Examining Recovery Status and Supports before and after Substance Abuse Disorder Treatment Among Clients Who Experienced Lifetime and Recent Firearm-Related Threats

Firearm-related risks have often been overlooked in the sequela of substance use and substance use disorders. This study compares adult substance abuse disorder treatment (SADT) clients who experienced recent ( n = 274) and lifetime ( n = 889) firearm threats to adults who were not threatened with a firearm ( n = 2029) before and 12 months after program entry. More men experienced firearm threats (38.8%) than women (34.2%). However, among those with any firearm threats, more women (27.2%) experienced firearm threats in the year before program entry than men (20.2%). Being threatened with a firearm was associated with increased economic vulnerability, criminal justice system involvement, mental health problems, and victimization both before and after SADT program entry. A higher number of adverse childhood experiences were associated with firearm threats and particularly recent firearm threats. Results of this study underscore the importance of screening for firearm-related risks in substance abuse disorder treatment programs.

Case Management

Case management plays a critical role in the Prolonged Exposure-Intensive Outpatient Program (PE-IOP) model. This chapter presents the logistics and rationale for case management as used in PE-IOP. The goal of case management is to provide necessary logistics to help the patient maximize therapeutic benefit from the PE-IOP program. Case management begins prior to program entry to assist with assessment and treatment planning and continues throughout the PE-IOP to ensure that the patient can fully engage with care (e.g., get where they need to go for in vivos, address financial concerns, etc.). Finally, planning for discharge and continued care begins at assessment and ends after patients return home to ensure that they can maintain the gains they made in PE-IOP.

Examining Recovery Program Participants by Gender: Program Completion, Relapse, and Multidimensional Status 12 Months After Program Entry

This study examined individual-level characteristics and factors associated with program completion, relapse, and multidimensional status at follow-up for 213 men and 248 women who entered one of 17 peer-led recovery programs and who completed a follow-up interview 12 months later. Study results found that although there were some significant gender differences at program entry among participants entering Recovery Kentucky, there were few gender differences at follow-up. In addition, although participants had significant psychosocial problems, polysubstance use patterns, and severe substance use disorder (SUD), the majority of both men and women reported completing the program (80.3%), a small minority reported relapse (9.5%), and about one third had worse multidimensional status about 12 months after program entry. Lower quality of life rating at program entry was associated with program completion and with better multidimensional status at follow-up. Study results suggest the recovery program provides an important option for some of the most vulnerable individuals with SUD.

Financial Incentives and Earnings of Disability Insurance Recipients: Evidence from a Notch Design

Most countries reduce disability insurance (DI ) benefits for beneficiaries earning above a specified threshold. Such an earnings threshold generates a discontinuous increase in tax liability—a notch—and creates an incentive to keep earnings below the threshold. Exploiting such a notch in Austria, we provide transparent and credible identification of the effect of financial incentives on DI beneficiaries’ earnings. Using rich administrative data, we document large and sharp bunching at the earnings threshold. However, the elasticity driving these responses is small. Our estimate suggests that relaxing the earnings threshold reduces fiscal cost only if program entry is very inelastic. (JEL H55, J14, J31)

The Effect of Treatment Completion on Recidivism Among TASC Program Clients

Despite the enormous resources spent by states in the United States on bridging the gap between criminal justice and behavioral health services, there have been relatively few statewide evaluations of drug treatment client recidivism. We present the results of an evaluation of recidivism outcomes for a sample of individuals ( n = 1,274) referred to the Treatment Accountability for Safer Communities (TASC) program in North Carolina from 2007 to 2008. The methodology accounted for both client and offense characteristics drawn from TASC, court, and corrections records. Multivariate analyses indicated that program completion is the most important predictor of re-arrest in the 3-year follow-up period, followed by a number of protective and risk factors. More specifically, being female, older at the time of program entry, as well as higher levels of educational attainment decreased the odds of re-arrest, whereas using crack/cocaine increased the odds of re-arrest. Suggestions for future research and policy implications are provided.

