Conrad, Kendon J.; Iris, Madelyn; Ridings, John W.; Langley, Kate; Anetzberger, Georgia J.
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…
Parisien, Lynne S.; Long, Bonita C.
Assessed 63 female counselor trainees after viewing videotape of client reporting sexual abuse, physical abuse, or role conflict. Results indicated that trainees who expected to counsel sexually abused client increased their positive self-statements. Applied Schwartz's States-of-Mind model to self-statement ratios, and, according to model,…
Lam, Chow S.; And Others
Rehabilitation clients enter treatment for alcohol and other drug abuse at various stages of readiness to change. It is important that treatment should be congruent with clients' readiness for change. Describes a substance abuse treatment matching model based on the Prochaska and DiClemente's Stages of Change Theory. (Author)
Hiller, Matthew L; Leukefeld, Carl G; Garrity, Thomas F; Godlaski, Theodore; Schoeneberger, Marlies; Townsend, Michael; Hascal, Karyn
Several national evaluations have been conducted since the late 1960s that have assessed the effectiveness of publicly-funded substance abuse treatment in the United States. These studies, however, have focused principally on urban-based treatment programs, and it is unclear whether findings from urban programs can be replicated in outcome studies of programs in rural areas. The current study, therefore, examined the treatment outcomes of clients admitted to one of several short-term inpatient or outpatient drug-free treatment agencies in rural Kentucky. Findings showed that treatment was associated with reductions in drug use and criminality during a six-month follow-up interval. Employment status also improved significantly, and health services utilization was reduced. The similarity between the current findings and findings from national outcome studies of urban-based treatment programs is discussed.
Bitar, Raoul; Dürsteler, Kenneth M; Rösner, Susanne; Grosshans, Martin; Herdener, Marcus; Mutschler, Jochen
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.
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…
Rapp, Richard C.; Li, Li; Siegal, Harvey A.; DeLiberty, Richard N.
Examines the role of motivation in substance abusers' acceptance of treatment and its relation to treatment outcomes. Better motivation was consistently associated with severity of substance use. Motivation was not related to alcohol and drug use severity six months later. Severity associated with motivation at entry was not related to clients'…
Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana
Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.
Teaster, Pamela B.; Roberto, Karen A.
Purpose: The purpose of this study was to develop a profile of sexual abuse cases among adults aged 60 and older receiving attention from Adult Protective Services units in Virginia over a 5-year period. Design and Methods: We used bivariate analysis to characterize older adults (n = 82) experiencing sexual abuse and the circumstances of the…
Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims' health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.
Domestic violence in older families is often referred to not as family violence but as elder abuse. This chapter will begin by discussing how perceptions of this type of violence impact informal and formal interventions. The prevalence and etiology of domestic violence are described, along with how the joint forces of ageism and sexism affect older female victims. National, state, and local efforts to prevent and remediate the abuse of older women are also covered. In conclusion, the author presents implications for working with groups and individual abused older women from a feminist perspective.
Kedia, Satish; Perry, Stephanie W
This study examined levels of agreement and directionality of disagreement between the post-treatment self-reports of substance abuse clients and their collaterals. The study population comprised 1252 clients with a primary or secondary diagnosis of substance abuse or dependence whose treatment was publicly funded in Tennessee. Client and collateral responses to 13 questions were analyzed for levels of agreement, revealing the following: (a) levels of client-collateral agreement were high, at least 75% agreement on all 13 questions and at least 88% agreement on 10 variables; (b) a Simple Kappa Test confirmed that 11 out of 13 items had moderate to excellent nonchance agreement; (c) there was no consistent trend in directionality, that is, clients neither reported information more positively nor more negatively than their collaterals did; (d) on average, those collaterals who were spouses, parents, and children agreed more with clients compared to other types of collaterals; and (e) those collaterals who saw the clients more frequently and more recently had higher agreement than those who saw the clients less frequently. This research reaffirms that collaterals are a valuable source for verifying the accuracy of clients' self-reports and that this approach continues to hold considerable promise for substance abuse post-treatment assessment.
Atkins, Dianne; Loewenthal, Del
This paper presents the results of an heuristic study based on the research question: 'How do psychotherapists experience working with older clients?' The question came from the researchers' experience and interest in working with older clients in general practice. It started from the researchers' desire to examine more closely feelings and…
Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.
Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…
Kedia, Satish; Sell, Marie A; Relyea, George
To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category-other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse.
... clothing for the weather should draw your attention. Financial abuse: Unusual patterns of spending or withdrawals from an older adult’s account; frequent purchases of inappropriate items; bank account withdrawals ...
Taylor, Brian J; Killick, Campbell; O'Brien, Marita; Begley, Emer; Carter-Anand, Janet
This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as peer researchers. Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent: some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests. Preventing abuse requires a wide-ranging approach including rebuilding respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviors that have occurred.
Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L.
History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence, psychological distress and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125
Turjamaa, Riitta; Hartikainen, Sirpa; Pietilä, Anna-Maija
In this qualitative focus group study, the resources available to older home-dwelling people, particularly incoming and existing home care clients, are described from the viewpoint of home care professionals (n = 32). The data were analyzed using inductive content analysis. There were three categories of older people requiring resources from the viewpoint of interviewers: home-dwelling people, incoming home care clients, and existing home care clients. Based on the analysis, the resources of older home-dwelling people were categorized in terms of support, meaningful life, everyday activities, and environment. Incoming home care client resources were support, out-of-home activities, in-home activities, and environment. Existing client resources were described in terms of support, everyday activities, and environment. Home care professionals described the resources of the older home-dwelling people in diverse ways, but those of the perspective of existing clients were reduced. The biggest difference was in everyday activities. Psychological and social resources, including meaningful life and social relationships, seemed to be forgotten. All available resources must be taken into account, especially in the everyday home care services for existing home care clients.
Senreich, Evan; Straussner, Shulamith Lala A.
Entering ("n"?=?475) and graduating ("n"?=?454) students at 3 master's of social work programs in the northeast were compared regarding their knowledge and attitudes concerning working with substance abusing clients. In comparison to entering students, graduating students demonstrated modestly higher levels of knowledge, role…
Elliott, William N.; Walters, Glenn D.
Proposes a psychoeducational model of intervention for use with drug abusers. Claims that the model may be particularly helpful during the early stages of intervention in reducing resistance to change since it addresses the eight thinking styles believed to shield the drug "lifestyle" from forces that would otherwise lead to change. (RJM)
McFarland, Bentson H; Deck, Dennis D; McCamant, Lynn E; Gabriel, Roy M; Bigelow, Douglas A
Medicaid conversion from fee for service to managed care raised numerous questions about outcomes for substance abuse treatment clients. For example, managed care criticisms include concerns that clients will be undertreated (with too short and/or insufficiently intense services). Also of interest are potential variations in outcome for clients served by organizations with assorted financial arrangements such as for-profit status versus not-for-profit status. In addition, little information is available about the impact of state Medicaid managed care policies (including client eligibility) on treatment outcomes. Subjects of this project were Medicaid clients aged 18-64 years enrolled in the Oregon Health Plan during 1994 (before substance abuse treatment managed care, N = 1751) or 1996-1997 (after managed care, N = 14,813), who were admitted to outpatient non-methadone chemical dependency treatment services. Outcome measures were retention in treatment for 90 days or more, completion of a treatment program, abstinence at discharge, and readmission to treatment. With the exception of readmission, there were no notable differences in outcomes between the fee for service era clients versus those in capitated chemical dependency treatment. There were at most minor differences among various managed care systems (such as for-profit vs not-for-profit). However, duration of Medicaid eligibility was a powerful predictor of positive outcomes. Medicaid managed care does not appear to have had an adverse impact on outcomes for clients with substance abuse problems. On the other hand, state policies influencing Medicaid enrollment may have substantial impact on chemical dependency treatment outcomes.
Eloranta, Sini; Routasalo, Pirkko; Arve, Seija
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.
Myers, Jane E.; Shelton, Barbara
Explores violence against the elderly in the home and in institutions. Includes areas of physical violence, neglect, financial exploitation and psychological abuse by caretakers, and whether these caretakers are family members, relatives, or persons employed to care for the frail, older adult. Explores the role counselors can play in addressing…
Bamatter, Wendy; Carroll, Kathleen M.; Añez, Luis M.; Paris, Manuel; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Suarez-Morales, Lourdes; Szapocznik, Jose; Martino, Steve
This study investigated the extent to which bilingual counselors initiated informal discussions about topics that were unrelated to the treatment of their monolingual Spanish-speaking Hispanic clients in a National Institute on Drug Abuse Clinical Trial Network protocol examining the effectiveness of motivational enhancement therapy (MET). Session audiotapes were independently rated to assess counselor treatment fidelity and the incidence of informal discussions. Eighty-three percent of the 23 counselors participating in the trial initiated informal discussions at least once in one or more of their sessions. Counselors delivering MET in the trial initiated informal discussion significantly less often than the counselors delivering standard treatment. Counselors delivering standard treatment were likely to talk informally the most when they were ethnically non-Latin. Additionally, informal discussion was found to have significant inverse correlations with client motivation to reduce substance use and client retention in treatment. These results suggest that informal discussion may have adverse consequences on Hispanic clients’ motivation for change and substance abuse treatment outcomes and that maintaining a more formal relationship in early treatment sessions may work best with Hispanic clients. Careful counselor training and supervision in MET may suppress the tendency of counselors to talk informally in sessions. PMID:20817381
Counte, M A
OBJECTIVE: To address the likely influences, on options faced by older clients, of specific changes in the delivery system and several possible responses to these changes and the changed options, by older persons in the aggregate. STUDY DESIGN: Four specific topics are discussed at length: (1) the probable altered role for the older healthcare client brought on by organizational changes; (2) findings from research on elderly health maintenance behavior and reasons for the increased importance of this issue; (3) the effectiveness of the conventional approach to explaining health services utilization in population studies; and (4) recommendations for future research into the direct or indirect influence of organizational changes in the primary healthcare system on the health-related decisions and behaviors of older persons. PMID:9618677
Coon, David W.; Thompson, Larry W.; Gallagher-Thompson, Dolores
There is growing evidence that psychosocial treatments incorporating behavioral intervention strategies can be effective in the treatment of depression in older adults with cognitive impairment. However, less work with such cases has focused on the use of cognitive interventions in tandem with these behavioral intervention strategies. This case…
Batastini, Ashley B; King, Christopher M; Morgan, Robert D; McDaniel, Brieann
Recent years have seen the incorporation of telepsychology into poorly accessed, rural, and underserved settings, including criminal justice and substance abuse treatment. A systematic search of the literature on telepsychological and related services with justice-involved and substance abuse clients revealed numerous descriptive reports, but few empirical studies. The results of 3 studies of criminal justice participants and 2 studies of substance-abuse participants were subjected to a series of 5 outcome-specific meta-analyses (mental health symptoms, therapeutic processes, program engagement, program performance, and service satisfaction). These 5 studies, all of which utilized a comparison group, contributed a total of 342 participants and 14 total effect sizes. Summary data on 3 additional uncontrolled studies are also presented. Results indicated that telepsychological outcomes were at least comparable with in-person outcomes. This review serves as an initial reference for clinicians and policymakers working with criminal justice and substance abuse clients, but also highlights the need for more rigorous scientific investigation into the nuances of telepsychological practice.
McElroy, Siobhan; Warren, Alison; Jones, Fay
The value of art therapy for older people with mental health problems is well documented although there is a paucity of research for people who are home bound. This study, based in England, involved five clients, all older people with mental health problems, receiving art therapy sessions at home. The clients and caregivers were then interviewed…
Cleak, Helen; Schofield, Margot J; Axelsen, Lauren; Bickerdike, Andrew
Family mediation is mandated in Australia for couples in dispute over separation and parenting as a first step in dispute resolution, except where there is a history of intimate partner violence. However, validation of effective well-differentiated partner violence screening instruments suitable for mediation settings is at an early phase of development. This study contributes to calls for better violence screening instruments in the mediation context to detect a differentiated range of abusive behaviors by examining the reliability and validity of both established scales, and newly developed scales that measured intimate partner violence by partner and by self. The study also aimed to examine relationships between types of abuse, and between gender and types of abuse. A third aim was to examine associations between types of abuse and other relationship indicators such as acrimony and parenting alliance. The data reported here are part of a larger mixed method, naturalistic longitudinal study of clients attending nine family mediation centers in Victoria, Australia. The current analyses on baseline cross-sectional screening data confirmed the reliability of three subscales of the Conflict Tactics Scale (CTS2), and the reliability and validity of three new scales measuring intimidation, controlling and jealous behavior, and financial control. Most clients disclosed a history of at least one type of violence by partner: 95% reported psychological aggression, 72% controlling and jealous behavior, 50% financial control, and 35% physical assault. Higher rates of abuse perpetration were reported by partner versus by self, and gender differences were identified. There were strong associations between certain patterns of psychologically abusive behavior and both acrimony and parenting alliance. The implications for family mediation services and future research are discussed.
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…
Guerrero, Erick G; Khachikian, Tenie; Kim, Tina; Kong, Yinfei; Vega, William A
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.
Loreck, David; Brandt, Nicole J; DiPaula, Bethany
Opioid use disorder is a public health epidemic. There is increasing attention being given to opioid abuse and overdose in the United States. The overall use of illicit substances by older adults is on the rise and in part can be attributed to the aging of Baby Boomers. Furthermore, much attention is being given to prescription opioid drug overdose, but it is important to note that heroin-related deaths have also increased sharply. Heroin use is part of a larger substance abuse problem, with more than nine in 10 individuals who use heroin also using at least one other drug (e.g., cocaine, prescription opioid medication). The current article highlights treatment approaches, namely buprenorphine, buprenorphine/naloxone, and naltrexone; insurance considerations; and resources to aid in understanding and managing this public health crisis.
Farber, Barry A; Feldman, Sarah; Wright, A Jordan
This study investigated the perceptions of adult clients (N=98; M age=32) with a history of childhood sexual abuse (CSA) of the costs and benefits of disclosure of this material. Significant benefits of disclosing included a sense of relief from sharing bottled-up emotions, and feeling more accepted and understood by one's therapist; significant negative consequences included feeling emotionally overwhelmed, and feeling uncomfortably vulnerable and exposed. Linear regressions indicated that CSA patients who generally disclose more have a greater tendency to experience both positive and negative effects of disclosure about abuse. In addition, a hierarchical regression analysis indicated that higher levels of symptomatology were predictive of higher levels of anxiety related to disclosure in therapy, suggesting that clinicians need to be cautious in encouraging disclosure about CSA with patients with severe pathology.
Chana, Richard; Marshall, Paul; Harley, Clare
The intermediate care team supports patients in their own homes to manage complex needs. They are ideally placed in the community to identify older adults at risk of loneliness. However, little is known about how intermediate care team professionals perceive, detect or respond to loneliness in their clients. This study explores intermediate care team professionals' attitudes to loneliness in the context of perceived service priorities and their experiences of managing loneliness in their clients. Eight professionals (n=2 physiotherapists, n=3 occupational therapists, n=3 nurses) took part in semi-structured interviews. Data were analysed thematically using framework analysis, applying the theory of planned behaviour as an interpretive framework. Intermediate care team professionals see loneliness as a significant issue for many of their older clients but a low priority for intermediate care team services. They believe that loneliness often goes undetected because it is difficult to measure objectively. Barriers to managing loneliness included high workloads, unsatisfactory referral systems and lack of close working with social care and independent sector services. Brief but reliable loneliness assessments into routine practice, receiving training on detecting and managing loneliness, and improving working relationships with social care and independent sector services were highlighted as strategies that could improve the detection and management of loneliness in intermediate care team clients.
Vaughn, Michael G; Ollie, Marcia T; McMillen, J Curtis; Scott, Lionel; Munson, Michelle
The purpose of this study was to explore prevalence and predictors of current and lifetime substance use, substance abuse disorder, and polysubstance use among older youth in foster care. Interviews were conducted with 406 17-year old youth (90% of those eligible) in one state's foster care system between December 2001 and June 2003. Forty-five percent of foster care youth reported using alcohol or illicit drugs within the last six months; 49% had tried drugs sometime during their lifetime and 35% met criteria for a substance use disorder. Having a diagnosis of Conduct Disorder and/or living in an independent living situation significantly increased the likelihood of current and lifetime substance use and disorder. A diagnosis of Post Traumatic Stress Disorder also predicted increased likelihood of polysubstance use and substance abuse disorder. In conclusion, older youth in the foster care system report similar levels of lifetime alcohol and illicit substance use when compared to the general adolescent population. However, rates of substance use disorder are high. Particularly at risk for both high rates of use and disorder are youth in independent living situations and youth with a diagnosis of Conduct Disorder or Post Traumatic Stress Disorder.
Bial, Martha C.; Gutheil, Irene A.; Hanson, Meredith; White-Ryan, Linda
This article reports on a project to sensitize graduate social work students taking courses in substance abuse to the needs of older adults. Graduate social work students at a major urban school of social work in the Northeast were recruited and trained to interview older adults with a history of substance abuse problems regarding their life…
Didden, Robert; Embregts, Petri; van der Toorn, Mirjam; Laarhoven, Nina
Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who did not. There were no differences in adaptive skills between groups. However, compared to clients without substance abuse, those who abused substances showed a more palliative coping style, and had more severe emotional and behavior problems such as anxiety/depression and intrusive thoughts and aggressive and antisocial behaviors. Implications for treatment are discussed.
Didden, Robert; Embregts, Petri; van der Toorn, Mirjam; Laarhoven, Nina
Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who…
Butler, Stephen F; Budman, Simon H; McGee, Michael D; Davis, Michael Sean; Cornelli, Rebecca; Morey, Leslie C
This article describes the development and reliability and validity testing of the Addiction Severity Assessment Tool (ASAT), a brief, 27-item multidimensional self-report measure of problem severity in daily functioning, relational functioning, dysphoric states, dependence severity, recovery skill/self-efficacy, and existential factors for adult substance abuse clients. Items generated for an Alpha version were conceptually and empirically evaluated. A Beta version underwent further empirical evaluation and item selection. Cross validation of the final version examined internal consistency, test-retest reliability, factor structure, and convergent/discriminant and known groups validity. Sensitivity to change was evaluated in a 3-month outcome study. Clients were recruited from inpatient, outpatient and residential substance abuse treatment centers, and a sample of 238 nonpatients were also recruited from community groups. The Beta version was tested with 201 clients, and cross validation involved 242 clients. Well-known standardized, self-report and interview-based comparison measures were used to test convergent/discriminant validity of the ASAT. Reliability coefficients for the six ASAT domains were acceptable. Reasonable convergent/discriminant and known groups, construct validity were demonstrated, along with sensitivity to change of the domain scale scores. The ASAT appears to comprise a useful new tool for assessing clinical outcomes of adult clients in substance abuse treatment.
Koenig, Lane; Fields, Errol L.; Dall, Timothy M.; Ameen, Ansari Z.; Harwood, Henrick J.
This report demonstrates three applications of case-mix methods using regression analysis. The results are used to assess the relative effectiveness of substance abuse treatment providers. The report also examines the ability of providers to improve client employment outcomes, an outcome domain relatively unexamined in the assessment of provider…
Carmel, Melissa J. Sheehy; Friedlander, Myrna L.
The authors assessed burnout, compassion fatigue, secondary trauma symptoms, and compassion satisfaction in relation to experienced therapists' perceptions of the working alliance. Participants, 106 specialists in the treatment of clients who commit sexual abuse, completed the Working Alliance Inventory-Short Form (T. J. Tracey & A. M.…
Senreich, Evan; Straussner, Shulamith Lala A.
This study compared 248 graduating seniors with 301 beginning juniors at 10 bachelor's-level social work programs in the Northeast concerning their knowledge and attitudes regarding working with substance-abusing clients. Graduating seniors demonstrated modestly higher levels of knowledge and only slightly more positive attitudes toward working…
Roger, Kerstin Stieber; Brownridge, Douglas A; Ursel, Jane
Little research can be found describing abuse of older immigrant women, despite an increase in our aging population and increasing research on abuse of older adults. This article examines factors that may contribute to low levels of reporting of abuse of older immigrant women. The authors present empirical qualitative data collected through interviews and focus groups, which examined how people living in the community understand and define abuse of older adults. Four main themes will be discussed: first, the individual in a family and cultural community context; second, English as a foreign or second language as part of the mainstream; third, the question of "naming" abuse; and finally, age as a discriminator. Preliminary frameworks to better understand these findings are introduced. Recommendations for future research and programming are presented.
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous
Lee, Anselm C. W.; Ou, Yvonne; Fong, Dawson
Objective: To describe a pattern of abusive head injury in a series of children older than 4 years of age. Methods: A hospital chart review of abused children with skull fractures from 1999 to 2001 was carried out. The clinical features, social background, and subsequent outcome and management are described. Results: An 11-year-old girl and a pair…
Damashek, Amy; Bard, David; Hecht, Debra
Home-based programs to treat child abuse and neglect suffer from high rates of attrition, limiting their impact. Thus, research is needed to identify factors related to client engagement. Using data (N = 1,305) from a statewide family preservation program, this study investigated the role of program type (i.e., SafeCare(®) [SC] vs. Services as Usual [SAU]) and client perceived provider cultural competence on client satisfaction and engagement with services. Families in SC completed more treatment goals than those in SAU. In addition, provider cultural competence and client satisfaction were higher in SC than in SAU. Higher provider cultural competence was associated with higher goal attainment and satisfaction, and these effects partially mediated the service program differences. The effects of service type and cultural competence on goal attainment and satisfaction varied somewhat by client ethnicity. Findings suggest that clients receiving manualized programs for child maltreatment may be more likely to meet their goals and may perceive such programs to be culturally appropriate and satisfactory.
Smith, Judith R
This study examines elder abuse within the broader framework of parenting in later life and focuses on the experience of mothers with "difficult" adult children. The sample is low-income and minority older women (>62). Using constructive grounded theory, the analysis reveals that the women's lens as mothers informs their explanations for not being able to take action to limit their adult children's difficult/abusive behaviors. The author suggests the utility of incorporating a feminist framework that highlights adult child-to-mother violence as a means of increasing self-reporting of elder abuse and older women's willingness to accept services.
Hirst, Sandra P; Penney, Tasha; McNeill, Susan; Boscart, Veronique M; Podnieks, Elizabeth; Sinha, Samir K
A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.
