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MENTAL HEALTH CLINICIANS' 12-STEP REFERRAL PRACTICES WITH DUALLY DIAGNOSED CLIENTS 心理健康临床医生的12步转诊实践与双重诊断的客户
Pub Date : 2005-07-01 DOI: 10.2190/4VXR-74QE-964D-0XKB
Cherie L Villano, A. Laudet, A. Rosenblum, C. Fong, S. Magura, T. Betzler, Howard S. Vogel, E. Knight
This study examines mental health clinicians’ beliefs about dually diagnosed clients’ self-efficacy and capacity for recovery and attitudes toward and referrals to traditional 12-step groups for such clients. Clinicians evidence moderate confidence in dually diagnosed clients’ self-efficacy and capacity for recovery, positive attitudes toward 12-step groups, but rarely refer dually diagnosed clients to traditional 12-step groups. Clinicians’ beliefs that dually diagnosed clients were unlikely to achieve total recovery are associated with less frequent 12-step referrals. Findings support the need for a dualfocus 12-step group that addresses both substance use and mental health disorders—such as Double Trouble in Recovery (DTR)—and the importance of staff training on client empowerment for recovery, including 12-step utilization. *This study was funded by NIDA Grant #R01DAO15912 (PI: S. Magura).
本研究考察了心理健康临床医生对双重诊断患者的自我效能感和康复能力的看法,以及对传统的12步治疗小组的态度和转介。临床医生对双重诊断患者的自我效能感和康复能力有适度的信心,对12步治疗小组持积极态度,但很少将双重诊断患者转介到传统的12步治疗小组。临床医生认为双重诊断的病人不太可能完全康复,这与较少的12步转诊有关。研究结果表明,有必要建立一个双重重点的12步小组,既解决药物使用问题,也解决精神健康障碍问题——如康复中的双重麻烦(DTR)——以及对员工进行康复授权培训的重要性,包括12步利用。*本研究由NIDA资助项目#R01DAO15912 (PI: S. Magura)资助。
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引用次数: 8
Destigmatization of HIV: Progress or Regress? 艾滋病污名化:进步还是倒退?
Pub Date : 2005-07-01 DOI: 10.2190/VK83-87L0-K726-67GH
I. Coulter, C. Maida
The HIV epidemic has resulted in a renewed interest by social scientists in stigmatization and in a corresponding need to reconceptualize stigma, especially its relationship to power. While the professions have some power to control stigma, the emergence of self-help and mutual aid groups such as those founded by the gay activists involved in the AIDS epidemic, has shown that patients are not simply passive victims in the process of stigmatization. This new approach to stigma raises the questions: does destigmatization occur? What would constitute evidence of such a process? This article examines the change from seeing HIV as an epidemic and as a fatal disease to seeing it as a chronic illness—a possible example of destigmatization in action, noting the basic problems and promise of this process.
艾滋病毒的流行使社会科学家重新关注污名化问题,因此需要重新界定污名化,特别是它与权力的关系。虽然这些职业有一些控制污名的力量,但自助和互助团体的出现,例如由参与艾滋病流行病的同性恋积极分子建立的团体,表明病人在污名化的过程中不仅仅是被动的受害者。这种针对污名化的新方法提出了以下问题:去污名化会发生吗?这一过程的证据是什么?本文考察了从将艾滋病毒视为一种流行病和致命疾病到将其视为一种慢性疾病的变化——这可能是行动中去污名化的一个例子,并指出了这一进程的基本问题和前景。
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引用次数: 4
PROVIDING NORMATIVE FEEDBACK ON THE INTERNET TO STIMULATE SELF-EVALUATION OF ALCOHOL, TOBACCO, AND CANNABIS USE 在互联网上提供规范性反馈,以促进对酒精、烟草和大麻使用情况的自我评价
Pub Date : 2005-07-01 DOI: 10.2190/5X95-18BJ-63M6-218A
Steven W. Villafranca, K. Weingardt, K. Humphreys, J. Cunningham
An internet application was created to provide users with personalized normative feedback regarding their use of alcohol, tobacco, and cannabis. Ninety-nine participants completed the alcohol assessment, 52 completed the cannabis assessment, and 60 completed the smoking assessment. Respondents expressed interest in the expansion of the site to include illicit use of prescription medications, hallucinogens, and methamphetamine. As far as the authors know, the present study, at time of preparation of this manuscript, is the first to examine e-mail broadcasting as a recruitment strategy, and to use normative feedback regarding cannabis usage over the internet. The use of personalized feedback over the internet offers an extremely costeffective approach to helping substance users who may not access traditional treatment services.
