M.A. / According to Edmonds and Wilcocks (1995:1-2), South Africa is in the grip of a major drug boom. If this is not taken seriously, South Africa could lose as much as 30% of its future generation in terms of health, happiness, functioning and even life. Drug abuse is an important factor that can affect the quality of life of not only the drug abuser, but also all those connected with them (Edmonds and Wilcocks, 1995:1-2). Substance abuse is a problem that influences the family system. Models such as Bell and Khantzian (1991) and Cooks' (1988) description of the Minnesota model define substance abuse as a disease. This model also known as the medical model, can be attributed to the work of Jellinek (1960). It focuses on individual biological factors with little consideration for familial, social or psychological variables. On the other hand, a family systems perspective indicates that the family system enables the substance abuser towards abusive patterns of behaviour. The family plays an important role in the process of dependency as well as in the rehabilitation process. These models are brought together in the study, as this combination is valuable in understanding the complexity of substance abuse and its effects on the family system. The aim of the study is to explore the families understanding of substance abuse and their role in the treatment process. A qualitative methodology is used to understand the life events, experiences and beliefs of family members, from their point of view. The focus of the research is on family members who have attended the family program at Stepping Stones Rehabilitation Center. Exploring the understanding they have of substance abuse and their role in the treatment process, from their frame of reference. The theoretical basis for the study is formulated within the medical model and a systems perspective. A nonprobability, purposive sample is utilized to seek information rich cases. Eleven respondents are interviewed. Different members within the family system are selected to illuminate the question under investigation. An interview schedule formulated from literature, is utilized to create consistency in the face-to-face interviews. The in depth interviews facilitate exploration. Data is gathered by means of a literature review, field notes and audiotapes transcribed by the researcher. Analysis of the data is done manually according to a schedule. The schedule I developed according to coding categories that are identified when working with raw data. The information from the data gathered is analysed and used to identify themes, which are offered as results. An extensive literature control is conducted, in order to further the validity of the research. From the study, methodological and theoretical conclusions can be made. Methodological conclusions indicate the effectiveness of using a qualitative methodology and face-to-face interviews in exploring the question under study. The theoretical conclusions indicate families understanding of substance abuse and their role in the treatment process. Recommendations in terms of intervention with families affected by substance abuse and future research, are drawn from the research process and context of the study ensure the link between results and conclusions and aims and objectives. The research indicates that families have an intellectual understanding of the disease concept of substance abuse. Their searching for alternative solutions and use of defence mechanisms, indicate that this concept has not been internalized. Respondents acknowledged the long term nature of recovery that is facilitated by the use of support groups.

Thesis (MSc)--Stellenbosch University, 2015 / Stellenbosch : Stellenbosch University / ENGLISH ABSTRACT : Substance abuse is a major problem globally with immeasurable consequences to the health of users. Rehabilitation is one of the strategies that can help to fight against substance abuse. It is divided into two forms: in-patient and out-patient rehabilitation. In this study, we consider a compartmental model of substance users in rehabilitation, where a periodic function is included to illustrate seasonal oscillations of drug users entering rehabilitation. In this thesis, we derive two basic reproduction numbers R0 and [R0], where R0 is the model with periodicity and [R0] the model without periodicity. We show that the model has a drug-free equilibrium when the basic reproduction number R0 is less than one and drug persistent equilibrium when R0 is greater than one. We fit the model to data and obtained sneak preview of the future of these forms of rehabilitation. Our results indicate that when R0 is less than one, the in- and out-patient populations decrease quickly and when R0 is greater than one drugs persists and after a long period of time, individuals in rehabilitation approaches w-periodic solution. Sensitivity analysis is performed and the results show that control measures should focus on the effective contact rate between susceptibles and drug users so as to control the epidemic. These results have significant implications on the management and planning of rehabilitation programs in South Africa. / AFRIKAANSE OPSOMMING : Dwelm misbruik is wêreldwyd ‘n ernstige problem met onmeetbare gevolge vir die gesondheid van gebruikers. Rehabilitasie is een van die strategieë wat dwelm misbruik kan help beveg. Dit word in twee vorms verdeel: binnepasiënt- en buitepasiëntrehabilitasie. In hierdie studie ondersoek ons ‘n kompartementele model van dwelmgebruikers in rehabilitasie, waar ‘n periodieke funksie ingesluit word om seisoenale skommelings aan te toon met betrekking tot dwelmgebruikers wat rehabilitasie aanpak. In hierdie tesis lei ons twee basiese reproduksienommers af, R0 en [R0], waar R0 die model met periodisiteit en [R0] die model sonder periodisiteit is. Ons toon aan dat die model ‘n dwelmvrye ekwilibrium het wanneer die basiese reproduksienommer R0 minder as een is en ‘n dwelm-voortsettingsekwilibrium het wanneer R0 meer as een is. Ons pas die model op die data toe en verkry ‘n vooruitskouende blik op die toekoms van hierdie vorms van rehabilitasie. Ons resultate dui aan dat wanneer R0 minder as een is, die binne- en buitepasiënt-bevolkings vinnig verminder en wanneer R0 meer as een is, die gebruik van dwelms voortduur en dat nà ‘n lang tydperk individue in rehabilitasie nader aan w-periodieke oplossing beweeg. Sensitiwiteitsontleding word uitgevoer en die resultate toon aan dat daar ‘n bewustheid moet bestaan dat die graad van effektiewe kontak tussen vatbare individue en dwelmgebruikers beperk moet word ten einde die epidemie onder beheer te bring. Hierdie resultate het betekenisvolle implikasies vir die bestuur en beplanning van rehabilitasieprogramme in Suid-Afrika. / rs201601