Lee, Cheryl D.; Ayon, Cecilia
Objective: The purpose of this research was to (a) find if there were associations between child welfare outcomes and the client-worker relationship and (b) learn what are the predictors of a positive client-worker relationship. Method: 100 (55 Family Maintenance [FM] and 45 Family Preservation [FP]) clients were interviewed in English and…
Brown, B. Bradford; Chiang, Chi-Pang
Compared 21 older clients of drug treatment facilities, 30 older abusers not in treatment, and 155 elderly nonabusers. Analyses suggested that age and gender affect the likelihood of receiving treatment more than the likelihood of being an abuser. Substance abuse appeared more prevalent among single elderly who lived alone. (JAC)
Iversen, Maria Helen; Kilvik, Astrid; Malmedal, Wenche
The objective of this study was to increase knowledge of sexual abuse against older residents in nursing homes. A qualitative approach was used. Through a focus group interview with staff in nursing homes, the aim was to reveal employees' thoughts, experiences, and attitudes. Findings from the focus group interview show that sexual abuse of older residents is a taboo topic among health professionals. Acts of sexual abuse are difficult to imagine; it is hard to believe that it occurs. The fact that staff are not aware that it could happen, or have a hard time believing that it actually happens, can amplify the residents' vulnerable position as potential victims of abuse, and it makes it even more challenging to report or uncover such acts. The study highlights the need for education of all health care workers in Norway as well as more research on sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step towards addressing sexual abuse of the aged in a more appropriate way. Further research must aim to reveal more about this taboo area. PMID:26078879
Chang, Yu-Ping; Compton, Peggy
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64). Prescription opioid drug use issues may emerge in the context of persistent pain, and risk factors for misuse/abuse and overdose in older patients with pain require further description. In keeping with national initiatives to combat prescription opioid drug abuse and overdose, current clinical guidelines reflect an "opioid-sparing" approach. To the degree that these guidelines improve persistent pain and opioid drug misuse/abuse outcomes, significant public health benefits will be accrued. Efforts to reduce both require action and are national priorities. [Journal of Gerontological Nursing, 42(12), 21-30.].
Fisher, Bonnie S.; Regan, Saundra L.
Purpose: This study assessed the extent of different types of abuse, repeated and multiple abuse experiences among women aged 60 and older, and their effects on the women's self-reported health. Design and Methods: A cross-sectional study of a clinical sample of 842 community-dwelling women aged 60 and older completed a telephone survey about type…
Most research on intimate partner violence to date has focused on young men. Although interest and research regarding older abused women has increased in recent years, research on the voices and experiences of older abusive men is still scarce. The purpose of this article is to present a typology of older battering men dwelling in lifelong intimate violence relationships. Fifteen older Israeli abusive men, aged 65 to 84 years, were interviewed in depth. Four types were identified: the "Non-quitter," the "Cover-up"-er, the "In-between"-er, and the "Normalizer." These types were constructed based on four dimensions: the construction of violence over the years, the perception of the spouse over the years, losses accompanying the violent relationship, and the meaning of violence in old age. The four types enable an in-depth look at the experiential world of older abusers and paint a complex picture of various ways in which abusive men live with violence over time.
Francis, Denille M.; Kaiser, Donna; Deaver, Sarah P.
Presents results of a study of the graphic indicators in drawings by patients with substance abuse disorders. The Bird's Nest Drawing, an assessment task previously devised to elicit pictorial representations of attachment security, was used to examine attachment patterns of volunteers. Results showed that those with substance abuse diagnoses were…
Schonfeld, Lawrence; Larsen, Rebecca G.; Stiles, Paul G.
Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims…
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…
Hunt, Linda A; Arbesman, Marian
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.
Sharma Bhattarai, Lok P
Little is known about elder abuse in Nepal. To gain further insights, the National Human Rights Commission in association with the Geriatric Center in Nepal published a report that analyzes all cases of older people's abuse published in two daily newspapers in Nepal over a 2-year period. This commentary discusses the main findings of the report, as well as future directions.
Rosen, Daniel; Engel, Rafael J; Hunsaker, Amanda E; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F
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.
Schiff, Miriam; Katz, Katalin
Objective: This study is the first in a comprehensive examination of therapeutic components and outcome of interventions in a public, nonresidential service for drug addicts in Jerusalem (SHALEM). Method: Data were gathered from 153 clients (35 women, 128 men; 35 Arabs, 118 Jews; median age = 39) using clinical data mining. Results: Men who had…
Flentje, Annesa; Livingston, Nicholas A.; Roley, Jason; Sorensen, James L.
Objective Lesbian, gay, and bisexual (LGB) orientation predicts greater substance use, treatment utilization, and poorer mental and physical health, but health needs of LGB individuals in substance abuse treatment remain largely unknown. The purpose of this study was to identify differences in mental and physical health needs of LGB individuals in substance abuse treatment. Methods Substance abuse treatment admissions data from the County of San Francisco were used in this investigation of differences in mental and physical health problems and service utilization between LGB (n=1,441) and heterosexual individuals (n=11,770). Results LGB individuals were more likely to have mental health diagnoses (adjORs ranging from 1.86–4.00) and current mental health prescription medications (adjORs from 1.79–4.99) than heterosexual counterparts. Gay and bisexual men and bisexual women but not lesbian women, were more likely to be receiving mental health treatment. Gay men and bisexual women were more likely than heterosexual counterparts to report physical health problems. Gay and bisexual men and bisexual women but not lesbian women were more likely to be receiving health care. There were no differences between LGB individuals and heterosexual counterparts in the number of emergency room visits or hospital overnight stays. Discussion This study found that LGB individuals entering substance abuse treatment have greater mental and physical health needs than heterosexual counterparts. Implications for healthcare integration, research, and practice are discussed. PMID:26314505
Discusses signs and symptoms in adult women who were molested as children. Identifies seven signs of child sexual abuse seen in adult trainees: depression, low self-esteem, anger and ambivalence toward parents, sexual adjustment problems, lack of trust, fear, and guilt. Makes suggestions for counselor educators to assist students in working…
Glover, Noreen M.; And Others
Volunteer participants (n=77) enrolled in 8 substance abuse treatment facilities were surveyed in order to examine the prevalence and nature of incest contacts among the group. Results indicated that approximately 49 percent of the participants had reported histories of incest. Data are presented under various parameters. Also gives comparisons by…
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
Mundon, Chandra R.; Anderson, Melissa L.; Najavits, Lisa M.
Despite the high prevalence of substance use disorder (SUD) and its frequent comorbidity with mental illness, individuals with SUD are less likely to receive effective SUD treatment from mental health practitioners than SUD counselors. Limited competence and interest in treating this clinical population 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
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous drug use. Clients
Ashby, Homer U; Verner, David
What does a pastoral counselor do when a clergy client reveals that he or she has been sleeping with a parishioner? Does the counselor have an ecclesiastical duty to report this offense to a church official; or does the pledge of confidentiality trump any disclosure? Some ecclesiastical bodies require their clergy to bring knowledge of these offenses to church authorities. Does this requirement apply to pastoral counselors? The authors have been confronted with these questions in their ministry of pastoral counseling and have struggled with producing a faithful, professional response. Along the way they have not received clear direction from judicatories or professional organizations. This article is the authors' attempt to answer the questions raised above as well as to challenge professional and ecclesiastical bodies to confront more forthrightly the dilemmas these situations cause for pastoral counselors who seek to protect the welfare of the Church as well as protect the pledge to maintain confidentiality.
Cole, Jennifer; Logan, T K; Walker, Robert
The purpose of this study was to examine the relationship of social exclusion, personal control, and self-regulation to perceived stress among individuals who participated in publicly funded substance abuse treatment. Participants entered treatment between June 2006 and July 2007 and completed a 12-month follow-up survey by telephone (n=787). The results of the OLS regression analysis indicate that individuals with greater social exclusion factors (e.g. greater economic hardship, lower subjective social standing, greater perceived discrimination), lower perceived control of one's life, and lower self-regulation had higher perceived stress. Furthermore, a significant interaction was found suggesting a stress-buffering effect of personal control between subjective social standing and perceived stress. Interestingly, income status was not significantly related to perceived stress, while economic hardship, which assesses participants' inability to meet basic expenses, was significantly associated with perceived stress. Future research should examine how to integrate the AA/NA teaching about powerlessness and its role in recovery with the importance of increased personal control and self-control in decreasing perceived stress. Implications for future research and substance abuse treatment are discussed.
Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer
The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed.
Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Chiatti, Carlos
Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD. PMID:28265571
Feeney, Joanne; Kamiya, Yumiko; Robertson, Ian H; Kenny, Rose Anne
Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early-life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population-based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self-rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding.
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,…
Miller, Susan B.
This book was written for teenagers and older children who have abusive, alcoholic, or mentally ill parents. Emphasis is placed on young people in such situations using their intelligence, understanding that parents are fallible, viewing the future with optimism, facing reality, and seeing the good in other people rather than assuming everyone…
Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon
Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and…
Keller, Thomas E.; Blakeslee, Jennifer E.; Lemon, Stephenie C.; Courtney, Mark E.
Objective: Distinctive combinations of factors are likely to be associated with serious alcohol problems among adolescents about to emancipate from the foster care system and face the difficult transition to independent adulthood. This study identifies particular subpopulations of older foster youths that differ markedly in the probability of a lifetime diagnosis for alcohol abuse or dependence. Method: Classification and regression tree (CART) analysis was applied to a large, representative sample (N = 732) of individuals, 17 years of age or older, placed in the child welfare system for more than 1 year. CART evaluated two exploratory sets of variables for optimal splits into groups distinguished from each other on the criterion of lifetime alcohol-use disorder diagnosis. Results: Each classification tree yielded four terminal groups with different rates of lifetime alcohol-use disorder diagnosis. Notable groups in the first tree included one characterized by high levels of both delinquency and violence exposure (53% diagnosed) and another that featured lower delinquency but an independent-living placement (21% diagnosed). Notable groups in the second tree included African American adolescents (only 8% diagnosed), White adolescents not close to caregivers (40% diagnosed), and White adolescents closer to caregivers but with a history of psychological abuse (36% diagnosed). Conclusions: Analyses incorporating variables that could be comorbid with or symptomatic of alcohol problems, such as delinquency, yielded classifications potentially useful for assessment and service planning. Analyses without such variables identified other factors, such as quality of caregiving relationships and maltreatment, associated with serious alcohol problems, suggesting opportunities for prevention or intervention. PMID:20946738
Harbison, Joan; Coughlan, Stephen; Beaulieu, Marie; Karabanow, Jeff; Vanderplaat, Madine; Wildeman, Sheila; Wexler, Ezra
This article provides an overview of the ways in which the mistreatment and neglect of older people have come to be understood as a social problem, one which is underpinned by a variety of substantive and theoretical assumptions. It connects the process of conceptualizing elder abuse and neglect to political-economic and social evolution. The authors draw on a review of the literature, government sources, interest group websites, and their own research to provide a critical commentary illustrating how these understandings have become manifest in legislation, policies, and programs pertaining to "elder abuse and neglect" in Canada. Suggestions are provided for changes in direction for policies, programs, and research.
Melchiorre, Maria Gabriella; Di Rosa, Mirko; Lamura, Giovanni; Torres-Gonzales, Francisco; Lindert, Jutta; Stankunas, Mindaugas; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Macassa, Gloria; Soares, Joaquim J. F.
Background Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims. Methods The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal. Results Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused. Conclusions Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting
Birke, Margot G
Elder law is a specialty area of law directed at the specific needs of older clients and clients with disabilities. This review discusses major legal issues faced by older patients, their families, and their health care providers, including the capacity to consent to treatment, advance directives, and surrogate decision-making. In addition, public benefit programs such as Medicare, Social Security Disability Insurance, Medicaid, and Supplemental Security Income are examined. Available options for long-term care, both institutional and community-based are also highlighted. Finally, elder abuse is discussed. All who provide care to an elder must be aware of the potential signs of abuse and the remedies available.
... member, a trusted teacher, a doctor, or a school or religious youth counselor. Many teachers and counselors have training in how to recognize and report abuse. Telephone and online directories list local child abuse and family violence hotline numbers that you can call for help. ...
Tredal, Ingrid; Soares, Joaquim J. F.; Sundin, Orjan; Viitasara, Eija; Melchiorre, Maria Gabriella; Torres-Gonzales, Francisco; Stankunas, Mindaugas; Lindert, Jutta; Ioannidi-Kapolou, Elisabeth; Barros, Henrique
Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression). Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60-84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with…
Dong, Xin Qi; Li, Ge
Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse. PMID:27606358
... people to control their actions. Certain types of personality disorders or mental illness might also interfere with ... self-control. Of course, not everyone with a personality disorder or mental illness becomes abusive. Fortunately, people ...
... Stages Early-Stage Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here ...
Schiamberg, Lawrence B; Oehmke, James; Zhang, Zhenmei; Barboza, Gia E; Griffore, Robert J; Von Heydrich, Levente; Post, Lori A; Weatherill, Robin P; Mastin, Teresa
Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.
Rosen, Tony; Bloemen, Elizabeth M.; LoFaso, Veronica M.; Clark, Sunday; Flomenbaum, Neal; Lachs, Mark S.
Background Elder abuse is under-recognized by Emergency Department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. Objective To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. Methods ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. 66 ED visits were judged to have high probability of being related to elder abuse and 244 of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Results Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. 42% of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring >1 day prior to presentation and the most common suspicious injury pattern being maxillofacial injuries. Conclusion Victims of physical elder abuse commonly have injuries on upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries. PMID:26810019
Falcão, Ana; Pereira, Fernando; Pimentel, Helena; Teixeira, Cristina; Rodrigues, Vitor
In contemporary Western societies, the aging population poses new challenges both to the policies and to the support systems for older persons. In Portugal, where the phenomena have a major impact, a new professional profile, the gerontologist, has emerged. These professionals have an academic background that corresponds to the 1st cycle degree at…
There is concern that people with dementia may be at particular risk of elder abuse however there is little data to confirm such fears. This paper presents findings from an up-dated investigation of secondary sources of data about the abuse of older people with dementia in England conducted in 2013. There are many sources of data about poor care, abuse and neglect of people with dementia in care home and hospital settings but these are collected for different purposes and hard to link. The article discusses the ways in which dementia care practitioners may be able to make the most of existing data.
Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David; Westendorp, Rudi Gerardus Johannes
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
Searby, Adam; Maude, Phil; McGrath, Ian
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.
Hickey, Tom; And Others
Professionals (N=228) were interviewed about their case experiences with neglect and abuse of the elderly. It was suggested that environmental contexts and situational problems trigger such behavior, and that the behavior is primarily based on flawed development of the perpetrator and disordered family relationships. (Author)
Sheykhi, Mohammad Taghi
The article explores and evaluates the quality of life, safety, and security of elderly people in Tehran City in Iran. In that, different dimensions of material and social well-being, and abuse of people of the age 65 and above, are assessed. Besides the human rights, the dignity, and the gradual decline of the elderly's social security are…
Soones, Tacara; Ahalt, Cyrus; Garrigues, Sarah; Faigman, David; Williams, Brie A.
With the rapid aging of the criminal justice population, legal professionals increasingly provide front-line identification and response to age-related health conditions (including cognitive and physical impairments) that may affect legal outcomes, such as the ability to participate in one's defense or stay safe in jail. The goals of this study were to assess legal professionals’ ability to recognize and respond to age-related conditions that could affect legal outcomes and to identify recommendations to address important knowledge gaps. This was a mixed quantitative-qualitative study. Legal professionals (N=72) in the criminal justice system were surveyed to describe their demographics, expertise and prior aging-related training, and to inform the qualitative interview guide. Those surveyed included attorneys (district attorneys (25%), public defenders and legal advocates (58%)), judges (6%), and court-affiliated social workers (11%). In-depth qualitative interviews were then conducted with a subset of 10 legal professionals who worked with older adults at least weekly. Results from the surveys and interviews revealed knowledge deficits in four important areas: age-related health, identification of cognitive impairment, assessment of safety risk, and optimization of services upon release from jail. Four recommendations to close these gaps emerged: (1) educate legal professionals about age-related health; (2) train professionals to identify cognitive and sensory impairment; (3) develop checklists to identify those at risk of poor health or safety; and (4) improve knowledge of and access to transitional services for older adults. These findings suggest that geriatrics knowledge gaps among legal professionals exist that may lead to adverse medical or legal outcomes for criminal justice-involved older adults and that partnerships between healthcare and legal professionals are needed to address these challenges. PMID:24611718
Elder care has undergone a marketization in recent years in which various models for care management have been introduced with the aim of making assessments efficient. This article investigates the effects the care management model has on resource allocation for home care when handling the requests of older persons in the needs assessment process. Sixteen tape-recorded assessment conversations with associated case-file texts were analyzed through discourse analysis. The results show that a managerialist thinking has had a partial impact on the assessment process where the documentation requirements have entailed bureaucratization in terms of the transfer that occurs from talk to text. The findings from the study nevertheless indicate that the assessment conversations have clear elements of an individual-centred perspective in which there is room for a care rational dialogue. This constitutes a welfare policy dilemma today. Providing for older people's requests should be on the basis of quality and an individual-centred perspective and care management has had a contrary effect in which focus is directed instead towards needs assessment and bureaucratic processes.
Sandmoe, Astrid; Hauge, Solveig
Background Abuse of older people is a serious issue and is associated with an increased risk of morbidity and mortality, and professionals will encounter elderly victims of abuse in all areas of the health care system. An important health determinant is behavioral factors, including coping style, which will impact on how older people manage stress and maintain control in their lives, and thereby protect themselves from abuse. The aim of this study was to explore the coping strategies elderly people abused by their offspring used to manage everyday life. Methods A qualitative approach was used and 14 elderly victims of abuse were interviewed. The interviews were recorded, transcribed, and subjected to qualitative content analysis. Results Five main coping strategies were identified. The main strategy was linked to the role of parent. Another prominent strategy was attitude towards being victimized. Further strategies were associated with hope for a better relationship with offspring in the future, while others felt that they had done the best they could, or that their offspring were no longer their responsibility. The results are discussed in light of theoretical perspectives related to coping and resilience. Conclusion Abuse of older people by their offspring imposes severe stress on victims and challenges the values and beliefs about the caring nature of families. The findings of this study indicate that victims of abuse use a wide range of coping techniques to manage everyday life, and that some strategies help them to maintain their self-respect in their role as parents and find some sort of resilience. PMID:25045272
Grey, Carl; Hall, P Bradley
Opioid abuse, misuse and overdose is now a public health epidemic receiving political, medical, and media attention at all levels. Despite the fact that many people know someone suffering from addiction, there is very little research focusing on this issue in older adults. Chronic pain, a highly prevalent affliction for the aging population, has been accompanied by a significant increase in opioid use. This, along with some unique aspects of older adults (increased susceptibility to illness, higher likelihood of altered presentation of illness, and impaired recovery), means that great care needs to be taken when considering opioids for treatment. Prudent prescribing is possible, but universal precautions should be taken to reduce the risk of opioid abuse, misuse, and addiction. This review provides education, summarizes current literature, and gives guidance in universal precautions for prescribing opioids.
Juhnke, Gerald A.; Watts, Richard E.; Guerra, Norma S.; Hsieh, Peggy
This article describes how the authors use prayer with clients who self-identify their personal faith in God and who have used prayer as a helpful recovery agent or who believe prayer would be helpful to their personal recovery.
Masson, Carmen L; Shopshire, Michael S; Sen, Soma; Hoffman, Kim A; Hengl, Nicholas S; Bartolome, John; McCarty, Dennis; Sorensen, James L; Iguchi, Martin Y
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.
Acquavita, Shauna P.; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine
Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; N = 114) was referral to a preferred outpatient program with advance appointment optional. Client Incentive (CI; N = 97) offered up to $100 in gift cards for intake and attendance during the first 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
Hansen, Marissa C.; Flores, David V.; Coverdale, John; Burnett, Jason
Purpose Self-neglect among older adults results in increased morbidity and mortality rates. Depression is strongly linked to self-neglect and when untreated severely complicates management of health and functional outcomes. The study aims to identify factors correlated with depression to inform approaches to service recruitment and retention that improve long-term outcomes. Methods The sample included urban community-dwelling older adults (n=96), 65-years of age and older with Adult Protective Services substantiated self-neglect. All participants completed a range of validated cognitive, functional and self-report demographic and clinical measures around health and mental health functioning. Results A secondary data analysis using multivariable logistic regression revealed that a positive screen for alcohol abuse, low self-rated health, and higher self-reported pain were associated with significantly higher odds of self-reported depression. Implications Further research is needed to understand the temporality between these correlates and depression and to inform prevention and intervention practices for self-neglecting older adults. PMID:26716386
This brochure outlines the substance abuse policy for students at the Philadelphia College of Osteopathic Medicine (PCOM/Pennsylvania). Noted are the dangers of substance abuse during the stressful time of medical training and later for the doctor and clients during professional practice. The policy's five goals are briefly stated. Described next…
Muehlbauer, Melissa; Crane, Patricia A
Elder abuse and neglect is a critical health care issue that must be brought to the attention of health care providers and older adults' family members. Adults older than 65 who live at home or in long-term care facilities may be at risk for abuse. Nurses should be aware of the causes, screening questions, symptoms of abuse, and resources in the community. Armed with information and a better understanding about the issue, nurses can minimize the devastating effects of abuse on older adults and their families.
Killick, Campbell; Taylor, Brian J
Social work and health care professionals internationally are recognizing the need to understand and respond to the abuse of older people. Policy and guidance have identified processes but definitions of key concepts remain problematic, and the literature suggests that practitioners and agencies have little insight or guidance for decision making. Nine bibliographic databases were searched for studies on professional decision making regarding abuse of older people. Relevant studies retrieved were appraised for quality using explicit criteria. The findings of the 19 articles meeting the inclusion criteria were synthesised using a structured narrative approach. Common themes identified were abuse factors, situational factors, and broader contextual factors. Abuse factors relating to risk levels and client vulnerability were central; age, gender, and health status were considered as key indicators of vulnerability. The opinion of adult protection workers about the potential effectiveness of their intervention was a factor in deciding about responding to alleged or suspected abuse. Professionals struggled with complex ethical dilemmas created by elder abuse, particularly when the victim did not want an investigation. Making objective judgements was difficult when faced with complex family and contextual factors. A structured approach to narrative synthesis of a diverse range of studies retrieved through an explicit search and inclusion process provided a useful summary of key issues for practice and identified gaps in the research literature.
Storck, Michael; Black, Laura; Liddell, Morgan
Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.
Childhood sexual abuse affects at least 18% of British women but the true figure may be far higher. Repressed memories may resurface at childbirth. Midwives need to be aware of certain behavioural tendencies which may indicate childhood sexual abuse. There are four recognised labour styles which may be adopted by abuse survivors. Extra sensitivity should be used by midwives when caring for a possible abuse survivor. Disclosure of abuse must always come from the client.