创建了一个互联网应用程序,为用户提供关于他们使用酒精、烟草和大麻的个性化规范反馈。99名参与者完成了酒精评估,52名完成了大麻评估,60名完成了吸烟评估。答复者表示有兴趣将该场所扩大到包括非法使用处方药、致幻剂和甲基苯丙胺。据作者所知,目前的研究,在准备这份手稿的时候,是第一个检查电子邮件广播作为一种招聘策略,并使用规范的反馈关于大麻在互联网上的使用。在互联网上使用个性化反馈为帮助可能无法获得传统治疗服务的药物使用者提供了一种极具成本效益的方法。
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引用次数: 1
MY MID-LIFE CRISIS AND AFTERWARD: VARIOUS HERMENEUTICAL ANALYSES OF LIVED EXPERIENCES: PART 3 - MEN'S WORK AND SOME THEORETICAL FRAMEWORKS 我的中年危机及其后:生活经验的各种解释学分析:第3部分:男人的工作和一些理论框架
Pub Date : 2005-07-01 DOI: 10.2190/5UK2-0M3Q-C3AN-0CUJ
E. Barton
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引用次数: 1
A PROPOSED MODEL FOR INTEGRATING MEDICAL AND BEHAVIORAL PRACTICES 一个整合医疗和行为实践的拟议模型
Pub Date : 2005-07-01 DOI: 10.2190/52GL-FFV2-N8CX-VJP8
I. Montoya, D. Bell
Background: To present four treatment models and evaluate their effectiveness in reducing HIV risk for high-risk patients. Methods: Four models are described: 1) Traditional Medical Practice Model; 2) Physician Management Model; 3) Integrated Provider-Patient Management Model; and 4) Integrated Network Treatment Model. Data from a study of 168 drug user and nonuser social networks are used to simulate the effects of each practice model on HIV transmission and seroconversion. Survey respondents described sexual and injection risk behaviors and partners for the last 30 days. An HIV risk index was computed for each individual, combining reported risk behaviors, HIV prevalence rates for partners and HIV transmission probabilities for each risk behavior. To evaluate the 4 models, 1 person from each network was selected as a “patient” and a simulation was performed to estimate the number of network members who would seroconvert to HIV over a 10-year period as affected by prevention efforts within each model. Results: The simulation projected that 99.7 persons in the social networks studied would seroconvert over 10 years without any intervention. The Integrated Network Treatment Model produced the greatest reduction in risk, producing 12.6 fewer seroconversions over 10 years. Conclusions: The greater the patient involvement in prevention-oriented interventions, the greater the effect. The most pronounced effect occurs when a patient’s unique social network is included in the prevention effort. *This study is supported by a grant from the National Institute on Drug Abuse #R01-DA11414. Opinions expressed herein are solely those of the authors.
