Recovery from alcoholism and substance abuse has had an ignominious history. There does not appear to be any statistics that stand up to any rigorous fact-checking which show how well treatment centers do at helping their clients to stay sober. Statistics that are used to show success rates are not considered credible and they are shockingly low. Despite these issues, substance abuse research has failed to link the historical knowledge of why people stay sober for long periods of time with what is being taught in treatment centers in hopes of creating a better, more accurate outcome. The qualitative, phenomenological research study was conducted to ascertain whether a treatment center was teaching the curriculum components that prior research studies had found allowed an addict or alcoholic to stay sober for 20 plus years. Twelve volunteer participants (i.e., nine clients and three counselors), at a treatment center located in Southeast Florida, were interviewe d regarding their perceptions of the curricula being taught in the treatment center. Patterns emerged with the clients regarding their perceptions of spirituality and 12-step programs, believing that spirituality and 12-step programs were significantly emphasized in treatment and that they were very important to their recovery when they left treatment. Counselors agreed with this finding, but felt stronger about the importance of family and social support than did the clients. Overall, the clients felt that what was emphasized in treatment was important to their recovery and intended to use their new knowledge in helping them stay sober. Implications for treatment centers and recommendations for future studies are discussed. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

Despite significant medical advances in HIV treatment, people living with HIV and substance use (PLWH-SU) remain left behind. Compared to people living with HIV (PLWH) without comorbid substance use, PLWH-SU are less likely to engage in medical care and to achieve viral suppression. As a result, PLWH-SU have more frequent preventable hospitalizations, higher rates of viral transmission, and greater morbidity and mortality. Although there is extensive research that explores ways to enhance PLWH-SU’s engagement in HIV care by improving patient-provider interactions, most have focused on the patient, and none have been effective. Grounded in the sociological theory of habitus, this dissertation attended to the medical provider in the patient-provider dyad and aimed to better understand how medical providers’ perceptions and dispositions towards PLWH-SU are formed, and how these perceptions and dispositions are displayed in the ways medical providers interact with and take care of PLWH-SU. Before engaging with habitus, I first conducted a systematic review on how the theory has been used to study medical providers’ clinical practices. Results of the review show that while existing literature has been limited and unclear in its usage of habitus, these studies are informative, and they demonstrate that habitus can be a suitable theoretical foundation for expanding present approaches to research on medical providers’ clinical interactions with PLWH-SU. Following the systematic review, I developed my conceptual framework of medical providers’ treatment habitus (i.e., medical providers’ dispositions towards caring for PLWH-SU) and estimated a typology of treatment habitus using survey data from 258 medical providers in Miami, Florida, Atlanta, Georgia, and the District of Columbia. My analyses show that among this sample of medical providers, there are four types of treatment habitus towards caring for PLWH-SU, and treatment habitus is associated with multi-level factors (e.g., providers’ race, study site, receipt of substance use disorder training). To further explore how medical providers came to develop and how they understand their own treatment habitus, I conducted conversational interviews with 36 medical providers who had completed the abovementioned survey. These interviews revealed medical providers exhibit a spectrum of treatment habitus that is distinguishable by their intentions (person-centered vs. provider-centered) and their methods (informative vs. directive). The interviews also revealed that there are discrepancies in how medical providers spoke about PLWH-SU and how they described their practices towards caring for PLWH-SU. Specifically, although most providers used negative terms to refer to PLWH-SU, the stigmatizing language was almost never accompanied by recollections of stigmatizing behaviors during clinical interactions with PLWH-SU. Taken together, this dissertation expanded on current knowledge about not only how medical providers act when caring for PLWH-SU, but also why they act the ways they do. Findings from this study contribute to an understudied area of HIV and substance use research and provide insights for the development of novel provider-based interventions that can improve the health of this vulnerable and marginalized population.

