No description available.

published_or_final_version / Sociology / Master / Master of Social Sciences

Research on the determinants of injection drug use behavior has traditionally concentrated on factors operating at the individual level. However, more recent studies have found that behaviors surrounding injection drug use are shaped, not only by individual-level characteristics, but also by the environment in which they occur. The risk environment paradigm, proposed by Rhodes and colleagues, describes how factors exogenous to the individual influence high-risk injection behavior and blood borne virus (BBV) transmission among people who inject drugs (PWID). To date, few elements of the risk environment have been evaluated as potential determinants of high-risk injection behavior. The purpose of this dissertation was to study the influence of two elements of the risk environment on unsafe injection practices among PWID – neighborhood socioeconomic disadvantage and social discomfort surrounding the acquisition of sterile syringes from syringe exchange programs (SEPs) and pharmacies. To this end, a systematic literature review was conducted on the relation between neighborhood context and injection drug use behavior. Research gaps and methodological challenges identified in this review were used to design analyses exploring relations among neighborhood disadvantage, social discomfort, and high-risk injection behavior. These analyses were conducted using data collected from 484 PWID enrolled in the Pharmacists as Resources Making Links to Community Services (PHARM-Link) study, combined with data from the American Community Survey. Poisson regression with robust error variance was used to estimate associations between measures of neighborhood socioeconomic disadvantage and high-risk injection behavior. SEP accessibility and drug-related police activity were evaluated as potential modifiers of these relations. Similar methods were used to estimate associations between measures of social discomfort and high-risk injection behavior, including neighborhood socioeconomic disadvantage as a potential effect modifier. The systematic literature review on neighborhood context and injection drug use behavior identified few articles pertaining to this relation (n=22). Selected studies primarily investigated the influence of structural aspects of the neighborhood environment on behaviors surrounding injection drug use, while aspects of the social environment and potential modifiers of neighborhood-behavior relations were understudied. Subsequent quantitative analyses revealed that neighborhood socioeconomic disadvantage was associated with safer injection behaviors among PWID. Injectors in disadvantaged neighborhoods reported less receptive syringe sharing and less unsterile syringe use than their counterparts in relatively better off neighborhoods. Drug-related police activity attenuated associations between neighborhood disadvantage and unsterile syringe use, while the direction of associations between neighborhood disadvantage and the use of unsafe syringe sources varied with levels of SEP accessibility. In neighborhoods with high SEP accessibility, neighborhood disadvantage was associated with decreased use of unsafe syringe sources, while in neighborhoods with low SEP accessibility, neighborhood disadvantage was associated with increased use of unsafe syringe sources. Social discomfort was not associated with high-risk injection behavior, but effect modification was detected between neighborhood disadvantage and two items measuring the quality of relationships between participants and syringe staff: “Pharmacists care about my health and well-being” and “The staff at syringe exchange programs seems to care about my health and well-being.” In disadvantaged neighborhoods, participants who reported positive relationships with syringe staff were less likely to engage in receptive syringe sharing. However, in relatively better off neighborhoods, positive relationships with syringe staff were associated with increased receptive syringe sharing. Overall, the results of this dissertation support the validity of the risk environment paradigm in shaping high-risk injection behavior among PWID. Future studies should continue to investigate contextual factors as determinants of behavior surrounding injection drug use. Understanding how aspects of local-area environments influence injection risk behavior will be essential to eliminating the transmission of BBVs among PWID.

published_or_final_version / Social Work and Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Sociology / Master / Master of Social Sciences