... to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified as the most frequently cited ... victim and/or the perpetrator who has the substance abuse problem. Substance abuse is believed to be a ...
Schuckit, Marc A.
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)
... and Resources Clinical Trials Share Older Adults and Mental Health Overview It’s just as important for an older ... this helpline, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), to receive immediate counseling. Calling ...
Burnes, David P R; Rizzo, Victoria M; Courtney, Erin
Little is known about conditions associated with favorable elder mistreatment (EM) case outcomes. The fundamental goal of EM protective service programs is to alleviate risk associated with substantiated cases of elder abuse and neglect. Using the EM socio-cultural model, this study examined victim, perpetrator, victim-perpetrator relationship, social embeddedness, and socio-cultural factors predicting risk alleviation of EM cases. Data from a random sample of EM protective social service cases (n = 250) at a large community agency in New York City were collected and coded by multiple, independent raters. Multinomial and binary logistic regression were used to examine undifferentiated risk alleviation for the entire sample of EM cases as well as differentiated financial, emotional, and physical abuse sub-types. Undifferentiated EM risk alleviation was associated with male victim gender, older victim age, previous community help-seeking, and victim-perpetrator dyads characterized by a separate living arrangement and shorter term abuse longevity. Financial abuse cases with younger perpetrators were less likely to have risk reduction. Physical abuse risk reduction was less likely when the perpetrator was male and the victim-perpetrator dyad included different genders. Distinct findings across EM sub-types suggest a need to develop targeted practice strategies with clients experiencing different forms of EM. Findings highlight a need to develop EM protective service infrastructure around perpetrator rehabilitation.
This paper describes a study that explored the extent and nature of workplace violence in child protective services (CPS). A total of 68 workers and clients reported on their experiences. Of workers, 70% reported being the victim of client violence, and 22% reported they had perpetrated a violent act toward a client. Of clients, 55% reported being a victim of assault by a CPS worker, while 42% acknowledged perpetrating violence. Future research needs and recommendations for practice including training, reporting, and policy development are discussed.
Özcan, Neslihan Keser; Boyacıoğlu, Nur Elçin; Sertçelik, Elmas
The aim of the study was to determine the relationship between the neglect and abuse that older people were exposed to by their primary caregivers and the experiences of caregivers' burden and abuse by their charges. This descriptive, cross-sectional and correlational study was conducted with 186 individuals over the age of 65 and 136 caregivers. The data were collected using questionnaires to determine neglect and abuse experienced by both older people and caregivers, and the Zarit Burden Scale. Abuse rate of the older people and their caregivers is both high and similar. This study is to make psychiatric nursing professionals aware of the problem of elder abuse and neglect. For researchers, educators, practitioners, and policymakers in the fields of aging, health, and mental health this study provides important data about elder abuse and neglect.
A survey of 35 cases of reported abuse to individuals aged 60 and older in the state of Tennessee sought to determine demographic characteristics of the abused, perpetrators of elder abuse and neglect, types of abuse that occur, and any existence of relationships in elder abuse and neglect between urban and rural counties and eastern and western…
Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys
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.
Goldblatt, Hadass; Band-Winterstein, Tova; Alon, Sara
The aim of this qualitative study was to explore social workers' reflections on their experience of the therapeutic encounter with victims and perpetrators of elder abuse and neglect. The research questions were as follows: How do social workers tune themselves toward the therapeutic encounter with elder abuse? How do they position themselves vis-à-vis the clients? How do social workers describe the meaning of the intervention both for the clients and for themselves? What is the added value of the therapeutic encounter in this field for the social workers? Participants were 17 experienced women social workers, who worked with abusers and with abused and neglected older adults in Israel. Data were collected via in-depth semi-structured interviews, which were later transcribed and content analyzed. Two main themes emerged from the findings, emphasizing two key aspects of the social workers' reflective process experienced during the therapeutic encounter: (a) focus on the client: "This is the journey of their lives"-reflection on the therapeutic "journey"; (b) focus on the social worker's inner and professional world: "'There is nothing to be done' is no longer in my vocabulary"-a personal and professional maturation process. The social workers expressed a positive attitude toward their elder clients. A unique dialogue developed in the therapeutic encounter, whereby the social workers considered any change as valuable if it allowed the elders a sense of control and self-worth, whereas the social workers were enriched by the elders' life experience, and matured both personally and professionally. Thus, both sides benefited from this reciprocal relationship. Implications for further research and practice are discussed.
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…
Cohen, Adam W., Ed.
This volume of six lessons provides expert information on a variety of issues in substance abuse counseling. The lessons, which may be applied toward continuing education credits, are: (1) "Ethics in Substance Abuse Rehabilitation" (Robert L. Hewes); (2) "Addressing the Needs of Clients with Traumatic Injury and Alcoholism"…
Williams, June M.; Ballard, Mary B.; Alessi, Hunter
Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.
Kane, Michael N.; Green, Diane
Human service students' (social work, criminal justice, public administration, psychology) were surveyed (N = 242). Their perceptions about older persons' resilience and recovery from substance abuse were investigated. Overall, respondents did not agree that treating older persons for a substance abuse problem was wasteful of resources or older…
Gibson, Rebecca L.; Hartshorne, Timothy S.
Data regarding history of sexual abuse, loneliness, and network orientation were gathered from 231 female university students, 24 of whom indicated a history of abuse, and from 26 female clients at 2 treatment centers. Victims of sexual abuse, especially those in treatment, were more lonely and less likely to utilize their social support system…
Landrum, Brittany; Knight, Danica K; Flynn, Patrick M
This article 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 (K. M. Broome, P. M. Flynn, D. K. Knight, & D. D. Simpson, 2007). This study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the United States. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, whereas 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.
Bonow, Jordan T; Follette, William C
Ethical principles of psychology, as exemplified in the American Psychological Association (APA) Code of Ethics (2002), provide impractical advice for addressing client values during psychotherapy. These principles seem to argue that each client's values should be respected and protected at all times, except in cases in which this would result in harm to the client or the general public. Although the code is appropriately designed as a defense against potential and actual abuses of professional power, this general proscription against directly targeting client values for change is based on an understanding of values that grants them special ontological status and has resulted in limited clinical interventions focusing solely on “values clarification.” With its strong foundation in a unified philosophical system, clinical behavior analysis offers a sophisticated alternative approach to values that both defines what they are and identifies when they can be ethically targeted to improve the lives of clients. PMID:22478514
... mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, and injuries. There ...
... or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...
... abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a ...
Ellis, Thomas E.; Patel, Amee B.
The loss of a client to suicide is a painful personal and professional experience for mental health providers. Whether trainee or experienced professional, the affected clinician often reports feeling overwhelmed and unprepared for the experience of client suicide, together with significant emotional distress and diminished work performance. In…
Browne, Dorothy Howze
Examines data from clients reported and treated for child abuse and neglect to determine the role of stress in the commission of subsequent acts of abuse and neglect. Results indicate that stressful events and seriousness of the initial abusive incident had significant effects on commission of subsequent abusive and neglectful acts. (BB)
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…
Warren, Jazmin I.; Stein, Judith A.; Grella, Christine E.
Individuals with co-occurring substance use and psychiatric disorders have a more severe clinical course and poorer outcomes than do individuals with one disorder. In an attempt to find intervening variables that may contribute to improvement in treatment outcomes among individuals with co-occurring disorders, we investigated the roles of social support and self-efficacy in a sample of 351 clients with co-occurring disorders in residential drug abuse treatment programs (53% male; 35% African American, 13% Hispanic). Given their demographic variability, we also explored how ethnicity and age influence self-efficacy and access to social support, as well as their relationships to the outcomes. Structural equation modeling was used to examine the impact of the demographics and baseline psychological status, substance use, social support, and self-efficacy on mental health and substance use outcomes 6 months after treatment entry. Time in treatment was included as a control. Greater social support at baseline predicted better mental health status and less heroin and cocaine use; greater self-efficacy predicted less alcohol and cocaine use. Older clients reported less social support. African-American ethnicity was associated with more cocaine use at baseline and follow-up; however, African Americans reported more self-efficacy, which moderated their cocaine use. The current study highlights the potential therapeutic importance of clients' personal resources, even among a sample of severely impaired individuals. PMID:17329040
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.
Myers, Bronwyn; Fakier, Nuraan
To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…
Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G
Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured.
Davidhizar, R; Newman-Giger, J
After years as a taboo topic, abuse has come "out of the closet" and is being talked about openly in society. Yet, while abuse in the workplace is being confronted, abuse within families still often goes unrecognized by outsiders, including by nurses. Failure of nurses to recognize abuse is unfortunate since frequently they are the first point of contact with the victim of abuse in the emergency room, clinic and home. Understanding and insight into the problem of family violence by nurses is critical in addressing this problem. Knowledge is crucial in planning strategies that will have the long-lasting effect of decreasing the cycle of abuse in families.
Bradley, H; Bedada, A; Tsui, A; Brahmbhatt, H; Gillespie, D; Kidanu, A
Integrating voluntary HIV counselling and testing (VCT) with family planning and other reproductive health services may be one effective strategy for expanding VCT service delivery in resource poor settings. Using 30,257 VCT client records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between HIV and family planning service integration modality and three outcomes: VCT client composition, client-initiated HIV testing and client HIV status. Associations between facility HIV and family planning integration level and the likelihood of VCT clients being atypical family planning client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating services in the same compound, those offering family planning and HIV services in the same rooms were 2-13 times more likely to serve atypical family planning client-types than older, ever-married women. Facilities where counsellors jointly offered HIV and family planning services and served many repeat family planning clients were significantly less likely to serve single clients relative to older, married women. Younger, single men and older, married women were most likely to self-initiate HIV testing (78.2 and 80.6% respectively), while the highest HIV prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located services, those integrating services at room- and counsellor-levels were 1.9-7.2 times more likely to serve clients initiating HIV testing. These health facilities attract both standard material and child health (MCH) clients, who are at high risk for HIV in these data, and young, single people to VCT. This analysis suggests that client types may be differentially attracted to these facilities depending on service integration modality and other facility
Efrat, M.; Bercovitch, J.
Throughout the world the two superpowers often conduct their global conflict by proxy, taking different sides in regional disputes. An important question of international relations is where the balance of power lies in the superpower client state relationship-how far are the interests of the superpower subordinated to those of the client state or vice versa. Taking the two case studies of the US-Israel relationship and the Soviet-Syrian relationship, this book explores the perceptions by each side of the relationship and the reality. It goes on to make general conclusions about superpower-client state relationships. Contents: Introduction; In Search of a Theoretical Framework; Client-States in Superpower Perception; Superpowers in Client States' Perception; The Case of US-Israel Relations; Israel in US Perspective; The USA in Israeli Perspective; Flows of US Civilian and Military Resources to Israel; The Case of Soviet-Syrian Relations; Syria in Soviet Perspective; The USSR in Syrian Perspective; Flows of Soviet Civilian and Military Resources to Syria; Comparative Analysis and Conclusions; Overview of the two cases studies and conclusions.
Petkus, Andrew J.; Wetherell, Julie Loebach
Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…
... seniors who are not abused. What are the indicators? Indicators are signs or clues that abuse has ... clusters of indicators that suggest a problem. Physical indicators Sprains, dislocations, fractures, or broken bones Burns from ...
... Who may be abusing inhalants?The most common abusers of inhalants are teenagers, especially those who are ... to your child about the dangers of trying drugs can help him or her make the right ...
... 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 ...
Foreman, Susan; Seligman, Linda
Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)
Buettner, Linda L; Fitzsimmons, Suzanne; Barba, Beth
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.
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)
A study was conducted of 262 training providers in Malaysia, where providers must be government approved. Government regulation, client demands for high quality, and an economic downturn that focused attention on training costs have all influenced evaluation in a positive direction. (SK)
Salyers, Kathleen M.; Ritchie, Martin H.; Cochrane, Wendy S.; Roseman, Christopher P.
Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational…
Salyers, Kathleen M.; Ritchie, Martin H.; Luellen, Wendy S.; Roseman, Christopher P.
Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational…
Smock, Sara A.; Trepper, Terry S.; Wetchler, Joseph L.; McCollum, Eric E.; Ray, Rose; Pierce, Kent
The present study compared solution-focused group therapy (SFGT) with a traditional problem-focused treatment for level 1 substance abusers. Outcome research on the effectiveness of solution-focused group therapy is minimal, especially in treating substance abusers. In the present study, clients were measured before and after treatment to…
Smock, Sara A; Trepper, Terry S; Wetchler, Joseph L; McCollum, Eric E; Ray, Rose; Pierce, Kent
The present study compared solution-focused group therapy (SFGT) with a traditional problem-focused treatment for level 1 substance abusers. Outcome research on the effectiveness of solution-focused group therapy is minimal, especially in treating substance abusers. In the present study, clients were measured before and after treatment to determine therapeutic effectiveness. Clients in the solution-focused group significantly improved on both the Beck Depression Inventory and the Outcome Questionnaire. The clients in the comparison group did not improve significantly on either measure. Therapist skill level and adherence to theoretical models were measured in each group to reduce confounding variables.
Thompson, Heather; Priest, Ronnie
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…
MacNeil, Richard D.; And Others
Examined the attitudes of 95 therapeutic recreation (TR) majors toward older adults regarding expressed job preferences. Subjects completed the TR Work Preference Survey. Findings indicated that TR majors preferred to work with younger clients. No matter what disability any hypothetical client had, subjects still preferred to work with younger…
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…
Friedman, Alfred S.; Utada, Arlene
Describes development of Adolescent Drug Abuse Diagnosis (ADAD), a 150-item instrument with a structured interview format, which produces a comprehensive evaluation of the life problem areas pertinent to the needs of adolescent drug abuse clients. A series of validity and reliability tests are described, along with characteristics of the…
Gold, Deborah T.; Gwyther, Lisa P.
Notes that research on elder abuse highlights importance of communication and conflict resolution in families of older people, and that few prevention programs are available for use with community groups. Reviews literature on elder abuse and describes an educational curriculum designed to prevent abuse and neglect in families of the elderly.…
Brown, B. Bradford
Surveyed perceptions of the causes, severity, and treatment of elderly substance abuse as reported by 30 drug-abuse, health care, and social service practitioners. Perceptions differed as a function of both the basic type of services an agency provided and its specific response to older abusers. (Author)
Murdach, Allison D.
Examines potentially assaultive or preassaultive client and suggests some ways to minimize the risk of assault by such clients. Data for the article are from author's 10-year experience in providing social work services on acute psychiatric ward in large public medical center. Reviews potentially assaultive client conditions of panic, rage,…
Surgenor, P. W. G.; Meehan, V.; Moore, A.
The study aimed to identify the level of suicidal ideation in early attrition clients and their reasons for the early termination of their therapy. The cross-sectional design involved early attrition clients (C[subscript A]) who withdrew from therapy before their second session (n = 61), and continuing clients who (C[subscript C]) progressed…
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…
Dong, XinQi; Chen, Ruijia; Simon, Melissa A
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.
Cochran, Bryan N; Cauce, Ana Mari
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.
Steenbergh, Timothy A; Runyan, Jason D; Daugherty, Douglas A; Winger, Joseph G
Members of the National Association of Alcoholism and Drug Abuse Counselors (n = 231) participated in a survey concerning their view of the role of personal responsibility in addictions treatment and its relation to their exposure to neuroscience (i.e., the amount to which members considered themselves familiar with current neuroscience research). We used the two-dimensional model of responsibility (Responsible/not responsible for development × Responsible/not responsible for recovery) proposed by P. Brickman et al. (1982) to guide our assessment of responsibility, thus inquiring about counselors' views of clients' responsibility for both the development of a substance-related addiction and its resolution. Findings suggest that counselors rate biological factors as most influential in the development of an addiction and assign clients less personal responsibility for the development of an addiction than for recovery from an addiction. Counselors' level of neuroscience exposure was negatively correlated with their ratings of client responsibility for the development of an addiction but positively correlated to ratings of client responsibility for recovery. This suggests that counselors are integrating neuroscientific findings with what is learned from other modes of enquiry in a way that diminishes the view that clients are responsible for addiction development but accentuates the view that clients are responsible for recovery. We explore reasons for why this is and why this approach may be beneficial.
Ioannidis, Vassilios; van Nimwegen, Erik; Stockinger, Heinz
ISMARA ( ismara.unibas.ch) automatically infers the key regulators and regulatory interactions from high-throughput gene expression or chromatin state data. However, given the large sizes of current next generation sequencing (NGS) datasets, data uploading times are a major bottleneck. Additionally, for proprietary data, users may be uncomfortable with uploading entire raw datasets to an external server. Both these problems could be alleviated by providing a means by which users could pre-process their raw data locally, transferring only a small summary file to the ISMARA server. We developed a stand-alone client application that pre-processes large input files (RNA-seq or ChIP-seq data) on the user's computer for performing ISMARA analysis in a completely automated manner, including uploading of small processed summary files to the ISMARA server. This reduces file sizes by up to a factor of 1000, and upload times from many hours to mere seconds. The client application is available from ismara.unibas.ch/ISMARA/client. PMID:28232860
The focus of this monograph is on three areas of counseling with older clients: career counseling, retirement counseling, and counseling regarding death and dying. The portion on career counseling includes reasons older persons change careers, obstacles they are likely to face when seeking employment, myths surrounding the employability of older…
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
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…
Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin
Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…
... for pornography is also sexual abuse. Most sexual abusers know the child they abuse. They may be ... friends, neighbors or babysitters. About one-third of abusers are related to the child. Most abusers are ...
Kent, Lindsey; And Others
Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…
Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth
Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases.
Carmona-Torres, Juan Manuel; López-Soto, Pablo Jesús; Coimbra-Roca, Ana Isabel; Gálvez-Rioja, Ruth Mary; Goergen, Thomas; Rodríguez-Borrego, M Aurora
In many parts of the world, elder abuse happens almost unnoticed. Until recently, this serious social problem was hidden from public view and was regarded as an essentially private matter. However, there is growing evidence that elder abuse is an important problem of public health and in the society. The objective of this study is to determine the degree of abuse of elder and vulnerable people in the families and communities of Eastern Bolivia. With this end in mind, we conducted a cross-sectional descriptive study with a sample size of 210 60-year-old people coming from different health care areas. Elder Abuse Suspicion Index (EASI) and Yaffe's Evaluation Form of Social Work were used. An abuse rate of 39% of the older adults was identified. The most common type of abuse observed was psychological abuse (32.4% of cases), followed by neglect (21.9%). Children were identified as triggers of the abuse in 66.7% of cases of abuse. The prevalence of elder abuse was similar to the prevalence of other types of abuse that exist in Bolivia, such as the gender-based abuse. Also, this prevalence is comparable to other developing countries and European countries. The profile of abused older adult is as follows: woman, widow, 70 years old, incomplete primary education, without an occupation, and an average of 4.59 children. The information obtained shows that dysfunctional families have a higher percentage of elder abuse.
Werthmann, H V
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.
Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.
This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists, experiences related to managing the chaotic nature of the client's lives, wanting to manage the client's lives, and frustration with client's life trajectories are reviewed. Observations related to the therapeutic process include the client's relationship to the therapist, balancing the client's independence and need for assistance, and unrealistic expectations among the clients. Recommendations for successfully approaching these clinical situations and experiences are offered. The purpose of this article is to document these therapy experiences to facilitate the work of future teams seeking to intervene in the lives of homeless families through homeless shelters or other settings. PMID:23285834
Mangrum, Laurel F
The study examines client and service characteristics of addiction treatment completers and non-completers with co-occurring disorders (COD). On demographic variables, completers were more likely to be male and homeless. In the psychiatric domain, a greater proportion of completers received diagnoses of depression and generalized anxiety disorder, whereas non-completers were more often diagnosed with bipolar disorder and posttraumatic stress disorder. No group differences were found in client-reported psychiatric symptom severity; however, non-completers were rated by clinicians as having more severe symptoms in the areas of interpersonal sensitivity, depression, and hostility. In the area of substance use patterns, no differences were found in primary substance of abuse but completers reported more days of use during the month prior to treatment. Completers also had a greater history of both prior detox and non-detox treatment. At discharge, completers achieved higher rates of past month abstinence and AA attendance, but no differences were found in length of stay in treatment. Examination of recovery support services utilization revealed that completers more often received peer mentoring services. Greater proportions of the non-completer group received educational support, clothing, medical care, and employment assistance. These results suggest that future studies are needed in examining possible differential treatment response by diagnostic category and the potential role of peer mentoring in enhancing addiction treatment completion of COD clients.
Dong, Xinqi; Simon, Melissa A; Gorbien, Martin
This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.
Scheel, Michael J.
Ryan and colleagues are applauded for elevating client factors in the form of motivation and autonomy to equal status with the alliance as common factors in psychotherapy. Next, client motivation and autonomy are explained to be inextricably linked with one promoting the other. Motivational methods are summarized for the major approaches, making…
Simpson, Arlene J.; Bedi, Robinder P.
Clients' perspectives on the therapeutic alliance were examined using written descriptions of factors that clients believed to be helpful in developing a strong alliance. Fifty participants sorted previously collected statements into thematically similar piles and then gave each set of statements a title. Multivariate concept mapping statistical…
Liebschutz, Jane; Savetsky, Jacqueline B.; Saitz, Richard; Horton, Nicholas J.; Lloyd-Travaglini, Christine; Samet, Jeffrey H.
This study examines the relationship between a history of physical and sexual abuse (PhySexAbuse) and drug and alcohol related consequences. We performed a cross-sectional analysis of data from 359 male and 111 female subjects recruited from an inpatient detoxification unit. The Inventory of Drug Use Consequences (InDUC), measured negative life consequences of substance use. Eighty-one percent of women and 69% of men report past PhySexAbuse, starting at a median age of 13 and 11, respectively. In bivariate and multivariable analyses, PhySexAbuse was significantly associated with more substance abuse consequences ( p < 0.001). For men, age ≤ 17 years at first PhySexAbuse was significantly associated with more substance abuse consequences than an older age at first abuse, or no abuse ( p = 0.048). For women, the association of PhySexAbuse with substance use consequences was similar across all ages ( p = 0.59). Future research should develop interventions to lessen the substance abuse consequences of physical and sexual abuse. PMID:12039614
Brunger, J B
Due to the nature of the work with this demanding population, who, in spite of all efforts, demonstrates only minimal changes at best, nurses need aggressive management of their own lives. Burnout is rampant. Work with this type of client is not for everyone. Programs need to offer staff the opportunity to work with these clients only if the staff is capable and desires the challenge. It is necessary to set realistic goals and expectations with clients and to learn to accept tiny changes. Nurses must help the client become more realistic in their expectations of what will be achieved. It is important to note that the therapist may scare the client into regressed behavior by being too hopeful, by pushing them too far too fast, and by allowing them to go too fast. Caution should be taken with respect to encouragement and expectations of normalcy. If goals are too high and the client "fails," the therapist perceives that he/she is the one who failed. The patient who manages to achieve a level of functioning that enables him to interface with the outside often finds a world that is cold, demanding, and cruel--one that is easier to escape from than to deal with. One must be flexible and accessible to the client--involved with honest detachment. For the nurse therapist to serve this population requires sophistication in the theories of child and adolescent suicide, crisis intervention, aggression management, chemical abuse and use, and the ability to negotiate housing, money, food, services--things which have previously been the domain of others.(ABSTRACT TRUNCATED AT 250 WORDS)
... 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Weiss RD. Drugs of abuse. In: Goldman L, ... Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...
