Thèse (M.Ps.) -- Université du Québec à Chicoutimi, programme en extension de l'Université du Québec à Trois-Rivières, 2006. / "Mémoire présenté à l'Université du Québec à Chicoutimi comme exigence partielle de la maîtrise en psychologie offerte à l'Université du Québec à Chicoutimi en vertu d'un protocole d'entente avec l'Université du Québec à Trois-Rivières." Comprend des réf. bibliogr. : f. [213]-232. Document électronique également accessible en format PDF.

Thesis (doctoral)--La Salle University, 2003. / ProQuest dissertations and theses ; AAT 3108298. Includes bibliographical references (leaves 113-129).

Background: Previous research shows that individuals with substance use disorder experience stigmatization in society, close relationships and even negative attitudes in health care. These individuals increase in number and are a patient group that general nurses can meet in their daily work. It has also been shown that nursing treatment with regard to these individuals may be crucial for seeking and maintaining treatment. This study therefore focuses on nurses’ attitudes towards these individuals but also on their experiences when caring for them. Aim: To investigate the nurse’s attitudes to and experiences of care of individuals with substance abuse disorder. Method: The method used was a systematic literature study with basic qualitative analysis. Result: The results is presented in two domains; "Nurses’ approach" and "Nurses’ experiences" with seven categories. What turned out was a link between high level of knowledge and awareness and good care. The results also showed that some nurses had negative expectations for this patient group, which negatively affected nursing care. We could also discern an inner conflict within the nurses, who often felt insufficient and unable to provide the care the individual was entitled to. Conclusion: Nursing approaches and experiences varied. A link between knowledge and awareness and provision of good care and preventing or reducing prejudice, was found. Society and its culture tend to affect the nurses’ views of individuals with substance abuse disorder. The inner conflicts occurred when nurses did not give the individual the care that he or she were entitled to.

abstract: There has been a rise in heroin use throughout the United States due to doctors increasingly prescribing painkillers to patients with chronic pain (Kanouse & Compton, 2015; Compton, Boyle, & Wargo, 2015). Individuals get addicted to painkillers and, when their doctor will no longer prescribe them, turn to alternative methods of relief; heroin is often their cheapest option (Kolodny, Courtwright, Hwang, Kreiner, Eadie, Clark, & Alexander 2015). Heroin users are three to four times more likely to die from overdose than other types of drug users (Darke & Hall, 2003). The purpose of this study is to determine the likelihood that heroin users successfully reenter the community upon release from prison in comparison to other types of drug users. There are several re-entry outcomes that can be considered “success”; this study measures success as an index of the quality of the returning offender’s familial relationships as well as recidivism. The data used for this analysis is the Serious and Violent Offender Reentry Initiative (SVORI). The sample consists of male offenders, aged 18 years and older, who have been convicted of and imprisoned for a serious or violent crime. Findings suggest familial social support does not have an effect on heroin use, but heroin use increases the risk of recidivism. These findings will provide a context for rehabilitation of heroin offenders and will launch future research focusing on the differences between heroin users and other types of drug users. / Dissertation/Thesis / Masters Thesis Criminology and Criminal Justice 2016

M.A. / According to Edmonds and Wilcocks (1995:1-2), South Africa is in the grip of a major drug boom. If this is not taken seriously, South Africa could lose as much as 30% of its future generation in terms of health, happiness, functioning and even life. Drug abuse is an important factor that can affect the quality of life of not only the drug abuser, but also all those connected with them (Edmonds and Wilcocks, 1995:1-2). Substance abuse is a problem that influences the family system. Models such as Bell and Khantzian (1991) and Cooks' (1988) description of the Minnesota model define substance abuse as a disease. This model also known as the medical model, can be attributed to the work of Jellinek (1960). It focuses on individual biological factors with little consideration for familial, social or psychological variables. On the other hand, a family systems perspective indicates that the family system enables the substance abuser towards abusive patterns of behaviour. The family plays an important role in the process of dependency as well as in the rehabilitation process. These models are brought together in the study, as this combination is valuable in understanding the complexity of substance abuse and its effects on the family system. The aim of the study is to explore the families understanding of substance abuse and their role in the treatment process. A qualitative methodology is used to understand the life events, experiences and beliefs of family members, from their point of view. The focus of the research is on family members who have attended the family program at Stepping Stones Rehabilitation Center. Exploring the understanding they have of substance abuse and their role in the treatment process, from their frame of reference. The theoretical basis for the study is formulated within the medical model and a systems perspective. A nonprobability, purposive sample is utilized to seek information rich cases. Eleven respondents are interviewed. Different members within the family system are selected to illuminate the question under investigation. An interview schedule formulated from literature, is utilized to create consistency in the face-to-face interviews. The in depth interviews facilitate exploration. Data is gathered by means of a literature review, field notes and audiotapes transcribed by the researcher. Analysis of the data is done manually according to a schedule. The schedule I developed according to coding categories that are identified when working with raw data. The information from the data gathered is analysed and used to identify themes, which are offered as results. An extensive literature control is conducted, in order to further the validity of the research. From the study, methodological and theoretical conclusions can be made. Methodological conclusions indicate the effectiveness of using a qualitative methodology and face-to-face interviews in exploring the question under study. The theoretical conclusions indicate families understanding of substance abuse and their role in the treatment process. Recommendations in terms of intervention with families affected by substance abuse and future research, are drawn from the research process and context of the study ensure the link between results and conclusions and aims and objectives. The research indicates that families have an intellectual understanding of the disease concept of substance abuse. Their searching for alternative solutions and use of defence mechanisms, indicate that this concept has not been internalized. Respondents acknowledged the long term nature of recovery that is facilitated by the use of support groups.