M.A. (Clinical Psychology) / The context of psychotherapy groups determine which factors are experienced as therapeutic. The nature of inpatient setting, the brief duration of the groups. and the concurrent nature of therapy were hypothesised as having a possible effect on which factors are perceived as therapeutic. For this particular study the added effect of substance dependency was taken into account. Each of these factors were discussed in a detailed review of the literature. The model of research used in the study was the attitudinal survey with the means of a questionnaire. The patients rank-ordered the relative importance of the various treatment experiences offered by Phoenix House. The primary research data was obtained by means of Yalom's (1985) therapeutic statement questionnaire. well validated in terms of reliability and validity. The statements have previously been used in a forced Q-sort method. In this study it was decided to leave it open as more factors may be rated as therapeutic than those achieved in a Q-sort. Time and expediency were also factors taken into account in using the questionnaire rating in an unforced manner. Open ended questions were used to obtain descriptive data regarding the helpfulness of group psychotherapy and their perceptions of concurrent therapy. A nonprobability sampling procedure was used. The present study addressed the following questions: 1. How do inpatients dependent upon substances perceive. in relation to other treatment methods, their group psychotherapy experiences? 2. Which aspects of the inpatient group psychotherapy experiences. as reflected in the therapeutic factors. seemto be perceived as most and least useful to people dependent upon substances? 3. How do the inpatients perceive their concurrent individual and group psychotherapy? 4. Do high and low valuers of inpatient group psychotherapy value different therapeutic factors?

Titled "Children of Addicted Parents", the purpose of this study was to evaluate the effectiveness of a psycho-educational group intervention for latency age children of alcoholics. The treatment group consisted of eleven children between the ages of eight and twelve, who have lived or who are living with an alcoholic parent or stepparent. Referrals were obtained from elementary school guidance counsellors, Family Service Agencies, Alcohol and Drug Programs and the Ministry of Social Services and Housing. The children and three therapists met one hour a week for nine weeks. The group's dual objectives include educating the children about alcoholism/drug addiction and its effect on the family as well as enhancing the childrens' inherent strengths by teaching strategies to increase self-esteem, problem solving and other coping skills. The program's objectives were carried out through brief lectures, discussion, film, art and therapeutic games. The treatment model has been evaluated using a quasi-experimental design. There was a significant change in the intensity of behaviour problems with a trend for a decrease in the number of problems, as well as a decrease in depression. In addition there was a tendency for an increase in self-esteem. / Arts, Faculty of / Social Work, School of / Graduate

No description available.

The purpose of this study was to gain a better understanding of how a problem-determined system developed around a case of drug addiction within the context of a system of relatedness. The epistemological framework informing this qualitative study was constructivism. The six participants who took part in the study represent the most prominent role players in the particular context of living. The individual battling with drug addiction, his parents, older sister, maternal grandmother and maternal aunt were interviewed. The methods of data collection employed were semi-structured interviews, a family-chronological event chart, genograms, and an eco-map. The interviews were interpreted using the hermeneutic approach. The different themes that emerged from each participant’s story were integrated in relation to each other and with respect to the collaborative sources of data. The most dominant themes extracted within this study are the initial reactions to Andrew’s drug addiction, life changes experienced due to Andrew’s drug addiction, support, as well as the meanings attributed to Andrew’s drug addiction. Further research into problem-determined systems in different cultures is recommended. / Psychology / Thesis (M.A. (Clinical Psychology)) Psychology

