Science.gov

Sample records for abused older clients

  1. Counseling Substance-Abusing Older Clients.

    ERIC Educational Resources Information Center

    Norton, E. Douglas

    1998-01-01

    Substance-abuse problems among older adults, involving alcohol, medications, and illegal drugs may arise from such stress factors as unstructured time, relationships with friends, loss, side effects of medications, and irrational beliefs. (SK)

  2. Snoezelen: benefits for nursing older clients.

    PubMed

    Morrissey, M; Biela, C

    1997-10-01

    In this article, the authors examine the possible benefits of Snoezelen for older clients. The authors suggest that nurses can be instrumental in developing and creating innovative therapeutic environments for this vulnerable client group. PMID:9370672

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

    ERIC Educational Resources Information Center

    Hayes, Christopher L.

    Clinicians who work with at-risk older adults are often faced with the difficult decision to override their client's civil rights and force institutionalization. Many times the professional is pressured by police or a housing manager to "just do something" with the judgmentally impaired older client. Clinicians faced with these decisions may…

  4. General and Specific Psychotherapy Role Induction with Substance Abusing Clients.

    ERIC Educational Resources Information Center

    Stark, Michael J.; Kane, Barbara J.

    Successful outcome in psychotherapy depends, in part, on clients' preconceptions and expectations. Research has shown that inaccurate expectations are more prevalent among lower socioeconomic status clients, who also represent the majority of substance abusers in community treatment programs. To investigate the effect of general and specific…

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

    ERIC Educational Resources Information Center

    Rosen, Daniel

    2004-01-01

    Purpose. The overall aims of this study are to describe the life stressors of, exposure to illegal drug use of, and illegal drug use by older methadone clients. Design and Methods. The current study focuses on a sub-sample of the larger administrative data of a methadone clinic that is limited to African American and White clients over the age of…

  6. A Multimodal Approach in Dealing with Older Clients.

    ERIC Educational Resources Information Center

    Weikel, William J.

    1990-01-01

    Notes that older persons underuse community-based and outpatient mental health services, yet are overrepresented in inpatient facilities. Argues for increased programing targeted for elderly client. Advocates use of multimodal model as efficient method of service delivery and provides sample case study using BASIC ID (Behavior, Affect, Sensation,…

  7. Preventing Elder Abuse and Neglect in Older Adults

    MedlinePlus

    ... Share Glossary previous page Related Documents PDF Preventing Elder Abuse and Neglect in Older Adults Download Join our e-newsletter! Resources Preventing Elder Abuse and Neglect in Older Adults Tools and Tips ...

  8. Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

    PubMed

    Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana

    2014-01-01

    Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse. PMID:24779540

  9. Substance abuse treatment client experience in an employed population: results of a client survey

    PubMed Central

    2012-01-01

    Background Understanding client perspectives on treatment is increasingly recognized as key to improving care. Yet information on the perceptions and experiences of workers with private insurance coverage who receive help for substance use conditions is relatively sparse, particularly in managed behavioral health care organization (MBHO) populations. Furthermore, the role of several factors including prior service use has not been fully explored. Methods Employees covered by a large MBHO who had received substance abuse services in the past year were surveyed (146 respondents completed the telephone survey and self-reported service use). Results The most common reasons for entering treatment were problems with health; home, family or friends; or work. Prior treatment users reported more reasons for entering treatment and more substance use-related work impairment. The majority of all respondents felt treatment helped a lot or some. One quarter reported getting less treatment than they felt they needed. Discussion and conclusions Study findings point to the need to tailor treatment for prior service users and to recognize the role of work in treatment entry and outcomes. Perceived access issues may be present even among insured clients already in treatment. PMID:22251622

  10. Sexual Abuse of Older Adults: Aps Cases and Outcomes

    ERIC Educational Resources Information Center

    Teaster, Pamela B.; Roberto, Karen A.

    2004-01-01

    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…

  11. Abuses against Older Women: Prevalence and Health Effects

    ERIC Educational Resources Information Center

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

    2011-01-01

    A clinical sample of 995 community dwelling women aged 55 and older were surveyed by telephone about their experience with psychological/emotional, control, threat, physical, and sexual abuse. Nearly half of the women experienced at least one type of abuse since turning 55. Sizable proportions were victims of repeated abuse, and many experienced…

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

    PubMed Central

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

    2015-01-01

    Despite an increasing literature related to elder abuse, sexual abuse of older persons in general and of vulnerable adults living in nursing homes in particular is still sparsely described. The purpose of this study was to assess the state of knowledge on the subject of sexual abuse against older nursing home residents through a literature review. Systematic searches in reference databases including Cinahl, Medline, OVID Nursing Database, ISI Web of Science, PsycINFO, Cochrane Library, and SveMed + were conducted. Through several phases of selection of the articles, using strict inclusion and exclusion criteria, six articles were chosen for a deeper examination. Findings from the review show that sexual abuse occurs in nursing homes and that both older women and men are victims of sexual abuse. Perpetrators appear mainly to be staff and other residents and mainly to be men, but also women abuse both older men and older women. Findings from the literature review show that there is a need for knowledge and further research on the topic of sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step in seriously addressing sexual abuse against older persons. PMID:25642347

  13. The Lived Experience of Psychotherapists Working with Older Clients: An Heuristic Study

    ERIC Educational Resources Information Center

    Atkins, Dianne; Loewenthal, Del

    2004-01-01

    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…

  14. Substance Use among Lesbian, Gay, and Bisexual Clients Entering Substance Abuse Treatment: Comparisons to Heterosexual Clients

    PubMed Central

    Flentje, Annesa; Heck, Nicholas C.; Sorensen, James L.

    2015-01-01

    Objective This study evaluated whether sexual orientation-specific differences in substance use behaviors exist among adults entering substance abuse treatment. Method Admissions records (July 2007-December 2009) were examined for treatment programs in San Francisco, California receiving government funding. Lesbian, gay, and bisexual (LGB) persons (n=1441) were compared to heterosexual persons (n=11770) separately by sex, examining primary problem substance of abuse, route of administration, age of first use, and frequency of use prior to treatment. Results Regarding bisexual males, the only significant finding of note was greater prevalence of methamphetamine as the primary substance of abuse. When compared to heterosexual men, gay and bisexual men evidenced greater rates of primary problem methamphetamine use (44.5% and 21.8% respectively versus 7.7%, adjusted odds ratios [ORs] 6.43 and 2.94), and there was lower primary heroin use among gay men (9.3% vs. 25.8%,OR 0.35). Among LGB individuals, race and ethnicity did not predict primary problem substance, except that among LGB men and women, a non-White race predicted cocaine use (OR 4.83 and 6.40, respectively), and among lesbian and bisexual women, Hispanic ethnicity predicted lower odds of primary cocaine use (OR 0.24). When compared to heterosexual men, gay men were more likely to smoke their primary problem substance (OR 1.61), first used this substance at an older age (M = 23.16 versus M=18.55, p<.001), and used this substance fewer days prior to treatment (M=8.75 versus M=11.41, p<.001). There were no differences between heterosexual and lesbian or bisexual women. Conclusions There wereunique patterns of substance use for gay and bisexual men entering substance abuse treatment, but women did not evidence differences. Gay men evidenced unique factors that may reflect less severity of use when entering treatment including fewer days of use and a later age of initiation of their primary problem substances. The

  15. Impact of Childhood Sexual Abuse on Client Spiritual Development: Counseling Implications.

    ERIC Educational Resources Information Center

    Ganje-Fling, Marilyn A.; McCarthy, Patricia

    1996-01-01

    Defines spirituality and discusses its relevance for counselors who work with childhood sexual abuse survivors. Describes the impact of abuse on client spirituality, and presents several suggestions for assessment and intervention approaches that address spiritual issues as part of the counseling process. (JPS)

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…

  17. Mono- versus polydrug abuse patterns among publicly funded clients.

    PubMed

    Kedia, Satish; Sell, Marie A; Relyea, George

    2007-01-01

    To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category-other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse. PMID:17996066

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

    PubMed

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

    2014-01-01

    This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as peer researchers. Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent: some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests. Preventing abuse requires a wide-ranging approach including rebuilding respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviors that have occurred. PMID:24779538

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

    PubMed Central

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

    2011-01-01

    History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence, psychological distress and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125

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

    PubMed

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

    2014-04-01

    History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence (IPV), psychological distress, and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125

  1. Early Working Alliance in Outpatient Substance Abuse Treatment: Predicting Substance Use Frequency and Client Satisfaction

    ERIC Educational Resources Information Center

    Knuuttila, Vesa; Kuusisto, Katja; Saarnio, Pekka; Nummi, Tapio

    2012-01-01

    Background: The study examined the effect of the early working alliance on outcome in outpatient substance abuse treatment. Methods: A total of 327 clients and 33 therapists participated in the study. Data were collected in southern and western Finland in outpatient treatment units (N = 7). The dependent variables were percentage of days abstinent…

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

    ERIC Educational Resources Information Center

    Senreich, Evan; Straussner, Shulamith Lala A.

    2013-01-01

    Entering ("n"?=?475) and graduating ("n"?=?454) students at 3 master's of social work programs in the northeast were compared regarding their knowledge and attitudes concerning working with substance abusing clients. In comparison to entering students, graduating students demonstrated modestly higher levels of knowledge,…

  3. Working With the Suicidal Client Who Also Abuses Substances

    PubMed Central

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

    2012-01-01

    Substance use disorders and suicidal thoughts and behaviors commonly co-occur in adolescent and adult psychiatric populations and are often functionally interrelated. Although the evidence base for treatment of this population is sparse, integrated cognitive behavioral treatment (CBT) protocols, or those that rely heavily on CBT techniques, hold promise. In this paper, we provide an overview of the evidence-based literature for interventions that target suicidal behavior and substance use disorders with adults and adolescents. We then discuss the manner in which these behaviors may be functionally interrelated and offer a conceptual framework (S-O-R-C) to guide case conceptualization and treatment planning for clients with co-occurring suicidality and substance use disorders. Next, we provide a case example of a client with suicidal behavior and an alcohol use disorder and demonstrate how to apply an integrated CBT treatment protocol to this case. This case example is followed by a more general discussion about the potential advantages of integrated CBT protocols for suicidality and substance use disorders, guidelines for prioritizing treatment targets and skill selection for each individual client, and other important treatment considerations. We conclude with recommendations for future research in this area. PMID:23209362

  4. Outcomes for Medicaid Clients With Substance Abuse Problems Before and After Managed Care

    PubMed Central

    McFarland, Bentson H.; Deck, Dennis D.; McCamant, Lynn E.; Gabriel, Roy M.; Bigelow, Douglas A.

    2005-01-01

    Medicaid conversion from fee for service to managed care raised numerous questions about outcomes for substance abuse treatment clients. For example, managed care criticisms include concerns that clients will be undertreated (with too short and/or insufficiently intense services). Also of interest are potential variations in outcome for clients served by organizations with assorted financial arrangements such as for-profit status versus not-for-profit status. In addition, little information is available about the impact of state Medicaid managed care policies (including client eligibility) on treatment outcomes. Subjects of this project were Medicaid clients aged 18–64 years enrolled in the Oregon Health Plan during 1994 (before substance abuse treatment managed care, N = 1751) or 1996–1997 (after managed care, N = 14,813), who were admitted to outpatient non-methadone chemical dependency treatment services. Outcome measures were retention in treatment for 90 days or more, completion of a treatment program, abstinence at discharge, and readmission to treatment. With the exception of readmission, there were no notable differences in outcomes between the fee for service era clients versus those in capitated chemical dependency treatment. There were at most minor differences among various managed care systems (such as for-profit vs not-for-profit). However, duration of Medicaid eligibility was a powerful predictor of positive outcomes. Medicaid managed care does not appear to have had an adverse impact on outcomes for clients with substance abuse problems. On the other hand, state policies influencing Medicaid enrollment may have substantial impact on chemical dependency treatment outcomes. PMID:16215446

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

    PubMed Central

    Counte, M A

    1998-01-01

    OBJECTIVE: To address the likely influences, on options faced by older clients, of specific changes in the delivery system and several possible responses to these changes and the changed options, by older persons in the aggregate. STUDY DESIGN: Four specific topics are discussed at length: (1) the probable altered role for the older healthcare client brought on by organizational changes; (2) findings from research on elderly health maintenance behavior and reasons for the increased importance of this issue; (3) the effectiveness of the conventional approach to explaining health services utilization in population studies; and (4) recommendations for future research into the direct or indirect influence of organizational changes in the primary healthcare system on the health-related decisions and behaviors of older persons. PMID:9618677

  6. Adapting Homework for an Older Adult Client with Cognitive Impairment

    ERIC Educational Resources Information Center

    Coon, David W.; Thompson, Larry W.; Gallagher-Thompson, Dolores

    2007-01-01

    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…

  7. Influences of family and friends on client progress during drug abuse treatment.

    PubMed

    Knight, D K; Simpson, D D

    1996-01-01

    Relationships with family and friends by 439 heroin addicts during the first 3 months of drug abuse treatment were examined in relation to behavioral improvements of clients. Family conflict and peer deviance were significant predictors of injection frequency and illegal activity during treatment, and reductions in family conflict were associated with lower drug use, injection frequency, and illegal activity during treatment. These results provide support for treatment emphasis on helping clients reduce conflict among family members, improve dysfunctional relationships with peers, and replace deviant friendships with others that encourage treatment participation and conformance to social norms. PMID:9058354

  8. Program Structure and Counselor–Client Contact in Outpatient Substance Abuse Treatment

    PubMed Central

    Knight, Danica K; Broome, Kirk M; Simpson, D Dwayne; Flynn, Patrick M

    2008-01-01

    Objectives To examine organizational structural attributes associated with counselor–client contact. Data Sources Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. Study Design The study uses a naturalistic design to investigate organizational structure measures—ownership, accreditation, and supplemental services—as predictors of time in counseling and case management, and caseload size, controlling for geographic differences. Data Collection Directors at 116 outpatient drug-free treatment programs located in four regions across the U.S. (Great Lakes, Gulf Coast, Northwest, and Southeast) voluntarily completed a survey about program structure. Primary Findings Clients received more counseling hours in programs that were “intensive,” publicly owned, accredited, and had a lower proportion of recently hired counselors. More case management hours were offered in “intensive,” private-for-profit or publicly owned (versus private-nonprofit) programs, serving a lower proportion of dual-diagnosis clients, and providing more on-site supplemental services. Smaller caseloads were found in programs that were accredited and had a smaller average client census and a lower proportion of criminal justice referred clients. Conclusions Organizational attributes are related to counselor–client contact and may have implications for staff turnover and service quality. PMID:18370970

  9. Client-centered home modifications improve daily activity performance of older adults

    PubMed Central

    Stark, Susan; Landsbaum, Amanda; Palmer, Janice; Somerville, Emily K.; Morris, John C.

    2010-01-01

    Background Remaining at home is a high priority for many older adults, but the capacity to “age in place” often is threatened by environmental barriers. Purpose To describe a client-centered occupational therapy, home modification intervention program and examine the impact of the intervention on daily activity performance over time. Methods Using a competence-environmental press framework, a client-centered home modification program for older adults was implemented. In this quasi-experimental, single group prospective study, participants’ subjective ratings of daily activity performance were evaluated before and after the intervention (baseline/post/post). Findings After home modification, participants’ perception of their daily activity performance at home improved significantly and was maintained 2 years post-modification. Implications Home modification may benefit older adults attempting to age in place. PMID:19757729

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

    PubMed Central

    Bamatter, Wendy; Carroll, Kathleen M.; Añez, Luis M.; Paris, Manuel; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Suarez-Morales, Lourdes; Szapocznik, Jose; Martino, Steve

    2010-01-01

    This study investigated the extent to which bilingual counselors initiated informal discussions about topics that were unrelated to the treatment of their monolingual Spanish-speaking Hispanic clients in a National Institute on Drug Abuse Clinical Trial Network protocol examining the effectiveness of motivational enhancement therapy (MET). Session audiotapes were independently rated to assess counselor treatment fidelity and the incidence of informal discussions. Eighty-three percent of the 23 counselors participating in the trial initiated informal discussions at least once in one or more of their sessions. Counselors delivering MET in the trial initiated informal discussion significantly less often than the counselors delivering standard treatment. Counselors delivering standard treatment were likely to talk informally the most when they were ethnically non-Latin. Additionally, informal discussion was found to have significant inverse correlations with client motivation to reduce substance use and client retention in treatment. These results suggest that informal discussion may have adverse consequences on Hispanic clients’ motivation for change and substance abuse treatment outcomes and that maintaining a more formal relationship in early treatment sessions may work best with Hispanic clients. Careful counselor training and supervision in MET may suppress the tendency of counselors to talk informally in sessions. PMID:20817381

  11. Appropriate care for shelter-based abused women: concept mapping with Dutch clients and professionals.

    PubMed

    Jonker, Irene E; Jansen, Carinda C J M; Christians, Milou G M; Wolf, Judith R L M

    2014-04-01

    We conducted a concept mapping exercise to gain insight into the perspectives held by abused women and professionals with regard to appropriate care in Dutch women's shelters. Three brainstorming sessions generated 92 statements that were then rated by 56 clients and 51 professionals. A total of 11 clusters were identified. The three most important clusters were "help with finding a safe house if necessary," "safety and suitable care for the children," and "a personalized, respectful approach." The most important statement was "take women seriously and treat them with respect." The mapping exercise identified key practice-based elements of intervention that should better accommodate the needs of shelter-based abused women. We have used these elements in developing a new intervention for shelter-based abused women in the Netherlands. PMID:24686124

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

    ERIC Educational Resources Information Center

    Reilly, Patrick M.; Shopshire, Michael S.; Durazzo, Timothy C.; Campbell, Torri A.

    This manual and workbook set focuses on anger management. The manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger programs. The manual describes a 12-week cognitive behavioral anger management group treatment. Each of the 12 90-minute…

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

    PubMed

    Chana, Richard; Marshall, Paul; Harley, Clare

    2016-06-01

    The intermediate care team supports patients in their own homes to manage complex needs. They are ideally placed in the community to identify older adults at risk of loneliness. However, little is known about how intermediate care team professionals perceive, detect or respond to loneliness in their clients. This study explores intermediate care team professionals' attitudes to loneliness in the context of perceived service priorities and their experiences of managing loneliness in their clients. Eight professionals (n=2 physiotherapists, n=3 occupational therapists, n=3 nurses) took part in semi-structured interviews. Data were analysed thematically using framework analysis, applying the theory of planned behaviour as an interpretive framework. Intermediate care team professionals see loneliness as a significant issue for many of their older clients but a low priority for intermediate care team services. They believe that loneliness often goes undetected because it is difficult to measure objectively. Barriers to managing loneliness included high workloads, unsatisfactory referral systems and lack of close working with social care and independent sector services. Brief but reliable loneliness assessments into routine practice, receiving training on detecting and managing loneliness, and improving working relationships with social care and independent sector services were highlighted as strategies that could improve the detection and management of loneliness in intermediate care team clients. PMID:27270197

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

    PubMed

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

    2016-04-01

    Opioid use disorder is a public health epidemic. There is increasing attention being given to opioid abuse and overdose in the United States. The overall use of illicit substances by older adults is on the rise and in part can be attributed to the aging of Baby Boomers. Furthermore, much attention is being given to prescription opioid drug overdose, but it is important to note that heroin-related deaths have also increased sharply. Heroin use is part of a larger substance abuse problem, with more than nine in 10 individuals who use heroin also using at least one other drug (e.g., cocaine, prescription opioid medication). The current article highlights treatment approaches, namely buprenorphine, buprenorphine/naloxone, and naltrexone; insurance considerations; and resources to aid in understanding and managing this public health crisis. PMID:27027362

  15. Client disclosure and therapist response in psychotherapy with women with a history of childhood sexual abuse.

    PubMed

    Farber, Barry A; Feldman, Sarah; Wright, A Jordan

    2014-01-01

    This study investigated the perceptions of adult clients (N=98; M age=32) with a history of childhood sexual abuse (CSA) of the costs and benefits of disclosure of this material. Significant benefits of disclosing included a sense of relief from sharing bottled-up emotions, and feeling more accepted and understood by one's therapist; significant negative consequences included feeling emotionally overwhelmed, and feeling uncomfortably vulnerable and exposed. Linear regressions indicated that CSA patients who generally disclose more have a greater tendency to experience both positive and negative effects of disclosure about abuse. In addition, a hierarchical regression analysis indicated that higher levels of symptomatology were predictive of higher levels of anxiety related to disclosure in therapy, suggesting that clinicians need to be cautious in encouraging disclosure about CSA with patients with severe pathology. PMID:23906369

  16. U.S. population estimates and correlates of sexual abuse of community-dwelling older adults.

    PubMed

    Cannell, Michael B; Manini, Todd; Spence-Almaguer, Emily; Maldonado-Molina, Mildred; Andresen, Elena M

    2014-01-01

    We describe the annual prevalence of sexual abuse among community-dwelling older adults in the United States. We also describe factors associated with experiencing sexual abuse. We used data from 24,343 older adults from the 2005 Behavioral Risk Factor Surveillance System pooled across 18 states. We estimated prevalence of sexual abuse, bivariate distributions, and odds ratio associations across demographic, health, and contextual factors. Our results show that 0.9% of older adults reported experiencing sexual abuse in the previous year. This represents approximately 90,289 community-dwelling older adults. We also report on factors associated with experiencing recent sexual abuse. There was a significant gender by binge drinking interaction, with a stronger association among women. There is a need for health promotion efforts targeted specifically toward older adults, encouraging them to seek services, if possible, after exposure to sexual abuse. PMID:24410194

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    This article reports on a project to sensitize graduate social work students taking courses in substance abuse to the needs of older adults. Graduate social work students at a major urban school of social work in the Northeast were recruited and trained to interview older adults with a history of substance abuse problems regarding their life…

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

    PubMed

    Shiel, Rebecca

    2016-06-29

    Domestic abuse is widespread and indiscriminate. Older women living with domestic abuse report more health-related concerns than any other group, and demonstrate a higher incidence of significant mental health issues. Research suggests that older women who have experienced domestic abuse are not having their psychological and physical support needs met by existing services. This article examines the physical and mental health issues that older women face as a result of abusive relationships, and the barriers to seeking help. Multidisciplinary healthcare professionals can facilitate the therapeutic engagement of older women living with domestic abuse. Refuges and related interventions are limited in terms of the support they can offer, however, research suggests that developing a stepped approach, tailored to suit older women's needs, could be beneficial. PMID:27353789

  19. Self-identified heterosexual clients in substance abuse treatment with a history of same-gender sexual contact.

    PubMed

    Senreich, Evan

    2015-01-01

    There is virtually no literature concerning the experiences of self-identified heterosexual clients in substance abuse treatment who have a history of same-gender sexual contact (HSGS). In a U.S. urban inpatient program in 2009-2010, 99 HSGS clients were compared to 681 other heterosexual and 86 lesbian, gay, and bisexual clients regarding background factors, program completion rates, and feelings about treatment. Male HSGS participants had lower completion rates than other male heterosexual participants. Qualitative data indicated that most male HSGS participants experienced difficult emotions regarding same-gender sexual encounters, particularly those involving trading sex for money or drugs. Implications for treatment are discussed. PMID:25364839

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

    PubMed Central

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-01-01

    Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who…

  2. Gender differences in manifestations of antisocial personality disorder among residential drug abuse treatment clients.

    PubMed

    Goldstein, R B; Powers, S I; McCusker, J; Mundt, K A; Lewis, B F; Bigelow, C

    1996-05-01

    We examined gender differences in manifestations of DSM-III-R antisocial personality disorder in 106 male and 34 female drug abusers enrolled in residential relapse prevention/health education treatment. In childhood, compared to males, females had more often run away but less often used weapons in fights, been cruel to animals, and set fires. Females also reported less vandalism. In adulthood, women had more often been irresponsible as parents and in financial matters, engaged in prostitution, made money finding customers for prostitutes, been physically violent against sex partners and children, failed to plan ahead, and lacked remorse. Our findings suggest that addiction treatment programs need to consider gender differences in antisocial symptomatology in the development of individualized treatment programs for both male and female clients. PMID:8793308

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    The authors assessed burnout, compassion fatigue, secondary trauma symptoms, and compassion satisfaction in relation to experienced therapists' perceptions of the working alliance. Participants, 106 specialists in the treatment of clients who commit sexual abuse, completed the Working Alliance Inventory-Short Form (T. J. Tracey & A. M. Kokotovic,…

  4. HIV testing among clients in high HIV prevalence venues: Disparities between older and younger adults

    PubMed Central

    Ford, Chandra L.; Lee, Sung-Jae; Wallace, Steven P.; Nakazono, Terry; Newman, Peter A.; Cunningham, William E.

