Amelia C. Roberts

Contextual factors and other correlates of sexual risk of HIV among African–American crack-abusing women

This study examined differences in contextual factors, substance use, sexual risk behaviors, and comorbid histories between African-American, out-of-treatment, crack-abusing women who had either a single sexual partner or multiple partners. Bivariate analysis indicated that women with multiple partners were more likely than women with a single partner to be homeless, financially dependent, and to have histories of sexual, physical, and emotional abuse. Women with multiple partners reported higher levels of depression, anxiety, and more symptoms of posttraumatic stress disorder (PTSD). In multiple logistic regression analysis, being unemployed, difficult childhood, and number of days of crack use in the previous 30 days, longer crack runs, and more frequent unprotected fellatio were associated with increased odds of having multiple sexual partners. Being married or living as married was associated with decreased odds of having multiple sexual partners. The importance of assessing contextual and historical factors and implications for future research is discussed.

Revisiting the Need for Feminism and Afrocentric Theory When Treating African-American Female Substance Abusers:

African-American women who are addicted to illicit substances are disproportionately over-represented in jails, prisons, and treatment programs. In addition, this group suffers greater deleterious physical and mental health effects of alcohol and drug abuse (McNeece & DiNitto, 1998). When African-American female substance abusers enter treatment or are the focus of intervention research, clinicians and researchers have a distinct opportunity to serve these women in a culturally competent manner and assist in the healing and recovery process. Black feminist theory and Black family theoretical perspectives are explicated as the theoretical underpinnings of the Afrocentric treatment paradigm, which is beneficial in developing culturally sensitive interventions for this group of women. Culturally appropriate treatment tools and interventions are suggested as a means of empowering substance dependent African-American women.

Treatment of Incarcerated, Sexually-Abused Adolescent Females: An Outcome Study.

ABSTRACT This study examined the psychosocial functioning of 100 adolescent females (ages 12–17) sentenced to secure care in a southeastern state and the impact of a gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to a gender-specific, CBT-based intervention.

COERCION AND DRUG TREATMENT FOR POSTPARTUM WOMEN

This research examined the extent to which various indicators of coercion were related to treatment retention in a gender-specific treatment program and a traditional outpatient program for pregnant and postpartum women who were mandated to enter treatment. Women who were given custody of their infant stayed in treatment longer than women who did not have custody. There was an interaction effect with women who had custody and were in the intensive day treatment program completing treatment at a much higher rate than those in the traditional program. Implications for social work professionals and policy makers are discussed.

Barriers to Engaging and Retaining African- American Post-Partum Women in Drug Treatment:

Little is known about barriers to engaging and retaining African-American women in drug treatment. This descriptive study addressed three questions regarding barriers to substance abuse treatment for African-American women: What barriers made it difficult for women to participate in treatment? Did identified barriers differ by program modality? To what degree were barriers related to treatment retention? Findings revealed that barriers considered to be internal in nature, i.e., “drug severity,” “did not feel like going,” and “felt I could manage on my own,” were most frequently reported. Only a few program-related barriers were found to be related to length of time in treatment and both internal and programmatic barriers had an effect on treatment completion. Implications for policy decisions, future research, and clinical competence in addressing barriers to treatment for African-American women are discussed.

Reconceptualizing Substance Abuse Treatment in Therapeutic Communities: Resiliency Theory and the Role of Social Work Practitioners

ABSTRACT Although therapeutic communities (TC) have achieved promising results in the treatment of substance abusers, several areas have been identified which might further enhance TC treatment effectiveness. Two of these, resiliency theory and the role of social work practitioners, are discussed. Resiliency theory provides a framework for re-conceptualizing interventions as they apply to therapeutic communities. Resiliency is explicated and illustrated via a case study of a therapeutic community TROSA (Triangle Residential Options for Substance Abusers), a non-profit TC in Durham, North Carolina. A number of contributions that social work practitioners can make to TCs are described.

Exploring Trauma Among Homeless Men in Treatment for Substance Abuse: A Qualitative Approach

ABSTRACT This paper presents data from qualitative interviews of ten homeless men attending a substance abuse treatment agency in the Southeast. Each subject participated in a one time in-depth qualitative interview focused on his family background, mental health, treatment experiences, and trauma. Qualitative analyses found that this sample of substance abusing homeless men reported a high prevalence of depression, family dysfunction, trauma, and a pattern of several previous treatment experiences for substance abuse and/or mental health. Findings imply that in order to promote long-lasting positive outcomes in substance abuse recovery, mental health stability, and quality of life, treatment professionals need to address complex and interrelated issues that often surround this underserved population.

Cocaine Abusing Women Who Report Sexual Abuse: Implications for Treatment

ABSTRACT Four hundred seventy-three substance-abusing women were assessed for histories of sexual abuse. The results of bivariate analysis indicated that Sexual Abuse Survivors (SAS) had higher levels of depression, anxiety, and psychological distress. A greater number of SAS reported histories of emotional and physical abuse. They also had greater severity on ASI scales of alcohol, drug, medical, and family/social difficulty. Logistic regression analysis indicated that women who were survivors of sexual abuse were more likely to have histories of emotional and physical abuse, higher levels of addiction severity, and more family members who used drugs. Implications for research and treatment are discussed.