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The focus of the study is on clients’ experiences of substance abuse recovery in a faith-based programme in the Western Cape. In describing the nature and extent of the substance abuse problem at an Imbizo on substance abuse, the speech of the Minister of Social Development, Benjamin (2006:1) stated that there are major challenges in rendering services to people who abuse substances. These challenges exist particularly with regard to prevention, rehabilitation and treatment of abusers. Baumann (1998: 238) stated that drug misuse is widespread and a growing problem in Southern Africa. This epidemic will have an increasing impact on mental and physical health. The focus of the literature review is to highlight the escalation of the problem over the last decade or so. Substance abuse is classified as a mental health illness, which could be healed in the application of various modalities of care. Little is understood and documented about the role of FBO programmes in substance abuse recovery in the Western Cape. The researcher hopes to add to the body of nursing research knowledge by conducting the study to answer the research question by understanding the experiences of clients accessing this level of care. The objective of the study is to explore, describe and interpret clients’ experiences of substance abuse recovery in a faith-based (FBO) programme in the Western Cape. An explorative, descriptive, interpretive, phenomenological, qualitative research design was chosen for this study. The population for this study comprised males and females, aged 18 years and older, who were admitted as in-patients in the 6-month residential substance abuse recovery facility, who followed the programme. The researcher used purposive sampling to recruit 7 participants who met the inclusion and exclusion criteria, until saturation of data was reached. The primary data collection tool used was in-depth semi-structured recorded interviews and field notes. The researcher used Nola Pender’s (1996) Health Promotion model (HPM) as the conceptual framework for the study as described The Braun and Clarke’s inductive thematic analysis (2006) was used to conduct the data analysis which yielded two overarching themes, namely, the positive recovery experience and the modified future experience. Recommendations were made based on the HPM assumptions and the thematic analysis. Ethical principles were followed in conducting the study and participants were advised that they are helping researchers to answer the research questions by participating in the study. / AFRIKAANSE OPSOMMING: Die studie fokus op kliënt-ervaringe van dwelmmisbruik-herstel in 'n geloof-gebaseerde programme in die Wes-Kaap. In die beskrywing van die aard en omvang van die dwelmmisbruikprobleem by 'n Imbizo op dwelmmisbruik tydens ‘n toespraak van die Minister van Maatskaplike Ontwikkeling (2006:1), is verklaar dat groot uitdagings heers met betrekking tot die lewering van dienste aan persone wat dwelmmidels misbruik. Hierdie uitdagings het veral betrekking op die voorkoming, rehabilitasie en behandeling van misbruikers. Baumann (1998: 238) verklaar dat dwelmmisbruik tans ‘n wydverspreide en groeiende probleem in Suider-Afrika is. Hierdie epidemie hou 'n toenemende impak op die geestelike en fisiese gesondheid van misbruikers in. Die fokus van die literatuuroorsig is om die verhoogde effek van die probleem uit te lig wat oor die laaste dekade voorgekom het. Die misbruik van dwelmmiddels word geklassifiseer as 'n geestesgesondheidsiekte wat gebruik kan word in die toepassing van verskeie modaliteite van gesondheidsorg. Daar is tans onvoldoende inligting beskikbaar om die rol van die FBO programme in die herstel van dwelmmisbruik in die Wes- Kaap behoorlik te kan ontleed en verstaan. Die navorser beoog om met die uitvoer van die studie die navorsingsvraag te kan beantwoord en sodoende ‘n meer ingeligte en in-diepte oorsig te kan vorm oor die ervaringe van kliente wat toegang het tot hierdie vlak van sorg. Die doel van die studie is om kliënt-ervaringe van dwelmmisbruik-herstel in 'n geloof-gebaseerde (FBO) programme in die Wes-Kaap te verken, beskryf en te interpreteer. Daar is besluit op 'n ondersoekende, beskrywende, verklarende en fenomenologiese kwalitatiewe navorsingsontwerp vir die studie. Die populasie vir hierdie studie het mans en vrouens in die ouderdom van 18 jaar en ouer ingesluit wat as kliente in die 6-maande residensiële dwelmmisbruik-herstel fasiliteit se progam toelating verkry het en wat deelgeneem het aan die programme. Die navorser het gebruik gemaak van ‘n doelgerigte steekproeftrekking en sodoende 7 deelnemers gewerf wat aan die insluitings en uitsluitings kriteria voldoen het. Die proses is gevolg totdat ‘n versadigingvlak van die data bereik is. Die primêre data insamelingsinstrument het die gebruik van ‘n in-diepte, ongestruktureerde onderhoud-metode behels, wat die neem van veldnotas en bandopnames ingesluit het. Die navorser het gebruik gemaak van die Pender se ‘Health Promotion Model’ (HPM) as die konseptuele raamwerk vir die studie. Die Braun en Clarke’s induktiewe tema-analise (2006) is gebruik om die data analise uit te voer wat twee oorkoepelende temas ingesluit het, naamlik, die positiewe herstelervaringetema en die gewysigde toekomstige ervaringe tema. Aanbevelings is gemaak wat op die HPM aannames en die tema analise gebaseer is. Etiese beginsels is streng gevolg en deelnemers is in kennis gestel dat hul deelname aan die studie die navorser instaat sou stel om die nodige data in te samel om sodoende die navorsingsvraag van die studie te kan beantwoord.