    2014-01-01

    The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus (HIV) testing of every client presenting for services in venues where HIV prevalence is high. Because older adults (age>50 years) have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent (past 12 months) and ever HIV testing in a probability sample of at-risk adults (N=1,238) seeking services in needle exchange sites, sexually transmitted disease clinics and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category (<50 years vs. >50 years) and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months (OR=0.6; 95% CI=0.40–0.90) or ever (OR=0.6; 95% CI=0.40–0.90). Aging-related disparities in HIV testing exist in these high HIV prevalence venues, and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. PMID:25303208

  5. Childhood Abuse and Current Health Problems among Older Adults: The Mediating Role of Self-Efficacy

    PubMed Central

    Sachs-Ericsson, Natalie; Medley, Amanda N.; Kendall – Tackett, Kathleen; Taylor, John

    2011-01-01

    Objectives Child abuse has negative consequences on health functioning and the self-concept. Prior studies have garnered support for these relationships in younger adults; yet few studies have looked at the effects of abuse on health in older adults and the psychosocial variables, specifically self-efficacy, that may influence the abuse-health relationship. Methods Data obtained from the Physical Health and Disability Study were used to explore the impact of child abuse on current medical problems among older adults who were screened on physical disability status (N=1396, Mean age = 67, SD = 10.2). The study was conducted in South Florida and employed a multiethnic sample that is representative of the general population in this area. Results Child abuse was associated with the number of current medical problems and disability. Child abuse was also related to lower self-efficacy, and self-efficacy explained the relationship between abuse and the number of health problems. Conclusions There are far reaching effects of child abuse on older adults' health and self-concept. Health care providers and gerontologists need to be aware that child abuse is a life-long risk factor for increased disability and specific health problems, especially among the elderly. Future research should examine treatments designed to increase self-efficacy, especially among those who experienced child abuse, and observe any positive effects on health functioning. PMID:21922052

  6. Examining barriers to self-reporting of elder physical abuse in community-dwelling older adults.

    PubMed

    Ziminski Pickering, Carolyn E; Rempusheski, Veronica F

    2014-01-01

    One out of 10 older adults experiences elder abuse in their lifetime, though less than one third of these cases ever get reported. The purpose of this study was to describe older adults' perceptions of physical abuse (PA) as a type of elder abuse including reasons why they may or may not self-report. An author developed vignette scale was used to present three types of PA and three barriers to reporting for each of three living situations. Older adults (n = 76) rated perceptions of whether or not the situation is abusive, likelihood of reporting and likelihood of reporting when presented with each of three barriers. The study participants had a consistent perception of PA; however the barriers affected their likelihood of reporting, which varied across types and situations. The results provide further evidence that reporting abuse is multifactorial and have implications for educational interventions. PMID:24341952

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

    ERIC Educational Resources Information Center

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

    2003-01-01

    Objective: To describe a pattern of abusive head injury in a series of children older than 4 years of age. Methods: A hospital chart review of abused children with skull fractures from 1999 to 2001 was carried out. The clinical features, social background, and subsequent outcome and management are described. Results: An 11-year-old girl and a pair…

  8. Unresolved Childhood Sexual Abuse: Are Older Adults Affected?

    ERIC Educational Resources Information Center

    Allers, Christopher T.; And Others

    1992-01-01

    Presents case studies and discussions regarding 3 observed characteristics of unresolved childhood sexual abuse in adult survivors over 65 years of age. Specifically, chronic depression, elder abuse, and misdiagnosis of residual abuse trauma as dementia or mental illness are compared to parallel issues identified by researchers working with…

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

    PubMed Central

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

    2013-01-01

    Increasing motivation and raising retention rates are considerable challenges for providers of adolescent substance abuse treatment. Research has shown that motivation for treatment, social influences (peers, family, counselors), and for some clients external pressure from the juvenile justice system, can serve as key factors in successful retention. To further understand influences on motivation and retention, focus groups were conducted in two residential treatment facilities. Adolescent clients, parents, and treatment staff were asked to describe their experiences with the treatment process focusing specifically on factors related to treatment attrition and retention. Qualitative data analysis revealed five themes affecting retention either positively or negatively. Themes included relationships (with family, peers, and counselors), responsibility (degree to which clients embrace jobs, roles, and rules), emotional regulation (ability to express feelings appropriately), thinking (identifying behavior patterns and recognizing consequences), and self-efficacy (feelings of empowerment). Implications for future research and for developing strategies aimed at increasing motivation and retention are discussed. PMID:26457049

  10. Best-Practice Guideline on the Prevention of Abuse and Neglect of Older Adults.

    PubMed

    Hirst, Sandra P; Penney, Tasha; McNeill, Susan; Boscart, Veronique M; Podnieks, Elizabeth; Sinha, Samir K

    2016-06-01

    A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed. PMID:27086668

  11. Drug and Alcohol Abuse among the Elderly: Is Being Alone the Key?

    ERIC Educational Resources Information Center

    Brown, B. Bradford; Chiang, Chi-Pang

    1984-01-01

    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)

  12. Evil and elder abuse: intersections of Paul Ricoeur's and Simone Weil's perspectives on evil with one abused older woman's narrative.

    PubMed

    Erlingsson, Christen L

    2011-10-01

    Doing violence and evil always indirectly or directly leads to making someone else suffer. Such is the dialogical structure of evil and it seems to be the dialogical structure of elder abuse as well. There is a perturbing sameness between definitions of evil and definitions of elder abuse. It is hard at times to see how or if there is any line of demarcation between the subjects. Two modern-day philosophers, Paul Ricoeur and Simone Weil have delved particularly into the concept of evil. The symbolism Ricoeur analyses in depth is that of defilement, sin, and guilt and the concept of the servile will. Integral in Weil's description of evil are the concepts of suffering and the special situation of extreme suffering, termed affliction. Grounded in the writings of Ricoeur and Weil, this paper is a series of reflections on the intersection of evil and elder abuse as exemplified in the narrative of an abused older woman. This woman provided around the clock care at home for her husband who had vascular dementia. She was also abused by her husband. This was witnessed by both family and others but no one intervened. In her narrative there were indications of defilement, sin, guilt, and true affliction as a servile will. This paper illuminates the evil of elder abuse that is harm and suffering, and the challenge of untangling issues of blame, free will, responsibility, and self-determinism. When engaging with abused, older persons it can be worthwhile for nurses to enter the encounter with non-judgemental compassion founded on the human to human connection and recognition of our mutual fallibility and potential for evil that is part of our human fragility. PMID:21906229

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

    PubMed Central

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

    2015-01-01

    The objective of this study was to increase knowledge of sexual abuse against older residents in nursing homes. A qualitative approach was used. Through a focus group interview with staff in nursing homes, the aim was to reveal employees' thoughts, experiences, and attitudes. Findings from the focus group interview show that sexual abuse of older residents is a taboo topic among health professionals. Acts of sexual abuse are difficult to imagine; it is hard to believe that it occurs. The fact that staff are not aware that it could happen, or have a hard time believing that it actually happens, can amplify the residents' vulnerable position as potential victims of abuse, and it makes it even more challenging to report or uncover such acts. The study highlights the need for education of all health care workers in Norway as well as more research on sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step towards addressing sexual abuse of the aged in a more appropriate way. Further research must aim to reveal more about this taboo area. PMID:26078879

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

    ERIC Educational Resources Information Center

    Fisher, Bonnie S.; Regan, Saundra L.

    2006-01-01

    Purpose: This study assessed the extent of different types of abuse, repeated and multiple abuse experiences among women aged 60 and older, and their effects on the women's self-reported health. Design and Methods: A cross-sectional study of a clinical sample of 842 community-dwelling women aged 60 and older completed a telephone survey about type…

  15. Behavioral Health Services Utilization among Older Adults Identified within a State Abuse Hotline Database

    ERIC Educational Resources Information Center

    Schonfeld, Lawrence; Larsen, Rebecca G.; Stiles, Paul G.

    2006-01-01

    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…

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

    ERIC Educational Resources Information Center

    Forman, Julia M.; McBride, Rebecca G.

    2010-01-01

    Mistreatment of older adults is commonplace. These individuals are subjected to abuse, financial exploitation, and neglect. The authors present an overview of the literature concerning mistreatment, with an emphasis on clinical, ethical, and legal considerations. Methods are proposed for prevention, including counselor education, advocacy, and…

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

    ERIC Educational Resources Information Center

    Cook, Paddy; Davis, Carolyn; Howard, Deborah L.; Kimbrough, Phyllis; Nelson, Anne; Paul, Michelle; Shuman, Deborah; Brooks, Margaret K.; Dogoloff, Mary Lou; Vitzthum, Virginia; Hayws, Elizabeth

    As alcohol and other drug disorders become acknowledged as major problems, the need increases for current information on the scope of the problem and appropriate treatment. This TIP serves to educate treatment providers with information about older adults who, in general, are more likely to hide their substance abuse, less likely to seek…

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

    ERIC Educational Resources Information Center

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

    2003-01-01

    Presents results of a study of the graphic indicators in drawings by patients with substance abuse disorders. The Bird's Nest Drawing, an assessment task previously devised to elicit pictorial representations of attachment security, was used to examine attachment patterns of volunteers. Results showed that those with substance abuse diagnoses were…

  19. Difficult-to-manage HIV/AIDS clients with psychiatric illness and substance abuse problems: a collaborative practice with psychiatric advanced practice nurses.

    PubMed

    Morgan, Betty D; Rossi, Anne P

    2007-01-01

    Complex clients with comorbid HIV disease, other medical illness, psychiatric illness, and substance abuse problems present tremendous challenges to providers. Medication adherence and case management become vital issues in providing comprehensive care to this population. This report describes the practice of two advanced practice psychiatric registered nurses who worked collaboratively with each other and with nurse practitioners to provide care to such complex clients. Description of collaborative practices and the model of collaboration used by the two practitioners are highlighted through three case studies. Conclusions about the practice and its use with complex clients are provided. PMID:17991601

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

    PubMed

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-05-01

    Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous drug use. Clients

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

    ERIC Educational Resources Information Center

    Schiff, Miriam; Katz, Katalin

    2007-01-01

    Objective: This study is the first in a comprehensive examination of therapeutic components and outcome of interventions in a public, nonresidential service for drug addicts in Jerusalem (SHALEM). Method: Data were gathered from 153 clients (35 women, 128 men; 35 Arabs, 118 Jews; median age = 39) using clinical data mining. Results: Men who had…

  2. A Crisis Intervention Service: Comparison of Younger and Older Adult Clients.

    ERIC Educational Resources Information Center

    Winogrond, Iris R.; Mirassou, Marlene M.

    1983-01-01

    Compares adult and elderly clients of a Crisis Intervention Service in an urban metropolitan area, which included a telephone counseling/referral service and a mobile intervention team for home assessments. Findings indicated the importance of using a biopsychosocial model, particularly in the assessment of elderly persons. (JAC)

  3. Does Bachelor's-Level Social Work Education Impact Students' Knowledge and Attitudes Regarding Substance-Abusing Clients?

    ERIC Educational Resources Information Center

    Senreich, Evan; Straussner, Shulamith Lala A.

    2013-01-01

    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…

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

    ERIC Educational Resources Information Center

    Glover, Noreen M.; And Others

    1995-01-01

    Volunteer participants (n=77) enrolled in 8 substance abuse treatment facilities were surveyed in order to examine the prevalence and nature of incest contacts among the group. Results indicated that approximately 49 percent of the participants had reported histories of incest. Data are presented under various parameters. Also gives comparisons by…

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

    PubMed

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

    2015-01-01

    Despite the high prevalence of substance use disorder (SUD) and its frequent comorbidity with mental illness, individuals with SUD are less likely to receive effective SUD treatment from mental health practitioners than SUD counselors. Limited competence and interest in treating this clinical population are likely influenced by a lack of formal training in SUD treatment. Using a factorial survey-vignette design that included three clinical vignettes and a supplementary survey instrument, we investigated whether clinical psychology doctoral students differ in their level of negative emotional reactions toward clients with SUD versus major depressive disorder (MDD); whether they differ in their attributions for SUD versus MDD; and how their negative emotional reactions and attributions impact their interest in pursuing SUD clinical work. Participants were 155 clinical psychology graduate-level doctoral students (72% female). Participants endorsed more negative emotional reactions toward clients with SUD than toward clients with MDD. They were also more likely to identify poor willpower as the cause for SUD than for MDD. More than a third reported interest in working with SUD populations. Highest levels of interest were associated with prior professional and personal experience with SUD, four to six years of clinical experience, and postmodern theoretical orientation. PMID:26375324

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

    PubMed

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

    2005-01-01

    This study evaluated the psychiatric symptoms, psychosocial problems, and treatment response of personality-disordered substance abusers receiving services within a homeless drop-in center. Fifty-two homeless clients were assessed after program admission and randomly assigned to receive either individual psychotherapy focused on personality disorder and substance abuse relapse prevention (dual-focus schema therapy [DFST]) or standard group substance abuse counseling (SAC). Client functioning was assessed using measures of personality disorder, psychiatric symptoms, early maladaptive schemas, interpersonal problems, and addiction-related psychosocial impairment. Therapy retention (total weeks in treatment) and utilization (number of weeks in which sessions were attended) were the primary outcomes. Although rates of cluster B personality disorders were comparable to other substance dependent samples, clusters A and C disorders were disproportionately more common. Clients reported significant psychiatric symptoms, criminality, and psychosocial impairment, yet made limited lifetime use of mental health services. Overall, there was greater utilization of individual DFST than group SAC. However, clients with more severe personality disorder symptoms demonstrated better utilization of SAC than DFST. PMID:16122538

  7. What do we know about older abusers? a typology of violent husbands dwelling in lifelong intimate violence relationships.

    PubMed

    Band-Winterstein, Tova

    2013-07-01

    Most research on intimate partner violence to date has focused on young men. Although interest and research regarding older abused women has increased in recent years, research on the voices and experiences of older abusive men is still scarce. The purpose of this article is to present a typology of older battering men dwelling in lifelong intimate violence relationships. Fifteen older Israeli abusive men, aged 65 to 84 years, were interviewed in depth. Four types were identified: the "Non-quitter," the "Cover-up"-er, the "In-between"-er, and the "Normalizer." These types were constructed based on four dimensions: the construction of violence over the years, the perception of the spouse over the years, losses accompanying the violent relationship, and the meaning of violence in old age. The four types enable an in-depth look at the experiential world of older abusers and paint a complex picture of various ways in which abusive men live with violence over time. PMID:23339131

  8. Childhood sexual abuse, post-traumatic stress disorder, and use of heroin among female clients in Israeli methadone maintenance treatment programs (MMTPS).

    PubMed

    Schiff, Miriam; Levit, Shabtay; Cohen-Moreno, Rinat

    2010-01-01

    This study investigated association between post-traumatic stress disorder (PTSD) and a 1-year follow-up heroin use among female clients in methadone clinics in Israel. Participants were 104 Israeli female clients from four methadone clinics (Mean age = 39.09, SD = 8.61) who reported victimization to childhood sexual abuse. We tested traces in urine of these female clients for heroin a year preceding and a year following the assessment of their PTSD. Results show that 54.2% reported symptoms that accedes the DSM-IV criteria for PTSD. We found that among childhood victimized women PTSD is associated with more frequent use of heroin at a 1-year follow-up even after controlling for duration of the stay at the clinic, background, other traumatic experiences and heroin use a year prior the assessment of their PTSD. This study shows the potential long-run negative consequences of childhood sexual abuse. Not only are these sexually abused women trapped into drug dependence and addiction, they cannot break the vicious cycle of continuing the use of illicit drugs even when treated for their addiction. One major practice implication is that treatment for PTSD proven efficacious will be provided in the methadone and other drug treatment services. PMID:20938876

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

    PubMed

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

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. PMID:25092045

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

    PubMed

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

    2016-08-01

    Central to nursing practice is the promotion of health and wellness practices. Drawing on the Community as Partner Model, nursing process, Nursing Interventions Classification, and Logic Model, second-year nursing students collaborated with staff and residents of an assisted living facility to promote health and wellness in the older adult population. Windshield surveys, resident surveys, key informant interviews, and focus group interviews were conducted to gain insight into the perceptions and experiences of staff and residents. The majority of residents indicated they were satisfied with life at the facility and their needs have been adequately met. Strengths and areas for improvement were identified in several aspects, including the facility atmosphere and location, quality of staff and health care services, recreational and dietary services, and social support networks. By partnering with community key stakeholders, valuing all different perspectives, and connecting theory to practice, a successful client-centered community clinical project was demonstrated. [Journal of Gerontological Nursing, 42(8), 44-51.]. PMID:27263539

  11. Cognitive function is preserved in older adults with a reported history of childhood sexual abuse.

    PubMed

    Feeney, Joanne; Kamiya, Yumiko; Robertson, Ian H; Kenny, Rose Anne

    2013-12-01

    Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early-life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population-based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self-rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding. PMID:24265204

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and…

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

    PubMed

    Milrod, Christine; Monto, Martin

    2016-07-01

    While there is evidence of increasing rates of sexually transmitted infections (STIs) among older men in the United States, there has been little research on older male clients of female sex providers. The purpose of the current study was to understand the sexual risk behaviors and psychosocial correlates among older men hiring sex providers through provider review websites and discussion boards. A convenience sample of 208 male clients ages 60 to 84 completed online surveys about their sexual behavior and psychosocial factors. Participants indicated the most common sexual activities with providers in the past 12 months were receiving condomless fellatio (33.7%) and having penile-vaginal intercourse with a condom (31.7%). Although condomless penile-vaginal sex with a provider in the past 12 months was only reported by 2.9%, about half (51%) of the respondents indicated that they had experienced this at least once during their lifetime. This was associated with a preference for providers who do not require condoms, having been previously diagnosed with an STI, and perceiving one's HIV risk to be higher, as well as advancing age and having more emotional relationships with providers. Findings demonstrate the need for general and sexual health care practitioners to openly discuss protective measures and strategies for avoiding STIs among their older-to-elderly male patients. PMID:26739295

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

    PubMed Central

    Melchiorre, Maria Gabriella; Di Rosa, Mirko; Lamura, Giovanni; Torres-Gonzales, Francisco; Lindert, Jutta; Stankunas, Mindaugas; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Macassa, Gloria; Soares, Joaquim J. F.

    2016-01-01

    Background Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims. Methods The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal. Results Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused. Conclusions Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting

  15. Abuse

    MedlinePlus

    ... also may fall prey to strangers who take advantage of their cognitive impairment. Types of abuse Signs ... property) to his or her disadvantage or the advantage of someone else Sexual abuse: touching, fondling or ...

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

    ERIC Educational Resources Information Center

    Tredal, Ingrid; Soares, Joaquim J. F.; Sundin, Orjan; Viitasara, Eija; Melchiorre, Maria Gabriella; Torres-Gonzales, Francisco; Stankunas, Mindaugas; Lindert, Jutta; Ioannidi-Kapolou, Elisabeth; Barros, Henrique

    2013-01-01

    Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression). Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60-84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with…

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

    PubMed Central

    Dong, Xin Qi; Li, Ge

    2016-01-01

    Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse.

  18. 2004 Survey of Adult Protective Services: Abuse of Adults 18 Years of Age and Older

    MedlinePlus

    ... for adults 18-59 (21.6%), followed by physical abuse (19.5%), and caregiver neglect/abandonment (18.3%) ( ... third largest category for adults 18-59 was physical abuse (13.2%). Percentages of self-neglect appeared to ...

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

    PubMed

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

    2014-01-01

    The Toronto Central Community Care Access Centre is leading a collaborative local health integration network systemic change initiative to implement and evaluate a practical model of integrated care for older adults with complex needs. The approach is embedded in the community where older adults and their families live and is designed to first and foremost improve the quality of care while ultimately bending the cost curve. The model is leveraging and aligning existing system resources by bringing together sectors from across the health system to create ways of working that build capacity in the system to be more responsive to this population. Outcomes to date will be discussed and next steps described. The secondary goal was to understand the key elements of this integration that can be scaled locally and across the province. PMID:25591612

  20. “My Older Clients Fall Through Every Crack in the System”: Geriatrics Knowledge Among Legal Professionals

    PubMed Central

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

    2014-01-01

    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

  1. Elder Abuse.

    PubMed

    Lachs, Mark S; Pillemer, Karl A

    2015-11-12

    Because older victims of abuse tend to be isolated, their interactions with physicians are important opportunities to recognize abuse and intervene. This review explores the manifestations of elder abuse and the role of multidisciplinary teams in its assessment and management. PMID:26559573

  2. Child Abuse

    MedlinePlus

    ... or become violent. An older child may use drugs or alcohol, try to run away or abuse others. Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.

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

    ERIC Educational Resources Information Center

    Sheykhi, Mohammad Taghi

    2010-01-01

    The article explores and evaluates the quality of life, safety, and security of elderly people in Tehran City in Iran. In that, different dimensions of material and social well-being, and abuse of people of the age 65 and above, are assessed. Besides the human rights, the dignity, and the gradual decline of the elderly's social security are…

  4. Violence against older women.

    PubMed

    2016-07-01

    Domestic abuse is widespread and indiscriminate. Older women living with domestic abuse experience a number of health-related concerns and significant mental health issues. Research suggests that the needs of older women experiencing domestic abuse are not being met by existing services. This article examines the issues that older women face as a result of abusive relationships and the barriers to seeking help. Research suggests that a stepped approach, tailored to suit older women's needs, could be beneficial. PMID:27384810

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

    PubMed Central

    Sandmoe, Astrid; Hauge, Solveig

    2014-01-01

    Background Abuse of older people is a serious issue and is associated with an increased risk of morbidity and mortality, and professionals will encounter elderly victims of abuse in all areas of the health care system. An important health determinant is behavioral factors, including coping style, which will impact on how older people manage stress and maintain control in their lives, and thereby protect themselves from abuse. The aim of this study was to explore the coping strategies elderly people abused by their offspring used to manage everyday life. Methods A qualitative approach was used and 14 elderly victims of abuse were interviewed. The interviews were recorded, transcribed, and subjected to qualitative content analysis. Results Five main coping strategies were identified. The main strategy was linked to the role of parent. Another prominent strategy was attitude towards being victimized. Further strategies were associated with hope for a better relationship with offspring in the future, while others felt that they had done the best they could, or that their offspring were no longer their responsibility. The results are discussed in light of theoretical perspectives related to coping and resilience. Conclusion Abuse of older people by their offspring imposes severe stress on victims and challenges the values and beliefs about the caring nature of families. The findings of this study indicate that victims of abuse use a wide range of coping techniques to manage everyday life, and that some strategies help them to maintain their self-respect in their role as parents and find some sort of resilience. PMID:25045272

  6. Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil.

    PubMed

    Abath, Marcella de Brito; Leal, Márcia Carréra Campos; Melo Filho, Djalma Agripino de; Marques, Ana Paula de Oliveira

    2010-09-01

    This cross-sectional study aimed to determine the profile of physical abuse against older people who underwent forensic examination at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. The cases, with data from 1,027 forensic reports, were described according to characteristics of the incident, victim, and aggressor. Most cases of violence were produced by mechanical energy, either with blunt objects or by empty-handed attack; the most common day of the week was Sunday, most frequently in the evening, and in the victim's home; typical cases involved mild injuries on more than one part of the victim's body. The majority of the victims were men, 60 to 69 years of age, brown (mixed-race), married or living with a partner, and retirees/pensioners. The majority of the aggressors were men, known to the victim, and attacking alone. The social transcendence of violence against older people clearly calls for investment in programs to deal with the problem in order to ensure better quality of life for the elderly. PMID:20877940

  7. Sex differences in the relative contribution of social and clinical factors to the Health Utilities Index Mark 2 measure of health-related quality of life in older home care clients

    PubMed Central

    Maxwell, Colleen J; Kang, Jian; Walker, Jennifer D; Zhang, Jenny X; Hogan, David B; Feeny, David H; Wodchis, Walter P

    2009-01-01

    Background The heterogeneity evident among home care clients highlights the need for greater understanding of the clinical and social determinants of multi-dimensional health-related quality of life (HRQL) indices and of potential sex-differences in these determinants. We examined the relative contribution of social and clinical factors to HRQL among older home care clients and explored whether any of the observed associations varied by sex. Methods The Canadian-US sample included 514 clients. Self-reported HRQL was measured during in-home interviews (2002-04) using the Health Utilities Index Mark 2 (HUI2). Data on clients' sociodemographic, health and clinical characteristics were obtained with the Minimum Data Set for Home Care. The relative associations between clients' characteristics and HUI2 scores were examined using multivariable linear regression models. Results Women had a significantly lower mean HUI2 score than men (0.48, 95%CI 0.46-0.50 vs. 0.52, 0.49-0.55). Clients with distressed caregivers and poor self-rated health exhibited significantly lower HRQL scores after adjustment for a comprehensive list of clinical conditions. Several other factors remained statistically significant (arthritis, psychiatric illness, bladder incontinence, urinary tract infection) or clinically important (reported loneliness, congestive heart failure, pressure ulcers) correlates of lower HUI2 scores in adjusted analyses. These associations generally did not vary significantly by sex. Conclusion For females and males, HRQL scores were negatively associated with conditions predictive or indicative of disability and with markers of psychosocial stress. Despite sex differences in the prevalence of social and clinical factors likely to affect HRQL, few varied significantly by sex in their relative impact on HUI2 scores. Further exploration of differences in the relative importance of clinical and psychosocial well-being (e.g., loneliness) to HRQL among female and male clients

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

    PubMed

    Grey, Carl; Hall, P Bradley

    2016-01-01

    Opioid abuse, misuse and overdose is now a public health epidemic receiving political, medical, and media attention at all levels. Despite the fact that many people know someone suffering from addiction, there is very little research focusing on this issue in older adults. Chronic pain, a highly prevalent affliction for the aging population, has been accompanied by a significant increase in opioid use. This, along with some unique aspects of older adults (increased susceptibility to illness, higher likelihood of altered presentation of illness, and impaired recovery), means that great care needs to be taken when considering opioids for treatment. Prudent prescribing is possible, but universal precautions should be taken to reduce the risk of opioid abuse, misuse, and addiction. This review provides education, summarizes current literature, and gives guidance in universal precautions for prescribing opioids. PMID:27301154

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    This article describes how the authors use prayer with clients who self-identify their personal faith in God and who have used prayer as a helpful recovery agent or who believe prayer would be helpful to their personal recovery.

  10. Possible Barriers to Enrollment in Substance Abuse Treatment among a Diverse Sample of Asian Americans and Pacific Islanders: Opinions of Treatment Clients

    PubMed Central

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

    2012-01-01

    This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. PMID:22985677

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

    PubMed

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

    2013-07-01

    Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; n=114) was referral to a preferred outpatient program with advance appointment optional. Client incentive (CI; n=97) offered up to $100 in gift cards for intake and attendance during the first 30days of treatment. Contracting with staff incentives (CSI; n=49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92 versus 52% in UC) and immediacy (1.0 versus 3.9days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361

  12. Examining the Efficacy of HIV Risk-Reduction Counseling on the Sexual Risk Behaviors of a National Sample of Drug Abuse Treatment Clients: Analysis of Subgroups.

    PubMed

    Gooden, Lauren; Metsch, Lisa R; Pereyra, Margaret R; Malotte, C Kevin; Haynes, Louise F; Douaihy, Antoine; Chally, Jack; Mandler, Raul N; Feaster, Daniel J

    2016-09-01

    HIV counseling with testing has been part of HIV prevention in the U.S. since the 1980s. Despite the long-standing history of HIV testing with prevention counseling, the CDC released HIV testing recommendations for health care settings contesting benefits of prevention counseling with testing in reducing sexual risk behaviors among HIV-negatives in 2006. Efficacy of brief HIV risk-reduction counseling (RRC) in decreasing sexual risk among subgroups of substance use treatment clients was examined using multi-site RCT data. Interaction tests between RRC and subgroups were performed; multivariable regression evaluated the relationship between RRC (with rapid testing) and sex risk. Subgroups were defined by demographics, risk type and level, attitudes/perceptions, and behavioral history. There was an effect (p < .0028) of counseling on number of sex partners among some subgroups. Certain subgroups may benefit from HIV RRC; this should be examined in studies with larger sample sizes, designed to assess the specific subgroup(s). PMID:26837631

  13. Individual and contextual determinants of resident-on-resident abuse in nursing homes: a random sample telephone survey of adults with an older family member in a nursing home.