The Complete Health Improvement Program (CHIP) And Reduction of Chronic Disease Risk Factors in Canada

Purpose: The short-term effectiveness of the nutrition-centred Complete Health Improvement Program (CHIP) lifestyle intervention for improving selected chronic disease risk factors was examined in the Canadian setting. Methods: A total of 1003 people (aged 56.3 ± 12.1 years, 68% female) were self-selected to participate in one of 27 CHIP interventions hosted in community settings by Seventh-day Adventist churches throughout Canada, between 2005 and 2011. The program centred on the promotion of a whole-food, plant-based eating pattern, and daily physical activity was also encouraged. Biometric measures, including body mass index (BMI), blood pressure (BP), blood lipid profile, and fasting blood sugar (FBS), were determined at program entry and 30 days into the intervention. Results: Over 30 days, significant overall reductions (P<0.001) were recorded in the participants’ BMI (-3.1%), systolic BP (-7.3%), diastolic BP (-4.3%), total cholesterol ([TC] -11.3%), low-density lipoprotein cholesterol ([LDL-C] -12.9%), triglycerides ([TG] -8.2%), and FBS (-7.0%). Participants with the highest classifications of TC, LDL-C, TG, and FBS at program entry experienced approximately 20% reductions in these measures in 30 days. Conclusions: The CHIP intervention, which centres on a whole-food, plant-based eating pattern, can lead to rapid and meaningful reductions in chronic disease risk factors in the Canadian context.

MBA program enrolment as a catalyst for boundaryless career goals (part two)

Purpose – Further investigation of the thoughts and attitudes contributing to the voluntary pursuit of an MBA degree and career change is necessary to better understand career motivations and to satisfy career goals. The purpose of this two-part paper is to achieve this objective. Design/methodology/approach – Factors contributing to the cognitive decision to enroll in an MBA program and the subsequent impact of self-discovery gained upon program entry on career strategy were explored using a 32-question survey based on empirical research findings. Findings – Part-time and full-time MBA students exhibited differences in decision criteria applied for MBA program entry. Following program enrollment, opportunities for career growth led to upward goal revision and increasingly focussed goals. Research limitations/implications – Participation was potentially limited by survey distribution during a demanding academic period where many project reports and group presentations were due. A single MBA program in the downtown Montreal area may not be representative all programs in the population. Practical implications – Anchoring individual career identity and social identity has become increasingly complex as employers in many industries undergo continuous transformational change. Social implications – Integration within the work environment of identified career roles requires additional attention to validate an individual's strategic career efforts. Originality/value – Surveying MBA candidates about career decisions and goal-revision allows for a valuable “snapshot” of career evolution over time. By promoting increased self-awareness, applied knowledge gained through MBA program activities acts as a catalyst for self-efficacy beliefs which results in upward distal goal-revision or increased goal focus.

MBA program enrolment as a catalyst for boundaryless career goals (part one)

Purpose – Further investigation of the thoughts and attitudes contributing to the voluntary pursuit of an MBA degree and career change is necessary to better understand career motivations and to satisfy career goals. This two-part article attempts to achieve this objective. Design/methodology/approach – Factors contributing to the cognitive decision to enrol in an MBA program and the subsequent impact of self-discovery gained on program entry on career strategy were explored using a 32-question survey based on empirical research findings. Findings – Part-time and full-time MBA students exhibited differences in decision criteria applied for MBA program entry. Following program enrolment, opportunities for career growth led to upward goal revision and increasingly focused goals. Research limitations/implications – Participation was potentially limited by survey distribution during a demanding academic period where many project reports and group presentations were due. A single MBA program in the downtown Montreal area may not be representative of all programs in the population. Practical implications – Anchoring individual career identity and social identity has become increasingly complex as employers in many industries undergo continuous transformational change. Social implications – Integration within the work environment of identified career roles requires additional attention to validate an individual's strategic career efforts. Originality/value – Surveying MBA candidates about career decisions and goal-revision allows for a valuable “snapshot” of career evolution over time. By promoting increased self-awareness, applied knowledge gained through MBA program activities acts as a catalyst for self-efficacy beliefs which results in upward distal goal-revision or increased goal focus.