背景:介绍四种治疗模式,并评价其对降低高危患者HIV风险的效果。方法:描述四种模型:1)传统医学实践模型;2)医师管理模式;3)综合医患管理模式;4)综合网络治疗模式。来自168个吸毒者和非吸毒者社交网络的研究数据被用来模拟每种实践模式对艾滋病毒传播和血清转化的影响。调查对象描述了过去30天内的性行为和注射风险行为以及伴侣。结合报告的危险行为、伴侣的艾滋病毒流行率和每种危险行为的艾滋病毒传播概率,计算每个人的艾滋病毒风险指数。为了评估这4个模型,从每个网络中选择1人作为“患者”,并进行模拟,以估计受每个模型中预防工作的影响,在10年内将服务转化为艾滋病毒的网络成员数量。结果:模拟预测,在没有任何干预的情况下,研究的社会网络中99.7人将在10年内服务转换。综合网络治疗模式最大程度地降低了风险,在10年内减少了12.6%的血清转换率。结论:患者参与预防干预越多,效果越好。当患者独特的社交网络被纳入预防工作时,效果最为显著。*本研究由国家药物滥用研究所资助,编号R01-DA11414。此处表达的观点仅代表作者的观点。
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引用次数: 0
MY MID-LIFE CRISIS AND AFTERWARD: VARIOUS HERMENEUTICAL ANALYSES OF LIVED EXPERIENCES: PART 2 - HEART CHALLENGES AND SOCIAL SUPPORT 我的中年危机和之后:生活经验的各种解释学分析:第2部分-心脏挑战和社会支持
Pub Date : 2005-07-01 DOI: 10.2190/AW1M-CJJ2-F8GB-Q42F
E. Barton
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引用次数: 0
An Initial Imprinting of the Self-Help Groups of Narcotics Anonymous and Alcoholics Anonymous in Greece: The Demographic Facts 希腊匿名麻醉品和匿名酗酒者自助团体的初步印记:人口统计事实
Pub Date : 2005-07-01 DOI: 10.2190/B064-7Q58-32T4-8585
Raftopoulos Antonis, Flora Katerina
Although the self-help groups of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) in Greece count more than 20 years of life, the related research in the field in this country is limited. This study is the first in this context. The study was conducted in a 16-month period (September 2004–January 2006) in the following towns: Athens, Thessaloniki, Serres, Nafplio, Iraklio, and Katerini. It was carried out in the frame of a diplomatic study in the postgraduate program of Social and Clinical Psychology of Addictions and Psychosocial Problems at Aristotle University of Thessaloniki under the supervision of Phoebus Zafiridis. The research aims to provide a general picture of AA and NA groups in Greece at the present time. We profile the people who participate in NA and AA groups. Specifically, this article presents an analysis of the answers of the 18 first items of a questionnaire on the demographic characteristics of AA and NA members. Findings are compared to those provided by the central organizations of AA and NA as well as similar official therapeutic programs in Greece. Our final sample includes 22 members of AA groups and 60 members of NA groups. The approach to the members proved to be the most difficult and important part of the research. The participants responded to 55 questions voluntarily and anonymously. Statistical analysis was conducted with statistical tool SPSS-12, in some cases augmented by qualitative Thematic Analysis. The findings describe the characteristics and main demographic features of our sample, specifically: sex, age, nationality/citizenship, denomination, marital
尽管希腊的匿名戒酒会(AA)和匿名戒毒会(NA)的自助团体都有20多年的生命,但该国在这一领域的相关研究有限。这是在这方面的首次研究。这项为期16个月的研究(2004年9月至2006年1月)在以下城镇进行:雅典、塞萨洛尼基、塞雷斯、纳夫普利奥、伊拉克和卡特里尼。该研究是在塞萨洛尼基亚里士多德大学成瘾和心理社会问题社会和临床心理学研究生课程的外交研究框架内进行的,由Phoebus Zafiridis监督。该研究旨在提供目前希腊AA和NA团体的总体情况。我们对参加匿名戒酒会和嗜酒者互戒会的人进行分析。具体而言,本文对AA和NA成员人口特征调查问卷的前18个问题的答案进行了分析。研究结果与AA和NA的中心组织以及希腊类似的官方治疗项目提供的结果进行了比较。我们的最终样本包括22名AA组成员和60名NA组成员。成员的方法被证明是研究中最困难和最重要的部分。参与者自愿匿名回答了55个问题。统计分析是用统计工具SPSS-12进行的,在某些情况下还辅以定性专题分析。调查结果描述了我们样本的特征和主要人口特征,特别是:性别、年龄、国籍/公民身份、教派、婚姻
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引用次数: 1
Effect of the Temporary Assistance for Needy Families (TANF) Work Mandate among Drug Users 贫困家庭临时援助(TANF)工作任务对吸毒者的影响
Pub Date : 2005-07-01 DOI: 10.2190/K703-V540-2768-0683
I. Montoya