Attention-Deficit Hyperactivity Disorder, (ADHD), is an established childhood psychiatric disorder, and it is the present diagnosis for children with major difficulties in the core symptoms; impulsiveness, attention and hyperactivity. The disorder is known to persist into adulthood and create major problems in coping with everyday life. With ADHD follows a vast variety of other conditions, which burdens the ADHD individuals even more. The major cause for the disorder is in heritage but also other possible explanations will be discussed. The main treatment for ADHD is psycho stimulants, such as methylphenidate and amphetamine. ADHD is associated with substance abuse and several articles in this essay will provide support for that. Is substance abuse in ADHD individuals a form of self-medication in order to ameliorate the symptoms or is the increased risk for substance abuse due to the stimulant medications? In this essay, I will describe what ADHD is, present what are its known causes, summarize the treatments available for ADHD, and discuss the relationships between ADHD and substance abuse.

BACKGROUND: Maladaptive patterns of alcohol consumption can lead to clinically significant impairment or distress and have been established as a partial cause of a wide variety of health conditions, including neuropsychiatric disorders, cardiovascular diseases, hepatic inflammations, certain cancers, and infectious diseases. In the United States, Hispanic and non-Hispanic white (NHW) men have comparable rates of moderate alcohol consumption, however, Hispanic men are more likely to consume higher volumes of alcohol and with more frequency and experience disproportionate levels of adverse health and social consequences of alcohol abuse when compared to NHW men. Further, Hispanic men face greater barriers than NHW men in accessing, engaging, and completing alcohol abuse treatment services despite the contrasting burden of alcohol-related consequences they face. OBJECTIVES: This dissertation is composed from three studies addressing the following aims to: 1) synthesize the culturally- and gender-responsive components of alcohol and substance abuse and dependence treatment programs designed for Hispanic males in the United States; 2) explore Hispanic male perspectives and opinions regarding alcohol use and abuse patterns that may lead to disparate rates of alcohol abuse in Hispanic males in the United States; and 3) examine U.S. Hispanic male perspectives regarding the barriers to alcohol abuse treatment-seeking related behaviors that lead to disparate treatment engagement and completion rates. METHODS: A systematic literature search was conducted for Aim 1 in which articles reporting on culturally- and/or gender-adapted alcohol and/or substance abuse interventions designed exclusively for Hispanic males were identified. Aim 2 and Aim 3 used semi-structured interviews to elicit Hispanic male perspectives of alcohol abuse and alcohol abuse treatment seeking behaviors. Separate thematic analyses were conducted as per the objectives of Aims 2 and 3. Data analysis was based on a deductive process including a preliminary codebook that was supplemented with inductive codes that surfaced during iterative thematic analyses. RESULTS: Regarding Aim 1, literature searches yielded 2685 titles, resulting in 12 articles that fit the parameters of the review. The most scientifically rigorous findings suggest that cultural adaptations may outperform standard treatment for Hispanic men (n=6). Nevertheless, a fraction of the included interventions (n=4) did not improve outcomes compared to standard treatment. Considering the scarce number of publications, it is difficult to discern how much findings reflect ineffective interventions or methodological limitations. Findings for Aim 2 indicate that there are intersected effects of machismo, a culture of normalized overconsumption, social context stressors, and poor coping strategies that may influence maladaptive relationships with alcohol use. Findings for Aim 3 suggest that treatment seeking behaviors are highly influenced by; a) structural factors related to treatment accessibility, and linguistic and cultural-responsiveness of available treatment, b) sociocultural factors related to difficulties problematizing alcohol abuse due to lack of knowledge and cultural normalization of consumption, and societal stigmatization of alcohol abuse treatment, and c) individual factors related to machismo-bound pride as well as lack of knowledge. CONCLUSIONS: Given the rapid expansion of the Hispanic population in the United States, and the parallel growth of alcohol abuse implications in this population, it is imperative that we learn where these problems may be rooted to better understand how to diminish the existing gaps. Collectively, these findings point to the need for treatment providers to disseminate accurate information about treatment availability and eligibility, and the treatment process. This work also illustrates the need to for consciousness building efforts targeting the Hispanic male community regarding the detrimental effects of alcohol-related problems and treatment, in order to diminish the stigma. Increased or redistributed funding for linguistically and culturally responsive programs is also needed in communities with large Hispanic populations in order to meet the growing demand, particularly for the uninsured. Further research is needed to identify other potential barriers and recovery resources for this population and other Hispanic subgroups in other parts of the United States.