... Break Up Respectfully Abuse Sexual Harassment and Sexual Bullying Love and Romance Getting Over a Break-Up Dealing With Bullying Posttraumatic Stress Disorder Sexual Attraction and Orientation Teens ...
Cosden, M; Cortez-Ison, E
Residential programs that provide safe environments and child care can attract perinatal women into treatment. Other factors, however, may prevent some women from benefiting from these programs. Attachment theory suggests that one's early history determines the effectiveness with which one can utilize available social supports. Lower levels of program retention were predicted for women who had been sexually abused and for those who had poor early bonding. Eighty-four women in residential substance abuse treatment programs were studied. Clients who reported sexual abuse also reported lower parental care. Parental care and overprotection were inversely related, and related, in predicted directions, to perceptions of social supports. Sexual abuse alone was associated with time in treatment and the likelihood of graduation. Implications for developing effective counseling programs for women in substance abuse treatment are discussed.
Dickey, Lore M.; Loewy, Michael I.
Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…
Molnar, Jack; Stup, Brenda
This article describes an ongoing survey that illustrates how evaluators, working with program managers, have effectively used client-based data to monitor performance in the Social Security Administration. The value of client-based data outweighs the limitations and problems collecting it. Customer perceptions are a critical barometer of quality.…
Esposito-Smythers, Christianne; Walsh, Adam; Spirito, Anthony; Rizzo, Christie; Goldston, David B.; Kaminer, Yifrah
Substance use disorders and suicidal thoughts and behaviors commonly co-occur in adolescent and adult psychiatric populations and are often functionally interrelated. Although the evidence base for treatment of this population is sparse, integrated cognitive behavioral treatment (CBT) protocols, or those that rely heavily on CBT techniques, hold…
Scholl, Mark B.; Schmitt, Dorothy M.
Motivational Interviewing (MI; W. R. Miller & S. Rollnick, 2002) is presented as a potentially effective counseling strategy for assisting traditionally aged college students in reducing their problematic, heavy alcohol use. MI's congruence with two developmental theories--Self-Determination Theory (R. M. Ryan & E. L. Deci, 2000) and…
Burke, Anna C.; Gregoire, Thomas K.
This study provides new evidence regarding the relation of coerced care to posttreatment substance use and addiction severity while controlling for two important factors: readiness to change and addiction severity at admission to treatment. The initial study sample consisted of 289 people who agreed to participate in a prospective study of…
Kalapatapu, Raj K; Sullivan, Maria A
The number of older adults needing substance abuse treatment is projected to rise significantly in the next few decades. This paper will focus on the epidemic of prescription use disorders in older adults. Particular vulnerabilities of older adults to addiction will be considered. Specifically, the prevalence and patterns of use of opioids, stimulants, and benzodiazepines will be explored, including the effects of these substances on morbidity and mortality. Treatment intervention strategies will be briefly discussed, and areas for future research are suggested.
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…
... Enter ZIP code here Enter ZIP code here Child Sexual Abuse Public This section is for Veterans, General Public, Family, & Friends Child Sexual Abuse What is child sexual abuse? Child sexual abuse ...
Bailey, Jeffrey J.
Proposes the metaphor of professional/client rather than student-as-customer to characterize the relationship between professors and students. Uses examples of fitness trainer, management consultant, accounting service, and mountain guide to illustrate faculty and student roles. (SK)
V Essen, H; Schlickewei, W; Dietz, H-G
Child abuse is most often diagnosed by an emergency doctor on call who sometimes "feels" more than knows what he is confronted with. He should nevertheless always take a medical history and make a physical and radiological examination. X-ray imaging and an ophthalmologic retinal examination are the most important diagnostic steps. Typical findings are multiple and/or dorsal rib fractures, complex skull fractures, physeal fractures, all fractures within the first 12 months, multiple fractures in different localisations and stages of healing, all injuries with uncommon distributions, all patterned bruises, immersion burns, intramural hematoma and every unexplained loss of consciousness. The first step towards victim protection is always the removal of the abused child from its caregivers by admitting it to hospital, as 95% of all cases of reported child abuse take place within the child's family.
Rubenzahl, Samuel A.; Gilbert, Brenda O.
Surveys of agencies specializing in treating victims of child sexual abuse indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not…
Schacht, Robert M.; Gaseoma, Lee
Vocational rehabilitation (VR) counselors in states where American Indians reside in large numbers were surveyed to determine the proportion of American Indian clients with alcohol or substance abuse problems in the counselors' caseloads and the kinds of specializes services provided to the clients A total of 124 VR counselors from 14 states…
Thompson, Lynda; Thompson, Michael; Reid, Andrea
This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting. The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS. An earlier paper (Thompson et al. 2009) reviews the symptoms of AS, highlights research findings and theories concerning this disorder, discusses QEEG patterns in AS (both single and 19-channel), and details a hypothesis, based on functional neuroanatomy, concerning how NFB, often paired with biofeedback (BFB), might produce a change in symptoms. A further aim of the current report is to provide practitioners with a detailed description of the method used to address some of the key symptoms of AS in order to encourage further research and clinical work to refine the use of NFB plus BFB in the treatment of AS. All charts were included for review where there was a diagnosis of AS or ASD and pre- and post-training testing results were available for one or more of the standardized tests used. Clients received 40-60 sessions of NFB, which was combined with training in metacognitive strategies and, for most older adolescent and adult clients, with BFB of respiration, electrodermal response, and, more recently, heart rate variability. For the majority of clients, feedback was contingent on decreasing slow wave activity (usually 3-7 Hz), decreasing beta spindling if it was present (usually between 23 and 35 Hz), and increasing fast wave activity termed sensorimotor rhythm (SMR) (12-15 or 13-15 Hz depending on assessment findings). The most common initial montage was referential placement at the vertex (CZ) for children and at FCz (midway between FZ and CZ) for adults, referenced to the right ear. Metacognitive strategies relevant to social understanding, spatial
Martin, Caren McHenry
The increased use of prescription drugs has brought pain relief too many and often improved the quality of life of elderly patients. But the increase in use and availability of prescription medications-especially controlled substances-brings with it an increased potential for abuse. Studies have shown that intentional abuse of prescription drugs is increasing among all age groups. As the number of persons 65 years of age and older skyrockets with the aging of the baby boomers, experts predict that prescription drug abuse among the elderly also will rise significantly. Efforts to increase awareness of drug abuse among elderly patients, caregivers, and health care practitioners, as well as research into how best to prevent and treat the elderly drug abuser, will be necessary to thwart what could become a significant public health problem.
O'Reilly, Mary Linda
Spirituality is an important part of human existence but is often overlooked in the conceptualization of the person as a biopsychosocial entity. This article examines spirituality as a concept, relates it to the experience of mental health clients, proposes spiritual assessments and interventions within the role of advanced practice mental health nurses, and discusses the necessity of including spiritual interventions to support healing and wholeness for mental health clients.
Marlowe, Douglas B; Festinger, David S; Lee, Patricia A; Dugosh, Karen L; Benasutti, Kathleen M
This article reports outcomes from a program of experimental research evaluating the risk principle in drug courts. Prior studies revealed that participants who were high risk and had (a) antisocial personality disorder or (b) a prior history of drug abuse treatment performed better in drug court when scheduled to attend biweekly judicial status hearings in court. In contrast, participants who were low risk performed equivalently regardless of the court hearings schedule. This study prospectively matches drug court clients to the optimal schedule of court hearings based on an assessment of their risk status and compares outcomes to clients randomly assigned to the standard hearings schedule. Results confirmed that participants who were high risk and matched to biweekly hearings had better during-treatment outcomes than participants assigned to status hearings as usual. These findings provide confirmation of the risk principle in drug courts and yield practical information for enhancing the efficacy and cost-efficiency of drug courts.
... bruises, while behavioral indicators are ways victims and abusers act or interact with each other. Some of the indicators listed below can be explained by other causes (e.g. inappropriate or unusual behavior may signal dementia or drug interactions) and no single indicator can be taken ...
Hoover, Robert M; Polson, Michol
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.
... 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 Awareness... Constitution and the laws of the United States, do hereby proclaim June 15, 2013, as World Elder...
Goldbach, Jeremy T.; Thompson, Sanna J.; Holleran Steiker, Lori K.
Nearly 10% of Latino youth who are twelve and older are in need of substance abuse treatment for alcohol or illicit drug use. Ethnic differences exist with regard to susceptibility to drug use, attitudes regarding drugs, and drug resistance strategies. The failure of some substance abuse prevention programs can be traced in part to their lack of…
US Department of Health and Human Services, 2004
Males are more likely to use, abuse, and be dependent on alcohol or illicit drugs than females. The 2003 National Survey on Drug Use and Health (NSDUH) asked questions of persons aged 12 or older to assess their use of alcohol and illicit drugs, as well as their symptoms of substance dependence or abuse during the past year. NSDUH defines "any…
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…
Weiss Ogden, Karen R.; Sias, Shari M.
Substance abuse counselors who address clients' spiritual development may provide more comprehensive counseling. This article presents an integrative supervision model designed to promote the spiritual development of substance abuse counselors-in-training, reviews the model, and discusses the implications for counselor education.
Wanlass, Janine; Moreno, J. Kelly; Thomson, Hannah M.
Although group therapy for abused and neglected youth is a viable and efficacious treatment option, facilitation is challenging. Group leaders must contain intense affect, manage multiple transferences, and advocate for their clients within the larger social welfare system. Using a case study of a group for sexually abused girls, this paper…
Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.
This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists,…
Joanning, Harvey; And Others
Assessed differential effectiveness of three models of adolescent drug abuse treatment: Family Systems Therapy (FST), Adolescent Group Therapy (AGT), and Family Drug Education (FDE). FST appeared more effective in stopping adolescent drug abuse than AGT or FDE, registering twice as many apparently drug-free clients as FDE and three times as many…
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…
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.…
Hamilton, C; Okoko, D; Tolhurst, R; Kilonzo, N; Theobald, S; Taegtmeyer, M
The rapid scale-up of HIV counselling and testing programmes in Kenya has led to quality concerns, including the potential for abuse within the private, confidential setting of client-initiated voluntary counselling and testing (VCT). A qualitative study was conducted in three provinces of Kenya, involving 26 VCT service providers and 13 key informants. First and second hand accounts of emotional, physical and sexual abuse emerged in all three study sites in spite of measures to mitigate such occurrences. Whilst uncommon, abuse was perceived by service providers to be serious and sufficiently widespread to raise significant concerns. Abuse occurred client to counsellor, from counsellor to client and from counsellor to counsellor. In all cases the person suffering the abuse was female. While the potential for abuse was demonstrated in VCT sites, we argue that experiences of abuse are not confined to VCT and are largely shaped by gender and power relations within the Kenyan cultural context. The international impetus for scale-up of HIV services provides an urgent rationale for the need to address and highlight these difficult issues at multiple levels. International guidelines, policy and methods need adapting in recognition of the potential for abuse. Systems for investigating and deregistering counsellors have been developed in Kenya but require formalizing. Institutions providing VCT should consider unlocked doors, semi-opaque windows and the use of 'mystery clients' as a quality assurance measure.
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…
Fogler, Jason M; Shipherd, Jillian C; Clarke, Stephanie; Jensen, Jennifer; Rowe, Erin
The literature on clergy-perpetrated sexual abuse suggests that there are two modal populations of survivors: boys and adult women. We review what is known about trauma and post-traumatic stress disorder following sexual abuse and explore the different treatment needs for these two survivor groups. For children, clergy-perpetrated sexual abuse can catastrophically alter the trajectory of psychosocial, sexual, and spiritual development. Depending on the age at which abuse occurred, adult clients may present with clinical issues that are more appropriate for a younger developmental stage. Additionally, the symptoms of traumatic stress may be misunderstood when clients conceptualize their abuse as an "affair" or "consensual" relationship. We discuss empirically supported treatments for post-traumatic stress disorder and potential adaptations for the needs of clergy-perpetrated sexual abuse survivors.
Keller, S; Finger, W R
Clients need both skill and motivation to effectively use natural family planning (NFP). Thus, NFP services must provide adequate counseling and training to clients. A good teacher of NFP does not need formal health care training but she/must have good communication skills. A teacher usually needs to meet with a client four times over a period of several months to teach NFP. Fertility awareness comprises the first step in NFP training. This involves helping couples to understand the reproductive system, menstrual cycles, and fertile periods. The NFP Training and Medical Services Center in Nairobi, Kenya, provides clients, many of whom live in slums and are illiterate, with an exercise book with small squares that they color so they can track their fertility signs. They tend to use the cervical mucus method rather than the basal temperature method which requires a thermometer. In Los Angeles, California, clients of one NFP program attend group sessions and individual counseling sessions to learn about the menstrual cycle, fertile period, and rules of NFP and how to apply them. The Twin Cities NFP Center in Minnesota found that individual counseling was 50% more expensive than group sessions and it affected changes in neither the pregnancy nor NFP continuation rates. Group training here involved more men. Catholic groups in Bangladesh, India, Kenya, South Korea, and the US conducted a study of NFP programs and found that client's willingness or ability to discuss NFP were not associated with socioeconomic status, previous family planning experiences, and education. Another study of the same users did find an association between higher education and lower unplanned pregnancy rate. The same was true for previous family planning use. Since limited resources prevent some family planning programs from training staff in NFP, the programs can refer clients to existing NFP services, sending one staff member to be trained in NFP, or having one staff member providing NFP
Melnick, G; De Leon, G; Thomas, G; Kressel, D
The present study is the first report on a client-treatment matching protocol (CMP) to guide admissions to residential and outpatient substance abuse treatment settings. Two cohorts, a field test sample (n = 318) and cross-validation (n = 407) sample were drawn from consecutive admissions to nine geographically distributed multisetting therapeutic communities (TCs). A passive matching design was employed. Clients received the CMP on admission, but agencies were "blind" to the CMP treatment recommendation (i.e., match) and assigned clients to treatment by the usual intake procedures. Bivariate and logistical regression analyses show that positive treatment dispositions (treatment completion or longer retention in treatment)) were significantly higher among the CMP-matched clients. The present findings provide the empirical basis for studies assessing the validity and utility of the CMP with controlled designs. Though limited to TC-oriented agencies, the present research supports the use of objective matching criteria to improve treatment.
Litwin, Howard; Zoabi, Sameer
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…
Marcenko, Maureen O.; And Others
Examined psychosocial characteristics and service needs of pregnant women with substance abuse histories. Interviewed 225 pregnant women defined as having high-risk pregnancies for psychosocial reasons. Compared to non-substance-abusing women, those with admitted history of substance abuse were significantly older, had more children, were more…
Gullattee, Alyce C.
Spouse abuse is being discussed and agonized over more frequently than in past years. Although interpousal and intrafamilial violence have been behaviors of note and considerable consequence, they have been attributable, almost exclusively, to the lower socioeconomic classes. Many hypotheses have been proposed concerning the etiology of violence. The author discusses some of the more general sociopolitical theories of violence and proposes three areas of significant moment to behaviorists. PMID:439165
Dillard, Dorothy; Bincsik, Arlene K; Zebley, Christopher; Mongare, Kefa; Harrison, James; Gerardi, Kimberly E; Parcher, David W
Treating minority substance abusers at risk of HIV or HIV positive is a critical public health issue. Delaware has achieved success in treating this population through its integrated nested services approach. Through three Center for Substance Abuse funded projects, Delaware has synthesized a number of evidence-based and best practices from the HIV medical treatment, substance abuse treatment and mental health treatment. Evaluation findings show that Project HOPE and Meeting the Challenges are having a positive impact on clients in a number of areas, including medical compliance, physical health, sobriety, employment/income and living situations. Clearly, this approach benefits all stakeholders, including the State of Delaware, local communities, staff and clients.
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…
Brockett, Daniel R.; Gleckman, Ari D.
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…
Griest, K J; Zumwalt, R E
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.
Paino, Maria; Aletraris, Lydia; Roman, Paul
Objective: The National Institute on Drug Abuse (NIDA) recommends a comprehensive treatment program for individuals with substance use disorder (SUD) in order to treat needs they often have in addition to their SUD. Specifically, NIDA suggests providing services related to the following issues: medical care, mental health care, HIV/AIDS, child care, educational, vocational, family counseling, housing, transportation, financial, and legal. By providing a comprehensive model that combines core and wraparound services, treatment centers can deliver a higher quality of treatment. In this article, we assessed the relationship between client characteristics and the availability of wraparound services in SUD treatment centers. Method: We combined two nationally representative samples of treatment centers and used a negative binomial regression and a series of logistic regressions to analyze the relationship between client characteristics and wraparound services. Results: On average, centers offered fewer than half of the wraparound services endorsed by NIDA. Our results indicated that client characteristics were significantly related to the provision of wraparound services. Most notably, the proportion of adolescent clients was positively related to educational services, the proportion of female clients was positively related to child care, but the proportion of clients referred from the criminal justice system was negatively associated with the provision of multiple wraparound services. Conclusions: Our findings have important implications for SUD clients and suggest that, although centers are somewhat responsive to their clients’ ancillary needs, most centers do not offer the majority of wraparound services. PMID:26751366
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)
Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.
Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…
Hohman, Melinda; Oliver, Rhonda; Wright, Wendy
Methamphetamine abuse is on the rise, particularly by women of child-bearing age. This article describes the history and effects of methamphetamine use. The authors examine the ways exposure to the manufacture of this drug affects clients and social workers in the course of their work. Because children are frequently found at the scene of a…
Koehn, Corinne; O'Neill, Linda; Sherry, John
Hope is a vital component of psychological healing and plays a critical role in counselling. With despair so prominent for individuals with serious substance abuse problems, the question arises as to how to foster hope in such clients. There are recent suggestions in the general counselling literature that some of the work in counselling involve…
Koehn, Corinne; Cutcliffe, John R.
This study used a grounded theory method to explore how counselors inspire hope in clients struggling with substance abuse. Findings from 10 participants revealed that hope inspiration occurred in 3 phases and consisted of several categories of hope-inspiring processes. Implications for counseling practice, counselor education, and research are…
Daley, Dennis C.
Discusses the problems of relapse with alcoholics and other drug abusers from three perspectives: client-related variables, common erroneous beliefs and myths held by professionals regarding relapse, and treatment system problems that may contribute to relapse. Offers proposed solutions and describes a relapse prevention model. (Author/ABB)
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A
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.
... Whether they're using street drugs or medications, drug abusers often have trouble at school, at home, with ... a short period of time may make a drug abuser aggressive or paranoid. Although stimulant abuse might not ...
Bird, P E; Harrington, D T; Barillo, D J; McSweeney, A; Shirani, K Z; Goodwin, C W
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
The nature and impact on educational and vocational functioning of prelingual deafness are reviewed, stereotypes are exposed, and the special needs of deaf clients in rehabilitation assessment, goal setting, service delivery, and placement are discussed. Trends in deafness rehabilitation are considered in terms of legislation, professional…
Wood, Dolores K.; Shultz, Jill Armstrong; Edlefsen, Miriam; Butkus, Sue N.
Two food pantries were surveyed for nutrition education (NE) interests and experiences. One site provided nutrition education classes; the comparison site was utilized to assess client interest in class topics. "Fixing low cost meals," "fixing quick and easy recipes," and "stretching food and food dollars" were topics…
Cooper, Claudia; Livingston, Gill
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.
This paper reviews theory and research on client classification and their processing in various organizational settings, with emphasis on drug abusers. Implications are drawn in terms of developing a better model of the social psychology of institutional life, and diagnostic-screening units more serviceable to needs of clients. (Author)
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…
Liebschutz, Jane M.; Finley, Erin P.; Braslins, Phillip G.; Christiansen, Demian; Horton, Nicholas J.; Samet, Jeffrey H.
Objectives We evaluated the prevalence of the sexually transmitted infections (STIs) chlamydia and gonorrhea in clients at a methadone maintenance program and a residential detoxification program. Methods We collected urine specimens for chlamydia and gonorrhea ligase chain reaction testing and assessed sexual, substance abuse and STI histories. Results Of 700 subject assessments, 490 occurred among detoxification clients and 210 in methadone maintenance. Chlamydia trachomatis was detected in 5/700 (0.9, 95% CI = 0.1–1.8%) and Neisseria gonorrhoeae in none. All chlamydia infected subjects were recruited from the detoxification program. Subjects reported high risk sexual behavior: 17% reported commercial sex exchange, and 22% reported inconsistent condom use with multiple sexual partners during the prior 2 months. Conclusion Based on prevalence in Boston, MA, universal screening for STI in substance abuse treatments programs is not warranted. However, routine screening for younger substance abusers and in communities with high prevalence should be considered. PMID:12681529
Winslow, Bradford T; Voorhees, Kenton I; Pehl, Katherine A
Methamphetamine is a stimulant commonly abused in many parts of the United States. Most methamphetamine users are white men 18 to 25 years of age, but the highest usage rates have been found in native Hawaiians, persons of more than one race, Native Americans, and men who have sex with men. Methamphetamine use produces a rapid, pleasurable rush followed by euphoria, heightened attention, and increased energy. Possible adverse effects include myocardial infarction, stroke, seizures, rhabdomyolysis, cardiomyopathy, psychosis, and death. Chronic methamphetamine use is associated with neurologic and psychiatric symptoms and changes in physical appearance. High-risk sexual activity and transmission of human immunodeficiency virus are also associated with methamphetamine use. Use of methamphetamine in women who are pregnant can cause placental abruption, intrauterine growth retardation, and preterm birth, and there can be adverse consequences in children exposed to the drug. Treatment of methamphetamine intoxication is primarily supportive. Treatment of methamphetamine abuse is behavioral; cognitive behavior therapy, contingency management, and the Matrix Model may be effective. Pharmacologic treatments are under investigation.
