protection of client…

  19. Accommodating blind and partially sighted clients

    PubMed Central

    England, Gary; Gebbels, Tim; Whelan, Chantelle; Freeman, Sarah

    2014-01-01

    Veterinary surgeons provide an important service to blind and partially sighted guide dog owners. By adopting basic disability awareness and visual impairment training, practices can ensure that the assistance needs of those clients are met, facilitating access to veterinary care. PMID:25642013

  20. Helping Clients Uncover Metaphoric Understandings of Bulimia.

    ERIC Educational Resources Information Center

    Cummings, Anne L.

    1998-01-01

    Written responses of three women with bulimia were analyzed for instances of metaphoric understanding of their difficulties with food during 20 to 24 therapy sessions. Results show a gradual deepening of the metaphoric understanding of what the troubled eating represented for each client. Metaphoric understanding included ways of dealing with self…

  1. Client/Server Architecture Promises Radical Changes.

    ERIC Educational Resources Information Center

    Freeman, Grey; York, Jerry

    1991-01-01

    This article discusses the emergence of the client/server paradigm for the delivery of computer applications, its emergence in response to the proliferation of microcomputers and local area networks, the applicability of the model in academic institutions, and its implications for college campus information technology organizations. (Author/DB)

  2. Child abuse - physical

    MedlinePlus

    ... to a child of any race, religion, or economic status. HELP AN ABUSED CHILD Learn about the ... as cigarette burns Choke marks around the neck Circular marks around the wrists or ankles from twisting ...

  3. Alcoholism and Alcohol Abuse

    MedlinePlus

    ... This means that their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or ... brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the risk of ...

  4. Substance Abuse/Use

    MedlinePlus

    ... Video Games Video Sharing Sites Webcasts/ Webinars Widgets Wikis Follow Us on New Media Virtual Office Hours ... users when they are included as part of medical and substance abuse treatment and prevention services. Syringe ...

  5. Sexual Abuse of Children.

    ERIC Educational Resources Information Center

    Csapo, Marg

    1988-01-01

    Canadian reports and legislation are reviewed to highlight the school's role in prevention and reporting of suspicions of child sexual abuse. The vulnerability of handicapped children and child pornography are two areas of victimization emphasized. (Author/DB)

  6. The Association Between Client Characteristics and Recovery in California’s Comprehensive Community Mental Health Programs

    PubMed Central

    Bruckner, Tim A.; Brown, Timothy T.

    2013-01-01

    Objectives. In November 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs. We examined whether these county-level programs, known as “full service partnerships,” promoted independent living arrangements (i.e., recovery) among their clients. Methods. We used Markov chain models to identify probabilities of residential transitions among 8 living arrangements (n = 9208 adults followed up to 4 years). We modeled these transitions on the basis of patterns of program participation and clinical and sociodemographic characteristics. Results. Interrupted program participation and substance abuse were significantly associated with a reduced likelihood of independent living and a greater probability of homelessness and incarceration. Persons with schizophrenia were the least likely to live independently, followed by persons with bipolar disorder. Compared with Whites, non-Whites were more frequently found to be homeless or in jail. Conclusions. Clients with sustained enrollment in California’s comprehensive community mental health programs appear most likely to transition to independent living. The likelihood of this transition, however, shows a disparity in that ethnic minority clients appear least likely to transition to independent living. PMID:23865662

  7. Vaccines for Drug Abuse

    PubMed Central

    Shen, Xiaoyun; Orson, Frank M.; Kosten, Thomas R.

    2012-01-01

    Current medications for drug abuse have had only limited success. Anti-addiction vaccines to elicit antibodies that block the pharmacological effects of drugs have great potential for treating drug abuse. We review the status for two vaccines that are undergoing clinical trials (cocaine and nicotine) and two that are still in pre-clinical development (methamphetamine and heroin). We also outline the challenges and ethical concerns for anti-addiction vaccine development and their use as future therapeutics. PMID:22130115

  8. Synthetic cathinone abuse

    PubMed Central

    Capriola, Michael

    2013-01-01

    The abuse of synthetic cathinones, widely known as bath salts, has been increasing since the mid-2000s. These substances are derivatives of the naturally occurring compound cathinone, which is the primary psychoactive component of khat. The toxicity of synthetic cathinones includes significant sympathomimetic effects, as well as psychosis, agitation, aggression, and sometimes violent and bizarre behavior. Mephedrone and methylenedioxypyrovalerone are currently the predominantly abused synthetic cathinones. PMID:23869180

  9. Predictors of Treatment Outcomes for Substance-Abusing Women: A Retrospective Study.

    PubMed

    Comfort, Marilee; Kaltenbach, Karol A.

    2000-03-01

    This study examined whether client characteristics at admission predict Retention, Abstinence, and utilization of Required Services and Specialized Services for pregnant women in outpatient and residential substance abuse treatment. Retrospective data were collected with the Psychosocial History (PSH), a structured clinical interview that is an expansion of the Addiction Severity Index, designed specifically to assess substance abusing women. The PSH was administered at intake for 183 pregnant women admitted to outpatient (n = 133) or residential (n = 50) treatment. Factor analysis reduced predictors to five factors with composite scores, and multiple regression procedures determined client characteristics that predict treatment outcomes. The findings suggest the complexity of predicting treatment outcomes for pregnant women. Significant predictors were composites of variables that encompassed all aspects of women's personal and family lives including medical and psychiatric needs, family and parenting issues, housing, victimization, and clients' perceived needs for treatment and assistance in all of these areas. The results suggest the need for a holistic approach to substance abuse treatment and continued exploration of a broad range of psychosocial assessments at intake in order to develop substance abuse treatment programs that effectively address multiple aspects of women's lives. PMID:12466646

  10. Asymmetry of Responsiveness in Client-Centered Therapy

    ERIC Educational Resources Information Center

    Shapiro, David A.

