Social processes during recovery: An expansion of Kelly and Hoeppner's biaxial formulation of recovery.

Recent conceptualizations frame addiction recovery as a complex process involving changes across behavioral, physical, psychological, and social domains. These broad conceptualizations can be difficult to apply directly to research, making detailed models of individual dimensions necessary to guide empirical work and subsequent clinical interventions. We used Kelly and Hoeppner's (2015) biaxial formulation of recovery as a basis for a detailed examination of social processes in recovery using social network approaches. We delineated how appraisal of situational risks and social network resources result in coping actions, and how repeated iterations of this process change a person's social recovery capital over time. In addition, we incorporated the experience of interpersonal trauma and structural oppression, and demonstrated how the model accommodates the complex issues often encountered during recovery. We present a measurable framework that can guide empirical testing of how social processes and social recovery capital change over time during recovery. The model presented here illuminates key factors in the recovery process that have the potential to support trauma- and social-network-informed interventions. We call for research that empirically tests this model in ways that will result in practical, trauma-informed social network interventions for people in recovery.

Translating Interventions that Target Criminogenic Risk Factors for use in Community Based Mental Health Settings.

This study explored facilitators and barriers associated with engaging criminogenic interventions in community mental health service settings. Focus groups and guided large group discussions were conducted with 46 consumers, providers and administrators. Results suggest that participants were generally supportive of offering criminogenic interventions to justice involved persons with serious mental illness in community based mental health service settings. Key issues to consider when engaging criminogenic interventions in community mental health service settings include identifying sustainable funding sources, providing adequate training for staff, and tailoring the delivery and pace of the content to the particular treatment needs of SMI participants.

Alcohol use, daily hassles, and religious coping among students at a religiously affiliated college.

OBJECTIVE: This article presents empirical findings which suggest that religious coping moderates the relationship between daily hassles stress and alcohol use among female college students. METHOD: This study utilized a cross-sectional data collection strategy and convenience sampling to examine the relationship between alcohol use, daily hassles stress, and religious coping among 423 undergraduate students (269 females and 154 males) at a religiously affiliated college in the Midwestern USA. Data were collected in 2008. Instruments utilized for data collection included the Inventory of College Student Recent Life Experiences, the Brief RCOPE, and quantity/frequency measures of alcohol use. RESULTS: Involvement in positive religious coping was significantly related to lower rates of alcohol use. Hierarchical multiple regression analysis revealed that among women, positive religious coping moderated the relationship between two types of daily hassles stress (academic alienation and romantic problems) and alcohol use. CONCLUSIONS: This study found that among female college students, the relationship between daily hassles stress and alcohol use weakened with increased participation in religious coping. This finding suggests that religious coping may protect against alcohol use among female college students. The results of this study also suggest that it may be important for university-based treatment and prevention practitioners to assess involvement in religious coping practices and to include such practices in the treatment planning process, when culturally appropriate and desired by consumers. Study limitations and areas for further research are also discussed.

Living with the loss of a child: mothers in the criminal justice system.

OBJECTIVE: Bereaved mothers have expressed the need to maintain a bond with their children who have died, to retain control over the funeral rituals, and to express their loss to others who are empathetic. This study describes grief over the loss of a child in women who have been or are currently incarcerated, and the influence of the women's family members. METHOD: This descriptive qualitative study consisted of open-ended interview questions to encourage the women to describe their experience in their own words. A purposive sample (N = 10) was recruited from a prison re-entry program and a county jail. RESULTS: All of the participants described maladaptive responses such as the use of alcohol and drugs, restricted family support, and dysfunctional coping. None of the participants had received focused bereavement services. SIGNIFICANCE OF RESULTS: The descriptive perspective from the participants can inform clinicians who work with women who have a history of involvement with the criminal justice system, and recommends that they should inquire about the women's children and experiences with loss. Community re-entry and jail/prison counselors should provide access to confidential and group-based therapeutic support, including Compassionate Friends.

Assessment of benefits of a universal screen for maternal alcohol use during pregnancy.

