An Exploratory Investigation of Rehabilitation Counselors' Perceived Readiness to Undertake Substance Use Disorder Screening in Vocational Rehabilitation

Screening for problems related to substance use occurs routinely in many systems of care and human services. However, at present, there is no universally accepted process for performing such a screening in the state-federal vocational rehabilitation system. This exploratory study analyzes data obtained from rehabilitation counselors participating in a substance use disorder screening implementation initiative. The responses provide preliminary information regarding rehabilitation counselors' perceived readiness to undertake such an initiative and potential barriers to its successful implementation.

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Recovery-informed Theory: Situating the Subjective in the Science of Substance Use Disorder Recovery

Journal of Recovery Science ◽

10.31886/jors.13.2019.38 ◽

2019 ◽

Vol 1 (3) ◽

pp. 1-15 ◽

Cited By ~ 5

Author(s):

Austin M Brown ◽

Robert D Ashford

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Systems Of Care ◽

Grand Theory ◽

Recovery Strategies ◽

Recovery Capital ◽

New Ideas

As recovery from substance use disorder becomes more than a mere quantifiable outcome, there exists a need to discuss and propose the underlying theoretical constructs that ultimately describe and identify the science of recovery. In this abstract undertaking, we propose an initial formulation of a grand theory of recovery science, built upon the seminal theories of recovery capital, recovery-oriented systems of care, and socioecological theory. This grand theory - labeled recovery-informed theory (RIT) - states that successful long-term recovery is self-evident and is a fundamentally emancipatory set of processes. This paper will discuss, analyze, and explore this theory as it is situated within the larger substance use, misuse, and disorder contexts. The uses, implications, and benefits of RIT as an organizing point of inquiry for recovery science are also discussed. By promoting the role of subjective recovery experience in the formulation of the study of recovery, it may be possible to summon new ideas, metrics, and strategies that can directly address substance use disorders in society. Adopting a recovery-informed understanding as follows from this grand theory may allow individual recovery and wellness trajectories to be explored, adapted, and modified to exemplify person-centered and individualized recovery strategies.

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Predictors of Successful Closure in the State-Federal Vocational Rehabilitation System: Findings from a Sample of Persons with Disability and Substance Use Disorders

Journal of Applied Rehabilitation Counseling ◽

10.1891/0047-2220.39.2.30 ◽

2008 ◽

Vol 39 (2) ◽

pp. 30-36 ◽

Cited By ~ 5

Author(s):

Mary McAweeney ◽

Joseph Keferl ◽

Dennis Moore ◽

Joseph Wagner

Keyword(s):

Substance Use ◽

Retrospective Study ◽

Drug Abuse ◽

Vocational Rehabilitation ◽

Substance Use Disorders ◽

Rehabilitation Service ◽

Accurate Assessment ◽

Secondary Diagnosis ◽

Rehabilitation System ◽

Work Disincentives

Numerous studies have focused on the predictors of successful closure of state-federal vocational rehabilitation (VR) applicants. However, there appears to be only one study focused solely on the predictors of employment with persons who were deemed eligible for services based on their alcohol or drug abuse diagnosis. This retrospective study examined the predictors of employment among this population. A sample of 940 persons with a primary or secondary diagnosis of alcohol or drug abuse and a closure status of 26 or 28 was randomly selected from the 2005 Rehabilitation Service Administration (RSA) 911 data. A combination of consumer characteristics, VR service variables, and work disincentives predicted employment. Knowledge of these predictors suggests ways for counselors to better serve consumers via accurate assessment, appropriate planning, and efficient case coordination.

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Community Rehabilitation and Hospitalizations Among People With Chronic Psychotic Disorder: Is There a Differential Association by Co-occurring Substance Use Disorder?

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.621259 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sharon Florentin ◽

Paola Rosca ◽

Tali Bdolah-Abram ◽

Yehuda Neumark

Keyword(s):

Mental Health ◽

Substance Use ◽

Vocational Rehabilitation ◽

Substance Use Disorder ◽

Repeated Measures ◽

Annual Number ◽

Rehabilitation Services ◽

Case Register ◽

Community Rehabilitation

Objective: Co-occurrence of chronic psychotic disorders and substance use disorder (SUD) is clinically challenging and increasingly prevalent. In 2000, legislation was passed in Israel to foster rehabilitation and integration in the community of persons with mental health disorders. In 2010, the need to allocate resources for patients with these co-occurring disorders (COD) was officially recognized. Yet, most rehabilitation services were not specifically designed for COD. This study examines the relationship between duration of community rehabilitation and number of psychiatric hospitalization days among persons with/without COD in Israel.Methods: Data from the National Psychiatric Case Register on 18,684 adults with schizophrenia/schizoaffective disorders hospitalized in 1963–2016, was merged with data from the Israel Mental Rehabilitation Register. Associations and interactions between COD-status (COD/non-COD), time-period (Period1: 2001–2009, Period2: 2010–2016), duration of housing or vocational rehabilitation on hospitalization days per year were analyzed using repeated-measures ANOVA.Results: The proportion of non-COD chronic psychotic patients who received rehabilitation services increased from 56% in Period1 to 63% in Period2, as it did among COD patients—from 30 to 35%. The proportion of non-COD patients who received longer-duration vocational rehabilitation (≥1 year) was significantly higher (43%) than among COD patients (28%) in both time periods. For housing rehabilitation, these proportions were 79 and 68%, respectively. Persons with COD experienced more hospitalization days annually than non-COD patients. Duration of rehabilitation (less/more than a year) was inversely associated with annual number of hospitalization days (p < 0.0001). This pattern was noted in both COD and non-COD groups and remained significant after controlling for age, sex, COD group, percent of hospitalizations with SUD, and age at first hospitalization.Conclusions: COD patients with prolonged rehabilitation seemingly achieve long-term clinical improvement similar to non-COD patients, despite most rehabilitation settings in Israel not being designed for COD patients. Yet, COD patients receive overall less rehabilitation services and for shorter periods than non-COD patients. Long-term rehabilitation services should be provided to COD patients, who may need more time to commit to treatment. To achieve better long-term mental health improvements, a continued expansion of community-based integrative treatment and rehabilitation services for COD patients is needed in Israel.