The proposed research aims to explore and describe the experiences, challenges and coping strategies of fathers, parenting children, abusing illegal substances. The use and abuse of illegal substances became national and global dilemmas. The impact and damage caused when drugs are widely used over time is irreversible, as it influences the lives of users and those of their families, their communities, and the country. This research provides an opportunity for fathers, parenting children, abusing illegal substances to share their experiences and challenges. Data are collected by conducting in-depth and face-toface interviews with the participants. The collected data are analysed by following the eight steps of Tesch in Creswell (2009:186). Data are analysed using Lincoln and Guba’s model of trustworthiness of qualitative research for validation. The study endeavours to obtain an understanding of the experiences and challenges encountered by fathers, parenting children, abusing illegal substances and how social workers could assist in addressing this dilemma. / Social Work / M.A. (Social Work)

The focus of this study is the relevance and effectiveness of the support structures available to high school learners with substance abuse problems. This research was confined to learners in Eersterust, a township situated to the east of Pretoria. Substance abuse, especially among high school learners in South Africa and in Eersterust, has increased in recent years. Substance abuse obviously poses a major barrier to learning. Along with poor academic motivation, this problem seriously interferes with learners’ academic performance and results in lower educational achievement. As an institution, the school is not able to provide support to these learners and so is obliged to link them with support structures such as the South African National Council on Alcoholism and Drug Dependance (SANCA) and the National Youth Development Outreach (NYDO). / Inclusive Education / M. Ed. (Inclusive Education)

The focus of this study is the relevance and effectiveness of the support structures available to high school learners with substance abuse problems. This research was confined to learners in Eersterust, a township situated to the east of Pretoria. Substance abuse, especially among high school learners in South Africa and in Eersterust, has increased in recent years. Substance abuse obviously poses a major barrier to learning. Along with poor academic motivation, this problem seriously interferes with learners’ academic performance and results in lower educational achievement. As an institution, the school is not able to provide support to these learners and so is obliged to link them with support structures such as the South African National Council on Alcoholism and Drug Dependance (SANCA) and the National Youth Development Outreach (NYDO). / Inclusive Education / M. Ed. (Inclusive Education)

The focus of this study was to explore and analyze the perceptions of treatment effectiveness among substance abuse clients involved in Bilingual Family Counseling Outpatient Treatment. The intent was to have a better understanding of a treatment centers program's outcome from the clients' point of view and its effectiveness in terms of the usefulness to the client.

In South Africa, substance use, abuse and dependency is twice the world norm. To address this trend, the continuum of care guides legislative prescriptions for the treatment of a substance use disorder. This study aimed to address the lack of a description of the utilisation thereof in literature and recent research findings. A qualitative approach was followed and purposive sampling was employed to collect data from both service providers and users of services. Tesch’s framework for qualitative data analysis (Creswell, 2014:218) was used to identify themes, sub-themes and categories, while the data was compared with existing literature on the identified themes. The trustworthiness of the findings was enhanced by the verification of the data through aspects of credibility/authenticity, transformability, dependability and conformability (Schurink, Fouché and de Vos, 2011:397). Informed consent, confidentiality , non-compensation, debriefing of participants, and the management of information were considered to ensure ethical practice. / Social Work / M.A.(S.S.)

The abuse of substances by South African young people has led to the development of specialised residential treatment programmes. This qualitative and phenomenological study sought to explore child and youth care interventions which contributes towards children’s recovery from substance abuse/dependency. Data was collected through purposive sampling, with face -to -face interviews with a broad interview guide and it’s analysis was influenced by Patton and Creswell’s eight steps for qualitative data analysis and interpretation. The study confirmed the involvement of South African child and youth care workers in substance abuse programmes for young people. Specific interventions such as an existence of a therapeutic relationship between child and youth care workers, the use of the relationship as a model for other relationships, the availability and presence of the child and youth care worker, the adolescent development programme and young people’s involvement in their individual development programme that contributed to recovery from substance dependency were identified. / Social Work / M. Tech. (Child and Youth Care)

The susceptibility of adolescents to chemical addiction has become a major international concern. Approximately 25% of people in Central Asia and Eastern Europe who inject chemical substances are under the age of 20 years (Youth at the United Nations, 2006), while up to 75% of unintentional injuries among adolescents in America are related to substance abuse (Page & Page, 2003:196). On the national level, approximately 25% of adolescents under the age of 20 are involved in substance abuse (Western Cape Department of Social Services and Poverty Alleviation Transformation Plan, 2006:13). Focusing on the Western Cape, a report from the South African Epidemiology Network (2007:3) highlights that the youngest patient in in-patient treatment was nine years of age, and among 2 798 persons who received in-patient treatment, 27% were under the age of 20, more than any other age group in treatment. Treatment of adolescent chemical addiction should include preparation for treatment, treatment, and also aftercare services to ensure that the addicted adolescent develops skills to maintain sobriety (Meyer, 2005:292-293). Section Six of the South African Prevention and Treatment of Drug Dependency Act (1992) prescribes that chemically addicted persons should have access to professional aftercare services to ensure that treatment is not terminated prematurely. The motivation for this study was based on the fact that, despite this statutory requirement, the Western Cape Drug Forum (2005:3) identified the need for the development of aftercare services in 2005, indicating the lack of focus on aftercare as part of treatment. This concern was confirmed by practitioners in the field of adolescent chemical addiction and findings resulted from previous research regarding relapse experiences of chemically addicted adolescents (Van der Westhuizen, 2007:129-130). / Social Work / D. Phil. (Social Work)

