AS in all Engineering activities, there lurks somewhere in the background — a compromise.
Eleanor Swain, Sara Boulter and Nicola Piek
This article outlines conventional dual diagnosis outcome measures and the challenges of using these measures to evaluate interventions in medium secure units. It suggests how…
Abstract
This article outlines conventional dual diagnosis outcome measures and the challenges of using these measures to evaluate interventions in medium secure units. It suggests how these challenges can be overcome by using alternative outcome measures such as measures of motivation, stages of change, beliefs, knowledge, group satisfaction, therapeutic alliance or coping strategies.
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George De Leon, Gerald Melnick and Josephine Hawke
This chapter summarizes findings and conclusions from recent studies exploring the role of motivation-readiness factors in drug abuse treatment. The research focuses on…
Abstract
This chapter summarizes findings and conclusions from recent studies exploring the role of motivation-readiness factors in drug abuse treatment. The research focuses on populations entering drug treatment, particularly therapeutic community programs in community- and prison-based settings. However, findings from studies in other modalities and from samples not entering treatment are also discussed. Issues addressed include (1) the nature of the motivational concept in recovery, (2) motivation as a variable affecting treatment retention and outcomes, (3) motivation in the treatment process, (4) differences in motivation across treatment populations and modalities, (5) client correlates of motivation, and (6) motivational enhancement. Conclusions highlight the critical role of motivation-readiness factors in understanding treatment-seeking, retention, and outcomes. Key implications are discussed for research, theory, treatment practice, and health care policy. These implications underscore issues relating to the interaction of motivation and treatment processes, the interaction of motivation and treatment demands, differences in motivation among special populations, client correlates of motivation, and self-selection and study designs.
Rosemary Ricciardelli, Matthew S. Johnston, Katharina Maier and Lorna Ferguson
The correctional system continues to face challenges with responding to and managing methamphetamine use among incarcerated individuals. This study aims to uncover what resources…
Abstract
Purpose
The correctional system continues to face challenges with responding to and managing methamphetamine use among incarcerated individuals. This study aims to uncover what resources and policies could better help correctional workers deal with these challenges. The authors also examined methamphetamine’s impact on correctional work and staff well-being.
Design/methodology/approach
An online survey was distributed to correctional workers (n = 269) in Manitoba, Canada, featuring questions about their experiences related to methamphetamine use in populations under their care, what supports are needed to adequately address the concern, and the potential effects on self and their occupational responsibilities. Using NVivo software, survey responses were analysed using an emergent theme approach.
Findings
Correctional workers believed policies and protocols for managing methamphetamine use and withdrawal are currently inadequate. Correctional workers reported having monthly contact with incarcerated individuals experiencing methamphetamine withdrawal, posing safety concerns to them and other incarcerated individuals. Respondents proposed more education and training on managing incarcerated people withdrawing from methamphetamines, related to the symptoms of use and withdrawal and how to support persons detoxing. Increased human and material resources were reported as being needed (e.g. more nurses onsite and better screening devices). Respondents also desired more medical intervention, safe living spaces for methamphetamine users and programming to support addiction.
Originality/value
The current study unpacks correctional workers’ perspectives, support desires and their experiences managing methamphetamine use amongst incarcerated people. The authors discuss the required knowledge to respond to gaps in prison living, re-entry and related policy needs.
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Vanessa Melton and Sue Ledwith
The purpose of this paper is to evaluate the use of node-link mapping (NLM) on the effectiveness of a structured treatment for dual diagnosis for men living in a low-secure…
Abstract
Purpose
The purpose of this paper is to evaluate the use of node-link mapping (NLM) on the effectiveness of a structured treatment for dual diagnosis for men living in a low-secure environment.
Design/methodology/approach
In total, 15 participants were recruited and randomly allocated to one of two conditions. The control group, treatment as usual (TAU) or the treatment group, TAU with NLM. Outcome measures used were: a qualitative evaluation form, The Alcohol and Illegal Drugs Decisional Balance Scale and the Brief Situational Confidence Questionnaire.
Findings
Results indicate no statistically significant difference for either group on the pre- and post-treatment outcome measures used. Qualitative data indicated that those using NLM reported the intervention as useful and instructive more often.
Research limitations/implications
The results gained were only a snapshot of the intervention straight after treatment and did not take into account any long-term benefits of therapy such as substance use relapse rates. The outcome measures used may not have been properly understood by all respondents, or reflect practical change. The NLM tool may not have been used as confidently as TAU. The TAU condition needs to be reviewed to improve effectiveness, and NLM to be included to improve the accessibility. A study comparing other outcome tools needs to be completed. Training for staff using NLM may require coaching.
Originality/value
This paper has a high/low originality. It highlights a number of advantages to NLM when comparing this to TAU.
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Christy Harris Lemak and Jeffrey A. Alexander
We draw upon and integrate two organizational theory perspectives to develop a conceptual model of how managed care influences the treatment practices of outpatient drug treatment…
Abstract
We draw upon and integrate two organizational theory perspectives to develop a conceptual model of how managed care influences the treatment practices of outpatient drug treatment providers. First, using resource dependence theory, we suggest that treatment practices will vary as a function of an organization's dependence on managed care and the scope and stringency of oversight mechanisms used by managed care firms. Second, we apply institutional theory to suggest that the expectations of the professional staff and sources of legitimacy will also directly influence treatment practices. Finally, we draw upon previous integrative frameworks and argue that institutional factors will also indirectly influence treatment by moderating the negative effects of managed care dependence and oversight.
Joseph Aaron Lowenstein, Jennifer Stickney and Ida Shaw
The purpose of this study/paper is to describe the implementation of a six-month schema therapy awareness (STA) group. Research supporting individual schema therapy (ST) as an…
Abstract
Purpose
The purpose of this study/paper is to describe the implementation of a six-month schema therapy awareness (STA) group. Research supporting individual schema therapy (ST) as an effective intervention for personality disorder is growing steadily within a number of settings including with forensic patients. Alongside individual ST, positive results have been reported for group ST. However, to the best of the authors’ knowledge, no current published research exists with regard to the use of group ST within forensic populations and more specifically within a low secure environment.
Design/methodology/approach
This paper describes the implementation of a six-month schema therapy awareness (STA) group with individuals situated within a low secure environment.
Findings
For individuals transitioning into the community from a secure setting, the focus of risk management should attempt to move away from external controls towards more of a reliance on internal factors. In ST, this is achieved by understanding the role of schema modes (and underlying schemas) that are linked to an individual’s offences/risk and developing this understanding into a coherent and accessible formulation for the individual to make changes.
Research limitations/implications
Further robust research evaluating clinical change is recommended as the next step.
Practical implications
The group protocol is described along with the challenges and potential solutions experienced during the implementation. This provides an opportunity for other professionals to replicate this approach in the future.
Originality/value
With regard to group ST within forensic populations, the research is sparse at present and this study focusses on practical application of theory and the challenges of operationalising a STA group.
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Matthew Chinman, Sarah B. Hunter and Patricia Ebener
This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community‐based organization setting.
Abstract
Purpose
This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community‐based organization setting.
Design/methodology/approach
CQI (e.g., plan‐do‐study‐act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine‐month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined.
Findings
Results indicated that CQI was feasible and acceptable for community‐based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes.
Research limitations/implications
The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes.
Practical implications
This project shows that it is feasible to adapt CQI techniques and processes for community‐based programs substance abuse prevention and treatment programs. These techniques may help community‐based program managers to improve service quality and achieve program outcomes.
Originality/value
This is one of the first studies to adapt traditional CQI techniques for community‐based settings delivering substance abuse prevention and treatment programs.