published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

A growing body of research suggests that patterns of personal pronoun use in couples - particularly we-talk (first person plural pronouns) and you-talk (second person pronouns) - are potentially meaningful markers of adaptive and maladaptive functioning, respectively. Despite this growing couple literature, very little is known about the relational implications of we-talk and you-talk in larger social units like families, where relevant interaction patterns are often triadic and involve members of different generations. The present study employed baseline observational and self-report data from a multi-site study of family therapy for adolescent substance drug abuse to (a) describe patterns of personal pronoun use in families consisting of two parent figures and at least one adolescent child, during conversations that had a collaborative (plan a menu) and a conflictual (discuss a recent argument) valence; and (b) explore associations between pronoun patterns and various indicators of adaptive adolescent and family functioning. As hypothesized, automated text analysis of transcripts from 74 English speaking families revealed more we-talk in the cooperative (menu) task, more you-talk and I-talk in the conflict (argument) task, and significant variations in pronoun frequency by family role (more I-talk by adolescents, more we-talk and you-talk by parents). Additional coding, guided by structural family systems theory, took into account the source and referent of each pronoun utterance (e.g., parent-parent we-talk, cross-generation you-talk), and these structural pronoun variables showed stronger associations with concurrently observed family interaction patterns than global (raw count) pronoun variables did. Contrary to expectation, you-talk was a stronger predictor of concurrent family behavior and adaptive youth/family functioning than we-talk, and associations between pronoun patterns and indicators of adaptive functioning were stronger for the conflict task than the cooperation task. The results suggest that relational meanings of pronouns are substantially more complex in triadic intergenerational family interactions than in dyadic romantic relationships. Discussion of these results includes study limitations and possible directions for further research.

Substance abuse has a severe impact on the South African population. Various organizations, governmental and non-governmental, take on the challenge to assist in the treatment of substance abuse. Several gaps have been identified in dealing with substance abuse in South Africa. One of these gaps includes regular audits of treatment services and prevention programmes. One of the major concerns is that most primary prevention programmes appear to be implemented in the absence of evidence on their effectiveness and are mostly implemented on an ad hoc basis. The respondent organizations appear to display a poor understanding of evaluation. It was evident that there is a need for a systematic review of what works in the context of substance abuse prevention among the South African population as well as the development of an effective regulatory regime regarding primary prevention activities. Evaluation can be an important tool to provide monitoring, as well as a tool to identify strengths and weaknesses in treatment programmes. In light of the above, the South Coast Recovery Centre, a substance abuse treatment centre that operates in the private sector, was approached to evaluate the effectiveness of its treatment programme. The research focused on gaining insight into and exploring the strengths and weakness of the programme based on how patients experienced the programme and how satisfied they were with it. The use of multimethod approach which included positivist and interpretative approaches to evaluation was viewed as an appropriate method to use for the study in facilitating an understanding of the patient’s experience of the programme and how satisfied they were with the intervention they received. The study is both qualitative and quantitative in nature and used questionnaires and focus group interviews as data sources. All participants in the study were inpatients at the South Coast Recovery Centre. Frequency distributions, chi square analysis, as well as a thematic analysis were used to analyze the data of the study. The study concluded that patients were in general satisfied with the treatment programme. The programme provided opportunity for behavior changes and introspective learning. They were satisfied with professionals’ skills and behaviours, 6 types of interventions provided, efficacy and accessibility. Areas that patients were not satisfied with included: the facilitated involvement of relatives, the provision of information, and the large amount of residents in the programme. Recommendations were made with regards to programme improvement. The recommendations included the following: a. A coherent programme with clear links between outcome objectives and programme activities should be created. b. The number of counsellors in the programme should be reconsidered. c. The number of patients that should be allowed in the programme should be reconsidered. d. A platform for counsellors to deal with their personal emotions and counter transference should be created. e. Counsellors’ emotional involvement with patients should be addressed and exposed. f. More structured leisure activities that use interactive learning styles could be implemented in order to facilitate the learning of social skills. g. An awareness of possible comorbid mental disorders should be developed. h. Patients can be more involved with the cost aspect of the programme in order to facilitate more ownership of their treatment process. i. Provision should be made in the programme to allow for more involvement of relatives. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Parents who abuse drugs and alcohol are at increased risk of child maltreatment, including the neglect of their children’s health. The present research investigates the effectiveness of the SafeCare® Health module in training mothers with a history of substance abuse living in a residential treatment facility to correctly identify and treat their children’s illnesses. Three mothers of children ages 5-years-old and younger participated in the study. Using a multiple-baseline, single-case experimental design, the research team examined the participants’ ability to select the most appropriate course of action for addressing their children’s illnesses. Results indicate that parents’ skills increased steadily during the intervention, with two of the three participating parents demonstrating mastery of the skills presented. The results suggest that this intervention has great potential to be feasible and effective with this population in this setting. Future research should further investigate the relevance of this intervention with vulnerable populations living in a residential setting to examine whether the changes in targeted parenting skills result in changes in behavior that impact child maltreatment incidence reductions.