    1977-01-01

    Each utterance of a psychotherapy session conducted by Carl Rogers was transcribed on a separate card. Fifteen undergraduate subjects reconstituted client-therapist sequences more accurately than therapist-client sequences. (Author)

  11. Restating a Client-Centered Approach to Career Counseling.

    ERIC Educational Resources Information Center

    Miller, Mark J.

    1988-01-01

    Asserts career counseling too often is associated with objective test scores and rational decision making. Reiterates the importance of considering the client's developing self-concept in career counseling. Provides sample client centered career counseling session. (Author/ABL)

  12. 19 CFR 111.39 - Advice to client.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of that noncompliance, error, or omission. (c) Illegal plans. A broker must not knowingly suggest to a client or prospective client any illegal plan for evading payment of any duty, tax, or other...

  13. Severe childhood sexual abuse and nonverbal learning disability.

    PubMed

    Little, L

    1998-01-01

    This article offers a review of, and case report on, the treatment of a young adult with a history of severe childhood abuse, dissociative symptoms, and right-hemisphere dysfunction, or nonverbal learning disabilities (NLD). The core of nonverbal learning disabilities is the inability to synthesize information and create meaning from complex information. Learning is a form of adaptation and disruptions in an individual's meaning-making process. There are major implications for the person's overall adjustment. Trauma is itself complex and often damaging to the survivor's well being. Clinical assessment must take into account a person's cognitive style and possible learning deficits in order to adequately address traumatic material. Therapy must be modified in order to respond to the unique learning style of the NLD client. Finally, and important issue for therapists remains their willingness to broaden their awareness and knowledge base, and shift the treatment paradigm to meet the needs of the client with neurocognitive vulnerabilities. Treating clients with difficult trauma histories' alone, can elicit negative reactions in the therapist. Repeated experiences with a client's mistrust, anger, noncompliance or self-defeating habits are particularly stressful. The neuropsychological perspective can provide a valuable tool in the mastery of those reactions, and in building a context for empathy and a joint narrative. PMID:9742317

  14. Animal-assisted therapy with children suffering from insecure attachment due to abuse and neglect: a method to lower the risk of intergenerational transmission of abuse?

    PubMed

    Parish-Plass, Nancy

    2008-01-01

    Children suffering from insecure attachment due to severe abuse and/or neglect are often characterized by internal working models which, although perhaps adaptive within the original family situation, are inappropriate and maladaptive in other relationships and situations. Such children have a higher probability than the general population of becoming abusing or neglecting parents. Besides the usual goals of psychotherapy, an overall goal is to stop the cycle of abuse in which abused children may grow up to be abusing parents. Therapy with these children is complicated by their distrust in adults as well as difficulties in symbolization due to trauma during the preverbal stage. Animal-Assisted Therapy (AAT) provides avenues for circumventing these difficulties, as well as providing additional tools for reaching the inner world of the client. This article gives a brief background of the connection between insecure attachment and intergenerational transmission of abuse and neglect as well as a brief overview of the principles of AAT in a play therapy setting. A rationale for the use of AAT as a unique therapy technique for children having suffered from abuse and neglect is followed by a number of clinical examples illustrating AAT. PMID:18411863

  15. Animal-assisted therapy with children suffering from insecure attachment due to abuse and neglect: a method to lower the risk of intergenerational transmission of abuse?

    PubMed

    Parish-Plass, Nancy

    2008-01-01

    Children suffering from insecure attachment due to severe abuse and/or neglect are often characterized by internal working models which, although perhaps adaptive within the original family situation, are inappropriate and maladaptive in other relationships and situations. Such children have a higher probability than the general population of becoming abusing or neglecting parents. Besides the usual goals of psychotherapy, an overall goal is to stop the cycle of abuse in which abused children may grow up to be abusing parents. Therapy with these children is complicated by their distrust in adults as well as difficulties in symbolization due to trauma during the preverbal stage. Animal-Assisted Therapy (AAT) provides avenues for circumventing these difficulties, as well as providing additional tools for reaching the inner world of the client. This article gives a brief background of the connection between insecure attachment and intergenerational transmission of abuse and neglect as well as a brief overview of the principles of AAT in a play therapy setting. A rationale for the use of AAT as a unique therapy technique for children having suffered from abuse and neglect is followed by a number of clinical examples illustrating AAT.

  16. State Regulations and the ACA Code of Ethics and Standards of Practice: Oil and Water for the Substance Abuse Counselor.

    ERIC Educational Resources Information Center

    West, Paul L.; Mustaine, Beverly L.; Wyrick, Barry

    1999-01-01

    Reviews state regulations responsible for determining the minimum qualifications for counselors, clinical supervisors, or client assessors in the substance abuse treatment field. Few of the 34 states surveyed required treatment outcome studies or referenced licensed professional counselors. Discusses implications new counselors may face when their…

  17. Ethical Issues in the Deinstitutionalization of Clients with Mental Disorders.

    ERIC Educational Resources Information Center

    Polcin, Douglas L.

    1990-01-01

    Claims that mental health counseling has not paid sufficient attention to the deinstitutionalization of clients in psychiatric hospitals or to their treatment in community programs. Describes the relevance of several key ethical principles in treating these clients in the community. Discusses conflicting interests of clients, politicians, funding…

  18. 37 CFR 10.84 - Representing a client zealously.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... into with a client for professional services, but a practitioner may withdraw as permitted under §§ 10... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client... Office Code of Professional Responsibility § 10.84 Representing a client zealously. (a) A...

  19. 37 CFR 10.33 - Direct contact with prospective clients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... prospective clients. 10.33 Section 10.33 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... clients. A practitioner may not solicit professional employment from a prospective client with whom the... not specifically known to need legal services of the kind provided by the practitioner in a...

  20. 32 CFR 776.33 - Client under a disability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Client under a disability. 776.33 Section 776.33... of Professional Conduct § 776.33 Client under a disability. (a) Client under a disability: (1) When a... impaired, whether because of minority, mental disability, or for some other reason, the covered...