The purpose of this study was to uncover the methadone counseling process among recovering and non-recovering chemical dependency counselors by examining the concepts and techniques utilized throughout the counseling process. This study examined whether the recovery status of a counselor affected the counselor's theoretical addiction model and the concepts and techniques that were utilized throughout the counseling process.

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Arts in Clinical Psychology. Johannesburg, 2016 / Substance dependence is a global issue that is becoming significantly more problematic. This is due to the fact that it does not just have a devastating effect on the individual but results in profound spin-off effects, which impact society as a whole. Much research has been conducted within this area and contemporary research has seemed to focus on the link between attachment styles and substance abuse. Since its conception by John Bowlby, attachment theory has achieved an empirical authority that has contributed to its popularity in modern times. However, despite this renewed interest there still exists a gap in the literature around the role that relationships, throughout the lifespan, play in areas such as pathology and recovery. Consequently, this research embarked on an interpretive phenomenological exploration of the way relationships impact the lives of individuals suffering from substance dependence. Adults in recovery from substance dependence were individually interviewed about their experiences of their relationships during and after their years of abusing substances. Hermeneutical phenomenological analysis was used to analyse this data and it revealed a typical model of pathology where a negative childhood experience had cascading effects that culminated in the later dependence on substances. Participants all highlighted relationships with themselves or others as pivotal to either seeking substances or to going into recovery. These themes were then located within Bowlby’s (1976, 1980) developmental pathways framework in order to make sense of the progression of substance dependence along the lifespan as it manifested in these participants. / MT2017