Owen, Jesse J; Tao, Karen; Leach, Mark M; Rodolfa, Emil
The current retrospective study examined whether clients' (N = 176) perceptions of their psychotherapists' multicultural orientation (MCO) were associated with their psychological functioning, working alliance, and real relationship scores. Moreover, we tested whether clients' perceptions of the working alliance and the real relationship mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. The results showed that clients' perceptions of their psychotherapists' MCO were positively related to working alliance, real relationship, and psychological functioning. Only clients' ratings of the working alliance mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. Thus, because clients perceive their psychotherapists as being more oriented toward cultural issues, they may view the therapist as being more credible and may gain a sense of comfort in the therapeutic process. In turn, clients' strong alliance facilitates improvement in psychological well-being.
Greenley, J R; Dottl, S L
Sociodemographic differences between rural and urban clients with severe mental illness (SMI) are explored using approaches which extend research in this area beyond limitations found in the few existing studies. Sixteen hundred adult clients from 18 Wisconsin counties are classified according to the degree of rurality of their counties of residence, using two definitions: a dichotomous metropolitan-non-metropolitan grouping and population density. There are significant differences between rural and urban clients for age, gender, and marital status, but not education or income. Young (18-35 years), unmarried males are more likely to live in more densely populated counties. Older (65 and older) women who are currently or previously married are more likely to live in less densely populated counties.
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…
A healthy group of loyal clients is of the utmost importance for a healthy practice.Knowing the clients’ expectations and making every effort to exceed them when clients meet with the veterinarian or visit the clinic will result in continued client satisfaction. Clients will show loyalty to a veterinarian when they perceive that the care provided to them suits them and their animal and exceeds their expectations.
Fenstermacher, Kurt D.; Ginsburg, Mark
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,…
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…
Dietzel, C. S.; Abeles, Norman
One hundred twenty tape recorded psychotherapy sessions representing early, middle, and late interviews with 20 clients were studied. Clients were divided into successful (N-10) and unsuccessful outcome (N-10) groups on the basis of clinicians' ratings of pre- and post-MMPI data. Raters scored the response units of clients and therapists and…
Dulaney, Diana D.; Kelly, James
Examines the gap in the theoretical and clinical training of social workers in helping the homosexual client. Proposes specific approaches for improving services to clients who are gay or lesbian. Discusses other neglected clients including heterosexual spouses, children of a homosexual parent, and aging homosexuals. (Author/RC)
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.
Fernando, Kumari; Medlicott, Louisa
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…
Straussner, Shulamith Lala A.; Vairo, Elena
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…
O'Halloran, David M; O' Reilly, Gary; Travers, Olive; Quinn, Paul; Stack, Jon; Cartin, Martin; Finnegan, Eileen; Ewart-Boyle, Shirley
This research explored the therapeutic events both clients and therapists from community-based treatment interventions for perpetrators of sexual abuse identify as significant in their experience of psychological therapy. A qualitative design was utilized to address this research objective. The sample for the present research is comprised of three different treatment programs for sexual offending. Twenty-five clients and nine therapists participated in the study. Two qualitative measures were used to elicit client and therapist responses. Significant Aspects of Therapy Form was administered every second treatment session during each intervention program. The Significant Aspects Follow-Up Interview was conducted with a sub-sample of participants at the conclusion of each treatment module. Thematic analysis was used to identify significant themes noted by clients and therapists from forms and interviews. Thematic analysis resulted in a model of significant events in therapy. In this model, significant events were categorized into six domains. The six domains were as follows: (a) the process of therapy, (b) making changes and progress in therapy, (c) content and structure of therapy, (d) therapist contributions, (e) negative contributions to therapy, and (f) other factors Each domain further contained between 6 and 18 themes, which are also reported. This study found much overlap and similarity in the experiences of therapy between clients of sexual offender therapy and general psychotherapy. Furthermore, there is overlap between therapists and clients in the aspects of therapy they identify as significant. The implications of these findings on effective service development and comprehensive service evaluations are discussed.
... 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 ...
Bowland, Sharon; Edmond, Tonya; Fallot, Roger D.
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…
Duran, Júlia; Villalbí, Joan R; Guix, Joan
Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.
Kearney-Cooke, A; Striegel-Moore, R H
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.
Sullivan, Maria A.
The number of older adults needing substance abuse treatment is projected to rise significantly in the next few decades. This article will focus on the epidemic of prescription use disorders in older adults. Particular vulnerabilities of older adults to addiction will be considered. Specifically, the prevalence and patterns of use of opioids, stimulants, and benzodiazepines will be explored, including the effects of these substances on morbidity and mortality. Treatment intervention strategies will be briefly discussed, and areas for future research are suggested. PMID:20958847
Tavrow, Paula; Withers, Mellissa; McMullen, Kara
This paper analyses the impact of high quality, user-friendly, comprehensive sliding-scale post-abortion services on clients' uptake of contraception in a Kenyan town. Data were drawn from detailed physician records in a private clinic that served 1080 post-abortion clients in 2006. All clients received confidential family planning counselling and were offered a complete range of contraceptives at no additional cost. One quarter of clients were below age 19. Prior to the abortion, no client aged 10-18 years reported having used contraception, as compared to 60% of clients aged 27-46 years. After the abortion and family planning counselling session, only 6% of clients aged 10-18 chose a method, as compared to 96% of clients aged 27-46, even though contraception was free, the provider strongly promoted family planning to everyone and all clients had just experienced an unwanted pregnancy. Significant predictors of contraceptive uptake post-abortion were: having a child, a previous termination, prior contraceptive use and being older than 21. These findings suggest that availability, affordability and youth-friendliness are not sufficient to overcome psycho-social barriers to contraceptive use for sexually-active young people in Kenya. To reduce unwanted pregnancies, more attention may be needed to developing youth-friendly communities that support responsible sexuality among adolescents.
Morris, Janet R
Bet Tzedek, Hebrew for the "House of Justice," provides free legal assistance to older adults in Los Angeles County. Their civil attorneys work alongside prosecutors and service providers for the elderly as members of multidisciplinary teams to assist older adults with complicated elder abuse and neglect cases. Case examples demonstrate how civil attorneys collaborate with the Los Angeles County Elder Abuse Forensic Center to address financial abuse, real estate fraud, and self-neglect issues. Cooperation among the courts, Bet Tzedek, and other county agencies has resulted in more user-friendly processes to expedite filing of conservatorships and elder abuse restraining orders.
Horton, E. Gail; Diaz, Naelys; Peluso, Paul R.; Mullaney, Donald; Weiner, Michael; McIlveen, John W.
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.)
Beach, Craig; Dykema, Lindsay-Rose; Appelbaum, Paul S; Deng, Louann; Leckman-Westin, Emily; Manuel, Jennifer I; McReynolds, Larkin; Finnerty, Molly T
OBJECTIVE This study compared rates of arrest and incarceration, psychiatric hospitalization, homelessness, and discharge from assertive community treatment (ACT) programs for forensic and nonforensic clients in New York State and explored associated risk factors. METHODS Data were extracted from the New York State Office of Mental Health's Web-based outcome reporting system. ACT clients admitted between July 1, 2003, and June 30, 2007 (N=4,756), were divided into three groups by their forensic status at enrollment: recent (involvement in the past six months), remote (forensic involvement was more than six months prior), and no history. Client characteristics as of ACT enrollment and outcomes at one, two, and three years were compared over time. RESULTS Clients with forensic histories had a significantly higher ongoing risk of arrest or incarceration, and those with recent criminal justice involvement had a higher risk of homelessness and early discharge from ACT. Psychiatric hospitalization rates did not differ significantly across groups. Rates of all adverse outcomes were highest in the first year for all ACT clients, especially for those with a recent forensic history, and rates of psychiatric hospitalization, homelessness, and discharge declined over time for all clients. For all ACT clients, homelessness and problematic substance abuse at enrollment were significant risk factors for arrest or incarceration and for homelessness on three-year follow-up. CONCLUSIONS Clients with recent forensic histories were vulnerable to an array of adverse outcomes, particularly during their first year of ACT. This finding highlights the need for additional strategies to improve forensic and other outcomes for this high-risk population.
Armstrong, Joshua J.; Sims-Gould, Joanie
Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial. PMID:27904234
Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul
Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.
Brown, B S; Benn, G J; Jansen, D R
The authors found similar attitudes toward methadone and methadone treatment programs in 75 detoxification and 115 methadone maintenance clients. Both groups expressed considerable ambivalence--although they viewed methadone as capable of helping them end their herioin addiction, they were concerned about possible methadone dependence and about side effects, both real and imagined. The authors stress the societal context of such concern and suggest that, althought they are not easily allayed, limiting the duration of methadone maintenace from the outset of treatment may be an ameliorative factor.
Koehn, Corinne V
Fifty women who were sexually abused as children were interviewed regarding their perceptions of helpful and hindering counseling behaviors. The critical incident technique was the methodology used. One major category that emerged from the data was Approach to Power and Control. This category comprised eight subcategories: (1) flexibility with agenda; (2) willingness to offer choices; (3) response to criticism; (4) response to client as an equal or with honor; (5) sexual interest; (6) approach to client's suggestions; (7) expectations regarding forgiveness; and (8) consultation with alter identities. Implications for counseling practice, research, and counselor education are discussed.
Pruszyński, Jacek J; Gebska-Kuczerowska, Anita; Cicha-Mikołajczyk, Alicja; Gromulska, Lucyna
Abuse, neglect and other forms of discrimination towards the elderly have always been present in history. There has been a model of "old person" in every culture, according to which older people are treated. The more idealized the model is, the less tolerant and more demanding society is towards the elderly. Presented results lead to the conclusion that significant number of older people feel mistreated because of their age in many aspects of daily life. Various forms of abuse may be difficult to thoroughly analyze, for they are so persistent in our collective consciousness. Unfortunately, material civilization progress is not sufficient to eliminate abuse. Thus, monitoring and relevant assistance to people exposed to abuse and violence, particularly those with compromised defense abilities, is crucial.
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
Brecht, Mary-Lynn; Urada, Darren
Methamphetamine (meth) is a major drug of abuse in California and several other states, particularly among criminal offender populations. Over the past decade, substance abuse treatment systems have had to adapt to and accommodate the increasing needs of meth users and, in California, deal with the impact of Proposition 36, which has resulted in a greater number of criminal offenders entering the treatment system. This study examines selected treatment performance and outcome indicators for California Proposition 36 offenders entering substance abuse treatment for meth use and compares their performance and outcomes to other subgroups of California treatment clients differentiated by whether or not they were admitted to treatment through Proposition 36 and whether or not their primary substance was meth. Significant improvements in all outcome domains were seen across the populations, and treatment performance and outcomes were not substantively inferior for the offender or meth-using groups.
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.
Swift, Joshua K; Derthick, Annie O
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.
Jargin, Sergei V
Violence in families and elder abuse can take many forms, which his sometimes difficult to recognize. In Russia, elder abuse is rarely discussed in professional literature and mass media. A border between elder abuse and parricide can be indistinct. Borderline cases can include involvement of older people in binge drinking, denial of help, and manipulation towards suicide. Three example cases are discussed in this report. A concluding point is that for prevention of parricide, it should be kept devoid of its reputation as an extraordinary crime, committed mainly by mentally ill individuals. The perpetrators can be mentally healthy or have a personality disorder. Parricide can have trivial appearance, not always recognized as such by victims and social environment.
... What Is Happening en español Cómo manejar el abuso Grown-ups are usually there to help and ... to understand the different types of abuse: physical, sexual, verbal or emotional, and neglect. Physical abuse: Physical ...
Todays Educ, 1969
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.
... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism
... from what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that was prescribed for someone else Taking a ... at higher doses or when taken with other medicines. NIH: National Institute on Drug Abuse
... way Uses harsh discipline Was abused as a child Alcohol or drug problems Emotional problems or mental illness ... Physical abuse - children References Berkowitz CD, Stewart ST. Child maltreatment. In: Marx JA, Hockberger RS, Walls RM, eds. ...
Tauriac, Jesse J.; Scruggs, Natoschia
Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…
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…
Doyle, Kathleen; Morrow, Marilyn J.
The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)
Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…
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…
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…
Abuse of older people needs to be given the same priority as child abuse, with special training for all frontline staff, according to Help the Aged, which has launched a campaign to highlight the issue.
Culberson, John W; Ziska, Martin
One quarter of the prescription drugs sold in the United States are used by the elderly, often for problems such as chronic pain, insomnia, and anxiety. The prevalence of abuse may be as high as 11 percent with female gender, social isolation, depression, and history of substance abuse increasing risk. Screening instruments for prescription drug abuse have not been validated in the geriatric population. Benzodiazepines, opiate analgesics, and some skeletal muscle relaxants may result in physical dependence; however, tolerance, withdrawal syndrome, and dose escalation may be less common in the older patient. Lower doses may decrease the risk of abuse and dependence; however, fear of abuse often results in a failure to adequately treat symptoms such as anxiety, pain, and insomnia.
Studied the process of child psychotherapy by means of analyses of client verbal behaviors. Analyses of variables demonstrated the nature of each client's verbal responding as well as their pattern of change. Summarized the overall verbal response behavior of each client best through the factor analyses. (Author)
The abuse of older people is a significant problem, with estimates intimating that there may be over 340,000 cases per year in the United Kingdom. Despite improvements in screening and assessment to identify and treat those who are abused or at risk of abuse, the healthcare community remains preoccupied with prevalence rather than prevention. In light of the paucity of health-related research evidence to support the effectiveness of preventative measures, the application of crime prevention theory and knowledge is appropriate. Routine activity theory and situational crime prevention literature acknowledges the vulnerability of older people to abuse and the potential of any person employed as a carer to be an abuser. Preventative measures are focused on techniques that make abuse more difficult and more risky for the perpetrator and, therefore, less 'rewarding'. The regulation of healthcare support workers and increased workplace surveillance are examples of the 25 techniques of situational prevention that could be applied in a healthcare setting.
Phelan, A; Fealy, G; Downes, C
Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse.
... 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...
Mastel-Smith, Beth; Binder, Brenda; Hersch, Gayle; Davidson, Harriett A; Walsh, Teresa
The purpose of this exploratory, qualitative study was to investigate storytelling by home care clients to their home care workers (HCWs). Specific research questions were: (a) When does storytelling by a care recipient occur during usual care?; (b) How do HCWs engage older clients in storytelling?; (c) How do HCWs respond to the stories told by clients?; and (d) What is the perceived effect of storytelling by older clients on the relationship between the client and the HCW? Two focus groups consisting of 10 HCWs each were conducted. Verbatim transcripts of both focus groups were analyzed using the constant comparative analysis method. Categories and concepts were identified. Characteristics of the HCW and client set the stage for storytelling. The process of storytelling included context, triggers, and temporal aspects. HCWs also shared the content of stories, the impact on their relationship with the client, and the perceived effect on each individual. A visual model depicting the nature of storytelling in association with the care of older clients is presented.
Holden, Janice Miner
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…
Hartley, Patrick H.
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…
Coyle-Shapiro, Jacqueline A-M.; Morrow, Paula C.
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…
Lichtenberg, James W.; Hummel, Thomas J.
The fundamental question to which most clients want and deserve an answer is, "Am I going to get better (as a result of counseling)?" Although meta-analyses provide strong evidence supporting the efficacy of counseling in general, if one wants to make probabilistic statements about individual client outcomes--rather than about the more generalized…
Bloch, Harriet I.; And Others
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)
Kohn, Paul M.; And Others
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…
Cummings, Anne L.
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…
Zwick, Rebecca; Attkisson, C. Clifford
Psychotherapy clients (N=62) were randomly assigned to view a pretherapy orientation videotape at admission or to a control group. Oriented clients understood and recalled the information in the videotape, showed a greater decrease in self-reported symptoms than the control group after one month, and gave favorable feedback regarding the…
McKinnon, Dean G.
Analyzed clients' (N=210) questionnaires rating willingness to see and disclose to androgynous, masculine, or feminine therapist on basis of written description. Clients rated androgynous- and masculine-oriented therapists significantly more favorably than feminine-oriented therapists. Masculine men received highest ratings and feminine men…
Southern Regional Education Board, Atlanta, GA.
Outcome evaluation assesses the results or benefits of mental health services received by clients or communities by comparing descriptive data on the mental health status of clients at different points in time. It aids clinicians and managers in planning programs and managing clinical services. A mental health center should establish goal-oriented…
Marlowe, D B; Merikle, E P; Kirby, K C; Festinger, D S; McLellan, A T
Motivational assessment instruments typically measure clients' attributions about their readiness to change problem behaviors. They do not indicate why a client may be motivated to change, or provide guidance on how to retain an unmotivated client in treatment. The authors interviewed 415 substance abuse clients about their reasons for entering treatment and scored their responses along the dimensions of (a) negative versus positive treatment-entry pressures, (b) internal versus external sources of those pressures, and (c) the life domain from which the pressures emanated. Exploratory cluster analysis yielded 5 types of clients characterized by different profiles of perceived treatment-entry pressures. Cluster membership was predictive of treatment outcomes, and the clusters differed by demographic variables. These data support the discriminative and predictive utility of performing a multidimensional assessment of pressures to enter treatment.
Cloyd, Elizabeth; Dyer, Carmel B
The plight of older adults during catastrophic events is a societal concern. Older persons have an increased prevalence of cognitive disorders, chronic illnesses, and mobility problems that limit their ability to cope. These disorders may result in a lack of mental capacity and the ability to discern when they should evacuate or resolve problems encountered during a catastrophe. Some older persons may have limited transportation options, and many of the elderly survivors are at increased risk for abuse, neglect, and exploitation. Recommendations for future catastrophic events include the development of a federal tracking system for elders and other vulnerable adults, the designation of separate shelter areas for elders and other vulnerable adults, and involvement of gerontological professionals in all aspects of emergency preparedness and care delivery, including training of frontline workers. Preparation through preevent planning that includes region-specific social services, medical and public health resources, volunteers, and facilities for elders and vulnerable adults is critical. Elders need to be protected from abuse and fraud during catastrophic events. A public health triage system for elders and other vulnerable populations in pre- and postdisaster situations is useful, and disaster preparedness is paramount. Communities and members of safety and rescue teams must address ethical issues before an event. When older adults are involved, consideration needs to be given to triage decision making, transporting those who are immobile, the care of older adults who receive palliative care, and the equitable distribution of resources. Nurses are perfectly equipped with the skills, knowledge, and training needed to plan and implement disaster preparedness programs. In keeping with the tradition of Florence Nightingale, nurses can assume several crucial roles in disaster preparedness for older adults. Nurses possess the ability to participate and lead community
Wild, T Cameron; Cunningham, John A; Ryan, Richard M
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.
Howard, Kimberly S.; Brooks-Gunn, Jeanne
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…
... this global public health issue, and we rededicate ourselves to providing our elders the care and... Affordable Care Act, and marked a major step forward in the fight against elder abuse, neglect, and... communities help protect older Americans from abuse and provide care to those who have already been...
Weeks, Lori E.; Bryanton, Olive; McInnis-Perry, Gloria; Chaulk, Paul
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…
Freeborn, D K; Pope, C R
This study seeks to compare clients' reports of satisfaction/dissatisfaction with an HMO and its medical care program to providers' perceptions of client satisfaction. The main conclusion is that providers are fairly aware of medical care system attributes with which clients are highly satisfied and dissatisfied. Those with direct patient contact, especially physicians and nurses, are most accurate in their perceptions. Personnel without direct patient contact are about equally accurate in their perceptions of client satisfaction, though personnel without patient contact perceive relatively more dissatisfaction than clients report. Most approaches to medical care evaluation examine costs and efficiency and, more recently, the technical quality of care. Less attention has been given to the assessment of client satisfaction, and almost no attention has been given to what providers perceive as the assessment of clients. Clearly, HMOs' viability is determined largely by their ability to identify and correct major problems affecting their enrollments.
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.
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
Alon, Sara; Berg-Warman, Ayelet
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).
Keller, Heather H.; Dwyer, John J. M.; Edwards, Vicki; Senson, Christine; Edward, H. Gayle
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…
... appropriate) or surrogate with verbal and written notice of the client's rights and responsibilities. The verbal notice must be in a language and manner that the client or client's representative or...
Conrad, Kendon J.; Iris, Madelyn; Ridings, John W.; Langley, Kate; Wilber, Kathleen H.
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…
Dinis-Oliveira, Ricardo Jorge; Magalhães, Teresa
The curiosity and the natural tendency to explore the environment put young children at an increased risk of poisoning over older children and adults. Poisonings are a significant area of concern from 1 year of age and progressively contribute more to overall rates of morbidity and mortality until children reach adulthood. Particularly, the abuse of children by poisoning is also highly common with thousands of fatalities. A practical strategy is presented that aims to alert health, forensic, and law enforcement professionals to this problem and to demystify the preconception that it is a rare form of abuse or neglect. Compounds that are foreign to a living organism (xenobiotics) and those present within body (endobiotics), mainly involved in children intoxications and contextual examples related to exposure are also reviewed. Particular concern is given to concepts in the field of children poisoning. The described history and the clinical and toxicological evaluation are discussed, and harmonized protocols regarding correct procedures for sample collection to forensic toxicological analysis are proposed. Since children are particularly vulnerable to the toxic effects of high doses of xenobiotics and endobiotics, special consideration on the preparation of the environment that surrounds children in order minimize all possible risks will be also considered.
Ermertcan, Aylin Turel; Ertan, Pelin
Child abuse is a major public health problem all over the world. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse and neglect. The most common manifestations of child abuse are cutaneous and their recognition; and differential diagnosis is of great importance. Clinicians, especially dermatologists, should be alert about the skin lesions of child abuse. In the diagnosis and management of child abuse, a multidisciplinary approach with ethical and legal procedures is necessary. In this manuscript, cutaneous manifestations of physical, sexual, emotional abuse and neglect are reviewed and discussed.
Uniform national guidelines on the delivery of family planning methods and services improve client care, assuming these guidelines are based on current scientific information. Compliance with these guidelines yields safe and efficient delivery of family planning services. Service providers need information, training, supplies, and guidelines to deliver quality services. Guidelines contribute to consistency among family planning programs in different settings. Even though clinics may not provide the same services, the guidelines allow them to provide the same standards of care. Specifically, eligibility criteria, contraindications, and follow-up schedules are the same regardless of the service delivery point. Various international health organizations (such as World Health Organization, USAID, Program for International Training in Health, International Planned Parenthood Federation, and Association for Voluntary Surgical Contraception) have developed guidelines for family planning service delivery. Governments can use these documents to develop national family planning guidelines and policies. They should adapt the guidelines to local needs and consider program resources. After development of the national guidelines, training, workshops, and dissemination of written materials should be provided for policymakers, physicians, nurses, and other health providers. Countries that have either developed or are working to draft their own national guidelines are Cameroon, Ghana, Mexico, and Nepal.