  1. Accommodating Extension Clients Who Face Language, Vision, or Hearing Challenges

    ERIC Educational Resources Information Center

    Angima, Sam; Etuk, Lena; Maddy, Deborah

    2016-01-01

    A survey-based study explored approaches used by one land-grant university to meet the needs of Extension clients who face language, vision, or hearing challenges. In attempts to serve such clients, the greatest gaps existed for clients whose main language was Spanish, followed by those who had vision impairments and then those who had hearing…

  2. Attitudes of Social Work Students toward Clients with Basic Needs

    ERIC Educational Resources Information Center

    Krumer-Nevo, Michal; Lev-Wiesel, Rachel

    2005-01-01

    This study examines the attitudes of 91 undergraduate social work students toward clients with basic needs in Israel. The results indicate that only about 1/3 of the students consider the treatment of clients with basic needs to be a part of the profession. In addition, a positive correlation was found between willingness to help clients with…

  3. Impact of Client Suicide on Practitioner Posttraumatic Growth

    ERIC Educational Resources Information Center

    Munson, Joseph Simon

    2009-01-01

    Our purpose was to examine posttraumatic growth in clinicians after the suicide death of a client. An experience such as a client suicide could be an opportunity for growth or a danger for the practitioner to become traumatized. Thus, the clinician who works with clients who complete suicide may either suffer or experience a positive change from…

  4. Client Anticipations and Preferences for Confidentiality of Records.

    ERIC Educational Resources Information Center

    VandeCreek, Leon; And Others

    1987-01-01

    Surveyed client preferences and anticipations about confidentiality of their client records rating the amount of information that they preferred and anticipated would be released by their psychotherapist. Most preferred less information to be released than they anticipated would be. Identified client clusters with unique anticipations and…

  5. Working with Resistant Clients in Career Counseling. ERIC Digest.

    ERIC Educational Resources Information Center

    Gysbers, Norman C.

    This Digest identifies and describes ways that clients' resistance may be exhibited during career counseling. It states that whenever clients are involved in change, client resistance should be expected. Some examples of types of resistance that may be exhibited include fear of counseling, fear of taking responsibility, making excuses, and overt…

  6. Predicting Categories of Improvement among Counseling Center Clients.

    ERIC Educational Resources Information Center

    Hummel, Thomas J.; Lichtenberg, James W.

    In looking at whether clients will improve with counseling, counselors must first determine what kinds of outcomes are likely with certain clients. In order to make probabilistic statements about individual client outcomes, rather than about the more generalized outcome of counseling, a different approach is needed. Using data from counseling…

  7. Incorporating Perceived Importance of Service Elements into Client Satisfaction Measures

    ERIC Educational Resources Information Center

    Hsieh, Chang-Ming

    2012-01-01

    Objective: The purpose of this study was to assess the need for incorporating perceived importance of service elements into client satisfaction measures. Method: A secondary analysis of client satisfaction data from 112 clients of an elderly case management setting was conducted. Results: This study found that the relationship between global…

  8. Counselor Interventions Preceding Client Laughter in Brief Therapy.

    ERIC Educational Resources Information Center

    Falk, Dana R.; Hill, Clara E.

    1992-01-01

    Examined whether 6 categories of counselor humor and 4 categories of risk interventions preceded client laughter in 236 events from 8 cases of brief psychotherapy. Found most client laughter was mild and moderate, with only eight instances of strong laughter. Humorous interventions led to more client laughter than did interventions that encouraged…

  9. 31 CFR 10.21 - Knowledge of client's omission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Knowledge of client's omission. 10.21 Section 10.21 Money and Finance: Treasury Office of the Secretary of the Treasury PRACTICE BEFORE THE... § 10.21 Knowledge of client's omission. A practitioner who, having been retained by a client...

  10. Successful Vocational Rehabilitation of Clients with Retinitis Pigmentosa.

    ERIC Educational Resources Information Center

    Taheri-Araghi, M.; Hendren, G.

    1994-01-01

    Statistical analysis of 10 personal (client) variables and four program variables related to 76 people who became blind from retinitis pigmentosa revealed that 6 variables predicted clients' rehabilitation outcomes: age, gender, race, work status, amount of case-service money spent on the client's behalf, and number of changes in career objectives…

  11. Corruption of Client Advocacy in a Community Mental Health System.

    ERIC Educational Resources Information Center

    Denner, Bruce

    This speech discusses client advocacy, a paraprofessional service offered in many community mental health centers to help bridge the gap between therapist and client. While having an advocate on the mental health team is an attractive idea, these client advocates are quite susceptible to "corruption." The author discusses two major causes of this…

  12. A Program Evaluation Using Client Records and Census Data.

    ERIC Educational Resources Information Center

    Bachrach, Kenneth M.; Zautra, Alex

    Use of client records and census data as a research methodology can provide mental health planners with information on community needs as well as the adequacy of existing programs. Three ways of analyzing client records in conjunction with census data are: (1) tract by tract, comparing client geographic distribution with census characteristics;…

  13. A Network Client Using the Gopher Information Discovery Protocol

    1993-10-05

    WSGOPHER uses the protocol known as Gopher, which is described in Internet RFC 1436. Specifically Gopher is a client/server protocol. Gopher servers provide information across the network to Gopher clients. WSGOPHER is an implementation of a Gopher client for Microsoft Windows 3.1 and Windows Sockets version 1.1.

  14. Client Good Moments: An Intensive Analysis of a Single Session.

    ERIC Educational Resources Information Center

    Stalikas, Anastassios; Fitzpatrick, Marilyn

    1995-01-01

    An intensive analysis of a single counseling session conducted by Fritz Perls was carried out to examine relationships among client experiencing level, client strength of feeling, counselor interventions, and client good moments. The possibility that positive therapeutic outcome is related to the accretion of good moments is discussed. (JBJ)

  15. What Business Students Should Know about Attorney-Client Privilege

    ERIC Educational Resources Information Center

    Draba, Robert; Marshall, Brent

    2012-01-01

    The case law on attorney-client privilege is extensive and can be somewhat complex. Over seven hundred articles in Westlaw, for example, have the phrase "attorney-client privilege" in the title; in the last three years alone, there have been over 3700 federal cases in which the phrase "attorney-client privilege" appears at least once. However,…

  16. 37 CFR 11.113 - Organization as client.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Organization as client. 11... Rules of Professional Conduct Client-Practitioner Relationship § 11.113 Organization as client. (a) A... substantial injury to the organization, then the practitioner shall proceed as is reasonably necessary in...