D. Cur. / The greatest potential developed by mankind this century is the increasing awareness of one's portfolio of rights. Amongst the many rights expressed verbally, is the right to mental health. Adolescents whose parents abuse substances also qualify for this right. Fortunately, rights can be earned. Adolescents can acquire the right to mental health if they act in such a way that this will persuade others to notice and listen to them. The reality is that all efforts made towards promoting mental health of these adolescents will improve their general well-being. Mental health is generally regarded as an integral component of a human's emotional, social, spiritual and physical well-being. There is substantial evidence that adolescents living in families whose members abuse substances have difficulty in facilitating their own self-development. As a result, they are deprived of the capacity to mobilise their inner resources promoting their mental health. The study utilised a theory generative, qualitative, explorative, descriptive and contextual design. Two main samples were used. Firstly, adolescents in Grade 11 whose parents abuse substances, who at that time lived in and around rural villages within a 20 km radius of Mafikeng in the North West Province participated as respondents. The second group consist of key community leaders which consisted of groups from the Chiefs Council, police officers, community nurses and ministers of the Christian congregations. The main question that was posed during in-depth group interviews was, "How can adolescents whose parents abuse substances improve their life situations?" Adolescents and traditional healers were interviewed on a one-to-one level. A central question that adolescents had to answer was: "How can you be assisted to improve your day-to-day life?" Informed consent had been obtained from all participating adolescents and their "gatekeepers" (Cresswell, 1994: 142) and the reasons for conducting the research study were explained to all of them. The theory for this thesis has been derived inductively from data obtained from interviews with adolescents, key community people and field notes. Approaches that were used to generate theory are those suggested by Chinn and Kramer (1991: 80-108). In addition, the reasoning strategies that were employed are the analysis, synthesis, inductive and deductive methods described by Tesch (in Creswell, 1994: 155). The results were verified during literature control. Emerging from the results is a strong belief that adolescents selfdevelopment will assist them to overcome the difficulties related to their parents' substance abuse. They can do that by becoming actively involved in the process of improving their social, physical, psychological and spiritual dimensions. Concepts obtained from the results of the interviews were defined according to the steps described in Wandelt and Steward (1975: 64-69), Chinn and Kramer (1991: 84) and Copi (1987: 169). In relation to this, the term self-development was examined by using dictionary definitions, subject definitions and a model case description. Self-responsibility, facilitation and conscious-awareness were identified as essential criteria to selfdevelopment. Measures that were used to maintain trustworthiness in this thesis are truthvalue, applicability, consistency and neutrality (Guba & Lincoln, 1985: 290). The model of self-development therefore emphasises the active participation of adolescents in self-development to develop self-responsibility in their own empowerment. It is envisaged that as adolescents take self-responsibility they will discover the inherent capacities based on their body-mind-spirit and thereby improve their locus of control. Undoubtedly people can gain these capacities through their acquisition of skills, beliefs, attitudes, thoughts and values which enable them to step beyond the environment of substance abuse. This thesis therefore proposes a model of self-development on which guidelines for the advanced psychiatric nurse practitioner can be operationalised. This will assist adolescents to become self-aware and reorganise themselves in order to continue in the lifelong process of self-development.

AFRIKAANS: Hierdie navorsingstudie het ten doel gehad om 'n nasorgprogram te ontwikkel vir die benutting deur maatskaplike werkers in die hantering en behandeling van substansafhanklike adolessente. Die misbruik van afhanklikheidsvormende middels word erken as een van die grootste gesondheids- en maatskaplike probleme in Suid¬Afrika. Die eskalerende patrone van dwelmmisbruik en die impak daarvan op die individu en ook op die groter samelewing benodig gespesialiseerde vaardighede om die probleem te verstaan en aan te spreek. Met hierdie behoefte in gedagte is daar besluit om hierdie studie te doen en 'n nasorgprogram te ontwikkel om aan die maatskaplike werker in die praktyk 'n hulpmiddel te verskaf om eff'ektiewe nasorgdienste aan die substansafhanklike adolessent te lewer. Die doel van hierdie ondersoek is om verkennende- en beskrywende navorsing uit te voer na substansafhanklikheid by adolessente. Die kwantitatiewe navorsingsproses is gevolg in die navorsing, alhoewel navorsingsmetodes uit beide die kwantitatiewe- en kwalitatiewe benaderings gebruik is. Daar is twee stellings vir die navorsingstudie geformuleer, naamlik: Daar bestaan 'n leemte aan bestaande bruikbare nasorgprogramme vir die benutting deur maatskaplike werkers in die praktyk vir hulpverlening aan die substansafhanklike adolessent; en dwelmmisbruik neem toe onder adolessente en moet dringend aangespreek word. Die stellings was deur middel van die verkennende navorsingsontwerp en met behulp van persoonlike vraelyste (kwantitatiewe data¬insamelingsmetode) en semi-gestruktuurde aangesig-tot-aangesig onderhoudsvoering (kwalitatiewe data-insamelingsmetode) ondersoek. AIle kwalitatiewe- asook kwantitatiewe data het 'n ooreenkomstige bevestiging op die stellings verskaf. Hierdie data het aangedui dat daar 'n groot leemte aan effektiewe nasorgdienste ten opsigte van die substansafhanklike adolessent bestaan en dat substansafhanklike adolessente as gevolg van oneffektiewe hulpverlening telkens 'n terugval beleef. Verdere navorsing deur middel van die benutting van narratiewe terapie met 'n gesin waar 'n adolessent dwelms gebruik is gedoen. 'n Suid-Mrikaans geformuleerde meetinstrument wat substansafhanklikheid binne die adolessente kultuur en leefwyse, asook eietydse eise en probleme kan vervat en meet, word gevolglik aanbeveel. ENGLISH: The purpose of this research study is the development of an aftercare programme for social workers to use in the handling and treatment of substance dependant adolescents. The abuse of dependant substances is recognised as one of the greatest health and social problems in South Africa. The escalating patterns of drug abuse and the impact thereof on the individual as well as the greater community asks for specialised skills to understand and solve these problems. With this need in mind the researcher decided to develop an aftercare programme, which would serve as a practical guideline for social workers in practice in order to supply effective aftercare services to the substance dependant adolescent. The aim of the study was to investigate substance dependency by adolescents through exploratory- and descriptive studies. The quantitative research process was followed although both the qualitative and quantitative methods were used. Two suppositions were formulated for the research study: A huge gap currently exists for aftercare programs for the assistance of social workers in practice to substance dependant adolescents. These suppositions were investigated through the use of exploratory research design and with the assistance of personal questionnaires (quantitative date gathering method) and semi-structured face-to-face interviewing (qualitative data gathering method). Both quantitative and qualitative data confirmed the formulated suppositions. The data clearly indicated the need for effective aftercare services for substance dependant adolescents, which frequently experience a relapse due to the lack of assistance. Further research can be done through the use of narrative therapy within a family in which an adolescent used drugs. A South African formulated measurement scale, which is able to measure substance dependency within the adolescent culture and way of life, are recommended. / Dissertation (MA (SW))--University of Pretoria, 2006. / Social Work and Criminology / unrestricted