M.A. / In the social work field of chemical substance abuse the success of rehabilitation of drug-dependent adolescents is greatly influenced by the support and involvement of their families. Experience in this field showed that the mothers of these adolescents are usually involved in the treatment programme, whereas the fathers are emotionally distant. This is often the way in which these families function. The researcher wanted to find out which aspects influence the dynamics of the relationship between an emotionally distant father and his chemically dependent adolescent. Subsequently, the following question was formulated as a research question: “what influences emotional involvement in the relationship between the emotionally absent father and his chemically dependent adolescent that causes it be emotionally distant?” In this study the researcher will aim to determine that aspects which contribute to emotional distance in the relationship between the emotionally absent father and his chemically dependent adolescent. In doing so the researcher will achieve the following objectives: • To improve professional skill and knowledge by providing new information; • To use qualitative data collection method; • To define and study an emotional absent father, a chemically dependent adolescent and the relationship between them; • To collect data about the causes of emotional absence in the relationship between an emotional absent father and a chemically dependent adolescent; • To explain and understand the relationship between an emotionally absent father and his chemically dependent adolescent in the context of the Systems theory; • To compare the findings of the study with relevant literature; • To understand the forces which influence the relationship between an emotional absent father and his chemical dependent adolescent; and • To get permission of the different role-players to conduct the study. The study is of a qualitative nature. Data was collected by using in-depth, guided interviews and field notes. Data was recorded by using audio recordings and transcriptions. The sample was collected using purposeful sampling. It was divided in two parts, namely adolescents and parents. The researcher used the QSR Nudist program to assist with data analysis. After data collection and analysis, a literature control was done as one of the ways of ensuring validity and reliability. The researcher concluded that various aspects contributed to emotional distance and absence on the father’s side. The relationship between father and child had been distant before the adolescent had been drugging, as early as early childhood. The adolescent’s drugging had little to do with the fact that there is emotional distance between father and child. Although both parties hoped for change, neither of them was sure that it could be obtained. Lastly, based on t he results of the study, the researcher made the following recommendations: 1. Further research be done with regards to aspects such as developing a practice model that will address the emotional distance between an emotionally absent father and a chemically dependent adolescent; 2. To incorporate the results of the study in treatment programmes where applicable in both in-patient and out-patient programmes as well as to act preventatively with regard to this particular relationship; and 3. The professional community can be trained in the dynamics of this particular relationship in order to address similar problems in other fields, for instance pastoral counsellors and psychologists. / Dr. W.J.H. Roestenburg

Magister Artium - MA / Young people have high rates of risk-taking, including alcohol use/abuse and high risk sex. The main purpose of this study was to gain insight into the drinking patterns and sexual behaviour of young UWC students. The aim was to investigate the relationship between alcohol use and unsafe sex practices (such as unplanned sex, multiple partners, and non/inconsistent condom use) and to identify any shifts in sexual practices in response to the HIV/AIDS crisis. / South Africa

Magister Artium (Social Work) - MA(SW) / Caregivers of people with psychiatric illnesses experience challenges, which contribute significantly to their burden of care and can result in health and mental health problems. The researcher was interested in the lived experiences of caregivers, which resulted in the following research questions: What are the lived experiences of caregivers caring for a co-morbid bi-polar and substance-abuse patient, and what context and situations contribute to the problems? The goal of this research was to explore the experiences of family members caring for relatives admitted in a psychiatric hospital, and the contexts in which these occurred. The objectives were to explore and describe the lived experiences of family members caring for a relative with a co-morbid diagnosis of bi-polar and substance abuse, as well as the situations or contexts in which these experiences occur. These objectives were followed by the last objective of the research, which was to make recommendations to the multi-disciplinary teams (MDTs) on services for family members caring for such a relative. A qualitative, phenomenological research approach was used for this study with explorative and descriptive research designs. The population for the study comprised families in the Western Cape caring for female relatives admitted to a psychiatric hospital with co-morbid bipolar and substance use disorder. The researcher purposively selected relatives of female in-patients admitted in a female admission ward. Families were chosen whose members were admitted for more than three months. In-depth phenomenological interviews were done with six participants until data saturation was reached. Phenomenological data analysis, focusing on the textural (lived experience) and structural (context in which it was experienced), were followed after data collection. Findings comprised a composite description of the phenomena of both textural and structural description. The findings of this research resulted in conclusions and recommendations for MDTs and social work on interventions for family members caring for a family member with this mental condition. Findings from this study conclude what was found in the literature regarding challenges in the system leads to caregivers feeling burdened with their mentally ill relative, and that resources and support are lacking in communities. This led to recommendations aiming at MDTs, government and social workers working in institutions, to align with community social workers in order to strengthen working relationships with the aim of providing the necessary support services to families caring for mentally ill relatives. Future research suggestions are also aimed at supporting families caring for patients with a mental illness for which reasons for re-admissions will be assessed and evaluated.