  17. 37 CFR 11.113 - Organization as client.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Organization as client. 11... Rules of Professional Conduct Client-Practitioner Relationship § 11.113 Organization as client. (a) A... substantial injury to the organization, then the practitioner shall proceed as is reasonably necessary in...

  18. Client vs. Therapist Perceptions of Psychotherapy Dropout and Outcome.

    ERIC Educational Resources Information Center

    Nichols, Kathie; Pekarik, Gene

    Therapy dropout is a statistically significant problem. The causes and effects of the high dropout rate still are not known. In this study the therapists' and clients' opinions of the desirability of staying in treatment were compared. At treatment termination clients (N=176) and their therapists (N=22) independently identified clients'…

  19. Health Promotion through the Use of Nurse-Client Contracts.

    ERIC Educational Resources Information Center

    Van Dover, Leslie J.

    Much of the practice of community health nurses is focused on health promotion. Nurse-client contracting has been used with clients experiencing hypertension, diabetes, or arthritis. A study was conducted to determine whether nurse-client contracting would be useful as a method for providing nursing care to assist sexually active young women to…

  20. Counselor Beliefs and Perceived Knowledge Regarding Clients with Learning Disabilities

    ERIC Educational Resources Information Center

    Bell, Tamekia R.

    2012-01-01

    Clients with learning disabilities constitute a cultural group that has not been extensively studied. The professional literature has found that counselors have reported the need for additional training in working with clients with disabilities. This study explored counselors' beliefs and perceived knowledge regarding counseling clients with…

  1. Culturally Appropriate Career Counseling with Gay and Lesbian Clients

    ERIC Educational Resources Information Center

    Pope, Mark; Barret, Bob; Szymanski, Dawn M.; Chung, Y. Barry; Singaravelu, Hernia; Mclean, Ron; Sanabria, Samuel

    2004-01-01

    This article details the current knowledge regarding the provision of culturally appropriate career services to gay and lesbian clients. It is divided into 5 parts: (1) history and context for the delivery of career counseling services to gay and lesbian clients; (2) counselor self-preparation for working with gay and lesbian clients; (3)…

  2. Channel Access Client Toolbox for Matlab

    SciTech Connect

    Terebilo, Andrei

    2002-08-07

    This paper reports on MATLAB Channel Access (MCA) Toolbox--MATLAB [1] interface to EPICS Channel Access (CA) client library. We are developing the toolbox for SPEAR3 accelerator controls, but it is of general use for accelerator and experimental physics applications programming. It is packaged as a MATLAB toolbox to allow easy development of complex CA client applications entirely in MATLAB. The benefits include: the ability to calculate and display parameters that use EPICS process variables as inputs, availability of MATLAB graphics tools for user interface design, and integration with the MATLAB-based accelerator modeling software--Accelerator Toolbox [2-4]. Another purpose of this paper is to propose a feasible path to a synergy between accelerator control systems and accelerator simulation codes, the idea known as on-line accelerator model.

  3. Utilization Sobriety: brief, individualized substance abuse treatment employing ideomotor questioning.

    PubMed

    Walsh, Bart J

    2003-01-01

    This article presents a substance abuse treatment method that acknowledges and accommodates the personal needs that are being addressed by substance. This method, Utilization Sobriety, bypasses perceived resistances and employs idiosyncratic psychobiological learning to achieve a body-mind gestalt that is complementary to the client's sobriety. It develops a safe framework for addressing any subsequent mental health themes directly or indirectly related to substance misuse. A treatment protocol for the use of Utilization Sobriety as well as relevant clinical material illustrating its application and a discussion of its implications are offered. PMID:12570092

  4. Implementing a secure client/server application

    SciTech Connect

    Kissinger, B.A.

    1994-08-01

    There is an increasing rise in attacks and security breaches on computer systems. Particularly vulnerable are systems that exchange user names and passwords directly across a network without encryption. These kinds of systems include many commercial-off-the-shelf client/server applications. A secure technique for authenticating computer users and transmitting passwords through the use of a trusted {open_quotes}broker{close_quotes} and public/private keys is described in this paper.

  5. Client-side Skype forensics: an overview

    NASA Astrophysics Data System (ADS)

    Meißner, Tina; Kröger, Knut; Creutzburg, Reiner

    2013-03-01

    IT security and computer forensics are important components in the information technology. In the present study, a client-side Skype forensics is performed. It is designed to explain which kind of user data are stored on a computer and which tools allow the extraction of those data for a forensic investigation. There are described both methods - a manual analysis and an analysis with (mainly) open source tools, respectively.

