scholarly journals Comparative analysis of treatment conditions upon psychiatric severity levels at two years among justice involved persons

2016 ◽  
Vol 9 (1) ◽  
pp. 38-47 ◽  
Author(s):  
John M Majer ◽  
Hannah M Chapman ◽  
Leonard A Jason
Keyword(s):  
Substance Use ◽  
Residential Treatment ◽  
Substance Use Disorders ◽  
Community Based ◽  
Content Type ◽  
Oxford House ◽  
Treatment Conditions ◽  
Psychiatric Severity ◽  
Dual Diagnoses ◽  
Severity Levels

Purpose – The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses. Design/methodology/approach – A randomized clinical trial examined treatment conditions among justice involved persons with substance use disorders who reported high baseline levels of psychiatric severity indicative of diagnosable psychiatric comorbidity. Participants (n=39) were randomly assigned to one of three treatment conditions upon discharge from inpatient treatment for substance use disorders: a professionally staffed, integrated residential treatment setting (therapeutic community), a self-run residential setting (Oxford House), or a treatment-specific aftercare referral (usual care). Levels of psychiatric severity, a global estimate of current psychopathological problem severity, were measured at two years as the outcome. Findings – Participants randomly assigned to residential conditions reported significant reductions in psychiatric severity whereas those assigned to the usual care condition reported significant increases. There were no significant differences in psychiatric severity levels between residential conditions. Research limitations/implications – Findings suggest that cost-effective, self-run residential settings such as Oxford Houses provide benefits comparable to professionally run residential integrated treatments for justice involved persons who have dual diagnoses. Social implications – Results support the utilization of low-cost, community-based treatments for a highly marginalized population. Originality/value – Little is known about residential treatments that reduce psychiatric severity for this population. Results extend the body of knowledge regarding the effects of community-based, residential integrated treatment and the Oxford House model.

Clinical trials and American Indians/Alaska Natives with substance use disorders: identifying potential strategies for a new cultural-based intervention

2014 ◽  
Vol 13 (4) ◽  
pp. 175-178 ◽  
Author(s):  
Daniel L. Dickerson ◽  
Kamilla L. Venner ◽  
Bonnie Duran
Keyword(s):  
Clinical Trial ◽  
Substance Abuse ◽  
Clinical Trials ◽  
Substance Use ◽  
Focus Groups ◽  
Substance Use Disorders ◽  
American Indians ◽  
Alaska Natives ◽  
Treatment Setting ◽  
Content Type

Purpose – The purpose of this paper is to address a significant public mental health disparity affecting American Indians/Alaska Natives (AI/ANs): the shortage of clinical trials research analyzing the benefits of AI/AN traditional-based treatments, e.g. drumming. Design/methodology/approach – A total of four focus groups were conducted among outpatient and inpatient AI/AN substance abuse patients and providers serving AI/ANs. The purpose of these focus groups was to obtain insights relating to the recent challenges of conducting a clinical trial within the outpatient treatment setting seeking to analyze the benefits of a new substance abuse treatment intervention utilizing drumming for AI/ANs [Drum-assisted Recovery Therapy for Native Americans (DARTNA)] and to obtain recommendations to successfully conduct a similar study within an inpatient treatment setting. Findings – The most prevalent barriers to conducting a clinical trial within an outpatient setting were transportation and child care issues. Recommendations were obtained with regard to optimizing recruitment and retention for a future study within an inpatient setting. Originality/value – This research offers the field rare information that helps toward identifying strategies to successfully conduct clinical trials investigating the benefits of culturally-appropriate treatments for AI/ANs with substance use disorders.

scholarly journals Substance Use Disorders in Men Presenting to a Psychosexual Clinic

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Ravi Philip Rajkumar
Keyword(s):  
Substance Use ◽  
Family History ◽  
Sexual Dysfunction ◽  
Substance Use Disorders ◽  
Substance Dependence ◽  
Causal Relation ◽  
Alcohol Use Disorders ◽  
Community Based ◽  
History Of ◽  
A Current

Introduction. Substance use disorders (SUDs) are commonly associated with a variety of psychiatric disorders. Community-based studies have found a significant association between SUDs and sexual dysfunction in men, with a possible causal relation in the case of nicotine. Methods. The case records of 105 men presenting to a clinic for patients with psychosexual disorders were reviewed. Men with and without comorbid SUDs were compared in terms of demographic, clinical, and familial variables. Results. 25 of the 105 men (23.8%) had a lifetime diagnosis of SUD, and 19 (18.1%) had a current SUD. The commonest substances involved were nicotine (n = 21, 20%) and alcohol (n = 9, 9.5%). Men with comorbid SUDs were more likely to report a family history of substance dependence, particularly alcoholism. Single men with SUDs were more likely to have a comorbid mood disorder. Conclusion. SUDs, particularly nicotine and alcohol use disorders, are common comorbidities in patients with psychosexual disorders. Identifying and treating these disorders in this population are important aspects of management.

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

2021 ◽  
Vol 23 (1) ◽  
pp. 39-52
Author(s):  
Michele Schmitter ◽  
Jeroen Vermunt ◽  
Eric Blaauw ◽  
Stefan Bogaerts
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Latent Class ◽  
Mental Health Problems ◽  
Treatment Approach ◽  
Future Research ◽  
Content Type ◽  
Forensic Patients ◽  
Axis I ◽  
Forensic Psychiatric

Purpose Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.

Psychosocial Treatment Approaches for Substance Use

2018 ◽  
Author(s):  
Lynn McFarr ◽  
Julie Snyder ◽  
Lisa Benson ◽  
Rachel Higier
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Meta Analysis ◽  
Contingency Management ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
Community Based ◽  
Theoretical Orientations ◽  
Psychosocial Treatments ◽  
Community Based Programs

Multiple psychosocial treatments for substance-use disorders have been studied for efficacy. A recent meta-analysis indicates that psychosocial interventions are effective across multiple types of substances used. In the case of opiates, psychosocial interventions combined with medication appear to be the most effective. Many studies further agree that psychosocial interventions are an integral and necessary part of treating substance-use disorders. Although theoretical orientations may differ across psychosocial treatments, they have several principles and practices in common. All involve talk therapy or talk in communities as a way to clarify triggers, build commitment, and improve accountability. Many also target addiction behaviors and work to develop alternative contingencies to reduce or eliminate use. Finally, targeting repeated performance (or building “chains of committed behavior”) decreases the likelihood of relapse. This chapter discusses the most frequently studied and employed psychosocial treatments for substance use including CBT, motivational interviewing, contingency management, mindfulness, and community-based programs.

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