Layne K. Stromwall

Promoting Reduced and Discontinued Substance Use among Adolescent Substance Users: Effectiveness of a Universal Prevention Program

Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin’ it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use. Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N=1,028), the rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N=1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research are discussed.

Using Cooperative Learning Strategies in Social Work Education.

Cooperative learning strategies employ formally structured groups of students working together to maximize their own and other students’ learning. This educational approach changes the classroom environment from one in which students are passive recipients of the instructor’s knowledge, to one in which they are active participants in their own education. Cooperative learning strategies have received little attention in the social work education literature, despite proven educational benefits elsewhere. This article defines cooperative learning, reviews the educational theory and research that support it, demonstrates its relevance to social work education, and provides case examples for use throughout the social work curriculum.

Identifying and Reducing Barriers to Reunification for Seriously Mentally Ill Parents Involved in Child Welfare Cases

Forming judgments about parenting capacity, a necessary part of permanency planning, is much more difficult when the parent has a serious mental illness. The time necessary for effective treatment for such parents is often longer than the court-ordered time limit for family reunification. This puts mentally ill parents at a distinct disadvantage in their efforts to preserve their families. Using Arizona as an example, this article discusses the barriers in both child welfare and mental health systems to accurate and effective assessment and treatment. It presents recommendations for research and suggestions for child welfare personnel to enhance the potential for mentally ill parents to reunify with their children.

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict womens unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.

Mental Illness Discrimination in Mental Health Treatment Programs: Intersections of Race, Ethnicity, and Sexual Orientation

People with mental illnesses (PWMI) who are of color and/or lesbian, gay, or bisexual (LGB) experience mental health disparities, including within mental health treatment programs (MHTPs). Informed by a critical framework with attention to intersectionality and microaggressions, this qualitative study asked 20 PWMI and family members who also are of color and/or LGB whether they had experienced mental illness discrimination in MHTPs, a possible factor in disparities. We also asked participants about aspects of MHTPs that supported recovery. Participants reported that they were ignored/not listened to, not viewed as complex individuals, experienced condescension/lack of respect and violations of privacy or other rights, and were presumed to lack intelligence. In addition, identifying mental illness discrimination was complex due to intersections of identities. Despite these perceptions of discrimination, participants described supportive aspects of MHTPs. Implications for practice and research are offered.

A community response to tragedy: Individualized services for families

The murder of a 13-year-old young woman mobilized one community to initiate a “wraparound” service model for their most hard-to-reach families. These families struggled with parental substance abuse, youth at high risk, and associated complex needs cutting across existing categorical programs. The strength and empowerment based program, in which interventions were designed specific to each family, presented challenges in evaluating outcomes with traditional standardized instruments. This paper describes the project, its outcomes for families and youth, and the evaluation design that evolved to measure outcomes in a strength-based program with no uniform intervention.

Women Service Members and Family Reintegration

Women are being deployed at increasing rates. This article reviews literature related to the risk and protective factors that explain varied levels of adaptation for servicewomen and their families. Implications suggest that clinicians assess risk factors for female soldiers upon return home such as the number and length of deployments, the presence of mental health challenges, physical injuries including traumatic brain injury, the experience of military sexual trauma, a history of childhood or adult sexual trauma, and the pile-up of additional life stressors that can lead to a cumulative negative effect for women and their families. Clinicians are also encouraged to assess and encourage family strengths that foster resilience such as social support, ongoing communication, family structure that is flexible, and positive appraisal.

The Vulnerability of American Indian Women in the New Welfare State

This article focuses on the unequal impact of PRWORA and TANF programs on American Indian women and their children in Arizona, despite exemptions from time limits on high-unemployment reservations. It discusses whether gaming, a controversial form of economic development in tribal communities, is a potential benefit to American Indian women and presents implications for social work practice and advocacy.

Social Work Faculty and Mental Illness Stigma

ABSTRACT Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice with people with mental illnesses, and attitudes about students with mental illnesses. On average, educators’ general and practice attitudes were not negative. However, respondents did view a student with a mental illness differently from a “typical social work student.” Findings suggest that we, as social work educators, must raise our awareness and address our own attitudes to support students and uphold our social work values.

Teaching Note—Oppression of People With Mental Illnesses: Incorporating Content Into Multiple-Issue Diversity Courses

Many social workers practice in settings serving people with mental illnesses, but social work education in the United States has given minimal attention to helping students understand the systemic nature of prejudice and discrimination experienced by this population. Some courses address prejudice (stigma) toward people with mental illnesses, but a critical consideration of systemic oppression appears to be lacking. We explain how an oppression framework used to understand the systemic nature of racism, sexism, and other forms of oppression is useful in illuminating experiences related to (perceived) mental health status. We offer suggestions for incorporating content into courses that focus on diversity and oppression with the goal of preparing students to engage in antioppressive practice with people who have mental illnesses.