  6. Health-related research on older inmates: an integrative review.

    PubMed

    Loeb, Susan J; Abudagga, Azza

    2006-12-01

    The literature on older inmates' health is fragmented and insufficiently developed. In this integrative review, 21 research articles on health and older inmates were identified, critiqued, and synthesized to determine: the minimum age criterion most commonly used; health-related variables explored; health status; the health impact of incarceration; and aging-specific policies, programs, and facilities. Age 50 and older was used most often. The top three health variables were psychiatric conditions, physical illnesses, and substance abuse. Self-reports of health status varied across studies; however, inmates consistently reported health declines since incarceration. Older inmates' health needs appear often to be left unmet. Nursing investigations are needed leading to practice innovations to enhance prisoners' self-management to reduce disease burden and fiscal and societal costs. PMID:17131280

  7. Dietary intake in clients with chronic wounds.

    PubMed

    Wojcik, Agnieszka; Atkins, Marlis; Mager, Diana R

    2011-01-01

    To assess relationships among food intake, anthropometrics, and wound severity, we studied 31 home care clients with pressure ulcers (PUs) or venous stasis ulcers (VSUs). Anthropometric variables (weight, height, waist circumference [WC]) were measured according to standard methodologies. Risk for PU development was assessed using the Braden Pressure Ulcer Risk Assessment score and wound severity according to the National Pressure Ulcer Advisory Panel. Three-day food records were analyzed to assess dietary adequacy. Adults with VSUs (65.8 ± 18.4 years) had a higher body mass index (48.1 vs. 25.9), WC (146.6 vs. 98.4 cm), and Braden score (20.2 vs. 17.5) than did those with PUs (67.8 ± 17.9 years) (p <0.05). Energy, protein, and zinc intake by diet alone did not meet estimated requirements in 41%, 32%, and 54.5% of clients, respectively. Intake by diet alone met the Estimated Average Requirement/Adequate Intake for all nutrients except fibre, vitamin D, vitamin E, vitamin K, folate, calcium, magnesium, and potassium. Nutrient supplementation resolved this for all nutrients except fibre, vitamin K, and potassium. In multivariate analysis, increasing wound severity was associated with decreased intakes of vitamin A, vitamin K, magnesium, and protein (r2=0.90, p<0.001). Optimizing nutrient intake may be an important strategy to promote wound healing and decrease wound severity in home care clients with chronic wounds.

  8. Hsp90: Friends, clients and natural foes.

    PubMed

    Verma, Sharad; Goyal, Sukriti; Jamal, Salma; Singh, Aditi; Grover, Abhinav

    2016-08-01

    Hsp90, a homodimeric ATPase, is responsible for the correct folding of a number of newly synthesized polypeptides in addition to the correct folding of denatured/misfolded client proteins. It requires several co-chaperones and other partner proteins for chaperone activity. Due to the involvement of Hsp90-dependent client proteins in a variety of oncogenic signaling pathways, Hsp90 inhibition has emerged as one of the leading strategies for anticancer chemotherapeutics. Most of Hsp90 inhibitors blocks the N terminal ATP binding pocket and prevents the conformational changes which are essential for the loading of co-chaperones and client proteins. Several other inhibitors have also been reported which disrupt chaperone cycle in ways other than binding to N terminal ATP binding pocket. The Hsp90 inhibition is associated with heat shock response, mediated by HSF-1, to overcome the loss of Hsp90 and sustain cell survival. This review is an attempt to give an over view of all the important players of chaperone cycle.

  9. Fears about treatment among young drug abusers in Hong Kong.

    PubMed

    Chung, Yida Y H; Shek, Daniel T L

    2011-01-01

    This study examined fears about drug treatment among 300 young male heroin abusers in Hong Kong (172 newcomers and 128 repeaters) recruited from non-government treatment agencies. An indigenous 35-item Fears about Treatment Scale (Fears Scale) was developed to measure fears about treatment among the participants. Results showed that four factors (fear of failure, fear of labeling or disclosure, fear of maladaptation and fear of withdrawal) were abstracted from the scale. Reliability analyses showed that subscales based on these four factors and the total scale were internally consistent. The findings showed that treatment failure was the major fear in the respondents. The present findings suggest that drug treatment and rehabilitation services should help clients, particularly young substance abusers, mitigate their treatment fears.

  10. Abuse of medications that theoretically are without abuse potential.

    PubMed

    Reeves, Roy R; Ladner, Mark E; Perry, Candace L; Burke, Randy S; Laizer, Janet T

    2015-03-01

    The potential for abuse of medications that are controlled substances is well known. Abuse of certain noncontrolled prescription drugs and over-the-counter medications also may occur. To some degree, any medication that exerts psychoactive effects may be abused if taken in high enough doses or by means that result in high serum or cerebrospinal fluid levels. Many clinicians may be unaware of the potential for abuse of these medications. This review examines evidence of the possibility of abuse of several common medications that theoretically do not have abuse potential, including cough and cold preparations, antihistamines, anticholinergics, antipsychotics, antidepressants, anticonvulsants, skeletal muscle relaxants, and antiemetics. Means by which such medications may be abused and biochemical and physiological mechanisms fostering their abuse also are discussed.

  11. Keeping older adults safe, protected, and healthy by preventing financial exploitation.

    PubMed

    Sullivan-Wilson, Janet; Jackson, Kimethria L

    2014-06-01

    As the number of older adults increases, the incidence of financial exploitation is also expected to rise. This prevalent older adult maltreatment often goes undetected and unreported and may result in poor physiologic and/or psychological health outcomes that are not perceived as abuse-related by healthcare providers. This article focuses on financial exploitation of older adults as a health care problem, as it often occurs when vulnerable older adults are receiving help and/or health care services from trusted caregivers.

  12. Client perceptions of cultural competence of community-based nurses.

    PubMed

    Starr, Sharon S; Wallace, Debra C

    2011-04-01

    Cultural competence is best understood by assessing provider and client perspectives. In this descriptive quantitative study, clients assessed dimensions of nurses' cultural competence including communication, decision-making, and interpersonal style. Nurses in 7 county health departments in North Carolina assessed their own cultural competence. Sixty-nine clients completed the Interpersonal Processes of Care and 71 nurses completed the Cultural Competence Assessment. Clients perceived their nursing care to contain key components of cultural competence. Nurses rated themselves as moderate to high cultural competence. Consistencies were noted between the clients' and nurse perceptions of cultural competence. These findings contribute to the enhancement of cultural competence among community nurses. PMID:21541868

  13. Caregiver burden, dementia, and elder abuse in South Korea.

    PubMed

    Lee, Minhong; Kolomer, Stacey R

    2005-01-01

    The purpose of this study is to identify characteristics that would increase the likelihood that a Korean older adult with dementia being cared for by a family caregiver is at risk of being abused. This analysis was based on a sample of 481 primary family caregivers from the data of Comprehensive Study for the Elderly Welfare Policy in Seoul (2003). Multiple regression analysis was used to examine predictors among the demographic characteristics of caregivers and care recipients, the severity of cognitive impairment, functional ability, caregiver burden, and social support for the degree of elder abuse. The degree of elder abuse was significantly associated with caregiver burden, mental impairment, dependency of daily living of care recipient, and use of formal services. PMID:16611617

  14. Schizophrenia in older adults.

    PubMed

    Collier, Elizabeth; Sorrell, Jeanne M

    2011-11-01

    Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.

