Kristen D. Seay

Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review

The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-White, non-heterosexual populations.

The comorbid and individual impacts of maternal depression and substance dependence on parenting and child behavior problems

Maternal depression, substance dependence, and the comorbidity of these conditions are highly prevalent risk factors among families involved with Child Protective Services (CPS). Data from the National Survey of Child and Adolescent Well-Being I (NSCAW I) were analyzed to examine the influence of maternal substance dependence, depression, and comorbidity on parenting and child behavior over 36-months among children reported to CPS who remained in the home at all waves. Although neglect and child behavior problems were highest for mothers with comorbidity at baseline, mothers with substance dependence had the poorest self-reported parenting and child behavior problems over time. Results indicate a need for intensive targeted services to address the complex needs of CPS-involved mothers with substance dependence and their in-home children.

The Influence of Childhood Sexual Abuse on Adolescent Outcomes: The Roles of Gender, Poverty, and Revictimization

Research on child sexual abuse has focused on adult revictimization and outcomes. This article examines the rate of child maltreatment revictimization among male and female children reported to child protective services for child sexual abuse and whether revictimization impacts outcomes. Using longitudinal administrative data, Cox regressions were used to examine relationships between initial report of child sexual abuse, maltreatment revictimization, and adolescent outcomes among children from poor and nonpoor families. Despite no significant differences in child sexual abuse rates between poor and nonpoor families, poor child sexual abuse victims were significantly more likely to have re-reports for maltreatment. Children with multiple reports were more likely to have negative outcomes. Interventions for child sexual abuse survivors should focus on preventing maltreatment recurrence generally and not ignore needs of male victims.

Caregiver Substance Abuse and Children's Exposure to Violence in a Nationally Representative Child Welfare Sample

Using data from the National Survey of Child and Adolescent Well-Being II, this article examines the impact of caregiver substance abuse on childrens exposure to violence in the home in a nationally representative sample of families involved with child protective services. Logistic regression analyses indicate an increased risk of witnessing mild and severe violence in the home for children whose primary caregiver was abusing alcohol or drugs. However, analyses did not find statistically significant relationships between child report of direct victimization in the home by mild or severe violence and caregiver alcohol or drug abuse.

A Meta-analysis of the Effectiveness of Interactive Middle School Cannabis Prevention Programs

This meta-analysis examines the effectiveness of interactive middle school-based drug prevention programs on adolescent cannabis use in North America, as well as program characteristics that could moderate these effects. Interactive programs, compared to more didactic, lecture style programs, involve participants in skill-building activities and focus on interaction among participants. A systematic literature search was conducted for English-language studies from January 1998 to March 2014. Studies included evaluations using random assignment or a quasi-experimental design of interactive school-based substance use prevention programs delivered to adolescents (aged 12–14) in North American middle schools (grades 6–8). Data were extracted using a coding protocol. The outcomes of interest were post-treatment cannabis use, intent to use, and refusal skills compared across intervention and control groups. Effect sizes (Cohen’s d) were calculated from continuous measures, and dichotomous measures were converted to the d index. A total of 30 studies yielding 23 independent samples were included. The random effects pooled effect size for cannabis use (k = 21) was small (d¯

Scaling Up: Replicating Promising Interventions with Fidelity

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Project STRONG: A Capacity-Building Intervention to Improve Grant Writing Among Substance Abuse Organizations

= -0.07, p < 0.01) and favorable for the prevention programs. The pooled effect sizes for intention to use (k = 3) and refusal skills (k = 3) were not significant. Moderator analyses indicated significant differences in program effectiveness between instructor types, with teachers found to be most effective (d¯