R. Lyle Cooper

Motivational Interviewing to Affect Behavioral Change in Older Adults

This article reviews and assesses the existing research literature on the efficacy of motivational interviewing (MI) to promote lifestyle changes and improve functioning among older adults confronting serious health challenges. A comprehensive literature review was conducted of intervention studies that tested the use of MI to achieve behavioral change among older adults with acute and chronic illnesses. Although limited in number, the studies revealed a significant improvement in physical activity, diet, cholesterol, blood pressure and glycemic control, and increased smoking cessation following MI. MI and its derivatives can be useful in dealing with a range of health issues faced by older adults. Further research to extend findings and address methodological issues is recommended. The integration of MI into social work courses focused on practice with older adults should be considered.

Alcohol Misuse Among Older Adult Public Housing Residents

Low-income older adults living in public housing are at heightened risk for substance misuse. This study identified the prevalence of alcohol misuse among older public housing residents (n = 187) and explored predictors of problem drinking. Including weekly drinking levels and binge drinking, 23% of the sample engaged in problem drinking behaviors. Logistic regression analysis revealed that race, gender, employment status, years smoking, and illegal drug use were significant predictors of problem drinking. No residents were receiving substance abuse treatment. As the number of older adults increase, training social workers to assess and treat alcohol misuse in older adults is critical.

Racial Differences in Retention in Residential Substance Abuse Treatment: The Impact on African American Men

Purpose: This study employed a static group comparison design with 106 men in residential treatment to examine the relationship of race to treatment retention. Methods: A retrospective analysis of retention, by race, including survival analysis, was undertaken. Results: Findings from the study indicated that (a) Caucasian men complete treatment more frequently than African American men, (b) Race was not predictive of time in treatment, and (c) that race was a factor in the receipt of both criminal justice coercion and case-management both of which were strong predictors of time in treatment. Conclusions: Race serves as a factor in the receipt of services related to retention. Future research should focus on further exploration how race impacts retention, and the interaction of race with coercion and the receipt of case-management.

Cyberbullying: A literature review of its relationship to adolescent depression and current intervention strategies

ABSTRACT The focus of this literature review examines interventions for 12–18-year-old adolescents experiencing depressive symptoms as a consequence of cyberbullying. Findings reveal a positive correlation between cyberbullying and depressive symptomology, but only a few interventions treat this problem. This review reinforces the urgent need for the creation of additional evidence-based intervention programs.

A review of the effectiveness of military suicide prevention programs in reducing rates of military suicides

ABSTRACT The suicide rate within the U.S. armed forces remains a pressing issue for the country. This comprehensive literature review found only five published studies on military suicide prevention programs and their outcomes. Substantial research design and methodological issues are noted, and only one study produces statistically significant results. Findings reveal a serious lack of empirical evidence demonstrating effective suicide prevention programs within the U.S. armed forces.

Integrated recovery management model for ex-offenders with co-occurring mental health and substance use disorders and high rates of hiv risk behaviors

&NA; This paper provides outcomes from an evaluation of a federally funded program combining HIV prevention services with an integrated mental health and substance abuse treatment program to a population of primarily African American ex‐offenders living with, or at high risk for contracting HIV in Memphis, Tennessee. During the 5‐year evaluation, data were collected from 426 individuals during baseline and 6‐month follow‐up interviews. A subset of participants (n = 341) completed both interviews. Results suggest that the program was successful in reducing substance use and mental health symptoms but had mixed effects on HIV risk behaviors. These findings are important for refining efforts to use an integrated services approach to decrease (a) the effects of substance use and mental health disorders, (b) the disproportionate impact of criminal justice system involvement, and (c) the HIV infection rate in African American ex‐offenders in treatment.

The Experiences of African American Male Commercial Sex Workers At-Risk for HIV: Accessing Outreach Services

Due to the lack of education and the stigma attached to HIV testing, African American men are less likely to seek outreach services; therefore they are often unaware of their HIV status. Stigmatization of homosexuality in communities of color may also influence the availability of HIV/AIDS education and services; compounded with the fact that access to appropriate health care may be limited in these communities. While infection rates among African American men having sex with men (MSM) are well documented, research on effective interventions is not, and is particularly limited for these men who are substance users and participate in the sex trade for drugs. This article explores and documents the experiences of African American MSM in a southeastern metropolitan city who are involved in the commercial sex trade, and presents the results of a focus-group investigation conducted specifically to gain input about accessing outreach services.

Addressing negative affect in substance use relapse prevention

ABSTRACT This review includes 15 studies, evaluating evidence of the effectiveness of interventions addressing negative affect in substance use relapse prevention. A unitary construct of “negative affect” was inadequate for reconciling conflicting findings. Instead, affect variables were divided by temporal range, model of affect, and discreteness of measurement. Results strongly support (1) cognitive behavioral therapy’s effectiveness for changing tonic affect and (2) mindfulness interventions effectively changing both tonic and phasic affect. Evidence also supports mindfulness weakening the relationship between affect and substance use outcomes. Recommendations for future research are made.

The Addicted Geriatric Patient

The older population in the U.S. is growing at an unprecedented rate. At present, there are 37 million people 65 years of age and over in the United States. Due to the aging of the baby boomers, this population will expand to more than 71 million by 2030 [1]. Approximately 2.5 million older adults have substance abuse problems. This number is expected to double to 5 million by 2020 [2]. Projections indicate that increases in the number of older adults with problem substance use will increase across race, ethnicity, and gender. As the population of older substance abusers continues to grow, so too will the number of older in-patients and surgical patients with substance abuse disorders.

Preliminary Outcomes of a Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk for Contracting HIV

In the United States, the threat of HIV/AIDS to African American womens health has become the focus of much concern. This paper describes a federally funded community-based program that provides services to African American women at risk for HIV/AIDS in Nashville, Tennessee. The program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important for the continued development of culturally relevant interventions aimed at reducing the disproportionate rates of HIV/AIDS within the African American community by ensuring treatment access to all populations.