  15. Abuse, neglect, and exploitation: considerations in aging with lifelong disabilities.

    PubMed

    Ansello, Edward F; O'Neill, Peggy

    2010-01-01

    Persons with lifelong disabilities are newcomers to later life. Many are relatively high functioning, engaged, and happy members of their communities. Some are, and have been, victims of abuse, neglect, and exploitation. This article reviews factors that contribute to the current incomplete picture of the victimization of these older adults, reports the state of existing data on prevalence and treatments, and suggests initiatives to strengthen continued community living and improve both prevention and identification strategies.

  16. Development of a Comprehensive Hospital-Based Elder Abuse Intervention: An Initial Systematic Scoping Review

    PubMed Central

    Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Elliot, Shannon; Spencer, Charmaine; Yaffe, Mark

    2015-01-01

    Introduction Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review. Objectives Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation. Methods The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1) addressed a response (e.g., an intervention) to elder abuse, 2) contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3) were available in English. Analysis The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics. Results 649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser; Assessment: physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of

  17. Older adult mental health: Teaching senior-level baccalaureate nursing students what they need to know.

    PubMed

    Puentes, William J; Bradway, Christine K; Aselage, Melissa

    2010-07-01

    Within the older adult population, certain idiosyncratic aspects of mental illness add to the challenges of helping clients manage these disorders. Older adults are more likely than younger populations to experience physiologically based comorbidities, a dynamic that further strains coping capacities. Barriers to the provision of comprehensive mental health nursing care for older adults include myths and stigmas about aging and mental health. Nurse educators are challenged to move students toward a more positive, empirically based approach to the care of older adults' mental health. In this article, background information supporting the importance of working to improve students' knowledge of and attitudes toward mental illness in older adults is provided. Specific teaching strategies in the areas of older adult mental health, dementia, and delirium are discussed. Resources to support the incorporation of these strategies into nursing curricula are described.

  18. Choice, access, information are among clients' rights.

    PubMed

    Finger, W R

    1993-08-01

    This general discussion of the importance of respecting client's rights and access to a choice of methods relies on the statements of researchers and family planners from a variety of international and private organizations which reiterate the features of successful programs. The emphasis on client's rights is a change for many programs. The example is given of a clinic in Niger that posts the list of client rights to accessibility, information, education, communication, and freedom of choice. Pressure from international groups focuses on promoting client's informed and voluntary choice of family planning (FP) method, because it assures continuation. Quality of care is directly related to continuation of care. The quality of care framework of Judith Bruce, from the Population Council, identifies the first and most fundamental element in assuring quality of service to be choice of method. The UN assures that contraceptive choice is a basic human right. The International Planned Parenthood (IPPF) Medical and Service Delivery Guidelines proposes 10 client rights; this list of rights has been widely distributed as a poster. IPPF's African director states that contraceptive prevalence is low because of a lack of quality care. Women's rights have been integrated into FP and promoted in the Safe Motherhood Initiative and in the focus of the International Decade for Women, 1975-85. The International Women's Health Coalition, which is an alliance of over 100 women's organizations from 50 countries, has released a "Women's Declaration on Population Policies" at UN headquarters, which calls for provision of reproductive health care, not just technology, for fertility management by women. Policy makers and planners are urged to provide access to wide contraceptive choices, pregnancy care, safe abortion, prevention of sexually transmitted diseases (STDs), development of new technology for protection against STDs, and encouragement of men to take responsibility for sexual

  19. Feasibility of Eight Physical Fitness Tests in 1,050 Older Adults with Intellectual Disability: Results of the Healthy Ageing with Intellectual Disabilities Study

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2013-01-01

    Although physical fitness is relevant for well-being and health, knowledge on the feasibility of instruments to measure physical fitness in older adults with intellectual disability (ID) is lacking. As part of the study Healthy Ageing with Intellectual Disabilities with 1,050 older clients with ID in three Dutch care services, the feasibility of 8…

  20. Client Education: Communicative Interaction between Physiotherapists and Clients with Subacute Low Back Pain in Private Practice

    PubMed Central

    Bassett, Raewyn; Fenety, Anne; Hoens, Alison M.

    2011-01-01

    ABSTRACT Purpose: To explore, through focus-group interviews, client education provided by physiotherapists in private practice who treat injured workers with subacute low back pain (SA-LBP). Methods: Six focus-group interviews were held in the fall of 2006 to explore treatment practices of physiotherapists for this population. Each of the 44 physiotherapists who volunteered attended one of six regional sessions. Results: Three overarching themes emerged: the critical importance of education; education: a multidimensional concept; and the physiotherapist–client relationship. In this study, we found that education provides continuity by tying together the separate tasks occurring during one treatment session. Our participants said that time is of the essence in private practice and described how they provide education seamlessly, making this type of delivery efficient. Conclusions: Education is a highly valued aspect of practice for physiotherapists. Verbal, tactile, and visual information obtained from the client as assessment and treatment progress is explored, expanded, and contextualized in conversation with the client. In a communicative, interactive process, client fears, other contextual information, and physiotherapist information about procedures and techniques, exercises, and anatomy are collaboratively interrelated. PMID:22379262

  1. Prevalence of Cardiovascular Risk Factors in Older People with Intellectual Disability

    ERIC Educational Resources Information Center

    de Winter, Channa F.; Magilsen, Karla W.; van Alfen, J. Claudia; Penning, Corine; Evenhuis, Heleen M.