    PubMed

    Schiamberg, Lawrence B; von Heydrich, Levente; Chee, Grace; Post, Lori A

    2015-01-01

    Few empirical investigations of elder abuse in nursing homes address the frequency and determinants of resident-on-resident abuse (RRA). A random sample of 452 adults with an older adult relative, ≥65 years of age, in a nursing home completed a telephone survey regarding elder abuse experienced by that elder family member. Using a Linear Structural Relations (LISREL) modeling design, the study examined the association of nursing home resident demographic characteristics (e.g., age, gender), health and behavioral characteristics (e.g., diagnosis of Alzheimer's Disease, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), types of staff abuse (e.g., physical, emotional), and factors beyond the immediate nursing home setting (e.g., emotional closeness of resident with family members) with RRA. Mplus statistical software was used for structural equation modeling. Main findings indicated that resident-on-resident mistreatment of elderly nursing home residents is associated with the age of the nursing home resident, all forms of staff abuse, all ADLs and IADLs, and emotional closeness of the older adult to the family. PMID:26026215

  14. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. PMID:27338970

  15. Drug Abusers' Perceptions of Factors Related to Drug Abuse.

    ERIC Educational Resources Information Center

    Billips, Kathleen; And Others

    Researchers surveyed 78 clients in drug abuse treatment facilities to determine their perceptions regarding factors related to their use and abuse of drugs. About 40% of the sample began using drugs between 11 and 15 years of age. Males tended to begin using drugs at an earlier age than did females. Over 90% of participants reported using drugs…

  16. Physical Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  17. Sexual Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  18. Addressing violence against older women.

    PubMed

    2016-07-01

    Domestic abuse is widespread and indiscriminate, causing health-related concerns and mental health issues in older women. Research suggests their needs are not met by existing services. This article examines physical and mental health issues faced by older women as a result of abusive relationships, and the barriers that exist to seeking help. Healthcare professionals can facilitate therapeutic engagement of older women living with domestic abuse. Refuges and related interventions are limited, but developing a stepped approach, tailored to older women's needs, could help. PMID:27369732

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

    ERIC Educational Resources Information Center

    Galea, Robert P.; And Others

    1988-01-01

    Describes voluntary testing for human immunodeficiency virus (HIV) in a residential substance abuse treatment program; highlights discussion group involving 5 clients who tested positive for HIV. Notes that clients in HIV groups dropped out of treatment at significantly lower percentages than clients in general, indicating HIV identification…

  20. Elder Abuse and Neglect Risk Alleviation in Protective Services.

    PubMed

    Burnes, David P R; Rizzo, Victoria M; Courtney, Erin

    2014-01-01

    Little is known about conditions associated with favorable elder mistreatment (EM) case outcomes. The fundamental goal of EM protective service programs is to alleviate risk associated with substantiated cases of elder abuse and neglect. Using the EM socio-cultural model, this study examined victim, perpetrator, victim-perpetrator relationship, social embeddedness, and socio-cultural factors predicting risk alleviation of EM cases. Data from a random sample of EM protective social service cases (n = 250) at a large community agency in New York City were collected and coded by multiple, independent raters. Multinomial and binary logistic regression were used to examine undifferentiated risk alleviation for the entire sample of EM cases as well as differentiated financial, emotional, and physical abuse sub-types. Undifferentiated EM risk alleviation was associated with male victim gender, older victim age, previous community help-seeking, and victim-perpetrator dyads characterized by a separate living arrangement and shorter term abuse longevity. Financial abuse cases with younger perpetrators were less likely to have risk reduction. Physical abuse risk reduction was less likely when the perpetrator was male and the victim-perpetrator dyad included different genders. Distinct findings across EM sub-types suggest a need to develop targeted practice strategies with clients experiencing different forms of EM. Findings highlight a need to develop EM protective service infrastructure around perpetrator rehabilitation. PMID:24407144

  1. Profile of Clients Attending a Methadone Clinic

    PubMed Central

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

    2015-01-01

    Background: Client characteristics provide useful information for designing programs that target individuals with risk factors for substance use and for determining client retention. Therefore, this study examined the profiles of clients attending a methadone clinic. Methods: A cross-sectional analysis of clients of a methadone clinic was conducted through a survey to obtain a profile of methadone clients. Results: Of the 51 patients who responded (response rate: 66.2%), the mean (SD) age at which they started substance use was 19.8 (5.1) years. Friends were cited as the most regular source of drugs (82.4%), and heroin was the most commonly used drug (98%). Daily substance use was reported by 72.5% of the respondents; 23.5% admitted to having stolen money to purchase drugs; 92.2% tried quitting substance use on their own and 98% stated that the main reason for registering at the clinic was that they wanted to stop their drug dependence. Approximately 60% of clients were receiving methadone doses of less than 60 mg/day. Conclusion: Heroin is still the most popular drug of abuse and most clients still receive methadone doses below the recommended level, despite evidence of poor patient retention rates associated with these low doses. PMID:25892951

  2. Elder Abuse and Substance Abuse

    MedlinePlus

    ... Additional Resources Return to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified ... the most frequently cited risk factor associated with elder abuse and neglect. It may be the victim and/ ...

  3. Predictors of Substance Abuse Treatment Outcomes in Tennessee.

    ERIC Educational Resources Information Center

    Kedia, Satish; Williams, Charles

    2003-01-01

    Identifies and analyzes several variables important in predicting the likelihood of abstinence among substance abuse clients. Data was collected from 1,350 clients treated for alcohol or drug abuse in residential, halfway house, or outpatient facilities. Analyzing 22 variables as possible treatment outcome predictors, results found one…

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

    PubMed

    Kosberg, Jordan I

    2014-01-01

    From research findings and practice experiences, it is concluded that abuse of older men is especially invisible and underreported, compared to abuse of older women. It is proposed that attention should be directed not to gender, but to those conditions in different countries and cultures leading to abuse of both older men and women, including (but not limited to) economic problems, few alternatives to family care of the elderly, violence, changing characteristics of the family, ageism, and sexism. Advocates for the prevention of elder abuse should work together in combating, reducing, and eliminating the problem of elder abuse of both older men and older women. PMID:24779537

  5. Psychotherapy and Memories of Childhood Sexual Abuse.

    ERIC Educational Resources Information Center

    Lindsay, D. Stephen

    This conference address examines the question of whether "memory work"--using therapeutic techniques to help clients recover suspected hidden memories of childhood sexual abuse--has led some clients to develop illusory memories or false beliefs. Prospective research on memory for childhood trauma indicates that the gist of traumatic childhood…

  6. Outpatient Treatment for Substance-Abusing Offenders.

    ERIC Educational Resources Information Center

    Hirschel, J. David; Keny, Janet R.

    1990-01-01

    Discusses trend towards involving criminal offenders in substance abuse programs and utilizing outpatient settings in treatment. Appraises the treatment performance of both court-referred and voluntary clients and the impacts criminal-justice-referred clients may have upon other persons in treatment programs to which they are admitted. Discusses…

  7. Substance Abuse in Rural Areas

    MedlinePlus

    ... of death from overdose and suicide. Rural and Urban Substance Abuse Rates (ages 12 and older, unless ... among rural youth aged 12-13 than among urban youth the same age. This study suggests that ...

  8. Perceptions of Elders' Substance Abuse and Resilience

    ERIC Educational Resources Information Center

    Kane, Michael N.; Green, Diane

    2009-01-01

    Human service students' (social work, criminal justice, public administration, psychology) were surveyed (N = 242). Their perceptions about older persons' resilience and recovery from substance abuse were investigated. Overall, respondents did not agree that treating older persons for a substance abuse problem was wasteful of resources or older…

  9. Aging and Alcohol Abuse: Increasing Counselor Awareness

    ERIC Educational Resources Information Center

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

    2005-01-01

    Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.

  10. Directions in Substance Abuse Counseling, 2000.

    ERIC Educational Resources Information Center

    Cohen, Adam W., Ed.

    2000-01-01

    This volume of six lessons provides expert information on a variety of issues in substance abuse counseling. The lessons, which may be applied toward continuing education credits, are: (1) "Ethics in Substance Abuse Rehabilitation" (Robert L. Hewes); (2) "Addressing the Needs of Clients with Traumatic Injury and Alcoholism" (Charles H.…

  11. Substance Abuse and Counseling: An Epilogue.

    ERIC Educational Resources Information Center

    Sales, Amos

    This chapter discusses current issues and future perspectives in relation to substance abuse counseling. Current issues include: abstinence versus controlled use; coercive versus voluntary treatment; and career development and counseling with clients with substance abuse problems. Future perspectives include: the impact of managed care; the…

  12. Pattern of Child Sexual Abuse by Young Aggressors.

    ERIC Educational Resources Information Center

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

    1997-01-01

    Medical evaluation of 316 children, mean age 6 years, found 39 perpetrators of sexual abuse were less than 16 years old and 15 were between 16 and 19. Young aggressors were more likely to abuse older female children. Adolescent aggressors appeared to engage in more genital/genital and genital/anal sexual abuse than older aggressors. (Author/DB)

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

    PubMed Central

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

    2011-01-01

    This paper explores the impact of organizational attributes on client engagement within substance abuse treatment. Previous research has identified organizational features, including small size, accreditation, and workplace practices that impact client engagement (Broome, Flynn, Knight, & Simpson, 2007). The current study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the U.S. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, while engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress, but was not related to participation. Two additional organizational measures – workload and influence – moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are discussed. PMID:22154029

  14. Client Suicide: What Now?

    ERIC Educational Resources Information Center

    Ellis, Thomas E.; Patel, Amee B.

    2012-01-01

    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…

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

    ERIC Educational Resources Information Center

    Heppner, P. Paul; Heesacker, Martin

    1983-01-01

    Examined interpersonal influence process within counseling including relationship between perceived counselor expertness, attractiveness, and trustworthiness and client satisfaction; between client expectations on perceived counselor expertness, attractiveness, trustworthiness, and client satisfaction; and effects of actual counselor experience…

  16. Interprofessional program to provide emergency sheltering to abused elders.

    PubMed

    Heck, Lauri; Gillespie, Gordon L

    2013-01-01

    Abuse of senior citizens should be paradoxical in a civilized society; however, the U.S. Government Accountability Office reports that 14.1% of noninstitutionalized older adults experienced some type of abuse within the previous year. This is suspected to be an underestimation of the number of abuses reported. In a society where the older population is predicted to increase significantly, it is likely that the number of cases for abused elders will increase proportionately. Through the success of advocacy groups to raise awareness of child and domestic partner abuse, funding has been channeled to shelter these abuse victims. The same cannot be said for elders who are abused. Providing shelter in a safe, secure, medically appropriate environment, free from violence, for an older adult is essential. This article describes a community's collaborative health planning process to respond to elder abuse and develop a program to shelter elders experiencing abuse or suspected abuse. PMID:23636048

  17. Drug and Substance Abuse

    MedlinePlus

    ... Latest Research Getting More Help Related Topics Anxiety COPD Delirium Depression Pain Management Prevention Related News Older Adults Who Drink Alcohol at Risk for Drug Interactions Monday, November 23, 2015 Join our e-newsletter! Aging & Health A to Z Drug and Substance Abuse ...

  18. Child abuser stereotypes: consensus among clinicians.

    PubMed

    Krowchuk, H V

    1989-02-01

    This article reports the results of an investigation of nurses' stereotypes of child abusers. Ninety-four registered nurses completed a questionnaire that measured subjects' knowledge of child abuse; professional contact with perpetrators and victims of abuse; knowledge of the causes of child abuse; and child abuser stereotypes. Results reveal a consensus among the subjects as to the stereotypes associated with child abusers. This study supports the notion that nurses stereotype individuals on the basis of demographic characteristics. This study also raises questions regarding the bias that may result from the use of child abuser stereotypes. Clinical decision-making processes could become compromised if biased judgements are used in planning nursing care for clients diagnosed as child abusers. PMID:2930179

  19. Consistency in Children's Reports of Sexual and Physical Abuse.

    ERIC Educational Resources Information Center

    Ghetti, Simona; Goodman, Gail S.; Eisen, Mitchell L.; Qin, Jianjian; Davis, Suzanne L.

    2002-01-01

    A study investigated the consistence of 222 children's (ages 3-16) reports of sexual and physical abuse. Older children were more consistent, children were more consistent when reporting sexual abuse, and girls were more consistent in sexual abuse reports. Consistency in sexual abuse reports was predicted by measures of memory. (Contains…

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

    ERIC Educational Resources Information Center

    Pope, Natalie D.; Kang, Byungdeok

    2011-01-01

    Social workers employed in areas such as public child welfare, substance abuse, and corrections often provide services to involuntary clients. These individuals do not seek social work services on their own volition and may be actively opposed to the services they are receiving. This study explores social work students' attitudes about working…

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

    ERIC Educational Resources Information Center

    Finkbiner, Richard

    Large numbers of clients entering publicly-funded substance abuse treatment facilities cite problems with alcohol as one reason for seeking treatment. This report presents the results of a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES) data set. It profiles the treatment experiences of three study groups that…

  2. The Effect of Adolescent Sex Offender Abuse History on Counselor Attitudes.

    ERIC Educational Resources Information Center

    Carone, Stacia S.; LaFleur, N. Kenneth

    2000-01-01

    Examines judgment of counseling students, with history of sexual or physical abuse, about their attitudes towards counseling adolescent sex offenders. Reports sexually abused counselors desired to see physically abused offenders as clients over sexually abused offenders. Presents implications for counseling, including ways in which nonabused…

  3. Sophia Client Version 12

    2012-08-09

    Sophia Client Version 12 offers command line access to the Sophia Daemon and the Sophia database files. It provides print, fingerprint, acknowledge, color coding and status access to these other resources.

  4. Treating the bisexual client.

    PubMed

    Dworkin, S H

    2001-05-01

    Therapists, having recently come to terms with treating gay and lesbian clients, now must consider the issues that bisexual clients face. This article reviews the literature on what it means to identify as bisexual in a world where sexual identity is viewed as dichotomous, heterosexual at one end and gay or lesbian at the other end. The article explores sexual identity and its biological versus social origins, internalized biphobia, coming out, relationship patterns, and therapist issues. Two cases illustrate issues that might arise when a therapist is treating a bisexual client. The first case is a 17-year-old young woman who is accepting of her bisexual identity, and the second case is a 56-year-old woman, heterosexually identified and married, who suddenly fell in love with a woman. Concluding remarks focus on some future directions for research and work with bisexual clients. PMID:11304706

  5. Understanding elder abuse in family practice

    PubMed Central

    Yaffe, Mark J.; Tazkarji, Bachir

    2012-01-01

    Abstract Objective To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse. Sources of information MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed. Main message Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index. Conclusion Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions. PMID:23242889

  6. Elder Abuse

    MedlinePlus

    ... Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs ... may be a sudden change in the person's financial situation. Elder abuse will not stop on its ...

  7. Elder Abuse

    MedlinePlus

    ... facilities or nursing homes. The mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, ...

  8. Child Abuse

    MedlinePlus

    ... 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 ...

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

    ERIC Educational Resources Information Center

    Petkus, Andrew J.; Wetherell, Julie Loebach

    2013-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for…

  10. Drug abuse

    MedlinePlus

    ... abuse References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Weiss RD. Drugs of abuse. In: Goldman ...

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

    PubMed

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

    2009-10-01

    There is a considerable disparity between the number of individuals who need substance abuse treatment and the number who actually receive it. This is partly due to the fact that many individuals with substance use disorders do not perceive a need for formal treatment. Another contributing factor, however, is a discrepancy between the real and perceived cost of services. Although many cost evaluations of substance abuse treatment have been conducted from the treatment provider perspective, less is known about the client-specific costs of attending treatment (e.g., lost work and leisure time, transportation, out-of-pocket and in-kind payments). Concerns about financial and other barriers to participating in treatment have encouraged addiction researchers to more carefully consider these previously unmeasured costs. To address this information gap, we administered the Client Drug Abuse Treatment Cost Analysis Program (Client DATCAP) to 302 clients (representing a total of 302 outpatient and 142 inpatient treatment episodes) as part of a larger study examining the cost-effectiveness of interventions designed to improve treatment linkage and engagement in Dayton, Ohio. The value of a client's time accounted for the largest component of total cost (more than 59%). The cost per visit for outpatient clients ranged from $19 for outpatient methadone to $38 for intensive outpatient/aftercare treatment. The average cost per day of treatment for inpatient clients was $235. Policy makers and treatment providers now have a broader view of the opportunity cost of addiction treatment and can use this information to support initiatives for improved treatment access and delivery. PMID:19574000

  12. Influence of organizational functioning on client engagement in treatment.

    PubMed

    Greener, Jack M; Joe, George W; Simpson, D Dwayne; Rowan-Szal, Grace A; Lehman, Wayne E K

    2007-09-01

    This study focused on the relationship between organizational functioning factors measured in a staff survey using the Texas Christian University (TCU) Organizational Readiness for Change assessment and client-level engagement measured by the TCU Client Evaluation of Self and Treatment in drug treatment programs. The sample consisted of 531 clinical and counseling staff and 3,475 clients from 163 substance abuse treatment programs located in nine states from three regional Addiction Technology Transfer Centers. Measures of client engagement in treatment (rapport, satisfaction, and participation) were shown to be higher in programs with more positive staff ratings of organizational functioning. In particular, these programs had fewer agency needs and more favorable ratings for their resources, staff attributes, and climate. These findings help establish the importance of addressing organizational factors as part of an overall strategy for improving treatment effectiveness. PMID:17433863

  13. Superpowers and client states

    SciTech Connect

    Efrat, M.; Bercovitch, J.

    1987-01-01

    Throughout the world the two superpowers often conduct their global conflict by proxy, taking different sides in regional disputes. An important question of international relations is where the balance of power lies in the superpower client state relationship-how far are the interests of the superpower subordinated to those of the client state or vice versa. Taking the two case studies of the US-Israel relationship and the Soviet-Syrian relationship, this book explores the perceptions by each side of the relationship and the reality. It goes on to make general conclusions about superpower-client state relationships. Contents: Introduction; In Search of a Theoretical Framework; Client-States in Superpower Perception; Superpowers in Client States' Perception; The Case of US-Israel Relations; Israel in US Perspective; The USA in Israeli Perspective; Flows of US Civilian and Military Resources to Israel; The Case of Soviet-Syrian Relations; Syria in Soviet Perspective; The USSR in Syrian Perspective; Flows of Soviet Civilian and Military Resources to Syria; Comparative Analysis and Conclusions; Overview of the two cases studies and conclusions.

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

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

  15. Predictors of Interest in Working with Older Adults: A Survey of Postgraduate Trainee Psychologists

    ERIC Educational Resources Information Center

    Koder, Deborah-Anne; Helmes, Edward

    2008-01-01

    Despite the growing number of older adults that implies an increasing need for psychological services, few psychologists choose to specialize in working with older clients. The present cross-sectional research examined predictors of student interest in working with older clients in an effort to understand factors that may influence future…

  16. Meeting clients' spiritual needs.

    PubMed

    Delgado, Cheryl

    2007-06-01

    True holistic care requires attention to spiritual as well as physical needs, but many health care providers do not feel comfortable discussing spiritual matters with clients. Although recognized by national nursing groups as a standard of care, nurses are not well prepared or rewarded for spiritual care efforts. There are several spiritual assessment tools available and many suggestions for interventions, but little research-based evidence on the effectiveness of spiritual care assessments or interventions. Nurses are well positioned by their continued intimate contact with clients and the importance of caring to nursing to lead the health care profession in developing spiritual care theory and practices. PMID:17544683

  17. Abuse Characteristics and Individual Differences Related to Disclosing Childhood Sexual, Physical, and Emotional Abuse and Witnessed Domestic Violence.

    PubMed

    Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G

    2016-04-01

    Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. PMID:25550167

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

    PubMed

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

    2016-01-01

    Specialized, fragmented acute care is not aligned optimally to serve older adults. Person-centered care (PCC) has emerged as an evidence-based solution that involves enlisting patients as partners in treatment planning. Although several efforts have captured person-centered voices in outpatient care, more information is needed at the organizational and provider level to better understand the feasibility, challenges, and effect of PCC in community-based and social services settings. To assess themes and emerging trends, researchers conducted telephone interviews with leaders at nine organizations providing PCC for older adults. Questions were focused on the legacy of PCC services, whether and how PCC was connected to better quality care, and what tools were used for measuring PCC. Three themes on PCC for older adults emerged. (1) Each organization ascribed to a unique definition and operational structure for PCC. (2) Despite these differences, all organizations specified a strong commitment to PCC. Most noted financial resources and staffing as challenges and opportunities affecting feasibility. (3) Terms such as "patient-centered" care and other PCC synonyms may warrant greater clarification, because ideological differences set these classifications apart. Results from this analysis indicate the lack of a single, established definition for PCC. As interest in and support for PCC mounts, organizations in outpatient medical and community-based settings clearly have undertaken individual efforts to interpret what PCC is and how to provide it. Interview responses reflect this inconsistency, highlighting how staff and financing in particular can bolster or burden the PCC paradigm and what a consensus definition could do for the field. PMID:26626544

  19. Counseling Bisexual Clients.

    ERIC Educational Resources Information Center

    Smiley, Elizabeth B.

    1997-01-01

    Provides a brief conceptual statement about bisexuality. Offers a review of existing research studies, and suggests issues to consider when counseling bisexual clients. Defines bisexuality and discusses prevalence studies, identity development, and implications for counseling. Claims that bisexuality challenges traditional rules about sexual…

  20. The Afghan Refugee Client.

    ERIC Educational Resources Information Center

    Firling, Kenneth

    1988-01-01

    Contends both Afghan refugee children and adults perceive school as the primary resource for their successful transition into American society. Claims the school counselor is in a position to guide clients by providing them with necessary educational and career information. Describes aspects of Afghan culture relevant to counselors. (Author/ABL)

  1. Training Evaluation: Clients' Roles.

    ERIC Educational Resources Information Center

    Hashim, Junaidah

    2001-01-01

    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)

  2. Short-Term Group Treatment for Survivors of Sexual Abuse: A Psychoeducational Approach.

    ERIC Educational Resources Information Center

    Thompson, Nikki; Renninger, Salina

    1995-01-01

    Counseling survivors of sexual abuse requires acknowledgment of the legitimacy of the client's ego defenses while helping the client abandon those defenses which have become obstacles to leading a fulfilling life. Such defenses may also impede the therapeutic process, as survivors are less likely to trust other people. Clients can arrive at a…

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

    ERIC Educational Resources Information Center

    Caliber Associates, Fairfax, VA.

    This paper summarizes similarities and differences between two cohorts of the National Treatment Improvement Evaluation Study (NTIES) clients, those age 45 or older and those younger than 45. Results reveal the following: Clients in the 45+ cohort were considerably more likely to be treated for problems with alcohol or with heroin, and they were…

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

    ERIC Educational Resources Information Center

    Meiselman, Karin C.; Sheehy, Nancy

    The occurrence of incest in which a female child is molested by an older male family member may be increasing as the number of stepfamilies increases, because previous evidence suggests that girls living with stepfathers are at greater risk for molestation. If psychotherapists will be seeing more incest-history clients as a result of this trend,…

  5. Psychotherapy with Older Dying Persons.

    ERIC Educational Resources Information Center

    Dye, Carol J.

    Psychotherapy with older dying patients can lead to problems of countertransference for the clinician. Working with dying patients requires flexibility to adapt basic therapeutics to the institutional setting. Goals of psychotherapy must be reconceptualized for dying clients. The problems of countertransference arise because clinicians themselves…

  6. Working with Potentially Assaultive Clients.

    ERIC Educational Resources Information Center

    Murdach, Allison D.

    1993-01-01

    Examines potentially assaultive or preassaultive client and suggests some ways to minimize the risk of assault by such clients. Data for the article are from author's 10-year experience in providing social work services on acute psychiatric ward in large public medical center. Reviews potentially assaultive client conditions of panic, rage,…

  7. The Competitive Advantage: Client Service.

    ERIC Educational Resources Information Center

    Leffel, Linda G.; DeBord, Karen B.

    The adult education literature contains a considerable amount of research on and discussion of client service in the marketing process, management and staff roles in service- and product-oriented businesses, and the importance of client service and service quality to survival in the marketplace. By applying the principles of client-oriented…

  8. Client Perceptions of Pretreatment Change

    ERIC Educational Resources Information Center

    Kindsvatter, Aaron; Osborn, Cynthia J.; Bubenzer, Donald; Duba, Jill D.

    2010-01-01

    The authors suggest that when counselors have a rich understanding of pretreatment changes, they are better able to assist clients in capitalizing on such changes. The current study examined client perceptions of pretreatment changes. Thirty-six clients completed Q-sorts pertaining to pretreatment changes they experienced. Four factors pertaining…

  9. Chapter 43: Registry Clients

    NASA Astrophysics Data System (ADS)

    Greene, G.; Plante, R.

    The registry is a central component for the development of astronomical tools and applications requiring search and discovery. It contains standard descriptions for a variety of astronomical resources and services, including methods for remote invocation. Using web service technology, programmatic interfaces to the registry offer a powerful and robust mechanism for extracting specific sets of services and also a framework for combining a variety of astronomical resources into complex applications, for example, Datascope, Open SkyQuery, and WESIX. While the legacy of the NVO does not extend far back into history, we present here the current state of interfaces that client applications and tools have been built on, yet also extend the concepts to the new standard Registry Interface which will provide a uniform client interface protocol throughout the IVOA registry network. We explore this technology and discuss several implementations that exist in the current VO framework using JAVA, C#, Python, and IDL.

  10. False allegations of abuse and Munchausen syndrome by proxy.

    PubMed Central

    Meadow, R

    1993-01-01

    Fourteen children from seven families are reported for whom false allegations of abuse were made by the mother. Twelve children were alleged to have incurred sexual abuse, one both sexual and physical abuse, and one physical abuse alone. Thirteen of the children had incurred, or were currently victims of, factitious illness abuse invented by the mother. The one child with no history of factitious illness abuse had a sibling who had incurred definite factitious illness abuse. The false allegations of abuse did not occur in the context of parental separation, divorce, or custody disputes concerning the children. They occurred in the context of Munchausen syndrome by proxy abuse. The age of the children, 3 to 9 years, was older than the usual age for Munchausen syndrome by proxy abuse. The mother was the source of the false allegations and was the person who encouraged or taught six of the children to substantiate allegations of sexual abuse. PMID:8503664

  11. Abusive Relationships

    MedlinePlus

    ... relationships and friendships. Emotional abuse (stuff like teasing, bullying, and humiliating others) can be difficult to recognize ... How to Break Up Respectfully Abuse Dealing With Bullying Date Rape Getting Over a Break-Up Posttraumatic ...

