Magister Artium (Social Work) - MA(SW) / It is a common fact that drug and alcohol abuse has become a complex problem with children in South Africa. There is also a risk that children of substance abusers will become substance abusers themselves. The aim of this study was to determine if there is a relationship between childhood exposure to substance use and substance use as an adult. The theory that was implemented in the study was the Social Learning Theory. The participants were obtained from an outpatient substance abuse treatment centre. A cross sectional study design was used whereby 192 participants were requested to complete an adapted version of the Child Exposure to Domestic Violence scale. The results of the study show that 48% of the respondents experienced exposure to substance abuse which they witnessed as a child. The results of the study indicated that past exposure to substance abuse accounted for a mean of 2.47. Respondents also responded in terms of exposure to parent/s that abused substances, which had a mean of 2.12. The results illustrated that there is a significant positive relationship between past experiences of substance abuse and current experiences of substance abuse within the total sample (r=.39, p:0.01). The study showed that for gender a positive relationship was found for males (r = .23, p:0.01) and for females (r = .34, p:0.01). In terms of family structure there was a significantly positive relationship, which for one parent was (r = .23, p: 0.05) and for two-parent families was(r = .38, p: 0.01). In conclusion early intervention strategies for children who are at risk and who are exposed to substance abuse, should be implemented.

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.

Substance abuse is a major social issue within the South African Police Service (SAPS). To address this issue, the SAPS implement an Employee Assistance Programme (EAP) as an intervention to address problems that may affect the work performance of employees. Despite the existence of this programme, substance abuse is still occurring and has a negative impact on work performance. This concern has fuelled the researcher to initiate this study. The goal of this study is to gain an understanding of Port Elizabeth SAPS employees’ perceptions regarding the effectiveness of the EAP substance abuse prevention programme. A qualitative research methodology, with a descriptive, exploratory and contextual research design was implemented. The researcher elected to use non-probability sampling, specifically, purposive sampling for this study. A sample of ten employees was chosen from an area demarcated for the purpose of the study, within the SAPS in Port Elizabeth. Data was collected through semi-structured, individual interviews. Interviews were continued until saturation point was reached. The interviews were analyzed according to the detailed guidelines set out by Tesch (in Creswell, 2003:192). The data was verified according to Guba’s principles (in De Vos, Strydom, Fouche & Delport, 2002:351). The researcher also employed the services of an independent coder in order to enhance the trustworthiness of the study. The perceptions of EAP as a substance abuse prevention programme, by employees of the SAPS in Port Elizabeth, have not been highlighted adequately within the South African context. The researcher’s study will hence contribute to the existing body of knowledge of the discipline.

Since the Narcotic Addiction Foundation of British Columbia opened its doors in 1958 it has been successful in contacting a large number of drug addicts in the Vancouver area. There has, however, been some concern expressed by the agency treatment staff over the high ratio of patients who discontinue treatment after the first few contacts. The authors of this exploratory study have undertaken the task of determining some of the factors which might influence the drug addict's continued treatment involvement at the Narcotic Addiction Foundation. This study sets the base for a projected three year study of the stated problem. The study was divided into two phases. The first is the retrospective study which utilizes the Paulus Study (55) conducted in 1964. Though pursued for different reasons, this study provides a convenient, and suitable sample of 105 addicts (50 male and 55 female) for the present research. The immediate aim of this retrospective study is to identify certain factors which are discernible at the time the addict presents himself for treatment and to relate them to the addict's subsequent treatment involvement. The second phase, a longitudinal study, will utilize the specific factors which emerge from the retrospective study as being significantly related to the addict's continued treatment involvement. The longitudinal study, to further prove the validity of each factor, has been projected to cover a twelve month period from the time the addict first presents himself for treatment. The results of the study point out some of the difficulties and areas of concern regarding the treatment of the drug addict and some recommendations pertaining to follow-up studies of this kind. While the drug addict exhibits some characteristics similar to clients of any agency, he is unique in many ways. The factors discerned in this study clarify some of this uniqueness and, it is hoped, (using the significant factors brought out,) that they will eventually lead to better prognostication of the addict's future success for continued treatment involvement. It should prove to be especially helpful to the staff of the Narcotic Addiction Foundation and other agencies geared to treating the drug addict in guiding changes in the treatment program and organization. / Arts, Faculty of / Social Work, School of / Graduate

Tron på den egna förmågan att förbli återhållsam (”abstinence self-efficacy”) har visat sig vara en bidragande faktor till att personer med substansberoende lyckas förbli återhållsamma. Syftet med studien var att undersöka om det fanns gemensamma teman inom tron på den egna förmågan hos människor med substansberoende, med särskilt fokus på faktorer som bidrar till förmågan att förbli återhållsam. Detta har undersökts genom åtta intervjuer med människor som inte längre är aktiva i sitt substansberoende. Deltagarna var 19-65 år gamla, varav en var kvinna. Alla deltagare har haft någon form av substansberoende, varav sex deltagare hade alkohol som sin huvudsubstans. De teman som hittades inom förstärkande faktorer var yttre - relationer och aktiviteter, samt inre - inneboende motivation och tankar. Det tema som hittades inom faktorer som försvagar var motgångar. Studien kan användas för att bättre förstå vilka faktorer som är bidragande när det kommer till substansberoendes tro på den egna förmågan att förbli återhållsam.