    2009-01-01

    The prevalence and correlates of cardiovascular risk factors in older adults with intellectual disability was examined. We conducted a cross-sectional study with 50- to 90-year-old clients (N = 470) of three Dutch intellectual disability care providing organizations and found that healthy behavior was low, with 98.9% of the participants having an…

  2. Evaluating the Influence of the Client Behavior in Cloud Computing.

    PubMed

    Souza Pardo, Mário Henrique; Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José

    2016-01-01

    This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system.

  3. Evaluating the Influence of the Client Behavior in Cloud Computing.

    PubMed

    Souza Pardo, Mário Henrique; Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José

    2016-01-01

    This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system. PMID:27441559

  4. Evaluating the Influence of the Client Behavior in Cloud Computing

    PubMed Central

    Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José

    2016-01-01

    This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system. PMID:27441559

  5. How Do People with Intellectual Disabilities View Abuse and Abusers?

    ERIC Educational Resources Information Center

    Northway, Ruth; Melsome, Melissa; Flood, Samantha; Bennett, Davey; Howarth, Joyce; Thomas, Becki

    2013-01-01

    People with intellectual disabilities have a higher risk of being abused than other people, but to date research has not explored their views regarding abuse. This article reports the findings relating to one question within a participatory research study concerning the abuse of people with intellectual disabilities. This question asked what…

  6. Alienation and Domestic Abuse: How Abused Women Cope with Loneliness

    ERIC Educational Resources Information Center

    Arokach, Ami

    2006-01-01

    This study explored the manner in which abused women cope with loneliness. Eighty women, victims of domestic abuse, were compared to 84 women from the general population who have had no history of abusive relationships. A 34-item yes/no loneliness questionnaire was utilized in order to compare the "beneficial" ways of coping with loneliness in the…

  7. Psychology's contribution to the well-being of older americans.

    PubMed

    Gatz, Margaret; Smyer, Michael A; DiGilio, Deborah A

    2016-01-01

    In concert with 6 decennial White House Conferences on Aging, psychologists have considered how developments in psychological science can contribute to the well-being of older Americans. We suggest 5 illustrative areas of psychological research: Advances in neuroscience elucidate ways to promote healthy cognitive aging; associated developments in neuropsychological assessment can help in protecting older Americans with cognitive losses from financial exploitation, abuse, and neglect. Psychological research on decision making and behavioral economics has much to offer to planning for retirement security and reducing vulnerability to financial abuse. Psychological research on self-management and behavior change can contribute importantly to enhancing good health behaviors among older adults; similarly the power of context on behavior can be harnessed in long-term care settings. Psychological research on attitudes and stereotypes gives insight into age bias that can be detrimental to healthy aging. Adaptive technologies and information technologies are beginning to transform assessment in research and clinical settings; technology also holds the promise of improving long-term support for older adults in both institutional and community-based settings. Finally, with 1 in 7 Americans now ages 65 and older, compared with 1 in 11 50 years ago, the psychology workforce-including health services providers and faculty to train those providers-is insufficient to meet the challenge of the aging population. (PsycINFO Database Record PMID:27159432

  8. Characteristics of clinicians likely to refer clients to 12-Step programs versus a diversity of post-treatment options.

    PubMed

    Fenster, Judy

    2006-07-27

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

  9. Behavior therapy in drug abuse treatment: review and evaluation.

    PubMed

    Stitzer, M L; Bigelow, G E; McCaul, M E

    1985-01-01

    The goal of drug abuse treatment is to decrease the dominance of drug-related behaviors while enhancing the dominance of alternative socially acceptable behaviors. The behavioral techniques of extinction, satiation, and punishment can be used to suppress undesirable behaviors, and reinforcement can be used to enhance desirable behaviors. Methadone maintenance offers unique advantages for treatment of opiate abuse since methadone satiates the drug abuser, thereby reducing the reinforcing efficacy of illicit opiate drugs, while also serving as a reinforcer whose delivery in the treatment setting can be used in contingent arrangements. Short-term efficacy has been demonstrated in studies that used contingent treatment termination or contingent dose decreases as punishing events and contingent dose increases or contingent take-home privileges as reinforcing events to promote reductions in drug use and cooperation with clinic rules. Systematic use of dose adjustments and take-home privileges may be a useful adjunct to methadone maintenance treatment, having a positive impact both on client outcomes and clinic operation. Rehabilitation efforts might also benefit if delivery of reinforcers available at the clinic is contingent upon participation in skills training and therapy programs or community activities outside the drug abuse clinic. PMID:3929125

  10. Child Abuse: The Hidden Bruises

    MedlinePlus

    ... AACAP Facts for Families Guide Skip breadcrumb navigation Child Abuse - The Hidden Bruises Quick Links Facts For Families ... 5; Updated November 2014 The statistics on physical child abuse are alarming. It is estimated hundreds of thousands ...

  11. National Center on Elder Abuse

    MedlinePlus

    ... Research Synthesize and disseminate high quality research on elder abuse to encourage the translation of research into practice. ... to further the field for those interested in elder abuse identification and prevention. What’s Happening National Center on ...

  12. Substance abuse and child maltreatment.

    PubMed

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  13. Public mental health clients with severe mental illness and probable posttraumatic stress disorder: trauma exposure and correlates of symptom severity.