  12. Drug Abuse

    MedlinePlus

    ... as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug ...

  13. Substance Abuse

    ERIC Educational Resources Information Center

    Rowe, Cynthia L.; Liddle, Howard A.

    2003-01-01

    Liddle and Dakof's (1995) comprehensive review of the status of family-based treatment for drug abuse concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using…

  14. Risk Factors in Adolescent Substance Abuse: Treatment and Management Implications.

    ERIC Educational Resources Information Center

    Thomas, Connie S.; Schandler, Steven L.

    1996-01-01

    Discusses research on adolescent substance abuse risk factors and their role in the management of adolescent substance abuse disorders. A selective literature review suggests specific intervention strategies; no generic approach fits all adolescent substance-use clients. Effective techniques require individual assessments, including the context in…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

    Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

    Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    The present study compared solution-focused group therapy (SFGT) with a traditional problem-focused treatment for level 1 substance abusers. Outcome research on the effectiveness of solution-focused group therapy is minimal, especially in treating substance abusers. In the present study, clients were measured before and after treatment to…

  18. Cultural Diversity Among Older Adults: Addressing Health Education

    ERIC Educational Resources Information Center

    Haber, David

    2005-01-01

    The diversity of the older adult population is increasing, and health professionals need to learn new knowledge and skills to improve the adherence of older ethnic clients to their health recommendations. Much of the existing research literature on diversity in gerontology concludes that ethnic older adults are at a health disadvantage. Few if any…

  19. National Survey on Drug Abuse: Main Findings 1982.

    ERIC Educational Resources Information Center

    Miller, Judith Droitcour; And Others

    This 1982 national survey on drug abuse is the seventh in a series of surveys since 1971 sponsored by the National Institute on Drug Abuse. To investigate the current prevalence of drug abuse in a nationwide sample, 5,624 randomly selected Americans (aged 12 and older) were personally interviewed in their homes using a specially designed answer…

  20. 32 CFR 161.18 - Benefits for abused dependents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... misconduct involving the abuse of the spouse or dependent child pursuant to 10 U.S.C. 1408(h), are eligible... abuse occurred. 5. Yes, if the child: a. Is older than 18 years old and is enrolled in a full-time... offense involving physical or emotional abuse of the spouse or child, or was administratively...

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

    ERIC Educational Resources Information Center

    Simpson, D. Dwayne; Sells, S. B.

    The Drug Abuse Reporting Program (DARP) was initiated in 1969 as a federally supported client reporting system for community-based drug abuse treatment programs. Posttreatment follow-up interviews were conducted with over 4,000 persons from 34 treatment agencies to describe major findings from the drug abuse treatment research of the DARP relating…

  2. Client/server study

    NASA Technical Reports Server (NTRS)

    Dezhgosha, Kamyar; Marcus, Robert; Brewster, Stephen

    1995-01-01

    The goal of this project is to find cost-effective and efficient strategies/solutions to integrate existing databases, manage network, and improve productivity of users in a move towards client/server and Integrated Desktop Environment (IDE) at NASA LeRC. The project consisted of two tasks as follows: (1) Data collection, and (2) Database Development/Integration. Under task 1, survey questionnaires and a database were developed. Also, an investigation on commercially available tools for automated data-collection and net-management was performed. As requirements evolved, the main focus has been task 2 which involved the following subtasks: (1) Data gathering/analysis of database user requirements, (2) Database analysis and design, making recommendations for modification of existing data structures into relational database or proposing a common interface to access heterogeneous databases(INFOMAN system, CCNS equipment list, CCNS software list, USERMAN, and other databases), (3) Establishment of a client/server test bed at Central State University (CSU), (4) Investigation of multi-database integration technologies/ products for IDE at NASA LeRC, and (5) Development of prototypes using CASE tools (Object/View) for representative scenarios accessing multi-databases and tables in a client/server environment. Both CSU and NASA LeRC have benefited from this project. CSU team investigated and prototyped cost-effective/practical solutions to facilitate NASA LeRC move to a more productive environment. CSU students utilized new products and gained skills that could be a great resource for future needs of NASA.

  3. Elder Abuse: Some Questions for Policymakers.

    ERIC Educational Resources Information Center

    Callahan, James J. Jr.

    1988-01-01

    Claims elder abuse is not clearly defined, affects relatively small numbers of older persons, is an under-funded area of social service and has weak political support. Recommends a broad-based service strategy for older persons. (Author/ABL)

  4. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

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

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  5. Child Abuse: Differential Diagnosis, Differential Treatment.

    ERIC Educational Resources Information Center

    Land, Helen M.

    1986-01-01

    Assesses the relationship between treatment intensity and rehabilitation of 89 child abusers whose MMPI (Minnesota Multiphasic Personality Inventory) profiles revealed high levels of psychological distress. The relationship was positive and statistically significant. The client receiving intense weekly treatment for longer durations was assessed…

  6. Client and service characteristics associated with addiction treatment completion of clients with co-occurring disorders.

    PubMed

    Mangrum, Laurel F

    2009-10-01

    The study examines client and service characteristics of addiction treatment completers and non-completers with co-occurring disorders (COD). On demographic variables, completers were more likely to be male and homeless. In the psychiatric domain, a greater proportion of completers received diagnoses of depression and generalized anxiety disorder, whereas non-completers were more often diagnosed with bipolar disorder and posttraumatic stress disorder. No group differences were found in client-reported psychiatric symptom severity; however, non-completers were rated by clinicians as having more severe symptoms in the areas of interpersonal sensitivity, depression, and hostility. In the area of substance use patterns, no differences were found in primary substance of abuse but completers reported more days of use during the month prior to treatment. Completers also had a greater history of both prior detox and non-detox treatment. At discharge, completers achieved higher rates of past month abstinence and AA attendance, but no differences were found in length of stay in treatment. Examination of recovery support services utilization revealed that completers more often received peer mentoring services. Greater proportions of the non-completer group received educational support, clothing, medical care, and employment assistance. These results suggest that future studies are needed in examining possible differential treatment response by diagnostic category and the potential role of peer mentoring in enhancing addiction treatment completion of COD clients. PMID:19303219

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

    PubMed

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

    2006-07-01

    The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 "recovery outcomes," identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non-substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients. PMID:16525088

  8. Ten-Year Recovery Outcomes for Clients With Co-Occurring Schizophrenia and Substance Use Disorders

    PubMed Central

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

    2006-01-01

    The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 “recovery outcomes,” identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non–substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients. PMID:16525088

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

    PubMed

    Sheridan, M J

    1995-05-01

    Although the link between substance abuse and child maltreatment has been relatively well established, there is a general recognition that this is not a simple cause-effect relationship. The current study explored the relationships among substance abuse, family functioning, and abuse/neglect in a sample of incarcerated substance abusers. Data were gathered on the earlier life experiences of 81 men and women serving sentences in two maximum security prisons, including assessments of their parents' substance abuse problems; levels of family competence within their families-of-origin; their exposure, as children and adults, to physical, emotional, and sexual abuse and physical/emotional neglect; and their own levels of substance abuse. Results showed generally high percentages of parental substance abuse and abuse/neglect, and relatively low levels of family competence. Correlational analyses revealed significant direct and indirect relationships among parental substance abuse, family dynamics, and exposure to both child and adult maltreatment. These four variables were also significantly associated with respondents' own substance abuse in later life, suggesting the potential for continuation of these patterns into successive generations. An intergenerational model of these family and personal functioning variables is presented and implications for service delivery with correctional clients is discussed. PMID:7664133

  10. Client Common Factors Represented by Client Motivation and Autonomy

    ERIC Educational Resources Information Center

    Scheel, Michael J.

    2011-01-01

    Ryan and colleagues are applauded for elevating client factors in the form of motivation and autonomy to equal status with the alliance as common factors in psychotherapy. Next, client motivation and autonomy are explained to be inextricably linked with one promoting the other. Motivational methods are summarized for the major approaches, making…

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

    ERIC Educational Resources Information Center

    Simpson, Arlene J.; Bedi, Robinder P.

    2012-01-01

    Clients' perspectives on the therapeutic alliance were examined using written descriptions of factors that clients believed to be helpful in developing a strong alliance. Fifty participants sorted previously collected statements into thematically similar piles and then gave each set of statements a title. Multivariate concept mapping statistical…

  12. Therapist Homophobia, Client Sexual Orientation, and Source of Client HIV Infection as Predictors of Therapist Reactions to Clients with HIV.

    ERIC Educational Resources Information Center

    Hayes, Jeffrey A.; Erkis, Andrew J.

    2000-01-01

    Analyses revealed that therapists responded with less empathy, attributed less responsibility to client for problem solving, assessed client's functioning to be worse, and were less willing to work with client when the client's source of HIV infection was from something other than drugs, when the client was gay, and when the therapist was more…

  13. Experiences Associated with Intervening with Homeless, Substance-abusing Mothers: The Importance of Success

    PubMed Central

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

    2015-01-01

    This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists, 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

  14. Beyond clients and servers.

    PubMed Central

    van Mulligen, E.; Timmers, T.

    1994-01-01

    Computer scientists working in medical informatics have to face the problem that software offered by industry is more and more adopted for clinical use by medical professionals. A new challenge arises of how to combine commercial solutions with typical medical software that already exists for some years and proved to be reliable with these off-the-shelf solutions [1]. With the HERMES project, this new challenge was accepted and possible solutions to integrate existing legacy systems with state-of-the-art commercial solutions have been investigated. After a period of prototyping to assess possible alternative solutions, a system based on an indirect client-server model was implemented with help of the industry. In this paper, its architecture is described together with the most important features currently covered. Based on the HERMES architecture, both systems for clinical data analysis and patient care (cardiology) are currently developed. PMID:7949988

  15. New drugs of abuse.

    PubMed

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

    2015-02-01

    Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases. PMID:25471045

  16. Using Clients to Monitor Performance.

    ERIC Educational Resources Information Center

    Molnar, Jack; Stup, Brenda

    1994-01-01

    This article describes an ongoing survey that illustrates how evaluators, working with program managers, have effectively used client-based data to monitor performance in the Social Security Administration. The value of client-based data outweighs the limitations and problems collecting it. Customer perceptions are a critical barometer of quality.…

  17. Group Work with Transgender Clients

    ERIC Educational Resources Information Center

    Dickey, Lore M.; Loewy, Michael I.

    2010-01-01

    Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…

  18. Retention of Under-represented Minorities in Drug Abuse Treatment Studies

    PubMed Central

    Magruder, Kathryn M; Ouyang, Bichun; Miller, Scott; Tilley, Barbara C

    2009-01-01

    We excluded those of multi-race/ethnicity and those from minority groups other than Hispanic or African American due to small numbers. Additionally, only three therapy types were represented among the six studies. Some potential variables that would influence retention, such as client housing, and client comorbidities, the race/ethnicity and gender of the staff who conducted study follow-up assessments, and reasons for loss to follow-up, were not collected by the CTN. Conclusions Although in our client model older African Americans and Caucasians had the greatest odds of retention and younger African Americans the lowest, in our final model, only age was significantly related to study retention. Additionally, primary drug of abuse, having HIV risk screening as a program benefit, and lower percentages of female admissions were significantly related to study retention. Efforts should be made to increase the study retention of younger participants to improve the validity and generalizability of drug abuse treatment study results. PMID:19528134

  19. Is managed care closing substance abuse treatment units?

    PubMed

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

    2007-03-01

    Despite high levels of unmet need for outpatient substance abuse treatment, a significant percentage of outpatient units have closed over the past several years. This study drew on 1999-2000 and 2005 national surveys to determine if managed care was associated with outpatient substance abuse treatment units' likelihood of surviving. Each substance abuse unit director was asked about the presence of any managed care contracts, percentage revenues from managed care, percentage of clients for whom prior authorization was required, and percentage of clients for whom concurrent review was required. A multiple logistic regression revealed that none of these factors was associated with substance abuse treatment unit survival. At this point, neither the presence nor the structure of managed care appears to affect the survival of outpatient substance abuse treatment units. Given the need for these facilities, however, and their vulnerability to closure, continued attention to managed care's potential influence is warranted. PMID:17458479

  20. Screening Spouse Abusers for Child Abuse Potential.

    ERIC Educational Resources Information Center

    Milner, Joel S.; Gold, Ruth G.

    1986-01-01

    Investigated the ability of the Child Abuse Potential Inventory to screen for child abuse in a group of spouse abusers. The completed, valid protocols revealed that 36.5 percent of the spouse abusers had elevated child abuse scores, while only 9.1 percent of the nonabusers had elevated abuse scores. (Author/BL)

  1. Uncovering sexual abuse: evaluation of the effectiveness of The Victims of Violence and Abuse Prevention Programme.

    PubMed

    Donohoe, J

    2010-02-01

    Discusses factors inhibiting open talk around a client's history of abuse including gender, age and diagnosis. * Evaluates the helpfulness of a training course designed to reduce and overcome these factors. * Aim of the evaluation is to help replicate the training nationally, following the positive impact found. Abstract Despite the high prevalence of sexual abuse among users of mental health services, it appears that mental health professionals are frequently unaware of clients' abuse histories. In order to address this, a Mental Health Trusts Collaboration Project of nine trusts was formed, which piloted delivering the Department of Health's Victims of Violence & Abuse Prevention Programme one-day education and training course regarding enquiring about histories of sexual abuse to various mental health practitioners. This hoped to educate practitioners in factors associated with victims and offenders, improve confidence and competence in asking about client's history of abuse and to increase awareness of the importance of asking. The purpose of this paper is to describe the impact of this course on mental health professionals' practice and attitudes in one of these nine trusts. It was found that since the delivery of the course, 44% (n= x) of professionals had been asking about abuse in 75-100% of cases. Gender, age and diagnosis of both the service users and the practitioners were all identified as factors potentially affecting practitioners' willingness to ask about abuse. Most importantly, 93% (n= x) of participants were found to feel they have the skills and knowledge to enquire about abuse and respond to disclosure in the appropriate way and 77% (n= x) of participants felt that this training had changed their clinical practice. The aim of this evaluation is to prove the effectiveness of the Department of Health's education and training course, which will help towards replicating the project nationally. PMID:20100302

  2. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  3. Sexual abuses.

    PubMed

    Abel, G G; Rouleau, J L

    1995-03-01

    The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator. PMID:7761302

  4. One Client, One Team: Health system integration for leaders.

    PubMed

    Daub, Stacey; Goldhar, Jodeme; Purbhoo, Dipti

    2016-07-01

    This article examines the implementation of the strategy and Integrated Client Care Program, a multi-level health system strategy to break down the barriers in a solid health system and a program to integrate care for populations with the most complex needs. Specific reference is made to two specialized programs, older adults with complex care needs and a palliative care program whose goal is to meet the needs of patients and their families in a community setting. PMID:27365383

  5. Dogmatism within the Counselor-Client Dyad

    ERIC Educational Resources Information Center

    Tosi, Donald J.

    1970-01-01

    Different levels of counselor and client dogmatism combined additively in terms of their effect on client ratings of the relationship. Client ratings of the relationship were progressively higher as more openness occurred in the dyad. (Author)

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

    ERIC Educational Resources Information Center

    Spaid, Wanda M.; Squires, Stuart P.

    2005-01-01

    Per se, increased knowledge about substance abuse has not been effective in altering social workers' negative attitudes towards substance abusers or their failure to recognize or address substance abuse problems among clients. In this paper, we describe an experiential abstinence assignment integrated with the content of an elective substance…

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

    PubMed

    Speller, Brittany; Stolee, Paul

    2015-03-01

    As the population ages, the demand for long-term care settings is expected to increase. Assisted living is a suitable and favourable residence for older individuals to receive care services specific to their needs while maintaining their independence and privacy. With the growing transition of older individuals into assisted living, facilities need to ensure that safe care is continually maintained. The purpose of this study was to determine the gaps and strengths in care related to safety in assisted living facilities (ALFs). A qualitative descriptive research design was used to provide a comprehensive understanding of client safety from the perspectives of clients, administrative staff and personal support workers. Interviews were conducted with 22 key informants from three ALFs in Toronto, Ontario throughout July 2012. All interviews were semi-structured, audio-recorded and transcribed verbatim. Initial deductive analysis used directed coding based on a prior literature review, followed by inductive analysis to determine themes. Three themes emerged relating to the safety of clients in ALFs: meaning of safety, a multi-faceted approach to providing safe care and perceived areas of improvement. Sub-themes also emerged including physical safety, multiple factors, working as a team, respecting clients' independence, communication and increased education and available resources. The study findings can contribute to the improvement and development of new processes to maintain and continually ensure safe care in ALFs. PMID:25175102

  8. Open Clients for Distributed Databases

    NASA Astrophysics Data System (ADS)

    Chayes, D. N.; Arko, R. A.

    2001-12-01

    We are actively developing a collection of open source example clients that demonstrate use of our "back end" data management infrastructure. The data management system is reported elsewhere at this meeting (Arko and Chayes: A Scaleable Database Infrastructure). In addition to their primary goal of being examples for others to build upon, some of these clients may have limited utility in them selves. More information about the clients and the data infrastructure is available on line at http://data.ldeo.columbia.edu. The available examples to be demonstrated include several web-based clients including those developed for the Community Review System of the Digital Library for Earth System Education, a real-time watch standers log book, an offline interface to use log book entries, a simple client to search on multibeam metadata and others are Internet enabled and generally web-based front ends that support searches against one or more relational databases using industry standard SQL queries. In addition to the web based clients, simple SQL searches from within Excel and similar applications will be demonstrated. By defining, documenting and publishing a clear interface to the fully searchable databases, it becomes relatively easy to construct client interfaces that are optimized for specific applications in comparison to building a monolithic data and user interface system.

  9. Working with the Suicidal Client Who Also Abuses Substances

    ERIC Educational Resources Information Center

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

    2012-01-01

    Substance use disorders and suicidal thoughts and behaviors commonly co-occur in adolescent and adult psychiatric populations and are often functionally interrelated. Although the evidence base for treatment of this population is sparse, integrated cognitive behavioral treatment (CBT) protocols, or those that rely heavily on CBT techniques, hold…

  10. Using Motivational Interviewing to Address College Client Alcohol Abuse

    ERIC Educational Resources Information Center

    Scholl, Mark B.; Schmitt, Dorothy M.

    2009-01-01

    Motivational Interviewing (MI; W. R. Miller & S. Rollnick, 2002) is presented as a potentially effective counseling strategy for assisting traditionally aged college students in reducing their problematic, heavy alcohol use. MI's congruence with two developmental theories--Self-Determination Theory (R. M. Ryan & E. L. Deci, 2000) and…

  11. Substance Abuse Treatment Outcomes for Coerced and Noncoerced Clients

    ERIC Educational Resources Information Center

    Burke, Anna C.; Gregoire, Thomas K.

    2007-01-01

    This study provides new evidence regarding the relation of coerced care to posttreatment substance use and addiction severity while controlling for two important factors: readiness to change and addiction severity at admission to treatment. The initial study sample consisted of 289 people who agreed to participate in a prospective study of…

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

    ERIC Educational Resources Information Center

    Bailey, Jeffrey J.

    2000-01-01

    Proposes the metaphor of professional/client rather than student-as-customer to characterize the relationship between professors and students. Uses examples of fitness trainer, management consultant, accounting service, and mountain guide to illustrate faculty and student roles. (SK)

  13. Accidents and Alcohol Abuse among Older Americans.

    ERIC Educational Resources Information Center

    Blai, Boris, Jr.

    Rising life expectancies, reductions in disease, and the ability of the elderly to care for themselves and cope with life stresses all attest to the fact that Americans are learning how to maintain and improve their health. However, experts have noted that greater knowledge about the health problems of the elderly is needed. The elderly are prone…

  14. Australian lawyers' views on competency issues in older adults.

    PubMed

    Helmes, E; Lewis, V E; Allan, A

    2004-01-01

    Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions. PMID:15386560

  15. The effect of severe child sexual abuse and disclosure on mental health during adulthood.

    PubMed

    O'Leary, Patrick; Coohey, Carol; Easton, Scott D

    2010-05-01

    This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy. PMID:20509077

  16. Risk taking among diabetic clients.

    PubMed

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

    1992-01-01

    Diabetic clients must make daily decisions about their health care needs. Observational and anecdotal evidence suggests that vast differences exist between the kinds of choices diabetic clients make and the kinds of chances they are willing to take. The purpose of this investigation was to develop a diabetic risk-assessment tool. This instrument, which is based on subjective expected utility theory, measures risk-prone and risk-averse behavior. Initial findings from a pilot study of 18 women clients who are on insulin indicate that patterns of risk behavior exist in the areas of exercise, skin care, and diet. PMID:1729123

  17. Elder abuse.

    PubMed

    Costa, A J

    1993-06-01

    Elder abuse is a tragedy both for the individual and for society because it occupies a pivotal position in the family life cycle of violence. Great variety exists among victims, abusers, and situations; thus, no single model is adequate to explain cause and direct treatment. Primary care physicians must be alert to the possibility of elder abuse in their patients and aware of resources within their community for managing cases once identified. Federal laws and regulations must take a proactive, long-term approach to the solution of this problem and must respect the autonomy of competent elderly patients. PMID:8356158

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

    ERIC Educational Resources Information Center

    Criss, Pamela Myatt

    2009-01-01

    Social work literature has documented that social workers may be the victims of client violence. However, to date, no studies have documented the nationwide prevalence of client violence towards social work students. This study examined direct and indirect incidents of physical assault, threats of physical harm, verbal abuse, threats of lawsuit,…

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

    PubMed

    Thompson, Lynda; Thompson, Michael; Reid, Andrea

    2010-03-01

    This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting. The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS. An earlier paper (Thompson et al. 2009) reviews the symptoms of AS, highlights research findings and theories concerning this disorder, discusses QEEG patterns in AS (both single and 19-channel), and details a hypothesis, based on functional neuroanatomy, concerning how NFB, often paired with biofeedback (BFB), might produce a change in symptoms. A further aim of the current report is to provide practitioners with a detailed description of the method used to address some of the key symptoms of AS in order to encourage further research and clinical work to refine the use of NFB plus BFB in the treatment of AS. All charts were included for review where there was a diagnosis of AS or ASD and pre- and post-training testing results were available for one or more of the standardized tests used. Clients received 40-60 sessions of NFB, which was combined with training in metacognitive strategies and, for most older adolescent and adult clients, with BFB of respiration, electrodermal response, and, more recently, heart rate variability. For the majority of clients, feedback was contingent on decreasing slow wave activity (usually 3-7 Hz), decreasing beta spindling if it was present (usually between 23 and 35 Hz), and increasing fast wave activity termed sensorimotor rhythm (SMR) (12-15 or 13-15 Hz depending on assessment findings). The most common initial montage was referential placement at the vertex (CZ) for children and at FCz (midway between FZ and CZ) for adults, referenced to the right ear. Metacognitive strategies relevant to social understanding, spatial

  20. The Value of Coordinated Services with Court-Referred Clients and Their Families: An Outcome Study

    ERIC Educational Resources Information Center

    Coll, Kenneth M.; Stewart, Roger A.; Morse, Renee; Moe, Amber

    2010-01-01

    This study assessed the effectiveness of building partnerships with community resources and systems for court-referred clients and their families through a participant outcome evaluation. Specific variables studied included change in substance abuse patterns, family well-being, child safety, and recidivism. Results from pre-post testing revealed…

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

    PubMed

    Rosenberg, Harold; Davis, Alan K

    2014-02-01

    To assess whether acceptability of non-abstinence outcome goals varied depending on the specific drug a client consumes (alcohol, cannabis, amphetamine, heroin, cocaine, MDMA/ecstasy, polydrug), severity of diagnosis (DSM-IV Abuse vs. Dependence), and finality of outcome goal (intermediate vs. final), we recruited 432 clinicians to complete a web-based questionnaire. More respondents rated non-abstinence acceptable as an intermediate goal for clients diagnosed with alcohol abuse (44%) or cannabis abuse (43%) than for clients diagnosed as abusing the other listed drugs (23 to 31%). Similarly, larger proportions of respondents rated non-abstinence as acceptable as a final goal for clients diagnosed with alcohol abuse (30%) or cannabis abuse (24%) than for clients diagnosed as abusing the other drugs (11 to 13%). Only 9 to 13% of respondents rated non-abstinence as an acceptable final goal for clients diagnosed with dependence, but 20% to 30% rated non-abstinence as acceptable as an intermediate goal for clients diagnosed as dependent. PMID:23953169

  2. Program characteristics for successful treatment of adolescent drug abuse.

    PubMed

    Friedman, A S; Glickman, N W

    1986-11-01

    The relationship to treatment outcome, as measured by reduction in drug use, of specific characteristics and elements of 30 drug-free outpatient programs for adolescents is reported. Admission and discharge data were obtained from National Institute on Drug Abuse-Client Oriented Data Acquisition Process on 5789 adolescents in the 30 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual clients, was the unit of analysis. While controlling for differences between programs on their client populations, multiple regression analysis indicated that the following characteristics of programs were found to predict the outcome criterion variable, to a statistically significant degree: treat a large number of adolescent clients; have a special school for school dropouts; have a relatively large budget; employ counselors or therapists who have at least 2 years' experience in working with adolescent drug abusers; provide special services such as vocational counseling, recreational services, and birth control services; use such therapy methods as crisis intervention, gestalt therapy, music/art therapy, and group confrontation; and be perceived by the clients as allowing and encouraging free expression and spontaneous action by clients. There was a high degree of replication of these findings across the two annual subsamples of clients; and the amount of variance in the treatment outcome criterion variable accounted for by the above-listed program characteristics was quite impressive. PMID:3772356

  3. Effectively communicating with your clients.

    PubMed

    Abood, Sarah K

    2008-08-01

    The successful ability to efficiently collect diet histories, convey appropriate health messages, and discuss client concerns about the safe feeding of pets requires excellent communication skills. In addition to understanding what the client wants for their pet, thorough nutritional interviewers gather information pertaining to animal factors, dietary factors, and feeding management factors. With the expansion of the Internet, increasing advances in medical care, and the health concerns associated with pet food recalls, small animal clients are looking to veterinarians for guidance and information on dietary recommendations in ever increasing numbers. Evaluating current information on changes in the pet food industry should be a periodic learning objective for all members of the veterinary health care team. Consistent, effective communication between veterinarians, their staff, and their clients can improve compliance, increase satisfaction levels, and improve patient outcomes. PMID:18656842

  4. Elder Abuse

    MedlinePlus

    ... to watch or be part of sexual acts. Money Matters: Financial Abuse and Healthcare Fraud After Victor’s ... the past 6 months, Victor has been taking money from their account for his own use. He ...