There is little known about mothers who are recovering from addictions who lose custody of their children. This hermeneutic thesis, using Canadian phenomenologist Max van Manen’s method and a combination of both scholarly elements and rich storytelling, explores the lived experience of four women recovering from addictions who have lost custody of their children. Using a dual approach of manual and computer-assisted coding, three themes (each with three sub-themes) emerged from semi-structured interviews. The first theme, betrayal, examines three sources of betrayal for the women. The second theme, soul-ache, describes the spaces that a mother finds herself in upon losing custody of her children. The third and final theme, reclamation, follows the mothers as they learn to live again. The findings of this thesis, situated within disciplinary knowledge, extend current knowledge regarding these mothers. The implications arising from this thesis are discussed and recommendations for future research are provided. / 2011-03

This thesis examines the associations between substance use/ misuse and mental health outcomes among Canadians with a Traumatic Brain injury (TBI). Its primary aim is to explore whether or not individuals with a TBI have higher rates of substance use/misuse and poorer mental health than Canadians without a TBI, and to examine two competing hypothesis that help to explain these behaviours -- the impaired brain functioning and the general coping hypotheses. Drawing on data from the 2009-2010 Canadian Community Health Survey, a nationally representative cross-sectional survey, this research assessed substance use and mental health outcomes among those with a TBI, as well as two control groups: (1) individuals with a back or spinal injury; and (2) healthy non-injured controls. Analyses include descriptive statistics and multivariate regressions (logistic and multinomial) adjusting for a range of injury and socioeconomic variables. Those with a TBI demonstrated significantly elevated rates of binge drinking, illicit drug use, and having an anxiety disorder relative to non-injured Canadians, and provided partial support for both the impaired brain functioning and general coping hypotheses to substance use. These findings indicate that public health policy should increase awareness amongst healthcare and social workers on the necessity of continued follow-up of those who experience a TBI in order to reduce future health conditions and to reduce the likelihood of re-injury.

Substance abuse is a major problem amongst the youth worldwide. The goal of this study was to explore the knowledge and perceptions on the dangers of substance abuse among the affected youth attending St John of God Community Services, in Mzuzu, Malawi. The participants in the study were selected on the basis that they had been diagnosed as having a substance induced psychotic disorder and are currently receiving treatment from the hospital either as hospitalised or as outpatients. The study used both quantitative and qualitative research designs. The purposive sampling method was used to identify the quantitative sample while the qualitative sample was selected by using the theoretical sampling method. Forty-five participants completed the questionnaire to provide the quantitative data and 7 participants were interviewed to provide the qualitative data. The quantitative data was analysed by using Statistical Package for Social Sciences (SPSS) and the results were presented in tables and graphs. The qualitative data was analysed manually and the results were presented by using the participants' direct quotes. The findings of the study revealed that lack of knowledge and perceptions of the dangers of substance abuse are not the only contributing fac tors to substance abuse amongst the youth. As the results showed, that the youth had vast knowledge on the dangers of substance abuse and they also perceived these dangers negatively. However, it was found that other factors such as the enjoyment aspect and unemployment influenced the youth to start abusing substances. / Thesis (M.N.)-University of KwaZulu-Natal, 2005.

This study addressed the efficacy of a multimodal substance abuse prevention program with elite-level athletes. By utilizing components of substance abuse information and education, coping skills training, and self-esteem strategies, the study examined the effect of these variables on the subsequent alcohol and drug use behaviors and attitudes of the participants.In addition, measures of self-esteem and stress were examined to determine the effect of prevention on these variables. Gender differences were examined regarding substance use behaviors and attitudes, and change score measures were utilized to observe for behavioral changes from pretest to follow-up testing.Results indicated no differences on any of the dependent measures. Utilizing a repeated measures multivariate analysis of variance (MANOVA), no significant differences in substance use behaviors and attitudes between athletes in the treatment and control conditions were found. There were also no gender differences reported on the dependent measures. In addition, chisquare (X2) analyses demonstrated no behavioral or attitudinal differences. A significant finding indicated that control group subjects had more substance abuse changes (both positive and negative) than the treatment condition. The hypotheses of the study were unconfirmed as a result of the statistical analyses.Limitations of the present study include the small sample size (although representative of the population), the small amount of actual reported use behaviors, and the length of the program (not sufficient time). It is recommended that future research in this area maintain the multimodal approach, while lengthening the time of implementation. Future dependent measures must be able to accurately detect small fluctuations in reported substance abuse behavioral changes.The survey data suggest that athletes at the elite level do demonstrate alcohol and drug use behaviors that may be detrimental to their personal and professional potential. Substance abuse education programs are necessary components of holistic prevention for athletes at all levels of training and competition. Future programs must consider the present study in the development of more successful and practical substance abuse education for athletes. / Department of Counseling Psychology and Guidance Services