    PubMed

    Lu, Weili; Yanos, Philip T; Silverstein, Steven M; Mueser, Kim T; Rosenberg, Stanley D; Gottlieb, Jennifer D; Duva, Stephanie Marcello; Kularatne, Thanuja; Dove-Williams, Stephanie; Paterno, Danielle; Hawthorne, Danielle; Giacobbe, Giovanna

    2013-04-01

    Individuals with severe mental illness (SMI) are at greatly increased risk for trauma exposure and for the development of posttraumatic stress disorder (PTSD). This study reports findings from a large, comprehensive screening of trauma and PTSD symptoms among public mental health clients in a statewide community mental health system. In 851 individuals with SMI and probable PTSD, childhood sexual abuse was the most commonly endorsed index trauma, followed closely by the sudden death of a loved one. Participants had typically experienced an average of 7 types of traumatic events in their lifetime. The number of types of traumatic events experienced and Hispanic ethnicity were significantly associated with PTSD symptom severity. Clients reported experiencing PTSD in relation to events that occurred on average 20 years earlier, suggesting the clinical need to address trauma and loss throughout the lifespan, including their prolonged after-effects.

  14. The missing link: district nurses as social connection for older people with type 2 diabetes mellitus.

    PubMed

    Lucas, Sandra

    2013-08-01

    The relationship between social connection and health is widely recognised. However, there is a paucity of literature regarding the impact of district nursing care on social connection for people with a chronic illness such as type 2 diabetes mellitus (T2DM). Using a mixed-method approach, an exploration of the perceptions of older people living in the community with T2DM regarding their health and social connections was carried out. Findings revealed a strong relationship between the clients and the district nurse. The district nurse is an important aspect of clients' social connection. For some clients where their social connection is limited, the district nurse is a central element. When the district nurse is the major social connection, problems can arise for the client, especially when they are being discharged or changes are made to their care.

  15. Prognostic value of rectal temperature at hospital admission in client-owned rabbits.

    PubMed

    Di Girolamo, Nicola; Toth, Giulia; Selleri, Paolo

    2016-02-01

    OBJECTIVE To determine whether rectal temperature at hospital admission, independently or in conjunction with other parameters, was associated with all-cause mortality in client-owned rabbits. DESIGN Prospective cohort study. ANIMALS 316 client-owned rabbits consecutively hospitalized in an exotics-only animal hospital. PROCEDURES Rectal temperature of each hospitalized rabbit was measured at admission. Individual variables, including survival up to 1 week after hospital discharge, were recorded. Univariate, multivariate, and sensitivity analyses were performed. RESULTS Rabbits with hypothermia at admission had a risk of death before or within 1 week after hospital discharge 3 times that of rabbits without hypothermia (relative risk, 3.09; 95% confidence interval, 2.17 to 4.39). For each 1°C (1.8°F) decrease in admission rectal temperature, the odds of death were doubled (OR, 2.11; 95% confidence interval, 1.69 to 2.64). Sensitivity analyses confirmed the robustness of the finding. Older age, suspected presence of a systemic disease, and presence of gastrointestinal stasis were also significantly associated with an increased risk of death. CONCLUSIONS AND CLINICAL RELEVANCE Rectal temperature was easily measured in rabbits and was a major predictor of death in the present patient cohort. Because of its association with death in both healthy and diseased rabbits in this study, rectal temperature should always be measured during physical examination of rabbits. Treatment of hypothermia in client-owned rabbits requires further research.

  16. Neurobiology of marijuana abuse.

    PubMed

    Abood, M E; Martin, B R

    1992-05-01

    Marijuana has a long history of abuse yet, as described here by Mary Abood and Billy Martin, there is little evidence that animals will self-administer the primary psychoactive constituent, tetrahydrocannabinol, or that marijuana stimulates brain reward pathways. While marked tolerance develops to marijuana, it has been difficult to demonstrate physical dependence, and until recently the mechanisms by which cannabinoids produced their behavioral effects were poorly defined. The development of new synthetic analogs played a critical role in the characterization and cloning of the cannabinoid receptor. Insight into cannabinoid receptors may lead to a better understanding of marijuana abuse in humans and provide new therapeutic strategies for several disorders.

  17. Using spiritually modified cognitive-behavioral therapy in substance dependence treatment: therapists' and clients' perceptions of the presumed benefits and limitations.

    PubMed

    Hodge, David R; Lietz, Cynthia A

    2014-11-01

    Cognitive-behavioral therapy (CBT) that has been modified to incorporate clients' spiritual beliefs and practices has been used to treat a variety of problems. This study examines the utility of this modality with the treatment of alcohol dependence and other forms of substance abuse. Toward this end, six focus groups (three therapist groups and three client groups) were conducted to identify the presumed benefits and limitations of using spiritually modified CBT in substance dependence treatment. In terms of benefits, spiritually modified CBT was perceived to enhance outcomes through operationalizing horizontal and vertical sources of social support, divine coping resources, and spiritual motivation. Potential challenges include the risk of therapists inadvertently imposing their own beliefs during the modification process and the possibility of offending clients when conflicts in belief systems emerge, particularly in group setting. The article concludes by providing suggestions for incorporating spiritually modified CBT into treatment and develops a number of illustrative examples of spiritually modified CBT self-statements.

  18. Use of technology to enhance mental health for older adults.

    PubMed

    Cangelosi, Pamela R; Sorrell, Jeanne M

    2014-09-01

    Recent research suggests that older adults may gain significant mental health benefits from health resources made available through emerging modern technologies, especially because this population is becoming more Internet savvy. Technology-enhanced interventions for older adults have been shown to be helpful not only for general wellness activities (i.e., exercise), but also to specifically enhance mental health. This article focuses on two types of interventions for mental health: (a) cognitive-behavioral therapy for depression and anxiety and (b) assistive technology for individuals with dementia. Nurses should reevaluate their assumptions that older adults fear technology and explore whether different types of modern technology might be effective in enhancing mental health for these clients.

  19. Drug Abuse in Southeast Asia.

    ERIC Educational Resources Information Center

    Scorzelli, James F.

    This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…

  20. Child Abuse Prevention Handbook. Revised.

    ERIC Educational Resources Information Center

    California State Office of the Attorney General, Sacramento. Crime Prevention Center.

    Intended to heighten public awareness and provide practical information to professionals, this handbook defines and describes child abuse (including sexual abuse) and its associated signs and injuries. The societal and family environments in which child abuse most typically occurs are described, and the California penal code sections pertaining to…