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Counseling professionals are committed to providing multiculturally competent services to the clients they serve. When clients first enter counseling, the therapeutic relationship typically begins by the counselor conducting an initial clinical interview. This initial clinical interview is a critical time to demonstrate cultural competence. Currently, there is no literature that has explored how counselors who work with the substance use population incorporate multicultural considerations during the initial clinical interview. The purpose of this study was to explore whether licensed professional counselors (LPCs) broach (Day-Vines et al., 2007) multicultural considerations during the initial clinical interview with clients who have substance use disorders (SUDs). The exploration of this phenomenon occurred through the use of a qualitative methodology. Semi-structured interviews were conducted with nine LPCs in Virginia. The LPCs shared their lived experiences conducting initial clinical interviews with members of the SUDs population. Four themes and a subtheme emerged related to how LPCs perceive the relevance of identifying multicultural factors in their work with the SUDs population: everyone has culture and it is all encompassing, culture is needed to understand clients (subtheme), multicultural factors impact substance use behavior and patterns, cultural identities emerge during the initial clinical interview, and multiculturalism was an important component in counselor preparation. Three themes emerged related to how LPCs describe the term and concept of broaching: no familiarity with the "broaching" term, broaching defined as initiating a topic, and some degree of understanding of the broaching concept. Five themes emerged related to whether and how LPCs introduce or broach multicultural considerations during the initial clinical interview: broaching approach varies, client introduces multicultural factors, appropriate timing, willingness to be open, and boundaries surrounding broaching. The themes that emerge from this data will help to fill gaps in the literature concerning how counselors broach multicultural considerations, particularly with the SUDs population. Implications for counselors and counselor education are discussed. The limitations of the study and recommendations for future research are provided. / Ph. D.

The transmission of emotion regulation from parent to adolescent as well as the relationship between adolescent emotion regulation and substance use is not clearly understood in extant psychological literature. The present study hypothesizes that parents transmit their emotion regulation skills to their adolescents via the mediator of parenting behaviors and that adolescents who are better emotion regulators are less likely to use substances. In the present study, cross-sectional and longitudinal structural equation modeling analyses were utilized to determine the relationship among these variables. In the cross-sectional analyses (n = 219), the sample was 55% male and were between the ages of 12 to 18 years (M = 15.12). In the longitudinal analyses (n = 129), the sample was 42% male and were between the ages of 13 to 21 years (M = 17.13). In both the cross-sectional and longitudinal models, adolescents with high negative parenting had higher levels of lability/negativity, whereas adolescents with high positive parenting had better emotion regulation skills and lower levels of substance use. In addition, in the longitudinal analyses, higher levels of suppression in parents were negatively related to adolescent emotion regulation. The findings of the present study highlight that parents transmit emotion regulation skills to their adolescents and that parenting behaviors may be a key point of intervention for promoting adolescent emotion regulation and demoting adolescent substance use. / Ph. D.

Background: Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder presenting with three core symptoms: inattention, hyperactivity, and impulsivity. The ADHD population is 3 times more susceptible to developing a cannabis use disorder compared to the general population. Psychostimulants are the first-line treatment for ADHD. There is currently no literature on the impact of cannabis on the psychostimulant response. Objectives: To compare the response to psychostimulant treatment in adults with ADHD between cannabis and non-cannabis users Methods: Sixty-five participants with a primary diagnosis of ADHD were recruited from the MacAnxiety Research Clinic and St. Joseph's Psychiatric Community Clinic. Participants were assigned to the cannabis, or non-cannabis group based on their cannabis status at baseline. The study was 8 weeks long and included 3 visits. The first visit of the study was called “Baseline” and would occur prior to the start of stimulant medication. Participants would be seen at two additional time points 4- and 8-weeks post-baseline visit at which point they would be taking their stimulant medication. At each study visit all participants would fill out the self-reported assessment battery conducted through REDCap. The study psychiatrist would assign a CGI-S score at the end of each visit and a CGI-I score at the end of week 4 and week 8. Results: Cannabis and non-cannabis users did not differ statistically in their BAARS-IV, CGI-S, and CGI-I scores over the study. Secondary outcomes investigating CUD, stimulant type, stimulant dosage, comorbidities, and responder rate did not produce significant outcomes. Conclusions: There was no difference in the treatment response to psychostimulants in adults with ADHD between cannabis and non-cannabis users. Further studies should continue exploring treatment response in populations with co-occurring adult ADHD and cannabis use. / Thesis / Master of Science (MSc) / Attention deficit and hyperactivity disorder (ADHD) has three main symptoms including inattention, hyperactivity, and impulsivity. Substance use disorder is commonly associated with ADHD. The ADHD population is at a 3 times greater risk for developing a cannabis use disorder compared to the general population. Psychostimulants are used to treat ADHD but there is currently no data looking at how cannabis use may affect the treatment response. This study aims to compare the response to ADHD treatment in adults with ADHD between cannabis and non-cannabis users. The study recruited forty participants who filled out a study questionnaire over 3 study visits for a total study length of 8 weeks. Study findings did not report a difference between cannabis and non-cannabis users in their ADHD symptoms, clinical severity, and clinical improvement throughout the study. Further studies should continue investigating populations with co-occurring ADHD and cannabis use in relation to treatment response.