Congress of the U.S., Washington, DC. House Committee on Education and Labor.
The booklet presents the report of the U.S. House of Representatives Committee on Education and Labor regarding the 1983 Child Abuse Amendments to the Child Abuse Prevention and Treatment Act and the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978. The Amendment expands the definition of child abuse to include abuse by…
Al-Omari, Hasan; Hamed, Razan; Abu Tariah, Hashem
The purpose of this study is to understand religious factors role during recovery period among Jordanian receiving treatment for alcohol and substances abuse. Participants were asked to answer open-ended questions related to role of religion on their recovery from alcohol and substances abuse. Content analysis was used to explore the role of religion on their recovery process. One hundred and forty-six clients from two treatment centers participated with two main themes that emerged from the analysis: role of religion and role of religious men. Religion not only helps during the recovery process, but also is considered as a protector from drug and alcohol abuse in the future.
Haug, Nancy A.; Sorensen, James L.; Gruber, Valerie A.; Lollo, Nicole; Roth, Gregory
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…
Boult, C; Pacala, J T
The complex array of needs posed by older adults has frequently produced fragmentation of care in traditional fee-for-service systems. Integration of care components in newer health systems will maximize patient benefits and organizational efficiency. This article outlines the major issues involved in integration of care for older populations. A health system must integrate its care of older adults in many ways: among providers, both in primary care and specialty services; with community-based sources of care; and across sites of care (clinic, hospital, emergency department, and nursing home). Integrating reimbursement structures for various services will serve to create a client-oriented system, as opposed to a finance-centered system, thereby enhancing coordination of care. The extent to which two experimental comprehensive systems, PACE (Program of All-inclusive Care of the Elderly) and SHMO II (Social Health Maintenance Organization), have achieved clinical and financial integration are discussed in detail. Healthcare organizations are encouraged to create integrated models of care and to study the effects of integration on patient outcomes.
Oveisi, Sonia; Karimi, Rana; Mahram, Manoochehr
This brief report provides a first look at self-reported instances of elder abuse by a sample of people 60 years and older living in Qazvin, Iran. Six hundred community-dwelling persons, drawn from the registry files of each health center in Qazin, completed questionnaires during April to October 2012. At least 80% of the participants reported experiencing some form of psychological abuse, financial abuse, and/or neglect at least once during a 2-month period. Physical and sexual abuse were rarely reported. Despite a strong Iranian cultural emphasis on respect for elders, the self-reporting of elder abuse, especially psychological abuse, is greater than our expectation. We recommend that health-related policies and programs begin to identify elder abuse and neglect as a first step in prevention.
Owen, Jesse; Leach, Mark M; Wampold, Bruce; Rodolfa, Emil
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.
Fuertes, Jairo N; Brobst, Karen
Differences in perceptions between Euro American and ethnic minority respondents were examined to compare the role of counselor multicultural competency in multicultural versus traditional counseling. Results showed a strong positive correlation between clients' ratings of counselors' multicultural competencies and clients' ratings of counselors' general competency and empathy. However, when comparisons were made between Euro American and ethnic minority clients' on satisfaction, counselor multicultural competency explained a large and significant amount of variance for the ethnic minority sample only, above and beyond counselor general competency and empathy. Results are discussed in the context of relevant literature and suggestions for future research.
Canham, Sarah L.; Gallo, Joseph; Simoni-Wastila, Linda
A phenomenological study explored whether older women who are chronic benzodiazepine users identified themselves as dependent, how dependence was perceived, and how meanings and understandings shaped experiences of benzodiazepine use. Self-reported benzodiazepine dependence was associated with being unable to reduce use or a desire to discontinue use and reliance on benzodiazepines to remain comfortable and able to handle daily life. Themes included: 1) benzodiazepine dependence is similar to dependence to diabetes or blood pressure medications; 2) dependence is distinctive from addiction/abuse; 3) addiction/abuse is perceived as worse than dependence; and 4) concerns of addiction/abuse result in low-dose benzodiazepine use. PMID:24918963
DeLiema, Marguerite; Gassoumis, Zachary D; Homeier, Diana C; Wilber, Kathleen H
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, promotores, local Spanish-speaking Latinos, were recruited and trained to interview a sample of Latino adults aged 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 elderly Latino adults had experienced some form of abuse or neglect within the previous year. Nearly 25% reported psychological abuse, 10.7% physical assault, 9% sexual abuse, and 16.7% 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 sexual abuse. Years lived in the United States, younger age, and prior abuse were associated with greater risk of financial exploitation. Years spent living in the United States 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 elderly adults, 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.
... addressing this public health crisis that puts millions at risk. Today, let us keep faith with a generation... live out the full measure of their days in health and security. Yet, every year, millions of older... Abuse Awareness Day, we call attention to this global public health issue, and we rededicate...
Kane, Michael N.; Green, Diane
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…
Jones, Lisa M.; Atoro, Kathryn E.; Walsh, Wendy A.; Cross, Theodore P.; Shadoin, Amy L.; Magnuson, Suzanne
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.…
Salmon, Ruth W.
Examined the impact of coercion in rehabilitation of drug abusers. A validated interview schedule was utilized for both coerced and non-coerced participants. Data analysis found that coercion facilitates success for certain groups (e.g., older, longer term heroin addicts), and certain criteria (e.g., arrest and abstinence). (Author/JAC)
Tsui, Venus; Cheung, Monit; Leung, Patrick
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…
Presents a model for conducting time-limited group therapy with adult survivors of severe childhood abuse who were diagnosed with complex post-traumatic and dissociative disorders. Group sessions are organized around verbal promises that encourage the client's active, attentive engagement. Gentle confrontation of dissociative defenses is integral…
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 the…
Sahker, Ethan; Acion, Laura; Arndt, Stephan
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…
Sosin, Michael R.; Durkin, Elizabeth
This article uses event history analysis to examine certain determinants of dropout from a case management program that serves homeless adults with substance abuse problems. The examined determinants are perceptions of conventional treatment services: (a) client perceptions concerning the value of the conventional services that case managers help…
McMicken, Betty L.; Ostergren, Jennifer A.; Vento-Wilson, Margaret
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)…
Roll, John M; Chudzynski, Joy E; Richardson, Gina
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.
Sutter, M E; Chenoweth, J; Albertson, T E
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.
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
Rosen, Tony; Bloemen, Elizabeth M; LoFaso, Veronica M; Clark, Sunday; Flomenbaum, Neal E; Breckman, Risa; Markarian, Arlene; Riffin, Catherine; Lachs, Mark S; Pillemer, Karl
Elder abuse is a common phenomenon with potentially devastating consequences for older adults. Although researchers have begun to identify predisposing risk factors for elder abuse victims and abusers, little is known about the acute precipitants that lead to escalation to physical violence. We analyzed legal records from highly adjudicated cases to describe these acute precipitants for physical elder abuse. In collaboration with a large, urban district attorney's office, we qualitatively evaluated legal records from 87 successfully prosecuted physical elder abuse cases from 2003 to 2015. We transcribed and analyzed narratives of the events surrounding physical abuse within victim statements, police reports, and prosecutor records. We identified major themes using content analysis. We identified 10 categories of acute precipitants that commonly triggered physical elder abuse, including victim attempting to prevent the abuser from entering or demanding that he or she leave, victim threatening or attempting to leave/escape, threat or perception that the victim would involve the authorities, conflict about a romantic relationship, presence during/intervention in ongoing family violence, issues in multi-generational child rearing, conflict about the abuser's substance abuse, confrontation about financial exploitation, dispute over theft/destruction of property, and disputes over minor household issues. Common acute precipitants of physical elder abuse may be identified. Improved understanding of these acute precipitants for escalation to physical violence and their contribution to elder abuse may assist in the development of prevention and management strategies.
Korper, Samuel P., Ed.; Council, Carol L., Ed.
This report provides evidence concerning the projected demand for substance abuse treatment services for older Americans over the next 20 to 30 years and suggests approaches for refining these projections. A work group of Federal agency representatives and university researchers was established by the Substance Abuse and Mental Health Services…
DeLiema, Marguerite; Gassoumis, Zachary D.; Homeier, Diana C.; Wilber, Kathleen H.
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
Pine, Gerald J.
An emphasis on existentialism as a dynamic philosophical force with significant implications for vocational guidance in the use of information to help clients, followed by a Comment by Lee Isaacson. (Author)
Kennedy, Bebe C.; And Others
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)
Shernoff, Michael J.
Suggests that social workers develop a professional approach that includes the treatment of lesbian and gay clients within the context of the family. Discusses self disclosure, legal issues, family relationships, and friendship networks. (JAC)
Develops a comparison between writing tutors and prostitutes. Suggests that the intimate arrangement of people that places one in the position of professional and the other in the position of client works against collaboration. (NH)
Wazaify, Mayyada; Bdair, Ahmad; Al-Hadidi, Kamal; Scott, Jenny
This study investigated the abuse of over-the-counter (OTC) products (e.g., proteins, dietary supplements) and prescription drugs (e.g., hormones) in gymnasiums in Amman by random distribution of a structured questionnaire to 375 gym clients (November 2012-February 2013). Data were analyzed using SPSS for Windows (version 17.0). A total of 31 (8.8%) clients admitted to using 21 products (mentioned 71 times) of anabolic steroids and other hormones (e.g., growth hormone and thyroxine) to increase muscular power at the gym or build muscle mass. Abuse of different prescription and OTC drugs among gymnasium clients is present in Jordan, but current methods for controlling the problem are ineffective. Better methods should be developed. The study's limitations are noted.
Padwa, Howard; Guerrero, Erick G.; Braslow, Joel T.; Fenwick, Karissa M.
Objective The publication of the President’s New Freedom Commission Report in 2003 led to hope and anticipation that system transformation would address barriers that have impeded the delivery of integrated services for clients with co-occurring mental health and substance use disorders. Have problems been resolved? This study analyzed providers’ perspectives on serving clients with co-occurring disorders in a large mental health system that has undergone transformation. Methods Six focus groups were conducted with providers at specialty mental health treatment organizations that received funding to transform services. Using content analysis, the authors identified major themes of the focus group discussions. Results Participants reported several barriers within the mental health system and challenges associated with collaborating with specialty substance abuse treatment providers that impede the delivery of integrated care. Conclusions In spite of efforts to improve co-occurring disorder service delivery in a transformed mental health system, barriers that have historically impeded integrated treatment persist. PMID:25686812
Glosser, D S
The effects of a token economy in modifying the illicit polydrug use of 97 methadone maintenance clients was investigated over a period of two and a half years. Subjects' drug-free urinalysis reports were reinforced with points which could be redeemed to obtain methadone. Each subject's daily dose level varied with the point balance. A multiple baseline analysis showed that when methadone acquisition was in part made contingent upon drug-free urinalyses, illicit drug use declined rapidly. After six months, the token economy group's urines were 14% positive for illicit drugs compared to 39% in the traditional treatment group. As time in treatment increased, illicit drug use further declined. These results suggest a more effective and practical strategy for the treatment of polydrug abusing methadone maintenance clients than has previously been available.
Kos, Liborka; Shwayder, Tor
Dermatologists and child abuse are not frequently associated in the minds of most physicians. Yet the most common manifestations of child abuse are cutaneous. This article reviews cutaneous manifestations of physical abuse, including bruises, lacerations, abrasions, human bites, and burns. It also discusses ways that dermatologists can differentiate abusive injuries from accidental ones as well as from the many dermatologic conditions that can mimic child abuse. Finally, we review what actions the dermatologist should take when suspecting abuse in a patient.
Poole, Christopher; Rietschlin, John
Accounts in both the scientific literature and popular media have brought about increased recognition of the reality of elder abuse. However, relatively little work has examined intimate partner victimization with respect to older adults. In this study, weighted data from cycles 13 (1999) and 18 (2004) of the General Social Survey are pooled to examine how factors uniquely influence the prevalence and risk of emotional, financial, and physical abuse among adults aged 60 and over. Considerations regarding elder abuse committed by spouses, versus abuse of older adults more broadly (by their children and other adults), are also discussed.
Gibbs, Lisa M
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.
Eisikovits, Zvi; Koren, Chaya; Band-Winterstein, Tova
The interaction and inter-penetrability overlap of abuse and neglect has been previously described. Therefore, the question is not whether a distinction can be made between the two, but how specific events are constructed into abuse and/or neglect based on how each of the protagonists involved (researchers, professional workers, family members, and the older persons themselves) make sense of abuse and neglect. The purpose of this paper is to explore the social and psychological construction of elder abuse and neglect and illustrate the theoretical constructs using case material and its application to the field.
Jargin, Sergei V
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.
Anetzberger, Georgia J.; And Others
A comparison group study of abusing and nonabusing caregivers suggested a correlation between alcohol use and violence against elderly parents. Findings reveal that abusers were more likely than nonabusers to drink, to become intoxicated, and to be identified as having a drinking problem. Policy and practice implications are discussed. (Author)
Thorne, Craig R.; DeBlassie, Richard R.
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)
Burns, Jarrett M; Boyer, Edward W
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
Spector, Anya Y.; Pinto, Rogério M.
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
Burr, Helen Turner
Elderly clients resistant to help present an ethical dilemma for professionals. This dilemma may climax when assumption of authority over the client for his safety is necessary. Social workers need to work for decisions closest to the wishes of the client. The at-risk client should be informed about changes that will occur and how these changes…
Dowling, Nicki A.; Cosic, Sanja
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…
... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE...' rights. The facility must ensure the rights of all clients. Therefore, the facility must— (1) Inform each client, parent (if the client is a minor), or legal guardian, of the client's rights and the rules of...
... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE...' rights. The facility must ensure the rights of all clients. Therefore, the facility must— (1) Inform each client, parent (if the client is a minor), or legal guardian, of the client's rights and the rules of...
... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE...' rights. The facility must ensure the rights of all clients. Therefore, the facility must— (1) Inform each client, parent (if the client is a minor), or legal guardian, of the client's rights and the rules of...
... 32 National Defense 5 2012-07-01 2012-07-01 false Client with diminished capacity. 776.33 Section... Rules of Professional Conduct § 776.33 Client with diminished capacity. (a) Client with diminished capacity: (1) When a client's ability to make adequately considered decisions in connection with...
... 32 National Defense 5 2013-07-01 2013-07-01 false Client with diminished capacity. 776.33 Section... Rules of Professional Conduct § 776.33 Client with diminished capacity. (a) Client with diminished capacity: (1) When a client's ability to make adequately considered decisions in connection with...
... 32 National Defense 5 2011-07-01 2011-07-01 false Client with diminished capacity. 776.33 Section... Rules of Professional Conduct § 776.33 Client with diminished capacity. (a) Client with diminished capacity: (1) When a client's ability to make adequately considered decisions in connection with...
... 32 National Defense 5 2014-07-01 2014-07-01 false Client with diminished capacity. 776.33 Section... Rules of Professional Conduct § 776.33 Client with diminished capacity. (a) Client with diminished capacity: (1) When a client's ability to make adequately considered decisions in connection with...
Ewing, Sara; Dover, Howard F.
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…
Wilford, B B
An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801
Kennair, Nicola; Mellor, David
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 focused on prevalence rates and the characteristics of perpetrators and victims. While various factors such as gender, age, emotional attachment to parents, race/ethnicity, socioeconomic status, family stress and parenting style and structure have been associated with parent abuse, findings are equivocal. Etiological models are general and untested, and treatment approaches lack empirical support. It is concluded that more rigorous and extensive research is required in order to provide a deeper understanding of this complex issue, and to inform treatment approaches.
Albertson, Timothy E
The use of recreational drugs of abuse continues to expand without limitations to national boundaries, social status, race, or education. Beyond the prevalence of illicit drug use and dependence, their contribution to the global burden of disease and death are large and troubling. All medical providers should be aware of the evolving drugs of abuse and their medical and social consequences. In addition to heroin and stimulants such as cocaine and methamphetamine, new designer stimulants called "bath salts" and cannabinoids called "spice," along with the abuse of prescription drugs and volatile substances, are now widely recognized problems in many societies. The wide variety and continuingly expanding clinical manifestations of toxicity of recreational drugs of abuse is not widely appreciated by clinicians. This edition attempts to summarize six major classes of drugs of abuse and their clinical effects with special emphasis on their immunological and respiratory effects.
Knight, Lucy; Hester, Marianne
Domestic violence affects every age group and is present throughout the life span, but, while the mental health impact of domestic violence is clearly established in working age adults, less is known about the nature and impact of domestic violence among older adults. This review, therefore, aimed to synthesize findings on the prevalence, nature, and impact of domestic violence among older adults, and its identification and management. Electronic searches were conducted of Medline, PsycINFO, Cinahl, and Embase to identify studies reporting on the mental health and domestic violence in older adults. Findings suggested that, although prevalence figures are variable, the likely lifetime prevalence for women over the age of 65 is between 20-30%. Physical abuse is suggested to decrease with age, but rates of emotional abuse appear to be stable over the lifespan. Among older adults, domestic violence is strongly associated with physical and mental health problems, and the scarce research comparing the impact of domestic violence across the age cohorts suggests that the physical health of older victims may be more severely affected than younger victims. In contrast, there is evidence that older victims may experience less psychological distress in response to domestic violence than younger victims. Internationally, evidence on the management of domestic violence in older adults is sparse. Findings suggest, however, that identification of domestic violence is poor among older adults, and there are very limited options for onwards referral and support.
Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.
Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018
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.
Proselkova, M E; Kozlovskaia, G V; Platonova, N V
Consequences of intrafamily noncontact abuse (40 children aged from 3 to 13 years) and out-of-family contact abuse (15 children aged from 7 to 15 years) have been studied. The intrafamily abuse was long-term and demanded from a child the immersion into situation of "secrecy". The out-of-family abuse had a character of the extreme influence upon a victim. Independently of the abuse character, border-line mental disorders were found in all children. A character of these disorders was determined by the specifics of psychogenic factor, its duration and child's age. A decreased mood, different levels of autism and disturbances of cognitive function were common features of border-line disorders. In cases of intrafamily abuse, uncontrolled drives, sexual character of games and fantasies, elements of depersonalization and age-specific transformation of affective disorders from depressiveness to dysphoric aggressive reactions were observed. In the out-of-family contact abuse, especially in teenagers, the main appearances approached to posttraumatic stress syndrome. In all cases, there was a trend to stronger differentiation of affective disorders, intensification of drives and formation of characteristic pathologic changes as children get older.
Janzen, Jennifer I.; Fitzpatrick, Marilyn R.; Drapeau, Martin; Blake, Emily
Twenty-four clients were asked to nominate an incident that was critical to the development of their therapeutic relationship with a trainee therapist. Therapist interventions within each client relationship building incident (RBI) were identified. The results of multiple regression indicated that attachment anxiety moderated the relationship…
Bridges, Nancy A.
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…
Williams, Robert J; Goodale, Leslie A; Shay-Fiddler, Michele A; Gloster, Susan P; Chang, Samuel Y
The prevalence of methylphenidate and dextroamphetamine misuse and abuse was examined in 450 adolescents referred for substance abuse treatment. Twenty three percent reported nonmedical use of these substances and six percent were diagnosed as methylphenidate or dextroamphetamine abusers. Abuse was more common in individuals who were out of school and had an eating disorder. Methylphenidate and dextroamphetamine abuse appears to be much less common than abuse of most other substances. It does occur, however, and parents and schools need to exert greater control over the dispensing of these medications. Physicians are advised to prescribe non-stimulant medications (eg, bupropion) when treating attention deficit hyperactivity disorder in substance-abusing individuals.
Zink, Therese; Jacobson, C. Jeff, Jr.; Pabst, Stephanie; Regan, Saundra; Fisher, Bonnie S.
Little is known about how older women cope in long-term abusive intimate relationships. Understanding their coping strategies may give insight into how to further support their effective coping efforts. Interviews were conducted with 38 women older than age 55 years. Grounded theory analysis demonstrated that women who remained in their abusive…
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.
Durall, John K.
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…
Woika, Shirley; Bowersox, Carissa
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…
Goforth, Harold W; Murtaugh, Reed; Fernandez, Francisco
Neurologic aspects of drug abuse vary. This article explains the general nature of drug abuse, identifies the physiologic effects of certain drugs, and briefly describes the neurobiology of addiction. This article also reviews available treatment options for those addicted to substances of abuse, and clarifies common misconceptions, including the differences between tolerance, abuse, and addiction.
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).…
Bunnell, Sarah L; Greenhoot, Andrea Follmer
Two studies were conducted to explore the conditions that elicit autobiographical memory problems in abuse victims and the mechanism that underlie them. In Study 1 older adolescents (n=80) with and without self-reported abuse histories completed a modified version of the Autobiographical Memory Test (AMT-U); participants were given an unlimited amount of time to provide specific memories in response to cue words. Participants also completed measures of depression and post-traumatic stress disorder (PTSD), working memory, and attentional biases. This study found that abuse severity and PTSD symptoms were positively related to memory specificity on the AMT-U. In Study 2 older adolescents (n=78) with and without self-reported abuse histories completed the traditional (timed) version of the AMT. Participants also completed measures of working memory, attentional biases, self-reported coping, and psychopathological symptoms (i.e., depression and PTSD). In this study the opposite relationship was observed, such that abuse severity was related to poorer memory specificity, but this relationship was explained by disengagement coping and PTSD symptoms. This work suggests that poor memory specificity may represent a form of avoidance, but the application of avoidant mechanisms depends on the remembering context.
Briefing Charts 3. DATES COVERED (From - To) 10 August 2015 – 3 September 2015 4. TITLE AND SUBTITLE ANDES TOOLS: Promotional slides for Industrial ...Clients 5a. CONTRACT NUMBER FA9300-13-C-2014 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Tim Holmes, D.Sc. 5d. PROJECT NUMBER 5e. TASK... Industrial Clients PA Case Number: #15479; Clearance Date: 9/3/2015 14. ABSTRACT Briefing Charts/Viewgraphs 15. SUBJECT TERMS N/A 16. SECURITY
... Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research ( ... include: PTSD and anxiety. Depression and thoughts of suicide. Sexual anxiety and disorders, including having too many ...
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)
... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... Someone Quit? Avoiding DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ...
... oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made ... NAS). Opioid abuse may sometimes also lead to heroin use, because some people switch from prescription opioids ...
