Stephanie Clone

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.

Barriers and Facilitators to Substance Use Treatment in the Rural South: A Qualitative Study

PURPOSE Little qualitative research has examined factors associated with care in substance abuse treatment agencies in Southeastern rural communities. This study explored client- and agency stakeholder-perceived barriers and facilitators to substance use treatment delivery in southeastern rural communities. METHODS Group and individual interviews were conducted with 40 key stakeholders and 40 clients at 9 substance abuse agencies serving rural communities in a southeastern state. Qualitative thematic analysis was used to identify perceived barriers and facilitators to substance abuse services in rural communities. FINDINGS Four primary themes emerged from the client and stakeholder interviews as both barriers and facilitators: availability of services for individuals with substance use disorders; access to the current technology for client services and agency functioning; cost of services; and stigma. CONCLUSIONS This study identifies novel barriers and facilitators to substance use care in the rural South and highlights essential areas for consideration when developing and implementing substance use care in this geographic region. These findings can be used as guidelines to provide better care to individuals with substance use disorders living in rural communities.

Exploring the Youth and Parent Perspective on Practitioner Behaviors That Promote Treatment Engagement

Treatment engagement is critically important to child and family social work practitioners, given its documented relationship with youth and family outcomes. Despite this, little is known regarding the practice behaviors youth and parents perceive as important for promoting their engagement in treatment. The purpose of this study was to explore the perspective of youth and parents regarding practitioner behaviors important for fostering treatment engagement. Three semistructured focus groups were conducted with 30 youth and parents. Using a constant comparative analysis procedure, two domains of practice behaviors emerged: developing the therapeutic alliance and collaborative service delivery. Specific alliance-building behaviors included building rapport and demonstrating care, acknowledging and listening to the youth and family perspective, asking questions, not judging youth and parents, allowing youth and family input to direct care, and supporting motivation to change. Collaborative practice behaviors included providing culturally competent services, sharing treatment information, demonstrating awareness of other services/supports, and engaging other meaningful adults. Youth and parents both discussed the importance of these practice behaviors. Youth, however, seemed to emphasize the therapeutic alliance more than parents in the sample. Clinical implications for family social work practitioners regarding these key practice behaviors are discussed.

Social Support Networks of Incarcerated Women: Types of Support, Sources of Support, and Implications for Reentry

We examined types and sources of support received by 60 incarcerated women. Women discussed emotional support from family members as integral to their well-being. Family members were also substantial providers of instrumental support, such as caring for the womens children during incarceration, sending money, and helping navigate personal and legal barriers. Support from other prisoners was also mentioned, with emotional support being common. Other prisoners also provided a great deal of informational support, helping guide newcomers through adjustment to incarceration. Support from professionals, partners, friends, and peer groups were also noted. Implications for womens transition back into communities are discussed.

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¯

“The Pill Line Is Longer Than the Chow Line”: The Impact of Incarceration on Prisoners and Their Families

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A Qualitative Study of the Role of Peer Support Specialists in Substance Use Disorder Treatment: Examining the Types of Support Provided

= -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¯