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

    PubMed Central

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

    2010-01-01

    This descriptive study presents the profiles of abused female sex workers (FSWs) in Chennai, India. Of 100 abused FSWs surveyed using a structured questionnaire, severe forms of violence by intimate partners were reported by most (98%) respondents. Of the total sample, 76% experienced violence by clients. Sexual coercion experiences of the FSWs included verbal threats (77%) and physical force (87%) by intimate partners and forced unwanted sexual acts (73%) by clients. While 39% of the women consumed alcohol before meeting a client, 26% reported that their drunkenness was a trigger for violence by clients. The findings suggest that there is an urgent need to integrate services, along with public-health interventions among FSWs to protect them from violence. Recognition of multiple identities of women in the contexts of intimate relationships versus sex work is vital in helping women to stay safe from adverse effects on health. PMID:20635631

  6. Differing Perspectives on Older Adult Caregiving.

    PubMed

    Brank, Eve M; Wylie, Lindsey E

    2016-07-01

    Informal older adult caregiving allows older adults to stay in their homes or live with loved ones, but decisions surrounding older adult care are fraught with complexities. Related research and case law suggest that an older adult's need for and refusal of help are important considerations; the current study is the first to examine these factors experimentally. Two samples (potential caregivers and care recipients) provided responses regarding anticipated emotions, caregiver abilities, and allocation of daily caregiving decision making based on a vignette portraying an older adult who had a high or low level of autonomy and who accepted or refused help. Study findings suggest differing views about caregiving; potential caregivers may not be as well prepared to take on caregiving as the potential care recipients anticipate and potential caregivers may allocate more decisional responsibility to older adults than the care recipients expect. Implications for older adult abuse are discussed. PMID:24652926

  7. Causal accounts as a consequential device in categorizing mental health and substance abuse problems.

    PubMed

    Raitakari, Suvi; Günther, Kirsi; Juhila, Kirsi; Saario, Sirpa

    2013-01-01

    Professionals in human service work are at the centre of complicated client cases. The ways client cases are constructed and the problems explained form the basis for professionals' assessments, decisions, actions and interventions. In this article the ways professionals make sense of dual-diagnosis client cases are examined. Applying the concept of causal accounting, it is argued that 'theories of cause' are embedded in professional discourse and profoundly shape professionals' understandings of social and health problems, as well as of their own roles and responsibilities and of what interventions and outcomes are possible. The data consist of 48 tape-recorded weekly team meetings among professionals in a supported housing unit targeted for clients with both mental health and substance abuse problems. It was found that professionals reason about the relationship between these two problems in four different ways: (1) substance abuse causes or makes mental health problems worse; (2) substance abuse eases mental health problems; (3) mental health problems cause or make substance abuse worse; or (4) good mental health reduces substance abuse. Causal account research makes visible the ways professionals do institutional work by categorizing clients, accounting for responsibilities as well as assessing their work and clients' achievements according to moral expectations of a 'good'professional and a worthy client. PMID:25233561

  8. Access to Generic Substance Abuse Services for Persons with Mental Retardation.

    ERIC Educational Resources Information Center

    Lottman, Thomas J.

    1993-01-01

    Investigated access to generic substance abuse services for persons with mental retardation. Telephone survey of chemical dependency treatment agencies revealed that agencies accepting mentally retarded clients differed significantly from nonaccepting agencies in their perceived difficulty in integrating these clients and in their acceptance of…

  9. Providing Sexual Education to Victims of Child Sexual Abuse: What Is a Clinician To Do?

    ERIC Educational Resources Information Center

    Rubenzahl, Samuel A.; Gilbert, Brenda O.

    2002-01-01

    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…

  10. Resistance, Reactance, and the Difficult Client.

    ERIC Educational Resources Information Center

    Dowd, E. Thomas; Sanders, Daniel

    1994-01-01

    Describes effect of client resistance and reactance in counseling and methods for assessing these phenomena. Conceptualizes client symptoms as ego-syntonic, where symptom is consonant with client's self-image, or ego-dystonic, where it is not. Uses concepts in deriving counseling strategies for working with difficult clients according to model…

  11. A Client Centered Approach to Job Placement

    ERIC Educational Resources Information Center

    Salomone, Paul R.

    1971-01-01

    A client centered placement approach for handicapped people is proposed as an alternative to the traditional selective placement method. The client centered placement is based on client responsibility and counselor direction and requires the counselor to have an unrealistic but optimistic attitude that the client will get a suitable job.…

  12. Client training vital for NFP.

    PubMed

    Keller, S; Finger, W R

    1996-01-01

    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

  13. Factors related to the process of seeking and completing treatment for drug abuse (qualitative methods in drug abuse research).

    PubMed

    Otiashvili, D; Djordjevic, A; Morales, D; Parsons, A; Platt, E; Stempliuk, V

    2005-05-01

    Numerous studies have demonstrated the effectiveness of drug abuse treatment. Yet many drug abusers do not enter treatment, many who do enter leave prematurely, and relapse following treatment is common. Understanding motivation for change and treatment readiness is key to understanding how to induct and engage drug users in treatment. To the extent that treatment programs focus initially on reducing drug use, rather than psychosocial problems that motivate individuals to seek treatment, treatment programs may fail to meet the primary needs of users and thus fail to attract or engage them. Outcomes of substance abuse treatment programs historically have been measured by successful program completion, reduced drug use and illegal activity, and improved social functioning (employment, education etc). There is minimal reference to client expectations of treatment and factors that influenced treatment-seeking behavior. Studies that have assessed client dropout from substance abuse treatment have generally focused upon quantitative measures that attempt to determine what types of clients drop out or stay, or what types of characteristics best predict client dropout. Qualitative methods are the most appropriate to fill these gaps in substance abuse treatment research. PMID:15988078

  14. Recovering substance abuse staff members' beliefs about addiction.

    PubMed

    Humphreys, K; Noke, J M; Moos, R H

    1996-01-01

    This study of 329 substance abuse treatment staff assessed how recovery status, in combination with other variables, influences beliefs about the causes and treatment of substance abuse. About 15% (n = 47) of participants were "in recovery" from substance abuse problems; these staff members were not significantly different than nonrecovering staff members on education, age, race/ethnicity, years of clinical experience, or amount of client contact. When examined in a multiple regression equation that also included age, education, and treatment program goals and activities, staff members' recovery status was not associated with endorsement of disease and psychosocial models of substance abuse. However, being in recovery was associated with endorsing an eclectic approach to substance abuse treatment. The importance of recognizing the diversity of beliefs about substance abuse among recovering staff and of acknowledging that multiple influences affect all staff members viewpoints on treatment is discussed. PMID:8699546

  15. Informal Discussions in Substance Abuse Treatment Sessions

    PubMed Central

    Martino, Steve; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Carroll, Kathleen M.

    2009-01-01

    This study evaluated the extent to which counselors initiated informal discussions (i.e., general discussions and self-disclosures about matters unrelated to treatment) with their clients during treatment sessions within two National Institute on Drug Abuse Clinical Trial Network protocols involving adaptations of motivational interviewing (MI). Sixty counselors across the two protocols had 736 sessions independently rated for counselor treatment fidelity and the occurrence of informal discussions. The results showed that 88% of the counselors initiated informal discussions in their sessions and that the majority of these discussions involved counselors sharing personal information or experiences they had in common with their clients. The major finding was that counselor training in MI was associated with significantly less informal discussion across sessions. A higher frequency of informal discussion was related to less counselor MI proficiency and less in-session change in client motivation, though unrelated to client program retention and substance use outcomes. The findings suggest that while some informal discussion may help build an alliance between counselors and clients, too much of it may hinder counselors' proficient implementation of MI treatment strategies and the clients' motivational enhancement process. PMID:18835679

  16. Special Considerations for Substance Abuse Intervention with Latino Youth

    ERIC Educational Resources Information Center

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

    2011-01-01

    Nearly 10% of Latino youth who are twelve and older are in need of substance abuse treatment for alcohol or illicit drug use. Ethnic differences exist with regard to susceptibility to drug use, attitudes regarding drugs, and drug resistance strategies. The failure of some substance abuse prevention programs can be traced in part to their lack of…

  17. 78 FR 37427 - World Elder Abuse Awareness Day, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-20

    .... (Presidential Sig.) [FR Doc. 2013-14969 Filed 6-19-13; 11:15 am] Billing code 3295-F3 ... Documents#0;#0; ] Proclamation 8995 of June 14, 2013 World Elder Abuse Awareness Day, 2013 By the President..., it takes a devastating toll on millions of older Americans each year. On World Elder Abuse...

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

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2004

    2004-01-01

    Males are more likely to use, abuse, and be dependent on alcohol or illicit drugs than females. The 2003 National Survey on Drug Use and Health (NSDUH) asked questions of persons aged 12 or older to assess their use of alcohol and illicit drugs, as well as their symptoms of substance dependence or abuse during the past year. NSDUH defines "any…

  19. Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 27.

    ERIC Educational Resources Information Center

    Cook, Paddy; Dogoloff, Mary Lou; Harteker, Linda; Nelson, Anne E.; Paul, Michelle M.; Shuman, Deborah J.; Mjoseth, Marcia; Vitzthum, Virginia; Hayes, Elizabeth; Gilbert, Max; Smith, Cara; Nguyen, Y-Lang

    This TIP contains information on the best practice guidelines on case management for substance abuse treatment providers. It serves to educate program coordinators and facilitators about the factors to consider as they decide to modify or implement case management activities. Many substance abuse clients arrive for treatment with a number of other…

  20. Group Therapy for Abused and Neglected Youth: Therapeutic and Child Advocacy Challenges

    ERIC Educational Resources Information Center

    Wanlass, Janine; Moreno, J. Kelly; Thomson, Hannah M.

    2006-01-01

    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…

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

    ERIC Educational Resources Information Center

    Moraes, Ricardo

    As a valuable addition to substance abuse treatment, adventure programming can have positive impacts on clients' self-efficacy, social behavior, and problem solving. A study explored the extent to which traditional substance abuse treatment programs use adventure programming, the level of adventure training and experience among substance abuse…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists,…

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

    ERIC Educational Resources Information Center

    Crenshaw, Wesley B.; Lichtenberg, James W.

    When deciding to report cases of child abuse, Mental Health Providers (MHPs) must confront legal mandates, concerns for client welfare, and a series of systemic and ethical issues. All 51 jurisdictions in the United States require MHPs to report suspected or known child abuse to appropriate authorities, with criminal penalties for noncompliance.…

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

    ERIC Educational Resources Information Center

    George Washington Univ. Medical Center, Washington, DC.

    A survey sought to determine the nature and extent of family therapy practiced in treatment and rehabilitation agencies serving drug abuse clients. Questionnaire responses to a three-phase study were on a voluntary basis. Phase I, with a 60% response rate, gathered information on the number of drug abuse treatment agencies providing family…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    Substance abuse counselors who address clients' spiritual development may provide more comprehensive counseling. This article presents an integrative supervision model designed to promote the spiritual development of substance abuse counselors-in-training, reviews the model, and discusses the implications for counselor education.

  6. Interpersonal psychotherapy with transgender clients.

    PubMed

    Budge, Stephanie L

    2013-09-01

    Interpersonal therapy (IPT) is a particularly useful approach to use when working with clients who identify as transgender or gender nonconforming. All transgender individuals will experience changes and adjustment throughout their identity process, often referred to as transitioning. IPT offers specific interventions for psychotherapists to use with clients whose presenting concerns are specifically related to transitions. The current article outlines a case example of a transgender man who is experiencing difficulty with "role transitions" and offers four transgender-specific clinical intervention strategies derived within the traditional IPT framework. PMID:24000851

  7. When a client considers surrogacy.

    PubMed

    Storch, Janet

    2002-05-01

    Although the registered nurse is not expected to have expert knowledge in all areas of practice, clients do ask questions in one health service area that might normally be handled in the context of another service area. When these sorts of 'surprising questions' arise, it is important for registered nurses to determine the nature of the question and to provide as much beginning assistance and guidance as possible to help the client to clarify the issues/concerns. Clearly, the nurse should do all she can to assist Sarah to access nurses and other health professionals who could provide more complete information and counselling for Sarah. PMID:12046496

  8. Child abuse and mental disorders in Canada

    PubMed Central

    Afifi, Tracie O.; MacMillan, Harriet L.; Boyle, Michael; Taillieu, Tamara; Cheung, Kristene; Sareen, Jitender

    2014-01-01

    Background: Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts. Methods: We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%). Results: The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose–response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men. Interpretation: We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts. PMID:24756625

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

    ERIC Educational Resources Information Center

    Marcenko, Maureen O.; And Others

    1994-01-01

    Examined psychosocial characteristics and service needs of pregnant women with substance abuse histories. Interviewed 225 pregnant women defined as having high-risk pregnancies for psychosocial reasons. Compared to non-substance-abusing women, those with admitted history of substance abuse were significantly older, had more children, were more…

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

    PubMed

    Fodor, Iris

    2015-11-01

    As an older woman therapist, I find that my life experience grounds me in my work with people of all ages and backgrounds as they deal with life crises, aging issues, and loss. People with whom I work in therapy appreciate the fact that I am older and have had varied life experiences. Gender issues are still central to my work with clients whether I am working with a man or a woman. I am an integrative therapist, with a background in cognitive-behavioral therapy and gestalt therapy. Therapists need to help clients to identify less with their aging bodies and our culture's view of attractiveness, shifting instead to a paradigm that values life experience and the cultivation of wisdom. We need to find ways of embracing what we have learned about life instead of extolling youthful values. As I get older, I more fully appreciate a constructivism framework and life-cycle perspective, focusing on making sense of clients' life narratives. Storytelling and memoirs have both provided a framework for working with clients on coping with the many changes and challenges of life that bring them to therapy and added another layer to my integrative therapeutic work. PMID:26394219

  11. Understanding and Counseling Narcissistic Clients.

    ERIC Educational Resources Information Center

    Stevens, Michael J.; And Others

    1984-01-01

    Provides counselors with an overview of narcissism and its treatment. In the first section, dysfunctional narcissism is described, drawing on the diagnostic indicators presented in the DSM-III and the contemporary object relations theories of Heinz Kohut and Otto Kerberg. The second section focuses on counseling narcissistic clients. (Author/JAC)

  12. Nutrition Education Needs Pantry Clients

    ERIC Educational Resources Information Center

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

    2007-01-01

    Two food pantries were surveyed for nutrition education (NE) interests and experiences. One site provided nutrition education classes; the comparison site was utilized to assess client interest in class topics. "Fixing low cost meals," "fixing quick and easy recipes," and "stretching food and food dollars" were topics rated highly by nutrition…

  13. Students: Customers, Clients or Pawns?

    ERIC Educational Resources Information Center

    Tight, Malcolm

    2013-01-01

    The metaphor of the student as a consumer or customer is widely used within contemporary higher education, and impacts on the ways in which students, academics and institutions behave. These, and a number of alternative metaphors for the student, are critically reviewed. The alternatives considered include both contemporary (student as client or…

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

    PubMed

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

    2015-01-01

    Violence against older women exists in the margins between domestic violence and elder abuse, with neither field adequately capturing the experiences of older women survivors of intimate partner violence (IPV). This commentary explores this oversight, identifying how the lack of gender analysis in the elder abuse field exacerbates older survivors' invisibility when the wider violence against women (VAW) field lacks a lifespan approach to abuse. Examining the impact of generational and aging factors on how older women experience IPV, we assert that the VAW field may be overlooking a wider population of survivors than previously thought. PMID:26371877

  15. Older Drivers

    MedlinePlus

    ... Affects Driving Tips for Safe Driving Making Your Vehicle Safe Regulations Affecting Older Drivers When Driving Skills ... Like drivers of any age, they use their vehicles to go shopping, do errands, and visit the ...

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

    ERIC Educational Resources Information Center

    Paley, Evelyn S., Ed.; Dea, Timothy Patrick, Ed.

    This manual, geared for mental health professionals, demonstrates that social network intervention provides an excellent framework and set of tools for working with the multiple problems of older adults. Social networks are "family" groupings of client, family members, friends and other community supports. The intervention focusses on bonding and…

  17. Mental health and older women.

    PubMed Central

    Liptzin, B

    1987-01-01

    The number of elderly women is growing in absolute numbers and in proportion to the U. S. population. Current epidemiologic research indicates that the most frequent psychiatric disorders among older women are phobias, severe cognitive impairment, dysthymia, and major depressive episode without grief. The rates of all of these disorders, except for cognitive impairment, are lower for older than for younger women. The rates of psychiatric disorders in older women are higher than in older men, except for alcohol abuse-dependence, which is higher in men. Depression is a common psychiatric problem in older women. The differential diagnosis includes other medical disorders, drug effects, normal grief, and early dementia. Older depressed women may present with physical complaints rather than complaints of depression, and thus be misdiagnosed. Treatment consists of psychotherapy, antidepressant medication, and activities to improve self-esteem. Dementia affects 4 percent of elderly women over age 65, and 20 percent of those over age 85. The most common cause is Alzheimer's disease. Current research is focusing on abnormalities in the cholinergic system in the brain. A careful psychiatric evaluation may identify medical conditions, including depression, which can be treated and can lead to improvements in the patient's functioning. PMID:3120218

  18. Including siblings in the treatment of child sexual abuse.

    PubMed

    Baker, J N; Tanis, H J; Rice, J B

    2001-01-01

    Siblings are often not included in treatment programs for children who have been sexually abused. This article describes the necessity of including siblings in the treatment of victims of child sexual abuse. Including siblings in treatment permits families to realize the maximum benefits of therapy for the victim as well as each family member. Theoretical and practical reasons to include siblings in treatment are discussed (i.e., preventing future abuse, providing support for siblings, teaching siblings to refrain from victim-blaming). Case examples using a particular intervention approach at The Family Learning Program and results of client satisfaction surveys are described. PMID:17521997

  19. Sexually abused boys.

    PubMed

    Reinhart, M A

    1987-01-01

    Male victims of child sexual abuse have received inadequate attention in the literature. This article is a retrospective review of the reports of 189 boys evaluated during 1983-85. This population was younger than those previously reported. Comparison to an age- and race-matched group of girl victims seen during the same period revealed many similarities in patterns of disclosure and perpetrator characteristics. The acts perpetrated against the boys included a wide array of invasive acts at all ages, but sodomy was more frequently reported in the older victims. Abnormal anogenital findings were seen more often in younger children, but the findings were often nonspecific. An examiner experienced with young children and infants is essential. PMID:3594283

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

    PubMed

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

    2011-09-01

    The current retrospective study examined whether clients' (N = 176) perceptions of their psychotherapists' multicultural orientation (MCO) were associated with their psychological functioning, working alliance, and real relationship scores. Moreover, we tested whether clients' perceptions of the working alliance and the real relationship mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. The results showed that clients' perceptions of their psychotherapists' MCO were positively related to working alliance, real relationship, and psychological functioning. Only clients' ratings of the working alliance mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. Thus, because clients perceive their psychotherapists as being more oriented toward cultural issues, they may view the therapist as being more credible and may gain a sense of comfort in the therapeutic process. In turn, clients' strong alliance facilitates improvement in psychological well-being. PMID:21639652

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

    ERIC Educational Resources Information Center

    Love, Arnold J.

    1989-01-01

    Assesses the feasibility and effectiveness of the Sexual Abuse Treatment Project used in a child welfare setting in Canada. Also evaluates the therapeutic process, which was based on an intensive psychodynamic model, and assesses its effectiveness for child and adult clients. (RJC)

  2. Elder Abuse and Black Americans: Incidence, Correlates, Treatment and Prevention.

    ERIC Educational Resources Information Center

    Cazenave, Noel A.

    Existing evidence on family violence rates by age and race as well as the available data on race and physical elder abuse incidence rates suggests that because such data are not based on random or representative samples and tend to reflect a "sampling artifact" of the particular client populations served by the professionals surveyed, there are no…

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

    ERIC Educational Resources Information Center

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

    2001-01-01

    Describes the necessity of including siblings in the treatment of victims of child sexual abuse. Theoretical and practical reasons to include siblings in treatment are discussed. Case examples using a particular intervention approach and results of client satisfaction surveys are described. (Contains 18 references.) (GCP)

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

    ERIC Educational Resources Information Center

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

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

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

    ERIC Educational Resources Information Center

    Lubell, Adele

    1989-01-01

    Use of anabolic steroids is believed to increase the odds of violent antisocial behavior, thus posing risks to consumers and the general public. Some research shows the danger of steroids in inducing severe adverse psychiatric effects. Certain lawyers use this abuse to plead insanity for their clients. (SM)

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

    ERIC Educational Resources Information Center

    Daley, Dennis C.

    1987-01-01

    Discusses the problems of relapse with alcoholics and other drug abusers from three perspectives: client-related variables, common erroneous beliefs and myths held by professionals regarding relapse, and treatment system problems that may contribute to relapse. Offers proposed solutions and describes a relapse prevention model. (Author/ABB)

  7. The Inspiration of Hope in Substance Abuse Counseling

    ERIC Educational Resources Information Center

    Koehn, Corinne; Cutcliffe, John R.

    2012-01-01

    This study used a grounded theory method to explore how counselors inspire hope in clients struggling with substance abuse. Findings from 10 participants revealed that hope inspiration occurred in 3 phases and consisted of several categories of hope-inspiring processes. Implications for counseling practice, counselor education, and research are…

  8. Hope-Focused Interventions in Substance Abuse Counselling

    ERIC Educational Resources Information Center

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

    2012-01-01

    Hope is a vital component of psychological healing and plays a critical role in counselling. With despair so prominent for individuals with serious substance abuse problems, the question arises as to how to foster hope in such clients. There are recent suggestions in the general counselling literature that some of the work in counselling involve…

  9. Methamphetamine Abuse and Manufacture: The Child Welfare Response

    ERIC Educational Resources Information Center

    Hohman, Melinda; Oliver, Rhonda; Wright, Wendy

    2004-01-01

    Methamphetamine abuse is on the rise, particularly by women of child-bearing age. This article describes the history and effects of methamphetamine use. The authors examine the ways exposure to the manufacture of this drug affects clients and social workers in the course of their work. Because children are frequently found at the scene of a…

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

    ERIC Educational Resources Information Center

    Russell, J. Curtis; And Others

    1989-01-01

    Evaluated effectiveness of instruction and presentation format of course on alcohol consumption and safe driving given to individuals convicted of first offense of driving while under the influence. Results showed that instructional information significantly increased clients' knowledge of alcohol and drug abuse and safe driving; course did not…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Abuse and HIV-related risk.

    PubMed

    Benson, J D

    1995-04-01

    Research has been conducted on the effects of childhood abuse that may lead to HIV risk-taking behaviors in adolescence and adulthood. There is evidence of a higher incidence of childhood abuse among HIV-infected individuals and those at highest risk, but not enough evidence to confirm childhood abuse as a root cause of risk-taking. Research is beginning to show important connections between psychological trauma and risk, and to suggest therapeutic approaches. The trauma of childhood sexual abuse is retained by the victims, which can cause dissociative defenses and damaging feelings of self-efficacy which may affect safer sex practices. To identify sexual abuse as an issue in therapy, it is advised that counselors develop client histories regarding relationships, sexual expression and identity, substance use, suicidality, and other recurring self-destructive patterns of thought and behavior. The treatment goal is to assist the patient in understanding how abuse has affected feelings, thoughts, and relationship styles, and to recognize patterns that lead directly to HIV-related risk or that set the stage for risky activities. The critical aspect of treatment is to accurately assess the patient's coping skills when determining the course of treatment. ¿¿¿¿¿¿¿ PMID:11362459

  13. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

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

  14. Spousal Abuse

    PubMed Central

    Gullattee, Alyce C.

    1979-01-01

    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

  15. Prescription Use Disorders in Older Adults

    PubMed Central

    Sullivan, Maria A.

    2012-01-01

    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

  16. Client Self-Disclosure in Psychotherapy.

    ERIC Educational Resources Information Center

    Stiles, William B.

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

  17. Client Introversion and Counseling Session Impact.

    ERIC Educational Resources Information Center

    Nocita, Andrew; Stiles, William B.

    1986-01-01

    Examined impact of counseling sessions as a function of clients' personality characteristics. Results indicated introverted clients rated their sessions as uncomfortable, unpleasant, tense, rough, and difficult and rated their postsession mood as relatively unfriendly, uncertain, sad, angry, and afraid. Conversely, extroverted clients rated their…

  18. Client-Side Monitoring for Web Mining.

    ERIC Educational Resources Information Center

    Fenstermacher, Kurt D.; Ginsburg, Mark

    2003-01-01

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

  19. Rehabilitation Counseling Student Perceptions of Obese Clients.

    ERIC Educational Resources Information Center

    Kaplan, Steven P.; Thomas, Kenneth R.

    1981-01-01

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

  20. Bulimia: Book for Therapist and Client.

    ERIC Educational Resources Information Center

    Bauer, Barbara G.; And Others

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

  1. Client Motivation and Rehabilitation Counseling Outcome

    ERIC Educational Resources Information Center

    Salomone, Paul R.

    1972-01-01

    This study investigated the relationship between client motivation or lack of motivation for rehabilitation services and rehabilitation counseling outcome. Using the case-closure system of the Minnesota Division of Vocational Rehabilitation, the results were that motivated clients were more frequently closed employed'' than unmotivated clients.…

  2. Community drug abuse agencies: an effective approach to the drug abuse problem.

    PubMed

    Cohen, M; Zitter, S; Savarese, R; Kern, J

    1976-01-01

    Community-based drug agencies were established as a means for confronting the drug abuse dilemma. However, due to the traditional guidelines that were followed in developing CBDA programs, the unique aspects of the problem were overlooked. This uniqueness relates to the ability of the drug culture to satisfy basic human needs. To be effective CBDA must be able to satisfy the same needs that clients previously met through participation in the drug culture. This article examines three areas of weakness which limit the effectiveness of CBDA: (1) fragment delivery of services; (2) perpetuation of minimal client involvement, commitment, and responsibility; and (3) motivational considerations of board members. The alternative family structure is described as an innovative CBDA approach that directly relates to the uniqueness of the drug abuse problem. PMID:10316884

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed

    Cooper, Claudia; Livingston, Gill

    2014-11-01

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

  5. "No secrets" and beyond: recent elder abuse policy in England.