The U.S Department of Health and Human Services (HHS) conducted a study and determined that approximately one-third to two-thirds of child neglect cases had some form of substance abuse related to the case. Further, it is reported that women who use alcohol or drugs are two times more likely to lose custody of their children than non- using mothers. The purpose of this study is to examine which treatment modalities substance use counselors find most effective when treating women with children. This study utilized a qualitative design asking eight open ended questions to fourteen substance use counselors employed at Prototypes in Pomona, CA. The substance use counselors were asked questions regarding what treatments they offered at their facility, what they believed the most effective treatment modalities are when treating women with children, and what barriers they faced when treating women with children. Findings from this study found the holistic and client centered approaches to be the most effective treatment modalities when treating women with children. The holistic approach considers every aspect of the client’s life and the client centered approach allows the counselors to develop care plans that are specific to their client’s unique needs. Social workers should strive to keep women with their children while they are in treatment. Further research is needed to gain a better understanding of this population and to provide appropriate treatment, services, and resources to women and their children.

"July 1994". / Thesis (PhD) -- Macquarie University, School of History, Philosophy and Politics, 1995. / Bibliography: leaves 400-462. / Women and substance use. An introduction -- Women and substance use from a different perspective. Feminist theory and methodology -- 'Fallen angels and moral heroines'. The historical construction of women and substance use -- 'When the normal is pathological and the pathological is normal'. Psychological explanations of women and substance use -- 'A foot in both camps'. Psychosocial explanations of women and substance use -- 'Violence as symptom and cause'. The role of substance use in the social control of women -- 'Breaking all the rules'. Legal responses to women and drugs-related crime -- 'When liberation is no liability'. Women as consumer targets -- 'A nice girl like you'. Women and substance use treatment -- Conclusion -- Bibliography. / In Australia today, as in many other comparable societies, women's use of alcohol and other legal drugs is not circumscribed as it has been in the past. On the face of it, this suggests that there has been a major shift in social attitudes towards use of certain substances by women in line with changes to women's social position that occurred in the last few decades. Despite these changes, however, or perhaps because of them, women's use of alcohol and other drugs still attracts different attitudes and social responses when compared to similar behaviour in men. -- The objective of this research is to investigate the reasons why women's substance use behaviour is viewed differently from that of men's, how this has come about, why it is so culturally pervasive, and what are the effects for women. It has involved exploring how the meanings attached to women's use of certain chemical substances have been socially and historically constructed through scientific discourse, and how these meanings continue to be reproduced, reinforced and legitimated within other interlocking discourses. They are reflected too in cultural images as well as in popular attitudes, held by both women and men. -- The research has been undertaken using a 'woman-centred' approach, within the framework of feminist analysis. Such approach provides an alternative way of understanding women's experience with substance use. / Mode of access: World Wide Web. / [9], 462 leaves

The current study explored the effects of simulated adjustment domains (i.e., partial denial and social desirability) on specialized substance abuse measures in a sample of 104 inpatient offenders with substance use disorders. Results indicated nearly two thirds (57.9%) of offenders successfully escaped detection on the SASSI-4 and InDUC-2R. Further, subtle approaches employed by the SASSI-4 failed to detect unacknowledged substance use by simulators, and the remaining decision rules were redundant and most likely contributed to the false positive rates for non SU offenders. More promisingly, the current study developed an empirically based validity scale to bolster the SASSI-4's effectiveness in detecting response styles that showed initial promise. Results, a review of detection strategies for SU validity scales, and implications for assessment are further explored.

Purpose: Most individuals do not perceive a need for substance use treatment despite meeting diagnostic criteria for substance use disorders and they are least likely to pursue treatment voluntarily. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for individuals who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for gender-specific treatment recruitment and retention. Using Andersen and Newman’s (1973/2005) model of individual determinants of healthcare utilization, the central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women with increasing problems due to their use of substances are more likely than men to perceive a need for treatment. Additional predisposing and enabling factors from Andersen and Newman’s (1973/2005) model were included in the study to understand their impact on perceived need. Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 American household residents (The unweighted sample was 5,484 participants). Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need (King & Zeng, 2001a; 2001b). Results: The moderating effect of female gender was not found. Conversely, men were significantly more likely than women to perceive a need for treatment as substance use problem severity increased. The study also found that a number of factors such as race, ethnicity, socioeconomic status, age, marital status, education, co-occurring mental health disorders, and prior treatment history differently impacted the likelihood of perceiving a need for treatment among men and women. Conclusion: Perceived treatment need among individuals who meet criteria for substance use disorders is rare, but identifying factors associated with an increased likelihood of perceiving need for treatment can help the development of gender-appropriate outreach and recruitment for social work treatment, and public health messages.

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