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Pre-implementation Assessment of Tobacco Cessation Interventions in Substance Use Disorder Residential Programs in California

10.21203/rs.3.rs-519609/v2 ◽

2021 ◽

Author(s):

J. Konadu Fokuo ◽

Caravella L. McCuistian ◽

Carmen L. Masson ◽

Valerie A. Gruber ◽

Elana Straus ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Tobacco Cessation ◽

Qualitative Interviews ◽

Program Directors ◽

The United States ◽

Relative Advantage ◽

Treatment Programs ◽

Successful Implementation ◽

Tobacco Policies

Abstract Background: Across the United States, substance use disorder (SUD) treatment programs vary in terms of their tobacco-related policies and cessation services offered to clients. Guided by the Consolidated Framework for Implementation Research (CFIR), the current study identified key factors that may influence the implementation of tobacco related cessation policies and services in residential SUD programs. Methods: We conducted semi-structured qualitative interviews with sixteen residential treatment program directors in California. The analysis was guided by a deductive approach using CFIR domains and constructs to develop codes and identify themes. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts.Findings: Guided by the CFIR constructs, themes that arose as facilitators for implementation included the relative advantage of the intervention compared with current practice, external policies/incentives to support tobacco related policy, program directors strong commitment and high self-efficacy to incorporate cessation into SUD treatment, and recognizing the importance of planning and engaging opinion leaders. Potential barriers included the SUD recovery culture, low stakeholder engagement, organizational culture, lack of workforce expertise and, lack of reimbursement for smoking cessation services.Conclusion: The CFIR provided a valuable framework for evaluating factors that may influence implementation of tobacco policies and services in SUD treatment. In order to support successful implementation, residential SUD programs (staff and clients) require extensive education on the effectiveness of tobacco cessation efforts on health outcomes and publicly funded SUD treatment programs should receive support through expanded reimbursement for tobacco cessation services.

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Validation of a substance use disorder screening instrument for use in vocational rehabilitation settings.

Rehabilitation Psychology ◽

10.1037/0090-5550.53.1.63 ◽

2008 ◽

Vol 53 (1) ◽

pp. 63-72 ◽

Cited By ~ 4

Author(s):

Allen W. Heinemann ◽

Linda E. Lazowski ◽

Dennis Moore ◽

Frank Miller ◽

Mary McAweeney

Keyword(s):

Substance Use ◽

Vocational Rehabilitation ◽

Substance Use Disorder ◽

Screening Instrument

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Pre-Implementation Assessment of Tobacco Cessation Interventions in Substance Use Disorder Residential Programs in California

10.21203/rs.3.rs-519609/v1 ◽

2021 ◽

Author(s):

J. Konadu Fokuo ◽

Caravella L. McCuistian ◽

Carmen L. Masson ◽

Valerie A. Gruber ◽

Elana Straus ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Tobacco Cessation ◽

Qualitative Interviews ◽

Program Directors ◽

The United States ◽

Relative Advantage ◽

Treatment Programs ◽

Successful Implementation ◽

Tobacco Policies

Abstract Background: Across the United States, substance use disorder (SUD) treatment programs vary in terms of their tobacco-related policies and cessation services offered to clients. Guided by the Consolidated Framework for Implementation Research (CFIR), the current study identified key factors that may influence the implementation of tobacco related cessation policies and services in residential SUD programs. Methods: We conducted semi-structured qualitative interviews with sixteen residential treatment program directors in California. The analysis was guided by a deductive approach using CFIR domains and constructs to develop codes and identify themes. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. Findings: Guided by the CFIR constructs, themes that arose as facilitators for implementation included the relative advantage of the intervention compared with current practice, external policies/incentives to support tobacco related policy, program directors strong commitment and high self-efficacy to incorporate cessation into SUD treatment, and recognizing the importance of planning and engaging opinion leaders. Potential barriers included the SUD reovery culture, low stakeholder enagement, organizational culture, lack of workforce expertise and, lack of reimbursement for smoking cessation services.Conclusion: The CFIR provided a valuable framework for evaluating factors that may influence implementation of tobacco policies and services in SUD treatment. In order to support successful implementation, residential SUD programs (staff and clients) require extensive education on the effectiveness of tobacco cessation efforts on health outcomes and publicly funded SUD treatment programs should receive support through expanded reimbursement for tobacco cessation services.

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