Masters in Public Administration - MPA / Globally, substance abuse has had a profound impact on society, compounding factors around public health and safety, as well as the social fabric of family systems and communities. The substance abuse problem is complex and requires a comprehensive approach to addressing the phenomenon. Treatment for substance abuse is one aspect of addressing the problem and aims to reduce the harm associated with the use thereof. Treatment demand has increased consistently in South Africa over the past few years and the need for services has been articulated in key legislative and policy documents. Substance abuse is a well-researched field in South Africa; however, limited research exists that captures the experience and perceptions of service users that received outpatient treatment. Various studies conducted in Cape Town in the Western Cape have confirmed an inextricable link between substance abuse and the structural challenges present in historically disadvantaged communities. This study explores the experiences of service users who had completed an outpatient substance-abuse treatment programme in the City of Cape Town's health clinics in Parkwood and Delft South. The objectives of the study are to explore the individual-level and service-level factors impacting on service users' experiences of outpatient substance-abuse treatment, to explore the outcomes of outpatient substance-abuse treatment for service users and to make service-level recommendations and recommendations for further study. Nine research participants for the qualitative study were purposively sampled, as they required certain attributes to respond to the area of study. Data was collected in the form of semi-structured interviews in order to allow for the in-depth exploration into the experiences of service users. Data was analysed with the use of conceptual analysis, where themes were thematically grouped and analysed. Key findings in the study were that the City's outpatient treatment programme is designed exclusively for adult service users. It was, however, found that the age of substance use and the onset of abuse occurred between the ages of 11 and 17-years. The study highlighted the need for the City to modify its outpatient programme to address the needs of youth service users and children of service users to facilitate their adjustment to a parent in recovery. A further finding in the study was the challenges experienced by service users, particularly female service users. It emerged that female service users experienced more stigmatisation than males accessing the service. The need for aftercare treatment post-treatment was a gap identified in the study. In the exploratory study, participants' experiences and perceptions of the City's outpatient programme were positive. The scope of the study was therefore narrow. Recovery, however, remains a challenge for service users due to triggers brought on by structural challenges present in disadvantaged communities, again highlighting the need for coordinated efforts by all government spheres to address the scourge of substance abuse. As a prospect for further study, it is proposed that the long-term impact of the City’s outpatient programme be considered with a larger sample of participants.

Globally, approximately 208 million people aged 15 and older used illicit drugs at least once in the last 12 months; 2 billion consumed alcohol and tobacco consumption affected 25% (World Drug Report, 2008). In the United States, 20.1 million (8.0%) people aged 12 and older were illicit drug users, 129 million (51.6%) abused alcohol and 70.9 million (28.4%) used tobacco (SAMHSA/OAS, 2008).Usually considered a problem specific to men (Lynch, 2002), 5.2% of pregnant women aged 15 to 44 are also illicit drug and substance abusers (SAMHSA/OAS, 2007). During pregnancy, illicit drugs and substance abuse (ID/SA) can significantly affect a woman and her infant contributing to developmental and communication delays for the infant and influencing parenting abilities (Budden, 1996; March of Dimes, 2006b; Rossetti, 2000). Feelings of guilt and shame and stressful experiences influence approaches to parenting (Ashley, Marsden, & Brady, 2003; Brazelton, & Greenspan, 2000; Ehrmin, 2000; Johnson, & Rosen, 1990; Kelley, 1998; Rossetti, 2000; Velez et al., 2004; Zickler, 1999). Parenthood is an expanded role that can be a trying time for those lacking a sense of self-efficacy and creates a high vulnerability to stress (Bandura, 1994). Residential treatment programs for ID/SA mothers and their children provide an excellent opportunity for effective interventions (Finkelstein, 1994; Social Care Institute for Excellence, 2005). This experimental study evaluated whether teaching American Sign Language (ASL) to mothers living with their infants/children at an ID/SA residential treatment program increased the mothers’ self-efficacy and decreased their anxiety. Quantitative data were collected using the General Self-Efficacy Scale and the State-Trait Anxiety Inventory showing there was both a significant increase in self efficacy and decrease in anxiety for the mothers. This research adds to the knowledge base concerning ID/SA mothers’ caring for their infants/children. By providing a simple low cost program, easily incorporated into existing rehabilitation curricula, the study helps educators and healthcare providers better understand the needs of the ID/SA mothers. This study supports Bandura’s theory that parents who are secure in their efficacy can navigate through the various phases of their child’s development and are less vulnerable to stress (Bandura, 1994).

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