Hypothesis on success in addiction treatment programs as measured by BEM Sex-Role Inventory.

Subjects were 2,950 patients who had previously received inpatient treatment for substance abuse at 40 treatment centers in 13 states and were followed up by the Chemical Abuse/Addiction Treatment Outcome Registry (CATOR) via telephone during the 2 years immediately following their treatment. All subjects were contacted every 6 months and asked a series of questions regarding their relapse status, medical utilization, illnesses, injuries, and arrests. Patient status was based on 3 categories: (1) abstinence from any abuse of a chemical, (2) brief relapse of less than 3 months abuse of any chemical, or (3) total relapse of longer than 3 months of any chemical. Findings showed that abstainers had fewer days in the hospital for emotional problems and detoxification. Abstainers also had fewer visits to the hospital for emergency reasons. Males in the brief relapse category had a greater number of injuries than abstainers or total relapsers. Regarding arrests and automobile accidents, no difference was discovered. However, regarding Drunk While Driving (DWI) arrests, abstainers had fewer arrests.

Analyzes the motivation of clients beginning a drug and alcohol treatment program to see if their level of motivation affects their success in the program, as measured by drug screens. Thirty-six participants from the Perris Valley Recovery Program (PVRP) in Southern California took a motivation for treatment questionnaire reflecting their levels of motivation for treatment. Results of the study found significant relationships between clients' motivation to be in substance abuse treatment and clean or dirty drug screens.

The purpose of this study was to gain a deep phenomenological understanding of how young adults living in a detoxification centre for people with no fixed abode made the life changing decision to free themselves from substance use and provide insights that could be helpful for counselling psychologists working therapeutically with this client group. An exploratory study was conducted using Interpretative Phenomenological Analysis (IPA). The participants were between the ages of 25 and 29 years old (1 female and 5 males). All participants had spent 6 weeks in the detoxification centre at the time the interview took place. Two specific areas were pinpointed for exploration during the semi-structured interviews: (1) self-concept before entering the project and after having entered the project and been abstinent for at least 6 weeks, and (2) possible links between homelessness and substance use. Emerging themes were clustered in terms of polarities and existential dimensions. Four superordinate themes comprising of eight existential polarities were extrapolated: control-chaos; connectedness-disconnection; meaning-meaninglessness; responsibility-guilt. The data analysis revealed participants’ struggle to resolve the conflict between these polarities. Identity issues seemed to be crucial, as well as a sense of having lost touch with or possibly never developed an authentic self and a struggle to live and accept emotions in the present moment. Another aspect that emerged was difficulties in grieving losses as well as death anxiety. Connecting with others and caring about oneself seemed to be closely linked and conducive to wellbeing in participants’ experience of abstinence from substance use. On the basis of this study recommendations are made for professionals working therapeutically with this group of clients. These include taking an existential approach and using mindfulness techniques to support clients to accept the polarities we experience in life and to develop the capacity to embrace the contradictions of our existence.