The present study examined the independent effects of work-activityparticipation status (whether a welfare recipient is required to work or is exempt from such requirements) on employment, receipt of cash welfare benefits known as Temporary Assistance for Needy Families (TANF), and psychological functioning. The sample consisted of 228 female TANF recipients, 75 of whom were chronic drug users. Participants were administered self-report instruments to measure self-perceived work skills and barriers to employment, drug use, employment-related variables, TANF receipt, and psychological functioning. Contrary to the tested study hypotheses, results show that the work mandate was not significantly related to employment and was positively related to TANF receipt. The work mandate showed no effect on psychological distress. Aside from initial psychological functioning, selfperceived employment barriers had the only significant impact on change in psychological functioning. Self-perceived office skills was a significant predictor of higher wages earned and less time to employment. It is concluded that training recipient in office skills training while continuing to address other barriers may be the best approach to accomplishing the goals of welfare reform. INTRODUCTION The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) established a new welfare cash assistance program known as Temporary Assistance for Needy Families, or TANF. PRWORA was enacted in order to curb welfare dependency by setting a five-year lifetime maximum on *This study was supported by grant #R01-DA-11414 from the National Institute on Drug Abuse. Opinions expressed herein are solely those of the author. 177 2005, Baywood Publishing Co., Inc. recipients’ eligibility for federally funded benefits. In conjunction with this federal time limit, states have been given the responsibility of requiring able-boded recipients of TANF to participate in “work activities,” such as paid employment, volunteer work, classroom training, and on-the-job training, in exchange for cash benefits. Recipients face financial sanctions for non-compliance. Whereas the first wave of welfare reform in 1996 required 50% of TANF families to be engaged in work activities by 2002, a newly proposed policy may require as many as 70% of TANF families to participate in work activities by the year 2007 [1]. The number of qualifying work activities would also be decreased, and the number of hours recipients are required to participate in work activities would increase. In light of these proposed changes, it is crucial to examine the effects of the TANF work mandate to this point. Understandably, studies of the work mandate and welfare reform in general have largely focused on employment rates and welfare receipt. These studies have generally found that welfare reform and the work mandate have been successful in moving welfare recipients into employment, though studies of specific outcomes have
本研究考察了工作-活动参与状态(福利接受者是否被要求工作或免于这种要求)对就业、领取现金福利(即贫困家庭临时援助)和心理功能的独立影响。样本包括228名女性TANF接受者,其中75名是慢性吸毒者。参与者使用自我报告工具来测量自我感知的工作技能和就业障碍、药物使用、就业相关变量、TANF收据和心理功能。与经检验的研究假设相反,结果表明,工作任务与就业不显著相关,与TANF收入呈正相关。工作任务对心理困扰没有影响。除了最初的心理功能外,自我认知就业障碍对心理功能的变化有显著影响。自我认知的办公室技能是高工资和短就业时间的重要预测指标。结论是,在继续解决其他障碍的同时,对受助人进行办公室技能培训可能是实现福利改革目标的最佳途径。1996年的《个人责任与工作机会协调法案》(PRWORA)建立了一个新的福利现金援助项目,称为贫困家庭临时援助,简称TANF。PRWORA的颁布是为了通过设定5年的寿命上限来抑制对福利的依赖。这项研究得到了国家药物滥用研究所#R01-DA-11414基金的支持。此处表达的观点仅代表作者的观点。177 2005, Baywood Publishing Co., Inc.受助人获得联邦资助福利的资格。与联邦规定的时间限制相结合,各州有责任要求身体健全的TANF受助人参加“工作活动”,如有偿就业、志愿者工作、课堂培训和在职培训,以换取现金福利。如果不遵守规定,接受者将面临经济制裁。