    PubMed

    Filinson, Rachel

    2006-01-01

    This paper provides an overview of English elder abuse policy including guidelines developed for adult protection by their Department of Health in 2000, a report released from the House of Commons Health Committee in 2004 on elder abuse, related policy changes affecting older adults, the mentally incapacitated, and social care regulations, and the launching of public awareness campaigns. In contrast to the U.S., English policy subsumes elder abuse within the larger category of vulnerable adult protection, steers clear of mandatory reporting, emphasizes abuse by formal caregivers rather than domestic violence, relies on a multi-agency approach to investigation and intervention, and supports more remedial, less punitive regulatory oversight. PMID:17439873

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

    PubMed

    Jogerst, Gerald J; Daly, Jeanette M

    2008-01-01

    This study evaluated on a county level the association of Iowa's domestic dependent-adult abuse investigations with the location of adult protective services (APS) offices, rurality, government resources, felony charges and prosecutions, child abuse reports, and census demographics. In 2003, the rate of dependent-adult abuse investigations for Iowa was 0.70 per 1,000 population age 18 and older. Higher rates of child abuse investigations, felony prosecutions, sheriff's annual salary, and lower rates of child abuse substantiations are associated with higher rates of dependent-adult abuse investigations and substantiations. PMID:18928053

  7. Short term neuropsychological recovery in substance use disordered clients

    PubMed Central

    Bates, Marsha E.; Voelbel, Gerald T.; Buckman, Jennifer F.; Labouvie, Erich W.; Barry, Danielle

    2010-01-01

    Background Cognitive impairments are frequently observed in clients who enter treatment programs for substance abuse. The potential for early recovery of cognitive abilities is suggested by previous research; however, the extent of improvement and risk factors that may help predict individual differences in rates of recovery remain unclear. This study is a 6-week follow-up and retest of an original sample of 197 men and women who had received a broad neuropsychological assessment at addiction treatment entry. The aim was to examine the potential clinical significance of changes in cognitive functioning and the extent to which differential recovery was predictable from client background information. Methods Fifteen neuropsychological tests were readministered to 169 of 197 clients 6 weeks after treatment entry. Structural equation modeling was used to estimate separately the practice effects and recovery in four cognitive domains: executive function, memory, information processing speed, and verbal ability. Client background information included age, sex, education, substance use and consequences, psychopathology, medical problems, familial alcoholism history, and childhood behavior problems. Results A four-factor model of latent neuropsychological ability that was previously identified at treatment entry was replicated at follow-up. Statistically significant increases in the means of the four latent abilities were found. Memory showed a medium effect size improvement. Executive function, verbal ability, and information processing speed, however, showed only small effect size improvements, suggesting limited clinical significance. Substance use between treatment entry and follow-up, antisocial personality disorder, negative use consequences, less education, and medical problems were modestly predictive of less recovery. Conclusion Cognitive recovery in the first 6 weeks of treatment is possible, but, with the possible exception of memory, improvement may be minor in

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

    ERIC Educational Resources Information Center

    Fernando, Kumari; Medlicott, Louisa

    2009-01-01

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

  9. Child Sexual Abuse

    MedlinePlus

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

  10. Drug abuse first aid

    MedlinePlus

    Drug abuse is the misuse or overuse of any medication or drug, including alcohol. This article discusses first ... use of these drugs is a form of drug abuse. Legitimate medications can be abused by people who ...

  11. Child Sexual Abuse

    MedlinePlus

    Sexual abuse is one form of child abuse. It includes a wide range of actions between a child ... to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual ...

  12. How to Handle Abuse

    MedlinePlus

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

  13. Elder abuse and neglect in a population offering care by a primary health care center in Izmir, Turkey.

    PubMed

    Kissal, Aygul; Beşer, Ayşe

    2011-01-01

    The objective of this study is to investigate the prevalence of abuse and neglect of the elderly aged 65 years and older, living with their relative in a primary health care center area and affecting factors. A descriptive study included 331 people aged 65 years. The most frequent type of abuse was psychological abuse and the least frequent was sexual abuse. Female gender, low education levels, living with spouses and children, and perception of familial relationships as average or below average significantly increased abuse. The nurses providing primary health care should be able to identify and observe the elderly at risk of abuse and conduct programs preventing abuse. PMID:21347984

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

    ERIC Educational Resources Information Center

    Straussner, Shulamith Lala A.; Vairo, Elena

    2007-01-01

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

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

    PubMed

    McCabe, Heather A; Wahler, Elizabeth A

    2016-07-01

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

  16. Variation in access to outpatient substance abuse treatment: organizational factors and conceptual issues.

    PubMed

    McCaughrin, W C; Howard, D L

    1996-01-01

    Access is a multidimensional concept representing the ease with which health services are initiated and sustained. In this study, conceptual domains of access--affordability, acceptability, accommodation, availability, service diversity, and competitive stance--are hypothesized to predict the time clients wait to receive services. A large, recently surveyed, nationally representative sample of outpatient substance abuse treatment organizations provided the data. Multivariate regression analysis of 326 organizations was conducted with the conceptual domains sequentially predicting the time clients waited to receive service. Results show that increased waiting time was positively associated with treatment staff case overload and the average number of months clients spent in treatment and negatively associated with the percent of a treatment organization's client base on public assistance. Implications for policy makers and clinicians concerning client selection strategies by organizations and problems with the organizational capacity to treat clients are discussed. Areas for future research also are highlighted. PMID:9058353

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

    PubMed

    Burns, Diane; Hyde, Paula; Killett, Anne

    2013-05-01

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

  18. Personalities of women reporting incestuous abuse during childhood.

    PubMed

    Karp, S A; Holmstrom, R W; Silber, D E; Stock, L J

    1995-12-01

    Previous studies of adult females reporting incestuous sexual abuse in childhood, using the Apperceptive Personality Test and Draw-a-Person Questionnaire, indicated abusees attributed more negative traits to their characters than did controls. No differences were found by type of abuse or relation to the abuser. In these studies abusees and controls were obtained from different sources, although matched on several characteristics. The present study compared 79 incestuous abusees to 79 matched controls all drawn from the same subject pool. Multivariate analysis of variance identified significant differences between the groups. In contrast with earlier studies questionnaire scores distinguished rape victims from those abused without rape and distinguished those abused by older relatives from those abused by peers in two additional multivariate analyses of variance. PMID:8668460

  19. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

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

  20. Dementia and elder abuse.

    PubMed

    Hansberry, Maria R; Chen, Elaine; Gorbien, Martin J

    2005-05-01

    Dementia and elder abuse are relatively common and under-diagnosed geriatric syndromes. A unique relationship is observed when the two entities coexist. Special issues can confound the care of the dementia patient suspected of being abused. Impaired language or motor abilities to communicate abusive situations to a third party, lack of decisional capacity to address the abusive situation, disinhibited behavior that contributes to a cycle of violence, and coincident depression of the abused elder complicate the diagnosis and management of elder abuse. Education of the caregiver and attention to caregiver stress, including depression, may prevent onset and perpetuation of abuse. PMID:15804553

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  2. Do client fees help or hurt?

    PubMed

    Barnett, B

    1998-01-01

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

  3. Working with clients by incorporating their preferences.

    PubMed

    Tompkins, Kelley A; Swift, Joshua K; Callahan, Jennifer L

    2013-09-01

    Working with clients by integrating their therapy preferences into the treatment decision-making process has been identified as an important part of evidence-based practice in psychology. Accommodating client preferences has also been demonstrated to lead to fewer treatment dropouts and improved therapy outcomes. In this article, we present a number of clinical interventions or techniques for addressing client preferences in psychotherapy. Clinical examples demonstrating the techniques are also provided. PMID:24000835

  4. Increasing hope by addressing clients' outcome expectations.

    PubMed

    Swift, Joshua K; Derthick, Annie O

    2013-09-01

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

  5. Catastrophic events and older adults.

    PubMed

    Cloyd, Elizabeth; Dyer, Carmel B

    2010-12-01

    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

  6. Association for medical education and research in substance abuse.

    PubMed

    Samet, Jeffrey H; Galanter, Marc; Bridden, Carly; Lewis, David C

    2006-01-01

    The Association for Medical Education and Research in Substance Abuse (AMERSA) is a multi-disciplinary organization committed to health professional faculty development in substance abuse. In 1976, members of the Career Teachers Training Program in Alcohol and Drug Abuse, a US federally funded multi-disciplinary faculty development program, formed AMERSA. The organization grew from 59 founding members, who were primarily medical school faculty, to over 300 health professionals from a spectrum of disciplines including physicians, nurses, social workers, dentists, allied health professionals, psychologists and other clinical educators who are responsible for advancing substance abuse education. AMERSA members promote substance abuse education among health professionals by developing curricula, promulgating relevant policy and training health professional faculty to become excellent teachers in this field. AMERSA influences public policy by offering standards for improving substance abuse education. The organization publishes a peer-reviewed, quarterly journal, Substance Abuse, which emphasizes research on the education and training of health professions and also includes original clinical and prevention research. Each year, the AMERSA National Conference brings together researchers and health professional educators to learn about scientific advances and exemplary teaching approaches. In the future, AMERSA will continue to pursue this mission of advancing and supporting health professional faculty who educate students and trainees to address substance abuse in patients and clients. PMID:16393188

  7. Character of abuse towards the elderly through history.

    PubMed

    Pruszyński, Jacek J; Gebska-Kuczerowska, Anita; Cicha-Mikołajczyk, Alicja; Gromulska, Lucyna

    2011-01-01

    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. PMID:22184956

  8. Lichen sclerosus et atrophicus and sexual abuse.

    PubMed Central

    Warrington, S A; de San Lazaro, C

    1996-01-01

    AIMS: The aetiology of lichen sclerosus et atrophicus (LSA) is unknown. A series of 42 cases of this uncommon condition is reported. The aim of this study was to identify associations of LSA and document the association with sexual abuse. METHODS: Information about the patients was obtained by retrospective case note review and some patients were contacted by telephone for further information. RESULTS: In 12 cases there was evidence of sexual abuse. The abused group were slightly older than the non-abused group but were similar in all other respects. All three patients who presented over the age of 12 years had evidence of sexual abuse. Genital trauma was recalled by the patient or found at examination in 17 cases. Evidence of autoimmunity was present in five cases. Positive microbiological isolates were obtained in 18 cases. In only 11 cases were there no associated factors. The symptoms of LSA started between the ages of 3 and 7 years in most patients. The usual symptoms were related to genital skin involvement, and symptoms related to bladder and bowel function were common (50%). CONCLUSION: In this large series of paediatric LSA, associations with trauma, autoimmunity, and infection were noted. There was a high rate of coexisting sexual abuse with LSA, possibly due to genital trauma. Images Figure 2 PMID:9014605

  9. Women's perceptions of power and control in sexual abuse counseling.

    PubMed

    Koehn, Corinne V

    2007-01-01

    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. PMID:17255076

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

    PubMed Central

    2012-01-01

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

  11. Collecting Multidimensional Client Data Using Repeated Measures: Experiences of Clients and Counselors Using the CCAPS-34

    ERIC Educational Resources Information Center

    Martin, Jessica L.; Hess, Timothy R.; Ain, Stacie C.; Nelson, Dana L.; Locke, Benjamin D.

    2012-01-01

    Many college counseling centers do not collect client data at each session because of perceived burdens. This study explored 55 clients' and 16 doctoral counselor trainees' experiences collecting and using data on client distress at each session over the course of counseling at a large public university's counseling center. Results indicated that…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  13. Intracranial haemorrhage and child abuse.

    PubMed

    Cheah, I G; Kasim, M S; Shafie, H M; Khoo, T H

    1994-01-01

    Intracranial haemorrhage is a major cause of severe morbidity and mortality in child abuse cases in developed countries. However, similar data are not available in most developing countries. This study therefore aimed to determine the incidence of intracranial haemorrhage amongst all cases of child physical abuse, the nature of the injuries incurred, and the morbidity and mortality resulting therefrom. Among 369 cases of physical abuse seen over a 4-year period, 41 (11.4%) had intracranial haemorrhage, of whom 37 (90%) were 2 years old or less. A history of trauma was present in only eight (20%), of which only two were compatible with the injuries incurred. Subdural haemorrhages accounted for 80% of the cases, with skull fractures present in only nine cases. Fifty-four per cent of the 37 children aged 2 years of age or less had no external signs of trauma, but 11 of them had retinal haemorrhages. This is in contrast to the children older than 2 years of age who all had external signs of trauma. The overall prognosis was dismal with an early mortality of almost 30% (13 cases) and at least seven cases with severe neurological sequelae. These findings are comparable with studies from developed countries which have established that non-accidental injury must be considered as a cause of intracranial haemorrhage in any young child, despite the absence of external signs of trauma. PMID:7880096

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  15. Attractive versus Unattractive Clients: Mediating Influences on Counselors' Perceptions.

    ERIC Educational Resources Information Center

    Lewis, Kathleen N; And Others

    1981-01-01

    Investigated the effects of clients' age, physical attractiveness, and behavior on subjects' attraction to the clients. Results indicated that "counselor" subjects were significantly more attracted to child than to adult clients and to clients demonstrating good in-session behaviors. Physically attractive clients were not rated significantly more…

  16. Training Clients for Counseling: A Social Psychological Perspective.

    ERIC Educational Resources Information Center

    Dorn, Fred J.

    Research on social influence in counseling has examined how clients perceive counselors and how counselors influence clients. There has been little attention to counselors' perception of clients or the ways clients influence counselors. Research in this area could identify client characteristics which contribute to the counseling process and could…

  17. 49 CFR 1103.23 - Confidences of a client.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  18. CLIENT/PATIENT SAMPLE SURVEY (CPSS)

    EPA Science Inventory

    The purpose of the Client/Patient Sample Surveys (conducted in 1970, 1975, 1980, 1986, and 1997) has been the collection of general purpose statistics on the sociodemographic, clinical, and service use characteristics of clients served in the inpatient, residential, outpatient, a...

  19. Client Outcome Evaluation in Mental Health Centers.

    ERIC Educational Resources Information Center

    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…

  20. Predicting Improvement among University Counseling Center Clients.

    ERIC Educational Resources Information Center

    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…

  1. Client Relations: More than Just "Business"

    ERIC Educational Resources Information Center

    Malloy, Courtney L.; Yee, Patricia A.

    2006-01-01

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

  2. Meeting Client Resistance and Reactance with Reverence.

    ERIC Educational Resources Information Center

    Cowan, Eric W.; Presbury, Jack H.

    2000-01-01

    Explores the meaning and function of client resistance in counseling from various theoretical orientations. A relational model of resistance is offered that redefines traditional formulations and has implications for clinical treatment. A vignette illustrates that the counselor's contribution to the emergence of client resistance is a relevant…

  3. The Client: Characteristics Which Influence Treatment.

    ERIC Educational Resources Information Center

    Neufeldt, Susan A.

    Research on client characteristics is reviewed. The degree of disturbance, client expectations, social and economic attributes, race, sex, intellectual variables, and the nature of the presenting problem are all shown to interact with treatment method in determining the outcome of counseling. Several specific recommendations are made: (1) Behavior…

  4. When Are Clients Ready to Terminate?

    ERIC Educational Resources Information Center

    Jakobsons, Lara J.; Brown, Jessica S.; Gordon, Kathryn H.; Joiner, Thomas E.

    2007-01-01

    Termination of psychotherapy has received less attention in the research literature than other aspects of the treatment process. This paper presents a structured framework emphasizing observable markers to indicate when termination with a client is appropriate during cognitive behavioral treatment. The 7 criteria that indicate when a client is…

  5. Organizational and Client Commitment among Contracted Employees

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  6. Experiential Interventions for Clients with Genital Herpes.

    ERIC Educational Resources Information Center

    Cummings, Anne L.

    1999-01-01

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

  7. Cut Costs with Thin Client Computing.

    ERIC Educational Resources Information Center

    Hartley, Patrick H.

    2001-01-01

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

  8. Employment Patterns of Methadone Maintenance Clients

    ERIC Educational Resources Information Center

    Bloch, Harriet I.; And Others

    1977-01-01

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

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

    ERIC Educational Resources Information Center

    Holden, Janice Miner

    2000-01-01

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

  10. Writing about Clients: Ethical Considerations and Options

    ERIC Educational Resources Information Center

    Sperry, Len; Pies, Ronald

    2010-01-01

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

  11. Client and Counselor Expectations of Rehabilitation Services.

    ERIC Educational Resources Information Center

    Murphy, Stephen T.; Salomone, Paul R.

    1983-01-01

    Collected data concerning perceptions and expectations of services by rehabilitation counselors (N=7) and 12 of their severely disabled clients. Results showed differences between counselors and clients regarding (a) counselor's role in vocational aspects; (b) control over decision making for rehabilitation services; and (c) counselor perceptions…

  12. Client Motivation and Rehabilitation Counseling Outcome.

    ERIC Educational Resources Information Center

    Salomone, Paul R.

    This study investigates the relationship between client motivation or lack of motivation for vocational rehabilitation services, and rehabilitation outcome. Clients who had received services at a rehabilitation center during a two year period were rated on their level of motivation for rehabilitation services using the contents of diagnostic…

  13. Experience-Seeking Characteristics of Methadone Clients.

    ERIC Educational Resources Information Center

    Kohn, Paul M.; And Others

    1979-01-01

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

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

    PubMed

    Cochran, Bryan N; Cauce, Ana Mari

    2006-03-01

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

  15. Supervisory Turnover in Outpatient Substance Abuse Treatment

    PubMed Central

    Knight, Danica K.; Broome, Kirk M.; Edwards, Jennifer R.; Flynn, Patrick M.

    2009-01-01

    Staff turnover is a significant issue within substance abuse treatment, with implications for service delivery and organizational health. This study examined factors associated with turnover among supervisors in outpatient substance abuse treatment. Turnover was conceptualized as being an individual response to organizational-level influences, and predictors represent aggregate program measures. Participants included 532 staff (including 467 counselors and 65 clinical/program directors) from 90 programs in four regions of the USA. Using logistic regression, analyses of structural factors indicated that programs affiliated with a parent organization and those providing more counseling hours to clients had higher turnover rates. When measures of job attitudes were included, only parent affiliation and collective appraisal of satisfaction were related to turnover. Subsequent analyses identified a trend toward increased supervisory turnover when satisfaction was low following the departure of a previous supervisor. These findings suggest that organizational-level factors can be influential in supervisory turnover. PMID:19949883

  16. Elder abuse and neglect versus parricide.

    PubMed

    Jargin, Sergei V

    2013-12-01

    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. PMID:24971292

  17. Cough and Cold Medicine Abuse

    MedlinePlus

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

  18. "Shadows of the heart": a dramatic video for the treatment resistance of spouse abusers.

    PubMed

    Stosny, S

    1994-11-01

    Successful intervention with spouse abusers, most of whom are ordered into treatment by the courts, must overcome formidable anger and resistance, often expressed by high attrition and scant participation in the group treatment process. The dramatic video "Shadows of the Heart" dissipates client resistance by providing internal motivation to control violent behavior. The video dramatizes spouse abuse from the viewpoint of a young boy, who as a man has become a spouse abuser. As clients experience compassion for the child witness to family violence, they learn to convert their habitual anger response into nonviolent actions. Developed to combat treatment resistance, the video presentation was tested in a randomized experiment with 106 male spouse abusers drawn from seven public and private agencies. Results indicate that the video presentation significantly increased attendance and participation in the group treatment process. PMID:7992138

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

    ERIC Educational Resources Information Center

    McMillan, Samuel H., Jr.

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

  20. Emotional abuse in intimate relationships: The role of gender and age

    PubMed Central

    Karakurt, Günnur; Silver, Kristin E.

    2012-01-01

    The present study aimed to investigate the moderating roles of gender and age on emotional abuse within intimate relationships. This study included 250 participants with an average age of 27 years. Participants completed the Emotional Abuse Questionnaire (EAQ; Jacobson and Gottman, 1998), whose four subscales are isolation, degradation, sexual abuse, and property damage. Multigroup analysis with two groups, female (n = 141) and male (n = 109), was used to test the moderation effect. Younger men reported experiencing higher levels of emotional abuse, which declined with age. Older females reported experiencing less emotional abuse than older males. Overall, emotional abuse was more common in younger participants. Younger women experienced higher rates of isolation, and women’s overall experience of property damage was higher than that of men and increased with age. Results are interpreted through the Social Exchange and Conflict frameworks. PMID:24364124

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

    PubMed

    Powell, Mebane

    2010-10-01

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

  2. Cough & Cold Medicine Abuse

    MedlinePlus

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

  3. Prescription Drug Abuse

    MedlinePlus

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

  4. Students and Drug Abuse

    ERIC Educational Resources Information Center

    Todays Educ, 1969

    1969-01-01

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

  5. Abuse during Pregnancy

    MedlinePlus

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

  6. Measuring abusive behaviors: is economic abuse a unique form of abuse?

    PubMed

    Stylianou, Amanda Mathisen; Postmus, Judy L; McMahon, Sarah

    2013-11-01

    Recent attention has been given by researchers to exploring economic abuse strategies used by abusers. However, little research has been conducted to understanding how to conceptualize economic abuse in relation to other forms of abuse. This article examines the factor structure of abusive items from the Scale of Economic Abuse--12 and the Abusive Behavior Inventory through confirmatory factor analyses using data collected with 457 female survivors of abuse. The findings provide evidence for conceptualizing economic abuse as a unique form of abuse moderately correlated with psychological, physical, and sexual forms of abuse. PMID:23946140

  7. Perceptions of benzodiazepine dependence among women age 65 and older.

    PubMed

    Canham, Sarah L; Gallo, Joseph; Simoni-Wastila, Linda

    2014-01-01

    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: (a) benzodiazepine dependence is similar to dependence to diabetes or blood pressure medications; (b) dependence is distinctive from addiction/abuse; (c) addiction/abuse is perceived as worse than dependence; and (d) concerns of addiction/abuse result in low-dose benzodiazepine use. PMID:24918963

  8. Perceptions of Benzodiazepine Dependence Among Women Age 65 and Older

    PubMed Central

    Canham, Sarah L.; Gallo, Joseph; Simoni-Wastila, Linda

    2014-01-01

    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

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

    ERIC Educational Resources Information Center

    Howard, Kimberly S.; Brooks-Gunn, Jeanne

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  11. [Care counselling - the client's expectations].

    PubMed

    Nickel, W; Hanns, S; Brähler, E; Born, A

    2012-12-01

    The amendment of legal care consultations in the context of the long-term care insurance law (2008) has broadened recent consulting practice within the action range of the nursing care insurance in Germany. The informational needs and consulting requests of the clients were not investigated so far. Our aim was to examine information needs and consulting requests of those in need of care and their informal carers.The consulting requests of visitors of 2 open citizen events were documented by the use of a semi-structured questionnaire. Content analysis following Mayring (2008) was used for data analysis.158 consulting discussions were documented, from which 177 consulting requests were formed. The consulting requests can be divided in 4 main categories: (1) inquiry about the care system [56/32%], (2) inquiry about individual access to care offers [43/24%], (3) inquiry about regional care suppliers [43/24%], (4) situation- and disease-specific inquiries [35/20%].Inquiries about local suppliers of care and situation- and disease-specific inquiries outweigh the number of inquiries about the care system in general. Furthermore, our results show that the informational needs of those in need of care do not only refer to the scope of care insurance law, but to additional social security codes. PMID:22354362

  12. Benefit–Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment “Pay for Itself”?

    PubMed Central

    Ettner, Susan L; Huang, David; Evans, Elizabeth; Rose Ash, Danielle; Hardy, Mary; Jourabchi, Mickel; Hser, Yih-Ing

    2006-01-01

    Objective To examine costs and monetary benefits associated with substance abuse treatment. Data Sources Primary and administrative data on client outcomes and agency costs from 43 substance abuse treatment providers in 13 counties in California during 2000–2001. Study Design Using a social planner perspective, the estimated direct cost of treatment was compared with the associated monetary benefits, including the client's costs of medical care, mental health services, criminal activity, earnings, and (from the government's perspective) transfer program payments. The cost of the client's substance abuse treatment episode was estimated by multiplying the number of days that the client spent in each treatment modality by the estimated average per diem cost of that modality. Monetary benefits associated with treatment were estimated using a pre–posttreatment admission study design, i.e., each client served as his or her own control. Data Collection Treatment cost data were collected from providers using the Drug Abuse Treatment Cost Analysis Program instrument. For the main sample of 2,567 clients, information on medical hospitalizations, emergency room visits, earnings, and transfer payments was obtained from baseline and 9-month follow-up interviews, and linked to information on inpatient and outpatient mental health services use and criminal activity from administrative databases. Sensitivity analyses examined administrative data outcomes for a larger cohort (N=6,545) and longer time period (1 year). Principal Findings On average, substance abuse treatment costs $1,583 and is associated with a monetary benefit to society of $11,487, representing a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. Conclusions Even without considering the direct value to clients of improved health and quality of life, allocating taxpayer dollars to substance abuse treatment may be a wise

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-11-01

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

  15. Preventing Child Abuse

    ERIC Educational Resources Information Center

    Alvy, Kerby T.

    1975-01-01

    Focuses on two major and general approaches to analyzing the problems of child abuse; briefly discusses the prevention implications; deals with the individual physical abuse of children, with particular emphasis on the relationship between theoretical formulations of the causes of individual physical abuse and preventative programs; and, finally,…

  16. Substance Abuse. Policy Statement.

    ERIC Educational Resources Information Center

    National Collaboration for Youth, Washington, DC.

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

  17. Elder Abuse in Japan

    ERIC Educational Resources Information Center

    Arai, Mizuho

    2006-01-01

    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…

  18. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Morrow, Marilyn J.; Doyle, Kathleen

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

  19. Older People and HIV

    MedlinePlus

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

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

    PubMed Central

    Dong, Xinqi

    2014-01-01

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

  1. Elder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture.

    PubMed

    Dong, Xinqi

    2014-04-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  3. Exploring Client and Therapist Experiences of Sexual Offender Intervention: Developing a Model of "Significant Events".

