Increased demands on amphetamine dependence treatment services point to a need for effective pharmacotherapies for withdrawal symptom suppression. However, empirical data on which to base effective treatments are scarce. To address the need for an evidence base, four studies were conducted in two countries - Australia and Thailand. Firstly, the time course and severity of amphetamine withdrawal symptoms were characterised in two inpatient samples of amphetamine users. Results identified the first week of abstinence as an acute withdrawal phase characterised by increased sleeping, eating and a cluster of mood and anxiety - related symptoms. Following the acute phase, most withdrawal symptoms remained stable and at low levels for the remaining two weeks of abstinence ( the sub - acute phase ). Data from these two studies formed the basis for a new instrument, the Amphetamine Cessation Symptom Assessment scale ( ACSA ). On psychometric testing, the ACSA showed satisfactory reliability and a clear psychometric structure, delineating symptom clusters and their correlates with a three factor solution providing the best fit to the data. Using the ACSA to measure outcome, the safety and efficacy of the serotonin and noradrenaline reuptake inhibitor antidepressant mirtazapine ( 15 - 60 mg per day, n = 13 ), and the wake-promoting drug, modafinil ( 400mg per day, n = 14 ) were assessed in successive, open - label, inpatient pilot trials. Study medication was administered for up to ten days. An historical comparison group ( n = 22 ) who received treatment as usual consisting of pericyazine 2.5 - 10mg per day for control of agitation served as a comparison. Results showed that modafinil and mirtazapine were well tolerated, producing minimal positive subjective effects. There were significant group differences in withdrawal severity ( F = 18.6, df 2,219 p < 0.001 ). Post - hoc analysis showed that modafinil was more effective than mirtazapine ( p = 0.041 ), and both were more effective than treatment as usual ( both p < 0.001 ) in ameliorating withdrawal severity. Overall, these studies identified a peak in withdrawal severity during the first week of abstinence ; demonstrated the reliability and validity of the ACSA and identified modafinil as a safe and potentially effective pharmacotherapy for the treatment of amphetamine withdrawal symptoms. / Thesis (Ph.D.)--Medical School, 2005.

<p>The aim of this study was to explore how professional helpers, who work at a clinic in South Africa, experience and are affected by their work in the assessment and treatment of child sexual abuse. Twelve professional helpers were interviewed using a qualitative, semi-structured interview. The analysis of the interviews resulted in five overall categories. These are; The work with children; Pressures at work; Motivation for doing the job; Influences on a personal level and Coping strategies. Our study reveals that all of the professionals are influenced by their work but most of them not to the extent that they cannot enjoy life. The people who, apart from working with abused children, also work within management seem more affected by their work. Thus one of the conclusions is that the professionals are influenced by the entire work situation and not only by the clients that they meet. Another conclusion is that the work with sexually abused children has an effect on the professionals'private lives and that boundaries between work and private life are hard to keep.</p>

The aim of this study was to explore how professional helpers, who work at a clinic in South Africa, experience and are affected by their work in the assessment and treatment of child sexual abuse. Twelve professional helpers were interviewed using a qualitative, semi-structured interview. The analysis of the interviews resulted in five overall categories. These are; The work with children; Pressures at work; Motivation for doing the job; Influences on a personal level and Coping strategies. Our study reveals that all of the professionals are influenced by their work but most of them not to the extent that they cannot enjoy life. The people who, apart from working with abused children, also work within management seem more affected by their work. Thus one of the conclusions is that the professionals are influenced by the entire work situation and not only by the clients that they meet. Another conclusion is that the work with sexually abused children has an effect on the professionals'private lives and that boundaries between work and private life are hard to keep.

Masters of Art / High rates of substance use and its associated problems afflict Cape Town, underscoring the need for easily accessible substance abuse treatment. Despite the substantial benefits for both individuals and society at large that substance abuse treatment confers, substance abusers often first have to negotiate considerable challenges in order to access treatment and accumulate these gains. That is, experiencing barriers to accessing treatment, together with the presence of socio-demographic features, rather than “need for treatment”, decides who accesses treatment. Referrals are the gateway to inpatient substance abuse treatment in the Western Cape. While several barriers to accessing treatment have been identified by prior studies, none examine these phenomena from the point of view of the agents responsible for referring substance users for treatment. Moreover, access barriers to inpatient substance abuse services are a neglected area in extant literature. To address this gap, this study explored the perceptions of referring agents‟ of the barriers to accessing state-funded inpatient substance abuse treatment centres in the Western Cape. This enabled the researcher to compare existing access barriers to treatment as identified by prior research, to those elucidated in the study. Bronfenbrenner‟s Process-Person-Context-Time model was employed as the basis for understanding identified barriers. In accordance with the exploratory qualitative methodological framework of the study, six semi-structured individual in-depth interviews were conducted with referring agents‟ of differing professional titles who were purposefully selected and expressed a willingness to participate in the study. Interviews were audio-recorded, and transcripts were analysed and interpreted by means of Thematic Analysis. Two broad thematic categories of access barriers were identified: Person-related barriers (denial, motivation for treatment, gender considerations, disability, active TB disease, homelessness, psychiatric co-morbidity) and Context-related barriers to treatment (cultural and linguistic barriers, stigma, community beliefs about addiction and treatment, awareness of substance abuse treatment, affordability/ financial barriers, geographic locations of treatment facilities, waiting time, lack of collaboration within the treatment system, beliefs of service providers‟, lack of facilities/ resources within the treatment system, practices at inpatient facilities, referral protocol and uninformed staff). Results suggest that by targeting the aforementioned barriers, access to inpatient and outpatient treatment services can be improved, and recommendations for interventions are offered in this regard. Ethical principles such as obtaining informed consent and ensuring confidentiality were abided by throughout the study and thereafter.

No description available.