1996年的第一波福利改革要求到2002年50%的TANF家庭参加工作活动,而一项新提出的政策可能要求到2007年多达70%的TANF家庭参加工作活动[1]。合格工作活动的数目也将减少,受助人参加工作活动的时数将增加。鉴于这些拟议的变化,至关重要的是要审查该基金工作任务到目前为止的影响。可以理解的是,关于工作任务和福利改革的研究基本上集中在就业率和福利收入上。这些研究普遍发现,福利改革和工作授权在推动福利接受者就业方面取得了成功,尽管对具体结果的研究产生了不同的结果。由于TANF要求所有健全的受助人参加工作活动,只有在TANF之前进行的研究才能将受助人随机分配到工作和非工作要求组。一项这样的研究将有受抚养儿童家庭援助(AFDC, TANF之前的现金援助计划)的受助人随机分配到强制性和非强制性的福利工作计划中,这些计划的制裁和工作要求与当前的TANF计划相似[2]。这项研究是在两个城市进行的,密歇根州的大急流城和加利福尼亚州的里弗赛德。对大急流城样本的分析显示,那些被强制参加该计划的人报告的就业率和福利收入相似,但收入明显高于那些没有被强制参加的人。然而,来自Riverside样本的结果表明,对于单亲父母来说,福利工作任务可能对就业、工资或福利收入没有明显影响(Riverside的强制双亲家庭确实报告了就业和收入的增加)。作者认为,结果的差异可能是由于劳动力市场的差异和执行政策的严格程度。另一项关于AFDC下的工作任务的研究是一项为期两年的随机分配研究,研究了洛杉矶县21,000名受助人对“工作优先增益”的回应[3]。结果显示,参加“从福利到工作”计划的人在两年的时间里受雇的可能性要高出10%。此外,接受工作优先增益计划的受助者的两年收入显著高于未接受该计划的受助者;单亲家庭的收入平均高出26%,双亲家庭的收入平均高出31%。尽管有这些令人鼓舞的发现,但研究发现,参加就业优先增益计划的人的平均总收入仅比不需要工作的人高2%,为178 /蒙托亚
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引用次数: 0
COMPARISONS: PROFESSIONALLY-DIRECTED AND SELF-DIRECTED INTERNET GROUPS FOR WOMEN WITH BREAST CANCER 比较:针对乳腺癌女性的专业指导和自我指导的网络小组
Pub Date : 2005-03-01 DOI: 10.2190/GE85-J31W-XJV7-LB9L
M. Lieberman, M. Golant, Andre Winzelberg, F. McTavish, D. Gustafson
Psychological interventions for women coping with breast cancer (BC) have embraced the idea that the open expression of negative emotions is beneficial. This study asks if there is a difference in the amount of negative emotions expressed by members of professional-led compared to self-directed on-line support groups. To answer this question we examined the support group messages written by participants of 11 Internet delivered BC support groups. Seven were facilitated by professionals and four were self-directed. We used two text analysis software programs, LWIC and PCAD, to categorize the interaction. Groups conducted by professionals expressed significantly more negative emotions, anxiety, hostility, and depression and fewer positive emotions than self-directed groups. These differences suggest what leaders encourage, reinforce, model, and may influence members’ behaviors. Professionals encourage the further expression of such emotions, whereas lay leaders more often respond with support and reassurance to members who express painful emotions.
针对乳腺癌妇女的心理干预已经接受了这样一种观点,即公开表达负面情绪是有益的。这项研究询问,与自我导向的在线支持团体相比,专业导向的在线支持团体成员所表达的负面情绪的数量是否存在差异。为了回答这个问题,我们研究了11个互联网BC支持小组的参与者所写的支持小组信息。其中七名由专业人士协助,四名是自我指导的。我们使用两个文本分析软件程序LWIC和PCAD对交互进行分类。与自我指导组相比,由专业人士指导的小组明显表现出更多的消极情绪、焦虑、敌意和抑郁,积极情绪较少。这些差异表明了领导者鼓励、强化、示范和可能影响成员行为的方式。专业人士鼓励进一步表达这种情绪,而非专业领导往往会对表达痛苦情绪的成员给予支持和安慰。
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引用次数: 10
THE CODE OF GRACE: A CULTURAL APPROACH TO 12-STEP FELLOWSHIP PROGRAMS IN HUNGARY 优雅的准则:匈牙利12步奖学金项目的文化方法
Pub Date : 2005-03-01 DOI: 10.2190/UQWD-57EU-48RK-6AE5
G. Kelemen, Marta B. Erdos
This article proposes a cultural approach to Hungarian self-help and self-care groups for drug and alcohol addicts. Authors rely on previous results of a qualitative data analysis in outlining a new code of communication, representing differing values, norms, and attitudes of the speech community of sober addicts. Functionally, the code of grace facilitates integration of human experiences that would count as taboos in the dominant culture. Major constituents and interrelations of the code are described.
这篇文章提出了匈牙利吸毒和酗酒者自助和自我保健小组的文化方法。作者依靠先前的定性数据分析结果,概述了一种新的交流代码,代表了清醒成瘾者语言社区的不同价值观、规范和态度。从功能上讲,优雅准则促进了人类经验的整合,而这些经验在主流文化中被视为禁忌。描述了该规范的主要组成部分和相互关系。
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引用次数: 3
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