Samuel A. MacMaster

Correlates of Secondary Traumatic Stress in Child Protective Services Workers

SUMMARY The purpose of this study was to add to the limited research on secondary traumatic stress in child welfare by investigating correlates of secondary traumatic stress (STS) in child protective services workers. Specifically, we examined the relationship between levels of STS in CPS professionals and personal history of trauma, peer and administrative support, intent to remain employed in child welfare, professional experience, and size of caseload. This study documents the existence of secondary traumatic stress in the population and the relationship between levels of secondary traumatic stress in CPS professionals and the group of potential correlates: personal history of trauma in the past year and lifetime, peer support, administrative support, intent to remain employed in child welfare, professional experience, and size of caseload.

Substance Abuse Among U.S. Latinos: A Review of the Literature

SUMMARY Latinos have recently become the largest minority in the United States. High fertility and high immigration rates suggest continued high rate of growth. Alcohol and illicit drug use within this population give reason for concern. Beginning in early adolescence, Latinos and Native Americans lead the nation in alcohol and illicit drug use. They also have a high need for alcohol and illicit drug treatment compared to Whites and African-Americans. Research concerning ethnic differences is reviewed in order to gain an understanding of the patterns and trajectories of substance use within the Latino community. Prevention and treatment interventions specific to Latinos are described, and gaps in the literature are noted. Finally, implications of the current research findings for social workers and recommendations for future research are discussed.

Experiences with and perceptions of, barriers to substance abuse and HIV services among African American women who use crack cocaine.

Abstract Significant health disparities in the rates of HIV infection exist that primarily impact African American women. While research has demonstrated that HIV is preventable through changes in high-risk behaviors facilitated by substance abuse treatment, an individual must first be able to access and engage with treatment to derive any benefit from these services. While there is some research that identifies barriers to treatment access and engagement for African American women who use crack cocaine, these barriers require further examination. Current literature has focused primarily on internal motivation and treatment readiness without placing these concepts within the unique environmental context of social stressors for crack cocaine-using African American women. This study presents the results of eleven focus groups with eighty-nine African American women in which respondents document the HIV risk behaviors of crack cocaine users, present their experiences in accessing substance abuse and HIV services, and documents their perceptions of barriers and services needs. The results of this study may further develop an understanding of the means by which individual service users experience their relationships with service providers and the factors that affect these relationships in order to better target potential interventions to reduce the spread of HIV.

Evaluation of a Faith-Based Culturally Relevant Program for African American Substance Users at Risk for HIV in the Southern United States

Objective: This article provides an evaluation of a federally funded faith-based program that serves African Americans who use heroin and cocaine and are at risk for HIV/AIDS in Nashville, Tennessee. Methods: Data were collected from 163 individuals at baseline and 6- and 12-month follow-up interviews. A subset of participants (n = 51) completed all three interviews. Results: Results suggested that this culturally relevant set of interventions was successful in reducing substance use and HIV/AIDS risk behaviors. The program was able to show data that supported the efficacy of a faith-based approach emphasizing spirituality rather than directive, aggressive, authoritarian, or coercive counseling techniques. Discussion: The model is important to the continued development of culturally relevant interventions that are vital to decreasing the disproportionate rates of HIV/AIDS within the African American community.

Applying behavior change models to understand spiritual mechanisms underlying change in substance abuse treatment.

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of “spiritual transformation” in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement.

Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment

ABSTRACT Despite increasing interest in “faith-based” substance abuse treatment and HIV risk reduction interventions, there is little systematic evidence of the efficacy of explicitly spiritual interventions. However, fundamental to effective interventions is an explicit conceptualization of mechanisms underlying behavior change. This paper discusses the definition of faith-based organizations, specifically as they relate to substance abuse treatment programs, briefly reviews relevant behavior change theories to identify key variables underlying change, presents an integrative conceptual framework articulating linkages between spiritual intervention components, behavior change processes and substance abuse outcomes, and discusses how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, the paper suggests that what happens in “faith-based” programs may not be so different from processes taking place in good social work practice in the addictions field.

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.

The International AIDS Questionnaire- English Version (IAQ-E): Assessing the validity and reliability

Abstract In order to address HIV infection among college students, a comprehensive measure is needed that can be used with samples from culturally diverse populations. Therefore, this paper assessed the reliability and validity of an HIV/AIDS questionnaire that measures fours dimensions of HIV/AIDS awareness—factual knowledge, prejudice, personal risk, and misconceptions about HIV transmission, and will enable cross-cultural research. The International AIDS Questionnaire—Chinese Version (IAQ-C) was developed and validated by Davis, Tang, Chan, and Noel (1999) for use with Chinese populations. In this study, the validity and reliability of the International AIDS Questionnaire—English Version (IQA-E) was assessed on a sample of English-speaking college students from the United States (N = 200) and Australia (N = 74). The results of the CFA supported the four-factor model, and the normative data show patterns similar to previous research. The total IAQ-E had a high internal consistency (Cronbachs alpha = 0.88). The Cronbachs alphas for the sub-scales were 0.87 (myths), 0.81 (attitudes), 0.66 (personal risk), and 0.40 (facts). A 2-week test-retest reliability study on a sub-sample of 32 students revealed a Pearson product-moment correlation coefficient of 0.882 (p < 0.001). This instrument provides a valid and reliable comprehensive measure of HIV/AIDS for use with English-speaking samples.

Demystifying the Injection Drug User: Willingness to Participate in Traditional Drug Treatment Services Among Participants in a Needle Exchange Program

Abstract Injection drug users have been vilified in our culture as being wild-eyed and willing to do anything for the next hit. These individuals are typically seen as being unemployed, uneducated and completely disinterested in making any changes in their lives. Sixty-one participants in a syringe exchange program in Cleveland, Ohio were interviewed using the NIDA Risk Behavior Assessment. Fifty (81%) of the respondents were either in an abstinence-based program or reported a willingness to participate in such a program. Importantly, although the sample consisted of long-term daily users of injection drugs (m=l9.95 years), the majority of the sample was employed (69%) and were high school graduates (51%). The results of this study suggest that injection drug users are willing to make changes in their use-related behaviors, involvement in a needle exchange program does not preclude involvement in abstinence-based programming, and needle exchange services may serve as an important component in a continuum of care when coupled with traditional abstinence-based services.

Identifying Co-Occurring Disorders in Adolescent Populations

Abstract A structured diagnostic interview (Practical Adolescent Diagnostic Interview) designed to gather basic information about substance use disorders, other mental health conditions, and related experiences was used in a variety of clinical settings. Anonymous data from 279 adolescents interviewed as part of routine clinical assessments in a variety of clinical programs were analyzed to assess the ability of the questions to identify potential problem areas and to provide a preliminary exploration of interrelationships between those problems. Results demonstrated that the vast majority of individuals manifested indications of multiple problems. For a given diagnostic condition, the trend is for those meeting at least the minimal DSM-IV criteria to exhibit substantially more than the minimum number of symptoms. Internal consistencies for item groups defining the various conditions range from more than .700 to over .900 indicating adequate to excellent internal consistency and reliability. Utility of the instrument for routine clinical use is also discussed.