    PubMed

    O'Halloran, David M; O' Reilly, Gary; Travers, Olive; Quinn, Paul; Stack, Jon; Cartin, Martin; Finnegan, Eileen; Ewart-Boyle, Shirley

    2016-06-01

    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. PMID:24867417

  4. Clients Who Frequent Madam Barnett's Emporium.

    ERIC Educational Resources Information Center

    Russell, Scott

    1999-01-01

    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)

  5. Counselor Values and the Pregnant Adolescent Client.

    ERIC Educational Resources Information Center

    Kennedy, Bebe C.; And Others

    1984-01-01

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

  6. Marketing Communication Consulting: Tips from Our Clients.

    ERIC Educational Resources Information Center

    Nord, Martha

    1989-01-01

    Presents advice on how business communication consultants can best work with clients to meet communication and training challenges. Summarizes the views of four training professionals and managers on successful marketing strategies for business communication consultants. (MM)

  7. Communication Scale for Older Adults (CSOA).

    PubMed

    Kaplan, H; Bally, S; Brandt, F; Busacco, D; Pray, J

    1997-06-01

    The communication Self-Assessment Scales for Older Adults (CSOA) are comprised of a 41-item Communication Strategies scale and a 31-item Communication Attitudes scale. Three-point and 5-point response formats are available. The scales were standardized on a population of 135 independent-living adults with hearing loss, ranging in age from 60 to 88 years. Item analysis, internal consistency reliability, test-retest reliability, normative data, and 95 percent confidence intervals are presented. A sample case illustrates how the scales can be used to evaluate the communication strategies and attitudes of an individual client. In addition, data are presented to show changes in the use of communication strategies and attitudes of a group of clients 3 months and 9 months after completion of aural rehabilitation programs. PMID:9188077

  8. Intimate partner victimization among adults aged 60 and older: an analysis of the 1999 and 2004 General Social Survey.

    PubMed

    Poole, Christopher; Rietschlin, John

    2012-04-01

    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. PMID:22471512

  9. Preventing and Recognizing Prescription Drug Abuse

    MedlinePlus

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

  10. Clients' and therapists' stories about psychotherapy.

    PubMed

    Adler, Jonathan M

    2013-12-01

    This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. PMID:22812587

  11. The case for integrating grounded theory and participatory action research: empowering clients to inform professional practice.

    PubMed

    Teram, Eli; Schachter, Candice L; Stalker, Carol A

    2005-10-01

    Grounded theory and participatory action research methods are distinct approaches to qualitative inquiry. Although grounded theory has been conceptualized in constructivist terms, it has elements of positivist thinking with an image of neutral search for objective truth through rigorous data collection and analysis. Participatory action research is based on a critique of this image and calls for more inclusive research processes. It questions the possibility of objective social sciences and aspires to engage people actively in all stages of generating knowledge. The authors applied both approaches in a project designed to explore the experiences of female survivors of childhood sexual abuse with physical therapy and subsequently develop a handbook on sensitive practice for clinicians that takes into consideration the needs and perspectives of these clients. Building on this experience, they argue that the integration of grounded theory and participatory action research can empower clients to inform professional practice. PMID:16221884

  12. Raising the Issue of Domestic Abuse in School

    ERIC Educational Resources Information Center

    Alexander, Helen; Macdonald, Elspeth; Paton, Sandra

    2005-01-01

    Previous studies suggest that around 30 per cent of children may witness domestic abuse, by which we mean physical or mental violence perpetrated by men on women. This paper reports the views of older children--a group from which there is little direct evidence available. Ninety-eight percent of pupils in a Scottish Secondary School consented to…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  14. Substance Abuse by Elders and Self-Enhancement Bias

    ERIC Educational Resources Information Center

    Kane, Michael N.; Green, Diane

    2009-01-01

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

  15. Alcohol abuse: medical effects of heavy drinking in late life.

    PubMed

    Gambert, S R

    1997-06-01

    As many as 15% of community-dwelling older persons are heavy drinkers, but their alcoholism is often hidden from their physicians. Depression, loneliness, and lack of social support are the most frequently cited antecedents to drinking for older alcoholics. Clinically, the same amount of alcohol once consumed with impunity may cause clinical symptoms in late life. Physiologic changes in volume of distribution make older patients susceptible to acute alcohol toxicity, with its CNS effects and metabolic disturbances. Liver disease, nutritional deficiencies, and impotence are consequences of chronic alcohol abuse. PMID:9194788

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

    PubMed

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

    2013-12-01

    Because few data exist on substance abuse rates in American Indian (AI) communities, the Methamphetamine and Other Drug project was developed and implemented by five nodes within the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). This article presents findings from AI clients in a Northern Plains urban non-Native substance abuse treatment setting. Alcohol and marijuana were used earlier, longer, and by more clients, followed by stimulants and prescription opioids. Most regularly smoked tobacco. Differences in substance use patterns were associated with age of onset and victimization. Age of onset was correlated with victimization, gender, cognitive impairment, and suicidal behavior. Despite considerable health and economic disparities, most clients found support for recovery in relationships and elements of Native culture. PMID:22843125

  17. Substance abuse and the course of welfare dependency.

    PubMed Central

    Schmidt, L; Weisner, C; Wiley, J

    1998-01-01

    OBJECTIVES: New provisions in welfare reform target recipients with addictions, even though there is limited research on how substance abuse affects people's experiences on welfare. This prospective study examined substance abuse as a determinant of subsequent welfare dependency. METHODS: Representative samples of clients on Aid to Families with Dependent Children (AFDC) and general assistance in a California county were interviewed while applying for services in 1989 and were reinterviewed in 1995. RESULTS: Among AFDC recipients, substance abuse was not a significant determinant of long welfare stays, repeat welfare use, or the total time a person remained on welfare during the 6-year period. However, substance abuse was a strong predictor of repeat welfare use among general assistance recipients. CONCLUSIONS: Alcohol and drug problems have played dramatically different roles in welfare dependency within the AFDC and general assistance populations. Under welfare reform, local general assistance programs will be the final safety net for recipients removed from federal entitlement programs. These programs will probably be confronted with clients with more complex disabilities related to addiction, as well as with greater family needs for cash assistance. PMID:9807526

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

    ERIC Educational Resources Information Center

    Ewing, Sara; Dover, Howard F.

    2012-01-01

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

  19. 49 CFR 1103.22 - Restraining clients from improprieties.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Restraining clients from improprieties. 1103.22... Practitioner's Duties and Responsibilities Toward A Client § 1103.22 Restraining clients from improprieties. A practitioner should see that his clients act with the same restraint that the practitioner himself...

  20. 32 CFR 776.4 - Attorney-client relationships.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 cases) is the client served by each covered USG attorney unless detailed to represent another client...

  1. 32 CFR 776.28 - Conflict of interest: Former client.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Conflict of interest: Former client. 776.28... ADVOCATE GENERAL Rules of Professional Conduct § 776.28 Conflict of interest: Former client. (a) Conflict of interest: Former client. A covered attorney who has represented a client in a matter shall...

  2. Client Engagement Characteristics Associated with Problem Gambling Treatment Outcomes

    ERIC Educational Resources Information Center

    Dowling, Nicki A.; Cosic, Sanja

    2011-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    1998-01-01

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

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

    ERIC Educational Resources Information Center

    Abu-Baker, Khawla

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Tsui, Venus; Cheung, Monit; Leung, Patrick

    2010-01-01

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

  9. Perceptions about Services and Dropout from a Substance Abuse Case Management Program

    ERIC Educational Resources Information Center

    Sosin, Michael R.; Durkin, Elizabeth

    2007-01-01

    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…

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

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1991-01-01

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

  11. Federal Confidentiality Regulations for Substance Abuse Treatment Facilities: A Case in Applied Ethics.

    ERIC Educational Resources Information Center

    Piazza, Nick J.; Yeager, Rebecca D.

    1990-01-01

    Discusses confidentiality in counseling, basing comments on ethical standards of American Association for Counseling and Development and National Academy of Certified Clinical Mental Health Counselors, as well as federal regulations adopted for drug and alcohol abuse treatment. Discusses disclosures with and without client consent and special…

  12. The Use of Therapeutic Stories in Counseling Child and Adolescent Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Kress, Victoria E.; Adamson, Nicole A.; Yensel, Jennifer

    2010-01-01

    Counselors will regularly counsel children and adolescents with histories of sexual abuse and be challenged with providing supportive and empowering interventions that serve to move the client from victim to survivor status. Therapeutic stories are a creative counseling technique that can be used when counseling child and adolescent sexual abuse…

  13. Substance Abuse Treatment Agencies and Self-Help Groups: Collaborators or Competitors?

    ERIC Educational Resources Information Center

    Humphreys, Keith; And Others

    While self-help groups such as Alcoholics Anonymous are becoming more integrated into the professional substance abuse treatment network, many professionals are still hesitant to encourage clients to attend self-help groups after treatment. This study examined what factors predict the degree of cooperation between professional agencies and…

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

    ERIC Educational Resources Information Center

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Edwards, Elizabeth D.

    1978-01-01

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

  16. Physical Abuse of Urban Native Americans

    PubMed Central

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

    2000-01-01

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

  17. A Lifetime of Intimate Partner Violence: Coping Strategies of Older Women

    ERIC Educational Resources Information Center

    Zink, Therese; Jacobson, C. Jeff, Jr.; Pabst, Stephanie; Regan, Saundra; Fisher, Bonnie S.

    2006-01-01

    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…

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

    PubMed Central

    Dong, XinQi

    2012-01-01

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

  19. Using client outcome monitoring as a tool for supervision.

    PubMed

    Swift, Joshua K; Callahan, Jennifer L; Rousmaniere, Tony G; Whipple, Jason L; Dexter, Kyle; Wrape, Elizabeth R

    2015-06-01

    A large body of research has supported the use of client outcome monitoring and client feedback in psychotherapy. However, discussions between supervisors and trainee clinicians in supervision are still largely based on subjective appraisals made by the trainees. In this article, we discuss 3 strategies for integrating client outcome data and feedback into the supervisory process: training students to obtain and use objective client feedback, using specific client data to inform discussions of clients, and identifying patterns of outcomes across clients to facilitate supervisee growth and development. PMID:25286066

  20. The intergenerational transfer of mother-daughter risk for gender-based abuse.

    PubMed

    McCloskey, Laura Ann

    2013-01-01

    In this 10-year longitudinal study 150 mother-daughter pairs were recruited to participate in a study examining gender-based abuse across three generations. Forms of gender-based abuse included: child sexual abuse, witnessing intimate partner violence against their mothers, and intimate partner violence or dating violence in adolescence or adulthood. Daughters were interviewed when they were on average 9, 14, and 16 years old. Regression analyses revealed that if the grandmother (G1) was abused by her husband, her daughter (G2) was more likely to be sexually molested in childhood and was also more likely to be in an abusive relationship as an adult. If the mother (G2) was sexually abused as a child her daughter (G3) was at increased risk for child sexual abuse. In turn, child sexual abuse for the daughters related to their reports of dating violence in adolescence. Daughters (G3) who were sexually abused expressed more anxiety about romantic relationships, reflecting early attachment conflicts. Both child sexual abuse and anxious romantic attachment style independently predicted adolescent sexual risk-taking as in having multiple sexual partners or dating older men. These findings demonstrate how informative it is to include multiple forms of gender-based abuse in research and practice to better illuminate complex family dynamics. In addition, the findings support previous empirical work showing the importance of attachment behavior in women who are in abusive relationships, which has unique clinical implications. PMID:23713622

  1. Nursing care of transgendered older adults. Implications from the literature.

    PubMed

    Berreth, Margaret E

    2003-07-01

    Although there has been considerable medical and psychological research into the phenomenon of transgenderism, little attention has been paid to issues specific to the older transgendered adult. This article seeks to address this gap by exploring issues relevant to the nursing care of the older transgendered adult. The specific topics covered include social support, abuse and neglect, medical concerns, and access to medical care. Resources for the transgendered older adult also are included. Journal articles and texts from nursing, medicine, and psychology are used. This review highlights implications for nursing, offers suggestions for promoting a therapeutic relationship in both the inpatient and outpatient setting, and concludes with areas for future research. PMID:12874939

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

    Petkus, Andrew J; M.A; Wetherell, Julie Loebach

    2015-01-01

    Older adults are the fastest growing segment of the population. With these changing demographics, mental health professionals will be seeing more older clients. Additionally, older adults are an underserved population in that most older adults in need of mental health services do not receive treatment. Thus, it is essential that treatments for 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

  4. Doping in gymnasiums in Amman: the other side of prescription and nonprescription drug abuse.

    PubMed

    Wazaify, Mayyada; Bdair, Ahmad; Al-Hadidi, Kamal; Scott, Jenny

    2014-08-01

    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. PMID:24611822

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

    ERIC Educational Resources Information Center

    Bridges, Nancy A.

    2010-01-01

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

  6. A Comparison of Intake Counselors' and Clients' Perceptions of Clients' Presenting Problems.

    ERIC Educational Resources Information Center

    Hutchinson, Roger L.; And Others

    Clients seeking psychological counseling, who initiate service of their own volition, do so to obtain help with a problem that they feel afflicts them. Counselors' perceptions of clients' presenting problems assist counselors in making predictions about behavior from which they construct treatment plans. Research has demonstrated that incongruity…

  7. The Relationship between Client Attachment and Therapist Interventions in Client-Nominated Relationship-Building Incidents

    ERIC Educational Resources Information Center

    Janzen, Jennifer I.; Fitzpatrick, Marilyn R.; Drapeau, Martin; Blake, Emily

    2010-01-01

    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…

  8. Imaging of Abusive Trauma.

    PubMed

    Shekdar, Karuna

    2016-06-01

    "Shaken baby syndrome" is a term often used by the physicians and public to describe abusive trauma inflicted on infants and young children. Advances in the understanding of the mechanisms and the associated clinical spectrum of injury has lead us to modify our terminology and address it as "abusive trauma" (AT). Pediatric abusive head trauma is defined as an injury to the skull or intracranial contents of an infant or a young child (< 5 y age) due to inflicted blunt impact and/or violent shaking. This chapter focuses on the imaging aspects of childhood abusive trauma along with a brief description of the mechanism and pathophysiology of abusive injury. The diagnosis of AT is not always obvious, and abusive injuries in many infants may remain unrecognized. Pediatricians should be cognizant of AT since pediatricians play a crucial role in the diagnosis, management and prevention of AT. PMID:26882906

  9. Balancing risk prevention and health promotion: towards a harmonizing approach in care for older people in the community.

    PubMed

    Janssen, Bienke M; Van Regenmortel, Tine; Abma, Tineke A

    2014-03-01

    Many older people in western countries express a desire to live independently and stay in control of their lives for as long as possible in spite of the afflictions that may accompany old age. Consequently, older people require care at home and additional support. In some care situations, tension and ambiguity may arise between professionals and clients whose views on risk prevention or health promotion may differ. Following Antonovsky's salutogenic framework, different perspectives between professionals and clients on the pathways that lead to health promotion might lead to mechanisms that explain the origin of these tensions and how they may ultimately lead to reduced responsiveness of older clients to engage in care. This is illustrated with a case study of an older woman living in the community, Mrs Jansen, and her health and social care professionals. The study shows that despite good intentions, engagement, clear division of tasks and tailored care, the responsiveness to receive care can indeed not always be taken for granted. We conclude that to harmonize differences in perspectives between professionals and older people, attention should be given to the way older people endow meaning to the demanding circumstances they encounter (comprehensibility), their perceived feelings of control (manageability), as well as their motivation to comprehend and manage events (meaningfulness). Therefore, it is important that both clients and professionals have an open mind and attempt to understand each others' perspective, and have a dialogue with each other, taking the life narrative of clients into account. PMID:22228192

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

    PubMed

    Kum, Oyeon

    2007-11-01

    Customized cancer radiation treatment planning for each patient is very useful for both a patient and a doctor because it provides the ability to deliver higher doses to a more accurately defined tumor and at the same time lower doses to organs at risk and normal tissues. This can be realized by building an accurate planning simulation system to provide better treatment strategies based on each patient's tomographic data such as CT, MRI, PET, or SPECT. In this study, we develop a real-time online client-server/client collaborative environment between the client (health care professionals or hospitals) and the server/client under a secure network using telematics (the integrated use of telecommunications and medical informatics). The implementation is based on a point-to-point communication scheme between client and server/client following the WYSIWIS (what you see is what I see) paradigm. After uploading the patient tomographic data, the client is able to collaborate with the server/client for treatment planning. Consequently, the level of health care services can be improved, specifically for small radiotherapy clinics in rural/remote-country areas that do not possess much experience or equipment such as a treatment planning simulator. The telematics service of the system can also be used to provide continued medical education in radiotherapy. Moreover, the system is easy to use. A client can use the system if s/he is familiar with the Windows(TM) operating system because it is designed and built based on a user-friendly concept. This system does not require the client to continue hardware and software maintenance and updates. These are performed automatically by the server. PMID:17943336

  11. A retrospective study of risk to siblings in abusing families.

    PubMed

    Hamilton-Giachritsis, Catherine E; Browne, Kevin D

    2005-12-01

    Relatively little research has considered the risk to siblings within maltreating families. The sample in the present study consisted of the 795 siblings from a cohort of 400 "index" children who had been referred to police child protection units in England for abuse and/or neglect. In 44% of families (valid cases), the index child was scapegoated, in 37% maltreatment was nonspecific to all siblings, and in 20% maltreatment was specifically directed at some but not all siblings. Scapegoated children were more likely to be older and to experience physical or sexual abuse, whereas younger children and index child referrals for neglect, emotional abuse, or mixed abuse were associated with risk to some or all siblings. Parental difficulties and family stressors increased the risk of maltreatment to all siblings. There was no evidence of increased risk to stepsiblings or children with difficulties, suggesting that the special victim model has limited application. PMID:16402877

  12. Rescue for sexually abused girls in Costa Rica.

    PubMed

    Treguear, T; Peters, L

    1995-01-01

    In San Jose, Costa Rica, the nongovernmental organization PROCAL has established two rescue homes for sexually abused girls 10-15 years of age. One of these homes is devoted to the care of pregnant girls. In almost all cases, the perpetrator was a male relative. Since girls are taught they must obey older male relatives, they are powerless to stop the abuse. When girls become pregnant as a result of sexual abuse, they face social ostracism and are blamed for their participation in sexual activity. PROCAL counsels the girls that they are victims of their own lack of power and provides them with skills and education they need to return to society and start a new life. The stories of two young girls who became pregnant as a result of sexual abuse and were helped by PROCAL are presented. PMID:12319363

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

    PubMed

    Jargin, Sergei V

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  15. Sexual abuse in children - what to know

    MedlinePlus

    Sexual abuse - children ... abused before they turn 18. Sexual abuse of children is any activity that the abuser does to get sexually aroused, including: Touching a child's genitals Rubbing the abuser's genitals against a child's ...

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

    PubMed

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

    1993-01-01

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

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

    PubMed

    2016-07-01

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

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

    PubMed

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

    2014-07-01

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

  19. Substance use and brain reward mechanisms in older adults.

    PubMed

    Snyder, Marsha; Platt, Lois

    2013-07-01

    Substance use among older adults is on the rise, with statistics indicating this to be a growing health problem. Brain changes in the reward center of the brain that naturally occur with aging are offered as one source of these statistics. Aging is generally associated with increased prevalence of chronic disease, disability, and death, and therefore a public health goal for older adults is to maintain health, independence, and function. Psychiatric-mental health nurses are uniquely positioned to assist older adults in achievement of these goals through health assessment and promotion. The use of client-centered counseling approaches that recognize the older adult's developmental need for autonomy and choice in decision making have been shown to be effective in increasing motivation in this adult population. PMID:23758223

  20. Cocaine abuse among opioid addicts: demographic and diagnostic factors in treatment.

    PubMed

    Kosten, T R; Gawin, F H; Rounsaville, B J; Kleber, H D

    1986-01-01

    Cocaine is becoming a major drug of abuse among the general population and among opiate addicts. Reports from the early 1970s found that most abusers were older Black males with some antisocial characteristics. Cocaine abuse at that time was reported by about 17% of opiate addicts seeking treatment and by 7 to 11% of ex-addicts on methadone maintenance. However, that rate increased dramatically during the 1970s, and in our 1980 study of 533 addicts we found that 74% of opiate addicts applying for treatment used cocaine. It was the second most abused nonopioid drug after marijuana, surpassing alcohol intoxication. Although the mean number of days of abuse over the previous 30 days was substantially lower among the addicts on our methadone maintenance program (mean = 1.4 days, n = 120) than among the addicts applying for treatment (mean = 9 days, n = 204), the following associations with cocaine abuse were consistent in both subsamples. Cocaine abuse was more frequent among Blacks. It was associated with a variety of antisocial indices including Research Diagnostic Criteria antisocial personality disorder, number of arrests, and legal, family, employment, and drug abuse problems as assessed by the Addiction Severity Index and the Social Adjustment Scale. Several differences emerged between Black and White cocaine-abusing addicts, the most interesting being an increased rate of anxiety disorders among White cocaine abusers. Based on these associations, we offer several guidelines for treating cocaine abuse in opiate addicts. PMID:3788892

  1. Special Issue: Substance Abuse.

    ERIC Educational Resources Information Center

    Fuhrmann, Barbara S., Ed.; Washington, Craig S., Ed.

    1984-01-01

    Presents ten articles about substance abuse: its effects, consequences, and strategies for intervention. Describes specific group therapy techniques and presents both a court service designed for assisting juveniles with drug/alcohol offenses, and a school-based substance abuse prevention program. Looks at strategies for counseling special…

  2. Battling Sexual Abuse

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2010-01-01

    From costly lawsuits on behalf of victims to negative media coverage, districts can face potentially devastating consequences as a result of sexual abuse of their students by district employees. This article offers a few tips on how to battle sexual abuse particularly in school districts. The author stresses that by adopting strong policies that…

  3. Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Thorne, Craig R.; DeBlassie, Richard R.

    1985-01-01

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

  4. Antitussives and substance abuse

    PubMed Central

    Burns, Jarrett M; Boyer, Edward W

    2013-01-01

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

  5. Antitussives and substance abuse.

    PubMed

    Burns, Jarrett M; Boyer, Edward W

    2013-01-01

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

  6. Substance Abuse and Disability.

    ERIC Educational Resources Information Center

    Sales, Amos

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

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

    ERIC Educational Resources Information Center

    Leach, Fiona; Machakanja, Pamela

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

  8. Depression in Older Adults

    ERIC Educational Resources Information Center

    Stickle, Fred; Onedera, Jill D.

    2006-01-01

    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.

  9. Dextromethorphan Abuse in Adolescence

    PubMed Central

    Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.

    2008-01-01

    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

  10. Helping Clients Uncover Metaphoric Understandings of Bulimia.

    ERIC Educational Resources Information Center

    Cummings, Anne L.

    1998-01-01

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

  11. Considering Thin Client Computing for Higher Education.

    ERIC Educational Resources Information Center

    Sheehan, Mark

    1998-01-01

    In response to concerns about the cost of keeping up with individual desktop computing technology, several new solutions have emerged. Referred to as "thin clients," or network-centric computers, they include two types of desktop device: the network computer and the Windows terminal. Purchase cost, life span, support costs, and overall total cost…

  12. Finding Happiness for Ourselves and Our Clients.

    ERIC Educational Resources Information Center

    Miller, Geri

    2001-01-01

    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)

  13. Counselor Loss: Terminating the Helped Client.

    ERIC Educational Resources Information Center

    Miller, Mark J.

    1981-01-01

    Discusses counselor feelings of loss due to client departure from therapy. Describes components of loss within a five-stage model including denial, anger, bargaining, depression, and acceptance. Outlines strategies for coping with counselor loss. Suggests feelings of loss are natural. (RC)

  14. The Existential Mode and Client Anxiety.

    ERIC Educational Resources Information Center

    Yoder, James D.

    1981-01-01

    Reviews and clarifies counseling from an existential perspective, with emphasis on the distinction between neurotic and ontological anxiety. The existentially oriented counselor insists that clients face themselves as referents in a phenomenological context by experiencing existential "anxiety" when confronted with the pain of finitude,…

  15. Client-Centered Employee Assistance Services.

    ERIC Educational Resources Information Center

    Bayer, Darryl Lee

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

  16. Pretherapy Information: An Investigation of Client Responses.

    ERIC Educational Resources Information Center

    Lewis, Kathleen N.; And Others

    1983-01-01

    Investigated effects of pretherapy information about a feminist therapist's values and therapy orientation. Studied self-identified feminist clients' judgments of similarity to the therapist's values, confidence in the therapist's helpfulness, and willingness to see the therapist. Subjects were not as willing to see the explicitly feminist…

  17. Client Confidentiality in Police Social Work Settings.

    ERIC Educational Resources Information Center

    Curtis, Patrick Almond; Lutkus, Anita M.

    1985-01-01

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

  18. Accommodating blind and partially sighted clients

    PubMed Central

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

    2014-01-01

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

  19. Attracting Clients to Service-Oriented Programs.

    ERIC Educational Resources Information Center

    Disney, Diane M.

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

  20. Three-Dimensional Audio Client Library

    NASA Technical Reports Server (NTRS)

    Rizzi, Stephen A.

    2005-01-01

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

  1. Client Perceptions of Prison Counselor Effectiveness.

    ERIC Educational Resources Information Center

    Booth, J. A. Gordon

    Research evidence indicates that counselors rated as more effective are lower in dogmatism. Additional research suggests that the counseling relationship with deliquent populations is different from that with nondelinquent populations. It is the intent of this study to investigate perceptions of counselor effectiveness held by clients in a major…

  2. Borderline Clients: Practice Implications of Recent Research.

    ERIC Educational Resources Information Center

    Johnson, Harriette C.

    1991-01-01

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

  3. Defining the Worker-Client Relationship.

    ERIC Educational Resources Information Center

    Proctor, Enola K.

    1982-01-01

    Suggests that effective use of the relationship between worker and client requires defining the concept of relationship more specifically. This may be accomplished through a consideration of the context and purpose of the particular treatment situations, the outcomes desired and the responses that are necessary to achieve these goals. (Author)

  4. Peer Abuse as Child Abuse and Indications for Intervention

    ERIC Educational Resources Information Center

    Healey, Jean B.