Petkus, Andrew J; M.A; Wetherell, Julie Loebach
Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for mental and behavioral health problems are empirically supported with older adults and that mental health professionals are aware of the special needs of older adult populations. Acceptance and Commitment Therapy (ACT) is an emerging approach to the treatment of distress. The purpose of this article is to provide a rationale for using ACT with older adults based on gerontological theory and research. We also review research on ACT-related processes in later life. We present a case example of an older man with depression and anxiety whom we treated with ACT. Finally, we describe treatment recommendations and important adaptations that need to be considered when using ACT with older adults and discuss important areas for future research. PMID:26997859
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
Bhandari, Suchitra; Winter, David; Messer, David; Metcalfe, Chris
OBJECTIVES. This study investigated the role of family variables in the development of psychological problems in childhood sexual abuse (CSA) survivors, contributing to the debate between the 'abuse related' perspective, which assumes a direct causal link between abuse and later problems, and the 'family dysfunction' perspective, which assumes that these problems are caused by the dysfunctional nature of families in which abuse occurs. The two questions of central concern were: (1) whether maladaptive family dynamics and CSA were each associated with later adjustment; and (2) whether these associations acted independently of one another. DESIGN. A retrospective cohort study comparing sexually abused and non-abused participants matched one-to-one on demographic variables. METHODS. The 64 clinical participants were recruited by sending questionnaires to clients on a psychological therapy waiting list, and 44 students were recruited from questionnaires made available at University Health Centres. Participants completed measures of psychological and sexual adjustment, family functioning, and construing. Multiple linear regression models investigated overall and independent associations between abuse, family circumstances, and adjustment in adulthood. RESULTS. There was only weak evidence for the influence of CSA, independently of family environment, on later psychological distress and sexual adjustment, but strong evidence for the influence of aspects of family environment, independent of abuse, on later psychological distress, sexual adjustment, self-esteem, body image, and sexual attitude. CONCLUSIONS. The findings provide support for the 'family dysfunction' perspective on the long-term effects of CSA.
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.
Levant, Ronald F.
This article critiques therapist-directed approaches to family therapy in light of research findings on therapist variables associated with positive outcomes in psychotherapy. An alternative, phenomenological view of the family is developed, which assumes the family to be motivated for enhancement and growth. A client-centered approach is…
Johnson, Harriette C.
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…
Getz, Marc; Vernon, McCay
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)
Solomonson, William L.
This study seeks to improve the contributions of performance consultants, instructional design consultants, and training consultants by explaining the effect that several variables have on trust as a mediator to relationship commitment within the context of the client-consultant relationship. The participants were 228 college students from two…
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…
Roberts, A. H.
A counselor blind from birth describes personal difficulties in fully understanding the experience of clients who are adventitiously blind. Congenitally blind counselors are urged to recognize that adaptive methods cannot compensate for the panoramic view of the environment provided by vision and that recently blinded individuals need to deal with…
Reviews D. G. Myers' (2000) examination of the contributing factors of happiness: money, relationships, and religion. Discusses the implications of these factors for counseling with specific recommendations made for counselors regarding their own self-care and their work with their clients. (GCP)
NTS Research Corp., Durham, NC.
This guide provides users of the Client Assessment Package (CAP)--a system of forms for recording the process of seeking and using information and assistance for educational improvement--with definitions, operational procedures, and instructions necessary to complete the forms accurately. The purposes of CAP are threefold: to help develop an…
Rizzi, Stephen A.
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.
Akaza, Kayoko; Bunai, Yasuo; Tsujinaka, Masatake; Nakamura, Isao; Nagai, Atsushi; Tsukata, Yukiyoshi; Ohya, Isao
This study examined the elder abuse cases that occurred in Gifu Prefecture, Japan between 1990 and 2000. We conducted a retrospective study of all the cases in which the victim was 65 years or older and autopsied in the Department of Legal Medicine, Gifu University School of Medicine. Fifteen victims were classified as elder abuse victims: five men and ten women. The victims ranged in age from 66 to 87 years (mean age, 74.5 years). The types of abuse were as follows: physical abuse, 13 cases; emotional abuse, five cases; neglect, four cases; and financial abuse, three cases. In eight cases, the victims were subjected to two or more types of abuse. The cause of death of the victims varied with the type of abuse. In the physical abuse cases, subdural hemorrhage was the most common cause, followed by other violence-related deaths and hypothermia. In the neglect cases, the victims died of either starvation or suffocation after the aspiration of food into the airway. In the domestic abuse cases, one of the victim's sons was the most common perpetrator, and little or no income was considered to be a risk factor for perpetrators. In the neglect cases, dementia and difficulty in performing activities of daily living were considered to be risk factors for victims, in addition to living in social isolation.
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.
Rosen, Daniel; Heberlein, Emily; Engel, Rafael J
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.
ABSTRACT "Elder Abuse and Neglect" was constructed as a social problem by experts and has largely been a product of "expert" knowledge building and intervention. The idea of woman abuse as a social problem, on the other hand, originated with women themselves. The paper examines the changing social context in which some older people are currently seeking ownership of responses to mistreatment. It explores emerging criticisms of present constructions of "elder abuse and neglect" and the needs they imply, and links these to feminist frameworks. It then considers the appeal and utility of these frameworks for older women active in the fight against mistreatment.
McNeill, Emma J M; Wilson, Janet A; Clark, Susan; Deakin, Jayne
Fundamental frequency (F(0)) of speech is used to measure the success of voice therapy in male-to-female transgender clients. This study evaluates the relationship between F(0) and patients' happiness with their voice. The study design used was a cross-sectional evaluation of client satisfaction questionnaires and voice recordings from transgender clients. This study was a comparative evaluation of voice recordings by voice professionals and lay observers. Twelve male-to-female transgender participants completed visual analogue scales (VASs), rating happiness with self-perceived femininity of their voice. Fifteen speech and language therapists (SLTs) and 40 naïve observers evaluated the anonymized recordings, using the same rating system. The correlation between mean F(0) and participant happiness was established. Relationships between participant happiness and rater opinions were explored. A significant relationship between F(0) and participant happiness could not be demonstrated (r=0.32, P=0.32). There was a moderately strong positive correlation between self-perception of vocal femininity and perception of femininity by SLTs and naïve observers (r=0.76 and 0.68, P=0.003 and P=0.01, respectively). This study demonstrates that happiness with voice in male-to-female transgender clients is not directly related to F(0). Clients can assess femininity of their voice in the form of perceived pitch. This may not affect happiness scores. Voice satisfaction may not correlate with perceptions of supervising voice professionals. However, professionals can reliably evaluate how the voice will be received by the lay public. Subjective measures of patient satisfaction, including VASs, are reliable and valid tools in evaluating therapeutic success.
Mundorf, Elisabeth S; Paivio, Sandra C
This study predicted that the quality of trauma narratives written before and following emotion-focused therapy for child abuse trauma would be positively associated with psychological disturbance before and following therapy. Narratives for 37 clients were coded for emotion words, temporal orientation, incoherence, and depth of experiencing. At pretreatment, negative emotion words and experiencing were correlated with abuse resolution, r(35) = -.36, and r(35) = -.34, respectively. At posttreatment, narrative incoherence was correlated with trauma symptoms, r(35) = .33, whereas present-future orientation and experiencing were correlated with abuse resolution, r(35) = -.37, and r(35) = -.31, respectively. Pretreatment incoherence was associated with posttreatment trauma symptoms, r(35) = .42, and pretreatment depth of experiencing was associated with posttreatment abuse resolution, r(35) = -.37. Results support narrative quality as an index of trauma disturbance.
Pau-Charles, I; Darwich-Soliva, E; Grimalt, R
Child abuse is far more prevalent today than is generally recognized. Up to 90% of victims suffer physical abuse that can be observed in signs on the skin. Dermatologists are particularly qualified to identify these signs and distinguish them from other conditions that can mimic abuse. This review covers the signs of child abuse that can be observed on the skin. We discuss clues that can help differentiate between lesions caused by abuse and those that are accidental, and we describe the skin conditions that mimic physical abuse.
Barillo, D J; Goode, R
Ethanol or drug use may increase the risk of fire-related injury or death. This study was performed to quantify the role of substance abuse in fatal fires occurring in New Jersey over a 7-year period. Records of all the fatalities of fire reported to the State Medical Examiners Office between 1985 and 1991 were retrospectively examined. Blood assay results for ethanol were positive in 215 of the 727 (29.5%) fatalities of fire tested. For this group, the mean blood-ethanol level was 193.9 mg/dl. Blood or urine assay results for substances of abuse were positive in 78 of the 534 (14.6%) fatalities tested. The most commonly detected illicit substances were cocaine, benzodiazepines, barbiturates, and cannabinoids. The test results were positive for both ethanol and drug use in 36 victims. Forty percent of all the fatalities of fire were aged younger than 11 or older than 70. In contradistinction, 75% of drug-positive fatalities of fire and 58% of ethanol-positive fatalities of fire were between the ages of 21 and 50, suggesting that inebriation may impair the ability to escape from fire. Substance abusers in middle life are a previously unrecognized group at higher risk of injury or death in a fire.
Shapiro, David A.
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)
Therapist's role and dilemmas faced in treating a gender dysphoric client are discussed. Examines ethical and moral issues relating to transsexualism and discusses the appropriateness of art therapy as a treatment for transsexual clients. (SNR)
... documents or written or electronic materials provided to the practitioner, or obtained by the practitioner... the practitioner by the client. The term also includes materials that were prepared by the client or...
... treatment; (3) Allow and encourage individual clients to exercise their rights as clients of the facility... food or hydration that contributes to a nutritionally adequate diet. (iii) The facility must...
Reeves, Roy R; Ladner, Mark E; Perry, Candace L; Burke, Randy S; Laizer, Janet T
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.
Nelson, Michael E; Bryant, Sean M; Aks, Steven E
Many new emerging drugs of abuse are marketed as legal highs despite being labeled "not for human consumption" to avoid regulation. The availability of these substances over the Internet and in "head shops" has lead to a multitude of emergency department visits with severe complications including deaths worldwide. Despite recent media attention, many of the newer drugs of abuse are still largely unknown by health care providers. Slight alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown. Many of these substances can be grouped by the class of drug and includes synthetic cannabinoids, synthetic cathinones, phenethylamines, as well as piperazine derivatives. Resultant effects generally include psychoactive and sympathomimetic-like symptoms. Additionally, prescription medications, performance enhancing medications, and herbal supplements are also becoming more commonly abused. Most new drugs of abuse have no specific antidote and management largely involves symptom based goal directed supportive care with benzodiazepines as a useful adjunct. This paper will focus on the history, epidemiology, clinical effects, laboratory analysis, and management strategy for many of these emerging drugs of abuse.
Yan, Elsie; Chan, Ko-Ling; Tiwari, Agnes
The number of older victims of domestic violence is expected to increase drastically in Asia as many countries are experiencing rapid population aging. In 2012, 11% of the population in Asia were aged 60 years and over. This is expected to rise to 24% by 2050. This article discusses the unique features of Asian cultures that are relevant to the understanding of elder abuse and summarizes the existing literature looking at the prevalence and risk factors of such abuse in Asian populations.
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;…
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…
Hill, Barry C.; Black, David R.; Shields, Cleveland G.
The purpose of this article is to identify characteristics of Black barbershop clients and barbers in an urban Midwestern city participating in a health promotion program called Affecting Cancer Together (ACT) that are associated with client knowledge about prostate cancer. Statistical analyses examined client and barber characteristics for their…
Anderson, Wayne; Bauer, Barbara
Compared personal characteristics of 80 counseling clients with elevated 2-4 (Depression-Psychiatric Deviate) scales on their Minnesota Multiphasic Personality Inventory and 109 clients without elevations. Results indicated that clients with 2-4 elevations were significantly more depressed, had lower self-esteem, and were more likely to come from…
Tucker, Robin C.; Snyder, William U.
The study investigated the relationships between student-therapists' tolerance for ambiguity in visual perception tasks and (a)the positive affect displayed toward them by their clients, (b)measures of improvement in clients' self self-reference statements, and (c)measures of improvement in clients'"adjustment". (Author)
Draba, Robert; Marshall, Brent
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,…
... false information. A broker must not withhold information relative to any customs business from a client... false information relative to any customs business. (b) Error or omission by client. If a broker knows that a client has not complied with the law or has made an error in, or omission from, any...
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…
... 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...
... 32 National Defense 5 2011-07-01 2011-07-01 false Attorney-client relationships. 776.4 Section 776... General § 776.4 Attorney-client relationships. (a) The executive agency to which assigned (DON in most... will not establish attorney-client relationships with any individual unless detailed, assigned,...
... 32 National Defense 5 2010-07-01 2010-07-01 false Attorney-client relationships. 776.4 Section 776... General § 776.4 Attorney-client relationships. (a) The executive agency to which assigned (DON in most... will not establish attorney-client relationships with any individual unless detailed, assigned,...
Strong, Tom; Massfeller, Helen F.
Counselors frequently conclude consultations with clients with suggestions or prescriptions for clients to follow up on, post-consultation. In this paper, we conceptualize the discussion regarding such post-consultation tasks as negotiations between counselor and client, focusing in particular on what observably occurs and is "talked into being"…
Taheri-Araghi, M.; Hendren, G.
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…
... 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 practitioner employed or retained by an organization represents the organization acting through its...
Stewart, Allan E.
Clinicians (N = 308) responded to identical counseling vignettes of a male client that differed only in the client's stated birth order. Clinicians developed different impressions about the client and his family experiences that corresponded with the prototypical descriptions of persons from 1 of 4 birth orders (i.e., first, middle, youngest, and…
Angima, Sam; Etuk, Lena; Maddy, Deborah
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…
... 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...
Bell, Tamekia R.
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…
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…
Reynolds, Kathleen; Ogiba, Shawn; Chambliss, Catherine
Training therapists effectively requires familiarizing them with the modal expectations that clients bring to the therapeutic encounter. Ways in which therapists can be apprised of clients' expectations of therapy are discussed. Accurate understanding of clients' attitudes permits development of appropriately focused therapy goals and is generally…
Brief therapy is an effective, time-limited approach that invokes clients values, appreciates their strengths, and is based on mutual respect. Counseling nonvoluntary clients can be extremely difficult because of the intense degree of denial, minimization, or rationalization of problems such clients typically bring to therapy. Therapists must…
Northway, Ruth; Melsome, Melissa; Flood, Samantha; Bennett, Davey; Howarth, Joyce; Thomas, Becki
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…
Stickle, Fred; Onedera, Jill D.
The purpose of this article is to address selected aspects of depression in older adults. Specifically, symptoms, risk factors, diagnosis, and interventions for depression in older adults are reviewed.
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.
Anyone who has ever managed people who abuse time--whether they are chronic procrastinators or individuals who work obsessively to meet deadlines weeks in advance--knows how disruptive they can be to a business's morale and operating efficiency. But lessons in time management will have no impact on these employees. That's because real time abuse results from psychological conflict that neither a workshop nor a manager's cajoling can cure. Indeed, the time abuser's quarrel isn't even with time but rather with a brittle self-esteem and an unconscious fear of being evaluated and found wanting. This article describes four types of time abusers typically encountered in the workplace: Perfectionists are almost physically afraid of receiving feedback. Their work has to be "perfect," so they can increase their likelihood of earning a positive evaluation or at least avoid getting a negative one. Preemptives try to be in control by handing in work far earlier than they need to, making themselves unpopular and unavailable in the process. People pleasers commit to far too much work because they find it impossible to say no. Procrastinators make constant (and often reasonable-sounding) excuses to mask a fear of being found inadequate in their jobs. Managing these four types of people can be challenging, since time abusers respond differently from most other employees to criticism and approval. Praising a procrastinator when he is on time, for instance, will only exacerbate the problem, because he will fear that your expectations are even higher than before. In fact, some time abusers, like the perfectionist, may need professional treatment. This article will give you insight into why they are the way they are--and what can be done to help them manage their problems.
Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Elliot, Shannon; Spencer, Charmaine; Yaffe, Mark
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
Operations research (OR) is a major component of the Quality Assurance Project's (QAP) strategy for improving the quality of health care delivery worldwide. QAP's Operations Research Program aims to improve the feasibility, utility, and cost-effectiveness of quality assurance strategies in developing countries. QAP and its field partners work to maximize the utility of each field study's findings. As such, the project hopes to disseminate information on all aspects of important OR projects, from the initial design to implementation and results. Over the course of the project, QAP's staff and their partners will develop studies in 16 technical areas. One key area of interest is the study of client satisfaction with health care delivery. The project currently has two major studies on client satisfaction underway in Niger and Peru. Phase one results from the Niger research and QAP and the Max Salud Institute in Peru are discussed.
This paper reports on MATLAB Channel Access (MCA) Toolbox--MATLAB  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.
Shen, X Y; Orson, F M; Kosten, T R
The currently available medications for the treatment of drug abuse have had only limited success. Anti-addiction vaccines, aimed at eliciting antibodies that block the pharmacological effects of drugs, have great potential for treating drug abuse. We review the status of two vaccines that are undergoing clinical trials (for cocaine and nicotine addiction) and two that are still in preclinical development (for methamphetamine and heroin addiction). We also outline the challenges and ethical concerns associated with the development of anti-addiction vaccines and their use as future therapeutics.
The role of imaging in cases of child abuse is to identify the extent of physical injury when abuse is present and to elucidate all imaging findings that point to alternative diagnoses. Effective diagnostic imaging of child abuse rests on high-quality technology as well as a full appreciation of the clinical and pathologic alterations occurring in abused children. This statement is a revision of the previous policy published in 2000.
de Weiss, S P; David, H P
An exploratory study of the perceptions of 156 abortion clients in Mexico suggests that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. "Too young" was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on average, equivalent to three to four weeks minimum wage; physicians' charges were about three times higher than those of nonphysicians. PMID:2343958
Meißner, Tina; Kröger, Knut; Creutzburg, Reiner
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.
The last two decades have heralded an increased community and professional awareness of the phenomenon of elder abuse and the challenges it poses to the enjoyment of the human rights of some older people. The contemporary Australian legal system provides many of the components of a framework required to assist in the promotion of the rights of the elderly and in the prevention and remedy of elder abuse. This framework acts in concert with health and community services dedicated to the advancement of health and wellbeing into old age. In the future, the acknowledgment and adoption of international legal principles which are directed to the needs of the elderly, the reform of existing domestic legislation and the development of new elder-specific statutes may all impact upon the incidence and consequences of elder abuse. To date, no Australian jurisdiction has adopted a legislative regime targeted specifically at the issues confronting older Australians who may be vulnerable to abuse and neglect. This column looks at some of the options for legal reform in this area.
McDonald, R; Free, D; Ross, F; Mitchell, P
This study was concerned with preferences for inpatient models of care by the HIV/AIDS client group, in particular the difference between gay white men (European) and black heterosexuals of African/Caribbean origin. Satisfaction with the care currently provided was also an area of interest. Thirteen per cent (n = 79) of the were surveyed. Seventy per cent (n = 56) of the HIV/AIDS client group indicated a preference for a dedicated care model. Significant results were obtained demonstrating differences in the care model preferred by gay white men and black heterosexuals (p < 0.01). Gay white men were much more likely to state they would leave the trust to receive dedicated care (p < 0.01). Black heterosexuals were more likely to state that they would change treatment areas to avoid dedicated care (p < 0.01) Differences in concern about confidentiality were noted between the two groups. Confidentiality may be one of a number of factors influencing preference of care for African/Caribbeans and this needs to be studied further. The clients surveyed were not universally satisfied with the care they had been receiving. Following the results of the survey radical changes in the management of HIV inpatient care were made.
Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…
Foynes, Melissa Ming; Freyd, Jennifer J.; DePrince, Anne P.
Objective: The current study tested several hypotheses about disclosure of childhood sexual, physical, and emotional abuse derived from Betrayal Trauma Theory [Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge, MA: Harvard University Press]. We predicted that the duration of time from abuse to its disclosure…
This document provides a review of recent, state-of-the-art literature concerning the nature, extent, dynamics, and effects of child sexual abuse and examines America's preventive intervention and treatment efforts for child sexual abuse. After an extensive presentation of the problems of defining terms in sexual abuse, these topics are discussed:…
Grayson, Joann, Ed.; Bartlette, Don
Literature indicating high rates of abuse in this population is reviewed, as is literature indicating high rates of developmental disabilities in child victims of abuse. Problems in data collecting practices are noted. Reasons for these children's greater risk for abuse are identified, including child attributes, stress, parent vulnerabilities,…
Murphy, Linda; Corte, Suzanne Della
The issue's major feature, on physical and sexual abuse of handicapped children, focuses on education and adult awareness of the problem. It has been well documented that children with handicaps are especially vulnerable to abuse. Parents or other adults who believe that abuse has occurred should first write down exactly what the child has told…
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…
... Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders, 14(4), 1-24. doi: 10.1300/J070v14n04_ ... 1996). Childhood sexual abuse and psychiatric disorder in young adulthood: Psychiatric outcomes of childhood sexual abuse. Journal ...
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…
MacKenzie, R G; Jacobs, E A
Adolescents are at high risk for using and abusing illicit drugs. Guidelines for recognizing drug abusers are presented as well as a staging process for progression of drug use. The family physician is in an ideal position to identify young users/abusers and to assist them and their families in obtaining much needed assistance.
Ferneau, E.; Mueller, S.
The drug-abuse questionnaire used to survey college student attitudes on the subject is provided. It is identical to the alcoholism questionnaire except for word changes appropriate to the subject matter. The questionnaire consists of 40 statements about drug abuse and drug abusers, with 7 possible responses: (1) completely disagree; (2) mostly…
Parran, T V; Jasinski, D R
Data are presented from a case series of 22 patients who abused methylphenidate hydrochloride (Ritalin-SR). The abuse pattern and symptoms of toxicity were similar to that seen with cocaine hydrochloride and amphetamine sulfate addiction; yet, the morbidity and mortality seen in this case series were greater than usual for a group of patients involved in intravenous drug abuse. We describe the characteristics of the methylphenidate abuse syndrome in terms of the pharmacology of methylphenidate, the constituents of the Ritalin-SR preparation, and the disease of chemical dependence. We propose solutions to the problem of methylphenidate abuse.
Francis, Karen J.; Wolfe, David A.
Objective: Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Methods: Abusive (n = 24) and non-abusive (n = 25) fathers…
Say, Gökçe Nur; Babadağı, Zehra; Karabekiroğlu, Koray; Yüce, Murat; Akbaş, Seher
The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitation of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.
Brolin, Mary F; Horgan, Constance; Amaro, Hortensia; Doonan, Michael
This issue brief outlines five strategies for improving the quality of treatment in Massachusetts: (1) Engaging detoxification clients in a broader continuum of treatment, (2) Improving retention in treatment, (3) Providing client/family-centered services, (4) Increasing the use of evidence-based treatment approaches, and (5) Supporting recovery to address the chronic nature of substance use disorders. These strategies are essential to maximizing the impact of our substance abuse dollars. We need to do it right and then expand access to treatment more broadly and fill the treatment gap. Although not the focus of this report we need to think harder about upfront prevention and efforts to encourage more people to seek care. Part of the public strategy also requires better coordination between BSAS, MassHealth, provider organizations, and other state agencies, including criminal justice and mental health agencies. Through these efforts we can reduce the costs and consequences of substance abuse and build a healthier, more productive community.