Bakgrund: Substansberoendet ökar stadigt i hela världen, vilket ökar trycket på den somatiska vårdens kunskap att vårda patienter med substansberoende. Sjuksköterskor upplever att de inte har tillräcklig kunskap och erfarenhet av att behandla patienter med substansberoende, vilket ofta leder till att patienter känner sig felbehandlade och sjuksköterskor känner sig obekväma i sin sjuksköterskeroll i olika vårdsituationer. Syftet var att undersöka hur sjuksköterskors utbildning påverkar omvårdnad av patienter med substansberoende, inom den somatiska vården. Metoden är en litteraturstudie med fokus på sjuksköterskors utbildning om substansberoende och omfattar sju kvantitativa och sex kvalitativa vetenskapliga artiklar från olika delar av världen. Resultatet visade sjuksköterskors upplevelse i mötet med substansberoende patienter och behov av utbildning för sjuksköterskor om substansberoende. Det framkom att sjuksköterskor har förutfattade meningar och negativa attityder om patienter med substansberoende. De förutfattade meningarna och negativa attityderna beror ofta på att sjuksköterskor inte har en tillräcklig utbildning i att vårda personer med substansberoende. Slutsats: För att minska de förutfattade meningar och förbättra attityden hos sjuksköterskor krävs mer utbildning om hur sjuksköterskor bör agerar i mötet med patienter som har substansberoende. Sjuksköterskor behöver mer tid för att utföra korrekta prioriteringar av patienter med substansberoende samt har en önskan om både teoretisk och praktisk utbildning och handledning. / Background: Substance dependence is steadily growing across the world, calling for increasing knowledge on how to care for patients with substance dependence within the somatic field. Nurses feel that they do lack sufficient training and experience in treating patients with substance dependency, causing patients to feel mistreated while the nurses feel uncomfortable in their nursing role in various caring situations. The purpose of this paper has been to examine how the training nurses receive impacts on the care of patients with substance dependence in the area of somatic care. The method used is a literature study focusing on nurses’ training within substance addiction, containing seven qualitative and six quantitative scientific articles from different parts of the world. The results described nurses’ experiences in meeting patients with drug addiction and the need for education of nurses regarding drug dependency. It showed that nurses have preconceived ideas and negative attitude towards patients with substance dependency. The preconceived ideas and negative attitudes are often a result of nurses having insufficient training in caring for patients with substance dependency. Conclusion: To reduce preconceptions and to improve the prevailing attitudes of nurses, more training is needed regarding how nurses should act when meeting patients suffering from substance dependency. Nurses need more time to make correct priorities for patients with substance dependency and they request more theoretical and practical training and coaching.

Program Description CHOICES: A Brief Alcohol Abuse Prevention and Harm Reduction Program, is a research-based intervention program that can assist college students in making safer choices as it relates to alcohol consumption. Students in CHOICES are informed of the risks associated with alcohol use and are provided with the tools and strategies necessary for reducing these risks. Students who complete CHOICES leave with the knowledge and strategies that are required to modify risky drinking behavior and reduce negative consequences related alcohol consumption. Evaluation Questions The purpose of the evaluation was to determine how effective is the CHOICES program. Program effectiveness was measured through the assessment of student’s change in background knowledge, knowledge of health related risks associated with alcohol consumption, and attitudes towards excesive drinking. Student’s perceived effectiveness of the program and their likelihood to modify their behavior was also assessed. Below are the five evaluation questions: Do students display an increase in background knowledge of alcohol consumption? Do students display an increased knowledge of health-related risks associated with alcohol consumption? Do students display a change in attitudes towards excessive drinking? Do students consider the CHOICES Program an effective alcohol abuse prevention program? Are students likely to modify their behavior as a result of the CHOICES Program? Methods There were 88 students mandated to participate in and complete Georgia State University’s CHOICES Program from May 2013 to December 2013. Of those 88 students, 83 of them completed pre- and post-tests, and 84 completed the de-identified evaluation. The data was entered directly into IBM’s SPSS Statistics Desktop Version 21. Reliability analyses were conducted to evaluate the internal consistency and reliability of the scales created to answer the evaluation questions. Frequencies were run on the responses from the pre-tests, post-tests and evaluations. A paired-samples t-test was used to compare mean scores of students before and after completing the CHOICES Program. An independent-samples t-test was used to compare the difference in mean scores between men and women. Key Findings Statistically significant findings suggests that CHOICES is an effective alcohol abuse prevention program. There was a statistically significant increase in background knowledge scores from the pre-test to the post-test. These results indicate that students who complete CHOICES display an increase in background knowledge of alcohol use. There was also a statistically significant increase in health knowledge scores from the pre-test to the post-test. This indicates that students who complete CHOICES display an increase in knowledge of health-related risk associated with alcohol consumption. Statistical significance was also found in the increase of student’s attitude scores from the pre-test to the post-test, indicating that students who complete CHOICES display a positive change in attitude towards excessive drinking. Over half of students gave CHOICES an overall rating of “excellent” and 38.6% gave it a rating of “good”. Also, 60.6% of students scored above a 28 on the Program Effectiveness Scale. These results indicate that students consider CHOICES an effective alcohol abuse prevention program. 60.7% of students reported that they would “definitely” change some aspect of their alcohol-related behavior as a result of the CHOICES Program. 29% reported “maybe”. These results indicate that the majority of students are likely to modify their behavior as a result of CHOICES. Students who participate in CHOICES leave the program with increased knowledge, a change in attitude towards excessive drinking and are motivated to make safer choices related to drinking.