No description available.

The purpose of this study was to compare nonverbal emotional expressiveness between substance users and nonsubstance users.

The purpose of this study was to determine what influence scheduled phone contacts would have on the extent of follow-through of continuing care recommednations by participants after treatment. Continuing care recommendations associated with ongoing sobriety include going to another level of care (individual therapy, group therapy, outpatient treatment), attending twelve-step meetings and communicating with a sponsor. Continuing care recommendations are typically written and referred to as a continuing care plan.

The Peer Recovery Support Specialist (PRSS), a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorders, plays a key role in the ongoing transformation of SUD treatment from one of acute clinical service provision with documented short-term outcomes including symptom reduction, to a more holistic and comprehensive approach to long-term recovery. Empirical evidence specific to outcomes of PRSS working in the addiction treatment realm is sparse and equivocal, indicating the need for additional research and improved methods designed to explore the nature of the PRSS role and fit within the expanding models of a recovery eco-system. This sequential exploratory mixed-methods study surveyed PRSS in five states of Central Appalachia in order to better understand the nature of their work, personal recovery characteristics and their interactions within existing recovery ecosystems. The final sample included 565 PRSS. Results indicate that PRSS frequently provide emotional support to persons they work with and are overwhelmingly satisfied with their work but have few professional advancement opportunities and generally feel that others misunderstand their role. They have a strong voice and wish to be heard as evidenced by their responses to open text questions and interest in future work. This baseline survey can serve as the beginning of a framework for improved methods if driven by PRSS.

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.

Alcoholics Anonymous (AA) continues to be the most accepted approach for the treatment of addictions in the United States. However, due to recent evidence questioning the effectiveness of AA, the need for alternative approaches to the treatment of addictions has become clear. The following research addresses the efficacy of one such alternative, Rational Recovery (RR). Node-Link Mapping (NLM), a graphic communication technique which uses links and nodes as building blocs to facilitate and enhance communication of information as well as awareness in a counseling environment, was implemented to enhance the recovery process. Three groups of ten (10), chemically dependent, adjudicated subjects were exposed to three different treatment approaches at an outpatient counseling center. The Experimental group received RR with NLM, the Comparison group was exposed only to RR, and the Control group continued in treatment according to the protocol of the counseling agency. All subjects were given the Substance Abuse Subtle Screening Inventory-2 (SASSI-2) as a measurement of symptoms associated with chemical dependency. The subjects were also administered the Rotter Internal-External Locus of Control Scale (Rotter I-E Scale) to determine locus of control prior to treatment and any change after treatment.

The study compared an experimental group (n=26) who participated in weekly SIS sessions as an adjunct to existing treatment protocols for a period of 6-8 weeks, to a control group (n=14) who matriculated in treatment without the addition of SIS training for a period of 6-8 weeks. Subjects completed a battery of questionnaires at the beginning of the measurement period and at the end of the measurement period. The SASSI-2, The McMaster Family Assessment Device (FAD), and the Rotter Internal-External Locus of Control Scale were used to measure groups on recovery related variables at Pre-Test and Post-Test. Results demonstrated a consistent pattern of improvement over the time measure. The results of the interaction of group and time demonstrated a pattern of gains which did not reach statistical significance, partially as an artifact of the small sample size. An investigation of effect sizes was conducted to detect the effect of SIS training. The training was found to have a moderate effect size, which was consistent with other research using SIS training. Some areas for possible future research were addressed.

This qualitative study examined the viability of traditional stories in substance abuse treatment. The subjects for this study were young women ages 18-30 who were in substance abuse treatment in a small, rural, health department. During the 4-week study, 4 traditional stories were used in group sessions that gave the women a common reference point and a common language to frame discussions. Using story in the IOP sessions helped to create a safe, supportive environment as well as creating an opening for discussions about trauma and abuse, and other significant issues. Principles of 12 Step Recovery were woven into the discussion to help the participants deal with and reframe their experiences.

No description available.

Though there is a high comorbidity between serious mental illness and substance use (dual diagnosis), little research has been conducted concerning the treatment of seriously mentally ill substance users. This study examined subjects (N=154) who participated in dual diagnosis treatment groups in a suburban out-patient community mental health center during a 10 year period, in order to determine the characteristics of subjects who responded well to outpatient group treatment. Data on 28 demographic, diagnostic, treatment and treatment participation variables were collected on each subject and the data was then analyzed by correlational, discriminant and multiple regression statistical procedures. Each of the procedures found that a more positive recovery status at admission combined with longer-term treatment and participation in additional treatment services were highly related to positive treatment outcomes. Four variables (more positive recovery status at admission, participation in a greater number of treatment groups, greater involvement in self-help groups and hospitalization while in treatment) were found significantly related to positive treatment outcome in all three statistical tests. There were also differences in gender and race/culture sub-groups concerning which variables contributed to positive treatment outcomes. / Master of Science