Linehan, M M
DBT is a comprehensive, behaviorally oriented treatment designed for highly dysfunctional individuals meeting criteria for BPD. Many of these criteria are characteristic of drug abusers, and some of the problems encountered in treatment of drug abusers, especially when various treatments are combined, are similar. The basic armamentarium of the DBT therapist is the balancing of validation and acceptance treatment strategies with problem-solving procedures, including contingency management, exposure-based procedures, cognitive modification, and skills training. In addition, a number of specific strategies have been woven together to enhance compliance and to reduce the staff splitting that is so frequent with this population. Those described in this chapter include orienting and commitment strategies and the focus in DBT on reducing therapy-interfering behavior and on consultation with the client rather than with the client's network.
Paivio, Sandra C; Jarry, Josee L; Chagigiorgis, Helen; Hall, Imogen; Ralston, Margaret
This study evaluated and compared emotion-focused therapy for trauma (EFTT) with imaginal confrontation (IC) of perpetrators (n=20) and EFTT with empathic exploration (EE) of trauma material (n=25). Clients were women and men with histories of different types of childhood maltreatment (emotional, physical, and sexual abuse; emotional neglect). Clients were randomly assigned to treatment condition. Outcome measures assessed symptom distress, self and interpersonal problems, and abuse resolution. Results indicated statistically and clinically significant improvements on eight measures at posttest, maintenance of gains at follow-up, and no statistically significant differences between conditions. There were higher rates of clinically significant change in IC and a lower attrition rate for EE (7% vs. 20%). More severe personality pathology negatively influenced some dimensions of outcome, particularly in EE.
Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José
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
He, Lichun; Sharpe, Timothy; Mazur, Adam; Hiller, Sebastian
Molecular chaperones are essential in aiding client proteins to fold into their native structure and in maintaining cellular protein homeostasis. However, mechanistic aspects of chaperone function are still not well understood at the atomic level. We use nuclear magnetic resonance spectroscopy to elucidate the mechanism underlying client recognition by the adenosine triphosphate-independent chaperone Spy at the atomic level and derive a structural model for the chaperone-client complex. Spy interacts with its partially folded client Im7 by selective recognition of flexible, locally frustrated regions in a dynamic fashion. The interaction with Spy destabilizes a partially folded client but spatially compacts an unfolded client conformational ensemble. By increasing client backbone dynamics, the chaperone facilitates the search for the native structure. A comparison of the interaction of Im7 with two other chaperones suggests that the underlying principle of recognizing frustrated segments is of a fundamental nature. PMID:28138538
Souza Pardo, Mário Henrique; Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José
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.
Gil, Ana Paula Martins; Kislaya, Irina; Santos, Ana João; Nunes, Baltazar; Nicolau, Rita; Fernandes, Ana Alexandre
In this study, we present findings of the Portuguese national prevalence study, "Aging and Violence," the purpose of which was to estimate the prevalence of abuse and neglect of older people in family settings over a 12-month period and examine the relationship between abuse and sociodemographic and health characteristics. Through a telephone survey of a representative probability sample (N = 1,123), we evaluated 12 abusive behaviors and demographic data. Overall, 12.3% of older adults experienced elder abuse in family settings. The prevalence rates of specific types were as follows: psychological, 6.3%; financial, 6.3%; physical, 2.3%; neglect, 0.4%; and sexual, 0.2%. Logistic regression was employed to determine the relationship between abuse and covariates. The study suggests that education level, age, and functional status are significantly associated with abuse. Accurate estimates of the prevalence of elder abuse and understanding of victim and perpetrator characteristics are fundamental to designing effective strategies for prevention and intervention.
United Nations Educational, Scientific, and Cultural Organization, Paris (France).
This book is a compilation of drug education and drug abuse prevention materials collected by United Nations Educational, Scientific and Cultural Organization (UNESCO) along with example of activities carried out by various countries. It opens with four introductory papers by separate authors: (1) "Prevention of Drug Dependence: A Utopian…
... Adults Making Your Wishes Known Home & Community Home › Aging & Health A to Z › Drug and Substance Abuse Font size A A A Print Share Glossary Basic Facts & Information Causes & Symptoms Diagnosis & Tests Care & Treatment Lifestyle & Management Other Resources Caregiving How ...
Sales, Amos, Ed.
This book focuses on the identification of practical knowledge and skills needed for counseling individuals with substance abuse problems. It is a resource for practitioners, students, and faculty in school counseling, rehabilitation counseling, mental health counseling, school psychology, or social work in recognizing, preventing, and treating…
Dupont, Robert I.; And Others
A decade of professional research on drug abuse has produced both an abundance of materials and a vocabulary that is not shared by planners, clinicians, and policy makers. This handbook compiles the major developments of the period and their treatment and research implications in a style intended to be understood by all three types of…
Carmichael, Karla D.
This document is a class presentation designed to present a history of child abuse and interventions for the beginning play therapist. Attempts to understand child behavior are traced back to their roots in the fields of mental retardation and special education as early as 1799 and followed through the mental health and child guidance movements of…
... hurting or harming someone) might have frightened the boy or girl into staying quiet. No matter what the abuser ... suit or underwear: breasts, vagina, and bottom for girls, and penis and bottom for boys. If an adult or another kid touches a ...
Hicks, Ralph A.; Gaughan, Daniel C.
Medical, social service, and coroner reports were reviewed for 14 cases of fatal child abuse and neglect identified at a children's hospital from 1988 to 1992. Median age was 6.5 months. Six families had prior protective service involvement (though four of these had involved a sibling). The cause of death in all cases was blunt impact head injury.…
Nessa, A; Latif, S A; Siddiqui, N I; Hussain, M A; Hossain, M A
Among the social and medical ills of the twentieth century, substance abuse ranks as on one of the most devastating and costly. The drug problem today is a major global concern including Bangladesh. Almost all addictive drugs over stimulate the reward system of the brain, flooding it with the neurotransmitter dopamine. That produces euphoria and that heightened pleasure can be so compelling that the brain wants that feeling back again and again. However repetitive exposure induces widespread adaptive changes in the brain. As a consequence drug use may become compulsive. An estimated 4.7% of the global population aged 15 to 64 or 184 million people, consume illicit drug annually. Heroin use alone is responsible for the epidemic number of new cases of HIV/AIDS, Hepatitis and drug addicted infant born each year. Department of narcotic control (DNC) in Bangladesh reported in June 2008 that about 5 million drug addicts in the country & addicts spend at least 17 (Seventeen) billion on drugs per year. Among these drug addicts, 91% are young and adolescents population. Heroin is the most widely abused drugs in Bangladesh. For geographical reason like India, Pakistan and Myanmar; Bangladesh is also an important transit root for internationally trafficking of illicit drug. Drug abuse is responsible for decreased job productivity and attendance increased health care costs, and escalations of domestic violence and violent crimes. Drug addiction is a preventable disease. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives. Most countries have legislation designed to criminalize some drugs. To decrease the prevalence of this problem in our setting; increase awareness, promoting additional research on abused and addictive drugs, and exact implementation of existing laws are strongly recommended. We should
... occurring within any relationship where there is an expectation of trust which causes harm or distress to ... older adults. Long-term care residents are generally female, frail, and cognitively impaired. All forms of elder ...
... Administration on Aging Administration on Disabilities Center for Integrated Programs Center for Performance and Evaluation National Institute ... Project Aging Statistics Profile of Older Americans AGing Integrated Database (AGID) Census Data & Population Estimates Projected Future ...
Hodge, David R; Lietz, Cynthia A
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.
Afifi, Tracie O; MacMillan, Harriet L; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Tonmyr, Lil; Hovdestad, Wendy
Much of what is known about child abuse in Canada has come from reported cases of child abuse and at-risk samples, which likely represent the most severe cases of child abuse in the country. The objective of the current study is to examine the prevalence of a broad range of child abuse experiences (physical abuse, sexual abuse, and exposure to IPV) and investigate how such experiences and sociodemographic variables are related to contact with child protection organizations in Canada using a representative general population sample. Data were drawn from the 2012 Canadian Community Health Survey: Mental Health collected from the 10 provinces using a multistage stratified cluster design (n=23,395; household response rate=79.8%; aged 18 years and older). Physical abuse only (16.8%) was the most prevalent child abuse experience reported with the exposure to specific combinations of two or more types of child abuse ranging from 0.4% to 3.7%. Only 7.6% of the adult population with a history of child abuse reported having had contact with child protection organizations. Experiencing all three types of child abuse was associated with the greatest odds of contact with child protection organizations (AOR=15.8; 95% CI=10.1 to 24.6). Physical abuse only was associated with one of the lowest odds of contact with child protection organizations. Preventing child abuse is widely acknowledged as an important, but challenging public health goal. Strategies to increase reporting of child abuse may help to protect children and to connect families with necessary services. One obvious priority would be physical abuse.
Health Questionnaire (PHQ-9) for depression,29 Generalized Anxiety Disorder screen (GAD-7),30 and the Brief Traumatic Brain Injury Screen (BTBIS).31...brief measure for assessing generalized anxiety disorder : the GAD-7. Arch Intern Med 2006; 166: 1092–7. 31. Schwab K, Baker G, Ivins B, Sluss-Tiller M
Guerrero, Erick G.
Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers’ tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. PMID:22658932
Chishugi, John; Franke, Trixy
A young girl was brought to the emergency unit after suffering sexual abuse by an older male. Additional abuses against women and girls include physical beating, forced marriage, female genital mutilation, breast ironing, widow's rites, psychological abuse, and discrimination in education, finance, employment, and legal access. Cameroon has adopted strategies aimed at eliminating violence against women, including ratification of international policies, penal codes, and support of local and international efforts that promote women; however, many of the laws remain in name only and are rarely enforced, given women's lack of financial access to quality lawyers and an unsympathetic male-dominated police force. Underreporting and culturally accepted abuses remain a challenge, too, as the country seeks to understand the extent of abuses and how to effectively fight against them. A complete paradigm shift in cultural attitude toward the female gender is required for abuses to cease.
Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.
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…
Rosenkoetter, Marlene M; Smith, Deborah; Stachura, Max E; McDonough, JoEllen; Hunter, Carol; Thompson, Darrell; Richter, Sally; Jones, Gail
The purpose of this project was to implement and evaluate the Video Analysis Tool (VAT) system, a tool for capturing and analyzing video evidence of students' clinical performance. Through the VAT system, nursing student dyads from 4 universities used a video camera, a computer, and a tripod in the residences of older adults to record interactions and psychosocial assessments of older adult clients. Using their recordings to compare their clinical activities with predefined clinical objectives derived from gerontological nursing standards, they made video clips of their assessments to demonstrate the required outcomes. Use of the VAT system received positive evaluations from students, faculty, and residents in multiple clinical sites. The process has significant implications for assessing clients and health care providers in their interactions in a variety of settings, including on home visits. It has additional applications for documenting performance measures of nurses and team members as they provide client care.
de Winter, Channa F.; Magilsen, Karla W.; van Alfen, J. Claudia; Penning, Corine; Evenhuis, Heleen M.
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…
Hanson, Meredith; Gutheil, Irene A.
Social workers and other health care professionals address problem drinking by older adults inconsistently. Reasons include client-related variables (for example, denial and poor information), practitioner-related factors (for example, inadequate knowledge about addictive behaviors, underdeveloped assessment tools, and limited empirically…
Kaufman, Allan V.
Presents a framework that identifies variables associated with relationship dynamics that exist between older persons and their social network members. Suggests framework can be used by case managers to help them assess the characteristics and functioning of their clients' social network relations and develop service strategies that maximize the…
Andiel, C; Liu, L
Atkinson and Shiffrin's (1968) modal model of memory is still commonly used by rehabilitation professionals to evaluate memory impairment in older adults. However, research to date has been unable to indicate that short-term memory declines with age. These findings have led some rehabilitation professionals to mistakenly conclude that short-term memory is not affected by the aging process. This article reviews both the traditional concept of short-term memory, as outlined by Atkinson and Shiffrin, and the more recent conceptualization of short-term memory in terms of Baddeley and Hitch's (1974) model of working memory. The implications of the concept of working memory has implications for occupational therapy interventions for older adults. For example, clients with dementia may experience difficulties in performing tasks that require drawing inferences. Similarly, language that contains vague references may present problems for these clients. In addition, changes in working memory in older adults suggest that they may experience difficulties with medication management and what Rule, Milke, and Dobbs (1992) called wayfinding. Therefore, evaluations of working memory would provide a better indication of older adults' memory performance than the modal model.
The National Storage Laboratory (NSL) is currently implementing a prototype storage system that utilizes network attached high performance storage devices to transfer data directly between storage devices and client processors using HIPPI IPI-3. The client processors in use at the NSL include Cray YMP-C90 supercomputers, IBM RISC System 6000 workstations, Silicon Graphics workstations, SUN workstations, and a PsiTech frame buffer. This paper describes the HIPPI IPI-3 interface between the client processors and the storage devices. It is intended to serve as a guide for vendors who desire to connect their products to the NSL. Clients direct their requests to a distributed storage system. A typical storage system will contain multiple storage devices. The storage system map client`s files onto regions on the storage devices. At the NSL, the data transfers are performed directly between the client processors and the storage devices, bypassing any processors in the storage system. The protocol used between the client processors and the storage devices is HIPPI IPI-3 third party copy. When a client processor wants to read or write data to or from the storage system, the client processor sends a request to the storage system across a control connection. The control path to the storage system is logically separated from the data path. When the storage system is ready to perform a data transfer, a third-party IPI-3 read or write command is sent to one of the IPI-3 slave devices in the storage system. The slave device then transfers the data directly to or from the client processor across the HIPPI data network. Using third party copy simplifies the implementation of the client processor`s interface to the storage system by isolating the client processors from the specific characteristics of the storage devices.
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.
Richmond, D.; Bicker, S.; Malloy, B.
Multiple Net-Centric approaches have been developed to expose optical and radar sensor data. Client applications have been developed to ingest and process this data by NASIC and JMS. Data flows and formats used that integrate these Net-Centric approaches with JMS and NASIC will be presented. Example data collected and examples of improved SSA benefits will be discussed. Potential future improvements to increase the precision of the SOI processing algorithm will be addressed. Specifics regarding the process to gain access to the N-CSDS GEODSS sensor data in near real time will be identified.
Vaughan, B. J.; Torok, K. E.; Kelly, L. M.; Ewing, D. J.; Andrews, L. T.
This paper describes the Medical College of Ohio's efforts in developing a client/server telemedicine system. Telemedicine vastly improves the ability of a medical center physician or specialist to interactively consult with a physician at a remote health care facility. The patient receives attention more quickly, he and his family do not need to travel long distances to obtain specialists' services, and the primary care physician can be involved in diagnosis and developing a treatment program [1, 2]. Telemedicine consultations are designed to improve access to health services in underserved urban and rural communities and reduce isolation of rural practitioners . Images Figure 2 Figure 3 Figure 4 PMID:8563396
Vandrey, Ryan; Stitzer, Maxine L; Acquavita, Shauna P; Quinn-Stabile, Patricia
Pay-for-performance (P4P) strategies improve employee productivity and morale in business settings and are increasingly being implemented in medical care settings. This study investigated whether P4P could improve treatment utilization and retention at a community drug treatment clinic. Counselors had the opportunity to earn cash bonuses based on therapy attendance rates of individual clients and on the quarterly retention rates of their caseload. Using a pre-post study design, average therapy sessions attended during the first month of treatment increased from 4.6 sessions prior to the intervention to 5.5 sessions per client during the intervention. The 90-day client retention rate increased from 40% to 53%. Additional analyses suggest that the improvement in the 90-day retention was mediated by the increase in attendance during the first month of treatment. This project demonstrates that implementing a P4P incentive program in community drug abuse treatment clinics is feasible and effective at improving utilization and retention.
Orendorff, Christopher J.; Nagasubramanian, Ganesan; Fenton, Kyle R.; Allcorn, Eric
As lithium-ion battery technologies mature, the size and energy of these systems continues to increase (> 50 kWh for EVs); making safety and reliability of these high energy systems increasingly important. While most material advances for lithium-ion chemistries are directed toward improving cell performance (capacity, energy, cycle life, etc.), there are a variety of materials advancements that can be made to improve lithium-ion battery safety. Issues including energetic thermal runaway, electrolyte decomposition and flammability, anode SEI stability, and cell-level abuse tolerance continue to be critical safety concerns. This report highlights work with our collaborators to develop advanced materials to improve lithium-ion battery safety and abuse tolerance and to perform cell-level characterization of new materials.
Fonseca, Ana Catarina; Ferro, José M
Cerebrovascular disorders contribute to the morbidity and disability associated with illicit drug use. Drug abusers have an increased risk of both hemorrhagic and ischemic stroke. In geographic areas with a high prevalence of illicit drug use, drug abuse is a frequent cause of stroke in the young adult. The illicit drugs more commonly associated with stroke are psychomotor stimulants, such as amphetamine and cocaine. Less commonly implicated are opioids and psychotomimetic drugs, including cannabis. Toxicology screening for illicit drugs should be done in young patients with stroke with no obvious cause, or if suggested by history or examination. Although in some patients the mechanism of stroke is identified using neuroimaging and other modern diagnostic tools, in a sizeable fraction of cases the mechanism of stroke remains unclear. Further studies are needed to elucidate the role of hemodynamic and immunologic mechanisms in these cases.
Goldenberg, Shira M; Cruz, Manuel Gallardo; Strathdee, Steffanie A; Nguyen, Lucie; Semple, Shirley J; Patterson, Thomas L
Background Tijuana, situated adjacent to San Diego, CA on the US-Mexico border, is experiencing an emerging HIV epidemic, with prevalence among female sex workers (FSWs) having risen in recent years from <1% to 6%. Comparable data on FSWs’ clients are lacking. We explored correlates of unprotected sex with FSWs among male clients in Tijuana. Methods In 2008, males from San Diego (N=189) and Tijuana (N=211) aged 18 or older who had paid or traded for sex with a FSW in Tijuana during the past 4 months were recruited in Tijuana’s red light district. Participants underwent psychosocial interviews and were tested for HIV, syphilis (Treponema pallidum), gonorrhea (Neisseria gonorrhoeae), and Chlamydia (Chlamydia trachomatis). Results Of 394 men, median age was 36 years, 42.1% were married, and 39.3% were unemployed. Ethnic composition was 13.2% white, 79.4% Hispanic and 7.4% black or other. Half (50.3%) reported unprotected vaginal or anal sex with FSWs in Tijuana in the past 4 months. High proportions reported using drugs during sex (66%), and 36% reported frequenting the same FSW. Factors independently associated with unprotected sex with FSWs were using drugs during sex, visiting the same FSW, being married, and being unemployed. Conclusions FSWs’ clients represent an STI/HIV transmission “bridge” through unprotected sex with FSWs, wives and other partners. Tailored interventions to promote consistent condom use are needed for clients, especially within the context of drug use and ongoing relations with particular FSWs. PMID:20081558
Cunningham, Jennifer; Calsyn, Robert J; Burger, Gary K; Morse, Gary A; Klinkenberg, W Dean
This study investigated the causal relationship between the working alliance and client outcomes in the client-case manager relationship. All 162 study participants received services fiom a case manager who worked as a member of an assertive community treatment team. All participants had both a substance use disorder and a diagnosis of severe mental illness and were homeless at baseline. A brief form of the Working Alliance Inventory (WAI) was used to measure the working alliance after 3 and 15 months of treatment. The Brief Psychiatric Rating Scale was used to measure psychiatric symptoms at baseline, 9, and 18 months. Days per month that clients used alcohol or illegal drugs was also assessed at baseline, 9, and 18 months. The data were analyzed using structural equation modeling (SEM). The correlations between the working alliance and the outcome measures were lower than similar correlations obtained in studies investigating the psychotherapy relationship. The SEM analyses revealed little or no causal relationship between the working alliance and client outcome in this sample.
Simmons, Shannon; Suárez, Liza
There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD.
Martinez, Jennifer S; Smith, Timothy B; Barlow, Sally H
Spiritual and religious interventions in psychotherapy have increasingly received research attention, particularly with highly religious clients. This study examined client opinions about and experiences with religious interventions in psychotherapy. A sample of 152 clients at a counseling center of a university sponsored by the Church of Jesus Christ of Latter-Day Saints (LDS) completed a survey with ratings of specific religious interventions concerning appropriateness, helpfulness, and prevalence. Out-of-session religious interventions were considered more appropriate by clients than in-session religious interventions, but in-session interventions were rated as more helpful. Specific interventions considered both appropriate and helpful by the LDS participants included referencing scriptural passages, teaching spiritual concepts, encouraging forgiveness, involving religious community resources, and conducting assessments of client spirituality. Some religious interventions were perceived as inappropriate or not helpful, and clients provided explanations for why religious interventions can be either effective or ineffective in psychotherapy.
Haber, Russell; Carlson, Ryan G; Braga, Cristina
To attain information about divergent agendas in family therapy, as well as incorporate client feedback, we present the Client Feedback Note (CFN). The CFN elicits information about each family member's feelings, learning, dislikes, and wishes for each session. Anecdotal feedback after each session may help the therapist have better insight into the clients' perceptions and experience of the therapy and the therapist. Sensitivity to information generated by the CFN can help both therapist and client work to coconstruct a therapeutic process that is relevant to the diverse needs of the client system. This manuscript will (a) discuss literature supporting the use of client feedback in therapy; (b) present the CFN and rationale for its development; (c) discuss our experiences utilizing the CFN along with case examples that illustrate its use; and (d) identify practical applications, limitations, and potential research with using the CFN in systemic therapy.
Moyers, Theresa B; Martin, Tim
Client language in favor of change is hypothesized to be a causal mechanism for motivational interviewing (MI), and specific therapist behaviors are prescribed to elicit such speech. This project examined 38 motivational enhancement therapy sessions from Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), using a sequential behavioral coding system to investigate the relationship between therapist behaviors and client speech. Conditional probabilities were calculated between MI-consistent (MICO) therapist behaviors, MI-inconsistent (MIIN) therapist behaviors, and immediately subsequent client speech. MICO behaviors were more likely to be followed by self-motivational statements, whereas MIIN behaviors were more likely to be followed by client resistance. These results lend support to the importance of therapist behaviors in shaping client speech during MI sessions.
Reardon, Claudia L; Creado, Shane
Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions. PMID:25187752