INTRODUCTION: The objective of this report is to estimate the benefits of universal meconium screening for maternal drinking during pregnancy. Fetal alcohol spectrum disorder (FASD), including its most severe manifestation fetal alcohol syndrome (FAS), is preventable and remains a public health tragedy. The incidences of FAS and FASD have been conservatively estimated to be 0.97 and 10 per 1000 births, respectively. Meconium testing has been demonstrated to be a promising at-birth method for detection of drinking during pregnancy. METHODS: The current costs of FAS and FASD, alcohol treatment programs, and meconium screening were estimated by literature review. Monetary values were converted roughly to equal dollars in 2006. RESULTS: Costs of adding meconium analysis to the current newborn screening program and of treatment for the identified mothers were estimated and compared to potential averted costs that may result from identification and intervention for mothers and affected infants. Three potential maternal treatment strategies are analyzed. Depending on the treatment type, the savings may range from $6 to $97 for every $1 spent on screening and treatment. DISCUSSION: It needs to be emphasized, however, that such screening is premature and that to be effective this screening can be implemented only if there is a societal willingness to institute prevention and intervention programs to improve both women's and children's health. Future research should be directed at improving detection and developing in-depth prevention and remedial intervention programs. A thorough consideration of the ethical issues involved in such a screening program is also needed.

Examining Criminogenic Risk Levels Among People with Mental Illness Incarcerated in US Jails and Prisons.

This study examines criminogenic risk levels of individuals with serious mental illness (SMI) involved in the justice system compared to justice-involved individuals without mental illness. The sample (N = 436) consisted of ninety-three individuals with SMI incarcerated in a county jail in a mid-size Midwest city, 217 individuals with SMI incarcerated in a state prison in the US Northeast, and 126 individuals without mental illness incarcerated in a state prison in the US Southwest. Results indicated that people with SMI incarcerated in jail and prison had higher overall criminal risk levels than prison inmates without mental illness. Results further demonstrated that, on average, higher percentages of persons with SMI had high/very high criminogenic risk scores. Finally, we noted that persons with SMI scored higher on most of the eight criminogenic risk domains measured by the Level of Service Inventory. These findings are possibly the most compelling to date in the growing body of literature demonstrating that justice-involved people with SMI have elevated criminogenic risk comparable to or greater than their non-mentally ill peers involved in the justice system. Consequently, treatment programs and interventions for justice-involved individuals with SMI need to explicitly target criminogenic needs into treatment efforts.

Correlates of service utilization among midlife and older adults with HIV/AIDS: the role of age in the equation.

OBJECTIVES: To determine the role of age on service utilization among persons with HIV/AIDS: METHODS: The study examined 571 individuals diagnosed with symptomatic HIV or AIDS ranging in age from 30 to 81 years. All individuals had been enrolled in case management services from July 1995 through June 1996. It was hypothesized that older persons would utilize higher rates of health and medical services and lower rates of psychosocial services. RESULTS: The study found that in the older age groups the proportion of women, those living alone, and those having private health insurance increased. Mortality also increased in the older age groups, whereas survival time from AIDS diagnosis to death decreased. Age did not emerge as a significant variable in a multiple regression of service utilization. Functional dependence and mortality were significant predictors of medical services, whereas geographical location and insurance coverage explained the majority of variance in home care services.

Spirituality, Religiousness, and Alcoholism Treatment Outcomes: A Comparison between Black and White Participants.

This study addresses an unexplained finding in the alcoholism treatment field: despite the health and socioeconomic disparities that exist between blacks and whites at intake, blacks and whites achieve equivalent treatment outcomes. Using Project MATCH data, this study explores religiousness and spirituality as strengths in the African American community that may account in part for equivalent outcomes. Using binary logistic regression, this study found that as purpose in life increased, blacks were more likely to achieve sobriety than whites. This study provides evidence that purpose in life is a cultural strength and an advantage among blacks in achieving sobriety.

The Impact of Infant Disability on Maternal Perception of Stress.

Twenty-seven mothers of infants and children with long-term tracheostomy were given a modified version of the Impact-on-Family Scale as part of a study designed to describe maternal perceptions of the impact of infant disability on various components of family life. Maternal perceptions of intensity of stress in different life areas were also examined as a function of salient medical, social, and demographic factors associated with the child's disability. Mothers report a high degree of stress in caring for their young disabled children, most notably in financial status. Mothers also report a strong sense of mastery in learning to care for their children. Several medical and demographic factors related to degree of maternal stress are identified.