Chemical substance abuse and dependence constitute an increasing international and national phenomenon. Individuals, groups and communities are at risk of the mental, biological, legal and environmental implications associated with substance dependence. Human sexual behaviour is no new phenomenon to be studied. Human beings experience sexual behaviour and gratification as important. Sexual behaviour is not vital for the survival of the individual but vital for survival of the species. Sexual behaviour in combination with chemical substance abuse might pose further dangers to a person or group. Sexual behaviour where persons engage in sexual actions when using or abusing chemical substances could construct certain positive functions for persons. Qualitative researchers are interested in discovering the meaning persons attach to experiences. In understanding the dynamics of the phenomenon, possible contributions to the human sciences could be made. Chemical substance abuse and dependency affect the individual, his/her family systems and the community. Depressants and stimulants change the chemical functioning of the human brain and the mental health of the user. Despite the harm caused to the dependent person, abuse of the chemical substance is continued. The substance has various functions that the biological and psychological person becomes dependent on. Sexual behaviour is inherent in human nature, but not chemical substance abuse. It is expected by the researcher that there might be certain function(s) served by chemical substances in the sexual behaviour of persons. A literature study on the topic on the function of chemical substances in the sexual behaviour of persons yielded unsatisfactory results. Little research was found with regard to the function of chemical substances in relation to people’s sexual behaviour. In response to this need the researcher embarked on a qualitative research journey to explore the function of the chemical substances within the context of an individual’s sexual behaviour and practices. Chemical substances have different functions and affect the sexual behaviour, functioning and experiences of the users of such substances. Six objectives were set with the aim of developing an in-depth understanding of the function of chemical substances in sexual behaviour. The research question of this investigation leads to a clear inquiry into the phenomenon that was examined and analysed and yielded useful new information. This qualitative research project is characterised by its inductive features, openness to change and interest in human behaviour. The study is characterised by an interpretive nature as an interpretative investigation. An effort was made towards understanding the phenomenon through observation and exploration. Persons were invited to participate in the research and reported themselves to the researcher, the process of self-selection sampling was utilised. In drawing a sample from the population of patients at a treatment centre an interactive approach to the process was followed by conducting semi-structured and in-depth interviews as a method of data collection. Data analysis and processing was executed according to the eight steps for qualitative data analysis as proposed by Tesch (in Creswell, 2009). Data verification for the assessment of the trustworthiness of the research findings was achieved by utilizing Guba’s model as espoused in Krefting (1991). Informed consent, confidentiality and management of information were some of the ethical considerations adhered to in the planning and execution of this research project. The nature of this study is marked by the person-centred approach in combination with the qualitative methodology and philosophy. The researcher found the two to be appropriate when a sensitive and private topic was to be explored. Participants were able to evaluate the meanings that were attached to their experiences within a psychologically sound environment. Themes became evident through the data analysis process. These themes were contrasted against a body of existing theory. The wholeness of human beings came to the fore and literature from a bio-neurological and humanistic perspective was found to be applicable. The social sciences and, in particular, social workers are concerned with the wellbeing of persons, their relevant systems and context. These dimensions of human beings were addressed by this study and aimed to contribute to further development in the science of psychotherapy and the understanding of the person within the phenomenon being studied. Therapists should be willing and demonstrate a sensitive ability to understand the client’s experiences from the person’s own point of view (Rogers, 1950: 444). In a relationship that is constructed for the purpose the aim should be mainly to understand the whole person (Rogers, 1952: 343). Therapists should develop an ability to see completely through the client’s eyes and adopt the person’s frame of reference. This is the basis for implementing “client-centred” therapy (Rogers 1950: 444). A key role of social work practice is facilitating the empowerment of persons, and their personal and interpersonal strengths according to their own self-determination (Zastrow, 2012:39); the researcher recommends a holistic full understanding of the person in his/her wholeness (Rogers, 1987: 486). / Exploring the functions of chemical substances in individuals' sexual behavior / Interviews in English and Afrikaans / Department of Social Work / M.A. (Social Work)