    2005-01-01

    Peer abuse in the form of bullying is now recognised as an endemic feature of school life and in terms of impact, outcomes and intervention requirements can be equated with other forms of child abuse. It is argued in the light of data presented here that the parallels between peer abuse and more generally accepted forms of child abuse must be…

  5. Some Factors Influencing Abusers' Justification of Their Child Abuse.

    ERIC Educational Resources Information Center

    Dietrich, Dorothee; And Others

    1990-01-01

    Interviews with 73 abusive caretakers were analyzed to determine aspects of the caretakers' situation and the interaction with the abused child that contributed to their belief that the abuse was justified or not. Justification was related to defiance of the child and environmental stressors on the abuser. (Author/JDD)

  6. WorldView Environmental Scan on Elder Abuse.

    PubMed

    Podnieks, Elizabeth; Anetzberger, Georgia J; Wilson, Susannah J; Teaster, Pamela B; Wangmo, Tenzin

    2010-01-01

    In response to a growing and worldwide recognition of elder abuse, the WorldView Environmental Scan on Elder Abuse was undertaken. It represented an attempt to collect both information on the nature of the problem of elder abuse and responses to it from a global perspective. The first of its kind, the Scan gathered information about elder abuse as well as on related legislation and policy, services and programs, educational resources and needs, training, and past and ongoing research. A total of 53 countries responded to the survey questionnaire, with 362 respondents representing the six world regions designated by the World Health Organization. Findings revealed that factors contributing to elder abuse include changing social and economic structures, isolation of victims, inadequate knowledge of laws and services, intergenerational conflict, and poverty. Barriers to seeking resources to intervene and protect older adults include the culture of the country, language issues, literacy, stigma, lack of mobility, lack of funding, and insufficient familiarity with and access to the internet. The data serve as a catalyst to take action, both globally and nationally, while emphasizing the changes necessary to protect the rights and dignity of older adults. PMID:20390830

  7. Aspects of abuse: abusive head trauma.

    PubMed

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

    2015-03-01

    Abusive Head Trauma (AHT) is a form of child physical abuse that involves inflicted injury to the brain and its associated structures. Abusive Head Trauma, colloquially called Shaken Baby Syndrome, is the most common cause of serious or fatal brain injuries in children aged 2 years and younger. The American Academy of Pediatrics recommends the term Abusive Head Trauma, as opposed to Shaken Baby Syndrome, as the former term encompasses multiple forms of inflicted head injury (inertial, contact, and hypoxic-ischemic) and a range of clinical presentations and radiologic findings and their sequelae. Children diagnosed with AHT are 5 times more likely to die compared with accidentally head-injured children, yet signs and symptoms are not always obvious, and therefore the diagnosis can be overlooked. Therefore, the American Academy of Pediatrics has tasked pediatricians with knowing how and when to begin an evaluation of children with signs and symptoms that could possibly be due to AHT. Overall, a detailed history of present illness and medical history, recognition of physical and radiological findings, and careful interpretation of retinal pathology are important aspects of formulating the differential diagnoses and increasing or decreasing the index of suspicion for AHT. PMID:25771265

  8. Abusive Behaviors of College Athletes.

    ERIC Educational Resources Information Center

    Chandler, Steve B.; Johnson, DeWayne J.; Carroll, Pamela S.

    1999-01-01

    Comparison of 126 college athletes and 216 nonathletes on a questionnaire concerning abusive behaviors found that athletes were more often involved in physical abuse of someone of the same sex or sexual abuse of someone of the opposite sex than nonathletes. Athletes reported a history of prior abuse (physical and/or sexual) associated with later…

  9. Educators, Schools, and Child Abuse.

    ERIC Educational Resources Information Center

    Broadhurst, Diane D.

    The booklet provides an overview on the school-related issues involved in child abuse and neglect. Definitions, causes, and effects of abuse and neglect are reviewed in the first chapter; guidelines for identifying physical and sexual abuse, neglect, and emotional maltreatment are offered in chapter 2. Aspects of reporting abuse are noted as are…

  10. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

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

  11. Encountering Child Abuse at Camp.

    ERIC Educational Resources Information Center

    Durall, John K.

    1997-01-01

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

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

    ERIC Educational Resources Information Center

    Miller, Mark J.

    1988-01-01

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

  13. 19 CFR 111.39 - Advice to client.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  14. 19 CFR 111.39 - Advice to client.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  15. Gender Dysphoria: The Therapist's Dilemma--The Client's Choice.

    ERIC Educational Resources Information Center

    Sherebrin, Hannah

    1996-01-01

    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)

  16. Counselor Stress in Relation to Disabled and Minority Clients

    ERIC Educational Resources Information Center

    Vander Kolk, Charles J.

    1977-01-01

    Physiological and self-reported reactions of counselors in training to five disabled clients and a minority client were examined. Implications for counselor practice, education, and in-service education are discussed. (Author)

  17. Osteogenesis imperfecta misdiagnosed as child abuse.

    PubMed

    Singh Kocher, Mininder; Dichtel, Laura

    2011-11-01

    The differential diagnosis of child abuse includes osteogenesis imperfecta (OI). Mild phenotypes of OI may be misdiagnosed as child abuse. The purpose of this study was to review the experience of families in which OI was misdiagnosed as child abuse. Sixty-one potential cases of misdiagnosis were identified from a lay support organization. Upon review of the medical records, 33 cases were identified with a confirmed diagnosis of OI (skin biopsy or DNA blood test). Questionnaires were given to families to describe their condition and experiences. There were 19 male and 14 female children. Mean age at presentation was 7.1 months (range: 1-23 months). All patients had fractures and the presenting symptoms included pain (n=14), swelling (n=7), decreased limb movement (n=5), or unusual limb position (n=2). Abnormal radiograph findings consistent with OI were found in 19 of 33 patients (58%), clinical findings of OI were present in 23 of 33 patients (70%), and a family history that could be supportive of OI was present in 18 of 33 families (55%). Children were removed from the family in 70% of cases and older siblings were removed from the family in 62% of cases. The mean age at the time of diagnosis of OI was 10.5 months (range: 3-35 months). The consequences of misdiagnosis of OI as child abuse are devastating to the family. OI should be considered in all cases of suspected child abuse. In children with any clinical, radiographic, or family history features of OI, early involvement of a bone specialist and performance of laboratory testing should be considered to establish a timely and accurate diagnosis. PMID:21716141

  18. Added value of elder abuse definitions: a review.

    PubMed

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

    2013-01-01

    Elder abuse has devastating consequences for older persons such as a poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. It is timely to discuss one of the basic problems that has hampered the study, detection and intervention of elder abuse as the variety of definitions that exist now produce a definitional chaos for researchers, practitioners, and policy makers. In this article we trace the elements of "how to define elder abuse" and situate them in their socio-historical context. We also analyze the purposes of these different definitions to assess their appropriateness in different settings concerned with elder abuse. Our analysis shows that elder abuse mirrors the societal arrangements which gave rise to them. It also highlights that it is a complex problem that is difficult to define. The central question is whether we need a common definition of elder abuse or different definitions that can be used in different settings. By evidence of our analysis we can see that there is a need for a sufficiently broad and flexible definition in order to cover different behaviors that can constitute abuse and the various settings in which it may occur. On the other hand, the definition needs to be specific and concrete to be useful in professional contexts. To take a further step forward for both research and practice of elder abuse, we propose to consistently adhere to the WHO definition that leads the enquirer towards a better understanding of the problem and helps to distinguish it from other phenomena; and to a simplified definition for professional practice that sets boundaries to the phenomena and is appropriate for effective prevention and intervention measures. PMID:22561470

  19. Aging in Place vs. Relocation for Older Adults with Neurocognitive Disorder: Applications of Wiseman's Behavioral Model.

    PubMed

    Kaplan, Daniel B; Andersen, Troy Christian; Lehning, Amanda J; Perry, Tam E

    2015-01-01

    Some older adults are more vulnerable to housing concerns due to physical and cognitive challenges, including those with a neurocognitive disorder who need extensive support. Environmental gerontology frameworks, including Wiseman's 1980 Behavioral Model of Elderly Migration, have informed scholarship on aging in place and relocation. Understanding Wiseman's model, including considerations for working with families confronting a neurocognitive disorder, can help practitioners ensure that older clients live in settings that best meet their wants and needs. PMID:26016530

  20. Mania following ketamine abuse

    PubMed Central

    Lu, Yuan-Yuan; Lin, Chieh-Hsin; Lane, Hsien-Yuan

    2016-01-01

    Ketamine, a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor, has multiple clinical uses. On the other hand, ketamine abuse or recreational use has been gaining increasing attention. Induction of mania and psychotic symptoms has been reported in a patient receiving IV ketamine therapy for reflex sympathetic dystrophy. We here report a 26 year-old man who abused ketamine by inhalation for 12 months and developed manic-like symptoms after ketamine use. This case suggests a possible relationship between manic symptoms and ketamine abuse. To the best of our knowledge, this may be the first report regarding mania after recreational use of ketamine. PMID:26869791

  1. A Responsive Client for Distributed Visualization

    NASA Astrophysics Data System (ADS)

    Bollig, E. F.; Jensen, P. A.; Erlebacher, G.; Yuen, D. A.; Momsen, A. R.

    2006-12-01

    As grids, web services and distributed computing continue to gain popularity in the scientific community, demand for virtual laboratories likewise increases. Today organizations such as the Virtual Laboratory for Earth and Planetary Sciences (VLab) are dedicated to developing web-based portals to perform various simulations remotely while abstracting away details of the underlying computation. Two of the biggest challenges in portal- based computing are fast visualization and smooth interrogation without over taxing clients resources. In response to this challenge, we have expanded on our previous data storage strategy and thick client visualization scheme [1] to develop a client-centric distributed application that utilizes remote visualization of large datasets and makes use of the local graphics processor for improved interactivity. Rather than waste precious client resources for visualization, a combination of 3D graphics and 2D server bitmaps are used to simulate the look and feel of local rendering. Java Web Start and Java Bindings for OpenGL enable install-on- demand functionality as well as low level access to client graphics for all platforms. Powerful visualization services based on VTK and auto-generated by the WATT compiler [2] are accessible through a standard web API. Data is permanently stored on compute nodes while separate visualization nodes fetch data requested by clients, caching it locally to prevent unnecessary transfers. We will demonstrate application capabilities in the context of simulated charge density visualization within the VLab portal. In addition, we will address generalizations of our application to interact with a wider number of WATT services and performance bottlenecks. [1] Ananthuni, R., Karki, B.B., Bollig, E.F., da Silva, C.R.S., Erlebacher, G., "A Web-Based Visualization and Reposition Scheme for Scientific Data," In Press, Proceedings of the 2006 International Conference on Modeling Simulation and Visualization Methods (MSV

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

    ERIC Educational Resources Information Center

    Bell, Tamekia R.

    2012-01-01

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

  3. Successful Vocational Rehabilitation of Clients with Retinitis Pigmentosa.

    ERIC Educational Resources Information Center

    Taheri-Araghi, M.; Hendren, G.

    1994-01-01

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

  4. Brief Therapy with Difficult Clients. Hatherleigh Professional Education.

    ERIC Educational Resources Information Center

    Loar, Lynn

    1995-01-01

    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…

  5. 31 CFR 10.21 - Knowledge of client's omission.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 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...

  6. 31 CFR 10.21 - Knowledge of client's omission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 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...

  7. 31 CFR 10.21 - Knowledge of client's omission.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 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...

  8. 31 CFR 10.21 - Knowledge of client's omission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 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...

  9. Can Knowledge of Client Birth Order Bias Clinical Judgment?

    ERIC Educational Resources Information Center

    Stewart, Allan E.

    2004-01-01

    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…

  10. 32 CFR 776.4 - Attorney-client relationships.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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,...

  11. 42 CFR 483.420 - Condition of participation: Client protections.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Client protections. 483... FACILITIES Conditions of Participation for Intermediate Care Facilities for the Mentally Retarded § 483.420 Condition of participation: Client protections. (a) Standard: Protection of clients' rights. The...

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

    ERIC Educational Resources Information Center

    Stalikas, Anastassios; Fitzpatrick, Marilyn

    1995-01-01

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

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

    ERIC Educational Resources Information Center

    Draba, Robert; Marshall, Brent

    2012-01-01

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

  14. 37 CFR 10.84 - Representing a client zealously.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client... Office Code of Professional Responsibility § 10.84 Representing a client zealously. (a) A practitioner shall not intentionally: (1) Fail to seek the lawful objectives of a client through reasonably...

  15. Developing Individualized Behavior Change Goals with Clients: A Procedure.

    ERIC Educational Resources Information Center

    Weigel, Richard G.; Uhlemann, Max R.

    This document reviews 10 specific and sequential steps which have emerged as being particularly effective in assisting clients in developing individualized behavior change goals in psychotherapy. The therapist and client typically work through these steps together near the beginning of treatment, but only after the client has had the opportunity…

  16. Impact of Client Suicide on Practitioner Posttraumatic Growth

    ERIC Educational Resources Information Center

    Munson, Joseph Simon

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Van Dover, Leslie J.

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

  18. A Network Client Using the Gopher Information Discovery Protocol

    1993-10-05

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

  19. Counselor Interventions Preceding Client Laughter in Brief Therapy.

    ERIC Educational Resources Information Center

    Falk, Dana R.; Hill, Clara E.

    1992-01-01

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

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

    ERIC Educational Resources Information Center

    Bachrach, Kenneth M.; Zautra, Alex

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

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

    ERIC Educational Resources Information Center

    Krumer-Nevo, Michal; Lev-Wiesel, Rachel

    2005-01-01

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

  2. WSGOPHER. A Network Client Using the Gopher Information Discovery Protocol

    SciTech Connect

    Brooks, D.L.

    1993-10-05

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

  3. 37 CFR 11.113 - Organization as client.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  4. 37 CFR 11.113 - Organization as client.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  5. Educating Therapists in Training about Clients' Expectations of Treatment.

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

    Hsieh, Chang-Ming

    2012-01-01

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

  7. 14 CFR 1261.317 - Attorney-client privilege.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Attorney-client privilege. 1261.317 Section... Injury or Death-Accruing On or After January 18, 1967 § 1261.317 Attorney-client privilege. (a) Attorneys... traditional attorney-client relationship with the employee with respect to application of the...

  8. 37 CFR 10.67 - Settling similar claims of clients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... clients. 10.67 Section 10.67 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE... Office Code of Professional Responsibility § 10.67 Settling similar claims of clients. A practitioner who represents two or more clients shall not make or participate in the making of an aggregate settlement of...

  9. 37 CFR 10.78 - Limiting liability to client.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Limiting liability to client... Office Code of Professional Responsibility § 10.78 Limiting liability to client. A practitioner shall not attempt to exonerate himself or herself from, or limit his or her liability to, a client for his or...

  10. 45 CFR 1639.4 - Permissible representation of eligible clients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Permissible representation of eligible clients... CORPORATION WELFARE REFORM § 1639.4 Permissible representation of eligible clients. Recipients may represent an individual eligible client who is seeking specific relief from a welfare agency....

  11. 32 CFR 776.33 - Client under a disability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  12. 42 CFR 483.420 - Condition of participation: Client protections.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Client protections. 483... FACILITIES Conditions of Participation for Intermediate Care Facilities for the Mentally Retarded § 483.420 Condition of participation: Client protections. (a) Standard: Protection of clients' rights. The...

  13. Is Child Sexual Abuse Declining? Evidence from a Population-Based Survey of Men and Women in Australia.

    ERIC Educational Resources Information Center

    Dunne, Michael P.; Purdie, David M.; Cook, Michelle D.; Boyle, Frances M.; Najman, Jake M.

    2003-01-01

    A study examined age-cohort differences of self-reported child sexual abuse (CSA) experiences of 1,784 Australian adults. CSA was reported significantly less by younger males than older males. Among females who had intercourse before 16, older women were more likely to say they were an unwilling partner on the first occasion. (Contains…

  14. Family characteristics and long-term effects of childhood sexual abuse.

    PubMed

    Bhandari, Suchitra; Winter, David; Messer, David; Metcalfe, Chris

    2011-11-01

    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. PMID:22003952

  15. Substance Abuse/Use

    MedlinePlus

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

  16. Prevent Child Abuse America

    MedlinePlus

    ... Abuse Cases A recent report from the Indianapolis Star has revealed multiple occasions in which allegations of ... Gymnastics. In many of the cases that the Star investigated, complaint… Read more Who we are Prevent ...

  17. Sexual Abuse of Children.

    ERIC Educational Resources Information Center

    Csapo, Marg

    1988-01-01

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

  18. Prescription Drug Abuse

    MedlinePlus

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that was ... prescription drugs can lead to addiction. These include narcotic painkillers, sedatives, tranquilizers, and stimulants. Every medicine has ...

  19. Alcoholism and Alcohol Abuse

    MedlinePlus

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

  20. Safety and abuse testing

    NASA Technical Reports Server (NTRS)

    Younger, G.

    1978-01-01

    A series of abuse tests on large lithium thionyl chloride cells was initiated. Performance data obtained in testing rectangular 2,000 and 10,000 ampere-hour cells are discussed and graphically presented.

  1. The Arab Muslim client: implications for anesthesia.

    PubMed

    Sheets, D L; el-Azhary, R A

    1998-06-01

    The Arab Muslim client has unique cultural characteristics that should be incorporated into anesthetic care. In obtaining a preoperative assessment and consent, issues such as privacy, family roles, body language, group decision making, communication distances, and use of translators should be addressed. Intraoperatively, the need for modesty and the client's possible adherence to folk beliefs should also be recognized. Postoperatively, pain and overall needs assessments are a continuing challenge. The anesthetist must also understand the underlying family roles, the high correlation between fear and pain, and the possible coexisting folk beliefs when working within the labor and delivery setting. By addressing these unique issues, the anesthetist can provide appropriate and safe anesthetic care. PMID:9830857

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

    ERIC Educational Resources Information Center

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

    1999-01-01

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

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

    PubMed

    Parish-Plass, Nancy

    2008-01-01

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

  4. Synthetic cathinone abuse

    PubMed Central

    Capriola, Michael

    2013-01-01

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

  5. Do-Do abuse.

    PubMed

    Loosmore, S; Armstrong, D

    1990-08-01

    Three cases of prolonged abuse of Do-Do tablets, an over-the-counter remedy for "coughs, wheezing and breathlessness", are reported. They have an amphetamine-like action and were used as easily obtained amphetamine substitutes, in one case to relieve social anxiety. Withdrawal symptoms similar to those following cessation of amphetamines occurred in two cases. Do-Do tablets are CNS stimulants and their abuse may be accounted for by the fact that they perhaps affect amine neurotransmitters. PMID:2224380

  6. Vaccines for Drug Abuse

    PubMed Central

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

    2012-01-01

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

  7. Implementing a secure client/server application

    SciTech Connect

    Kissinger, B.A.

    1994-08-01

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

  8. Client-side Skype forensics: an overview

    NASA Astrophysics Data System (ADS)

    Meißner, Tina; Kröger, Knut; Creutzburg, Reiner

    2013-03-01

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

  9. Dietary intake in clients with chronic wounds.

    PubMed

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

    2011-01-01

    To assess relationships among food intake, anthropometrics, and wound severity, we studied 31 home care clients with pressure ulcers (PUs) or venous stasis ulcers (VSUs). Anthropometric variables (weight, height, waist circumference [WC]) were measured according to standard methodologies. Risk for PU development was assessed using the Braden Pressure Ulcer Risk Assessment score and wound severity according to the National Pressure Ulcer Advisory Panel. Three-day food records were analyzed to assess dietary adequacy. Adults with VSUs (65.8 ± 18.4 years) had a higher body mass index (48.1 vs. 25.9), WC (146.6 vs. 98.4 cm), and Braden score (20.2 vs. 17.5) than did those with PUs (67.8 ± 17.9 years) (p <0.05). Energy, protein, and zinc intake by diet alone did not meet estimated requirements in 41%, 32%, and 54.5% of clients, respectively. Intake by diet alone met the Estimated Average Requirement/Adequate Intake for all nutrients except fibre, vitamin D, vitamin E, vitamin K, folate, calcium, magnesium, and potassium. Nutrient supplementation resolved this for all nutrients except fibre, vitamin K, and potassium. In multivariate analysis, increasing wound severity was associated with decreased intakes of vitamin A, vitamin K, magnesium, and protein (r2=0.90, p<0.001). Optimizing nutrient intake may be an important strategy to promote wound healing and decrease wound severity in home care clients with chronic wounds. PMID:21645427

  10. Hsp90: Friends, clients and natural foes.

    PubMed

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

    2016-08-01

    Hsp90, a homodimeric ATPase, is responsible for the correct folding of a number of newly synthesized polypeptides in addition to the correct folding of denatured/misfolded client proteins. It requires several co-chaperones and other partner proteins for chaperone activity. Due to the involvement of Hsp90-dependent client proteins in a variety of oncogenic signaling pathways, Hsp90 inhibition has emerged as one of the leading strategies for anticancer chemotherapeutics. Most of Hsp90 inhibitors blocks the N terminal ATP binding pocket and prevents the conformational changes which are essential for the loading of co-chaperones and client proteins. Several other inhibitors have also been reported which disrupt chaperone cycle in ways other than binding to N terminal ATP binding pocket. The Hsp90 inhibition is associated with heat shock response, mediated by HSF-1, to overcome the loss of Hsp90 and sustain cell survival. This review is an attempt to give an over view of all the important players of chaperone cycle. PMID:27295069

  11. ADATSA Follow-Up Study of Extended Outpatient Care: A Comparison of 90 Days versus 180 Days of Outpatient Treatment for Clients of Washington State's Alcoholism and Drug Addiction Treatment and Support Act.

    ERIC Educational Resources Information Center

    Van Der Hyde, Vincent A.; And Others

    This study was designed to compare outcomes for two groups of alcohol and substance abuse clients (N=230): a control group assigned to regular 90 days of outpatient treatment, and an experimental group assigned to 180 days of extended outpatient care. Outcomes were compared in the following nine categories: (1) relapse, measured as reported…

  12. Perspectives on Adolescent Residential Substance Abuse Treatment: When Are Adolescents Done?

    PubMed Central

    Wisdom, Jennifer P.; Gogel, Leah P.

    2013-01-01

    Objectives The study evaluated responses from adolescents in substance abuse treatment, their parents, and treatment staff to the question of what constitutes treatment success. Methods Semistructured interviews were conducted with 28 adolescents, 30 parents, and 29 staff at three residential substance abuse treatment programs in two states. Data were coded and organized into themes by respondent type. Results Respondents reported knowing when treatment was no longer needed based on changes in adolescents’ substance use, treatment-related and other behaviors, and attitudes and character. A fourth category of responses indicated respondents’ ambiguity regarding successful completion of substance abuse treatment. Little concurrence was found among adolescents, parents, and treatment center staff to indicate criteria suggesting that discharge is appropriate. Conclusions Substance abuse treatment programs and their clients may benefit from ensuring that staff, parents, and adolescents are aware of treatment goals to promote more effective treatment and improve collaboration toward the adolescent’s recovery. PMID:20675841

  13. Narrative quality and disturbance pre- and post-emotion-focused therapy for child abuse trauma.

    PubMed

    Mundorf, Elisabeth S; Paivio, Sandra C

    2011-12-01

    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. PMID:22144230

  14. Abuse of aging caregivers: test of a nursing intervention.

    PubMed

    Phillips, Linda R

    2008-01-01

    Although most women find it difficult to provide care to an older family member, some women face additional challenges and health risks because the care recipient is abusive or aggressive toward them. This study tested a 12-week psychoeducative nursing intervention intended to decrease the frequency and intensity of physical and verbal/psychological aggression toward older caregiving wives and daughters by care recipients and improve selected abuse-related outcomes. The intervention, which focused on pattern identification, advocacy counseling, reframing of the caregiving situation, and nonconfrontational caregiving strategies, was individualized and highly interactive with emphasis placed on mutual problem solving and mutual planning. Subjects included women older than 50 who provided care to elders older than 55. Subjects were randomly assigned to group (intervention, N = 38; control, N = 45) and data collectors were "blinded" to group assignment. Findings indicated the intervention significantly reduced frequency of verbal/psychological aggression, and feelings of anger for caregivers providing care to fathers or husbands. It was not effective for caregivers providing care to mothers, and it did not reduce burden. Implications for nursing include raising awareness about the special vulnerabilities of older caregivers, providing provocative new information about the gender-based power dynamics in caregiving situations and underscoring the need for nurses to assume a stronger leadership role in building science with regard to family caregiving. PMID:18497592

  15. Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy

    PubMed Central

    Strathdee, Steffanie A.; Shoveller, Jean; Rusch, Melanie; Kerr, Thomas; Tyndall, Mark W.

    2009-01-01

    Objectives. We investigated the relationship between environmental–structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of “hot spots” for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estimate the relationship between environmental–structural factors and being pressured by a client into unprotected sexual intercourse. Results. In multivariate analyses, being pressured into having unprotected sexual intercourse was independently associated with having an individual zoning restriction (odds ratio [OR] = 3.39; 95% confidence interval [CI] = 1.00, 9.36), working away from main streets because of policing (OR = 3.01; 95% CI = 1.39, 7.44), borrowing a used crack pipe (OR = 2.51; 95% CI = 1.06, 2.49), client-perpetrated violence (OR = 2.08; 95% CI = 1.06, 4.49), and servicing clients in cars or in public spaces (OR = 2.00; 95% CI = 1.65, 5.73). Conclusions. Given growing global concern surrounding the failings of prohibitive sex-work legislation on sex workers' health and safety, there is urgent need for environmental–structural HIV-prevention efforts that facilitate sex workers' ability to negotiate condom use in safer sex-work environments and criminalize abuse by clients and third parties. PMID:19197086

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  17. Alcohol as a Response to Stress in Older Adults: A Counseling Perspective

    ERIC Educational Resources Information Center

    Hunter, I. Roy; Gillen, Mark C.

    2006-01-01

    The authors explore the relationship between stress and alcohol use in older adults. The importance for the counselor to determine the client-specific role of alcohol use, whether as a stress buffer or as a coping mechanism, is discussed. (Contains 1 table and 2 figures.)

  18. Provision of High-Quality Orientation and Mobility Services to Older Persons with Visual Impairments.

    ERIC Educational Resources Information Center

    Hill, M.-M.

    1991-01-01

    The provision of high quality orientation and mobility (O&M) services to older persons with visual impairments requires consideration of problems in attitudes, client characteristics, financial resources, inservice training, and the availability of age-appropriate assessment instruments. This paper discusses research on O&M interventions and…

  19. Motivational Strategies with Alcohol-Involved Older Adults: Implications for Social Work Practice

    ERIC Educational Resources Information Center

    Hanson, Meredith; Gutheil, Irene A.

    2004-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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