Love and Service in Adolescent Addiction Recovery

Well-being in institutionalised adolescents

BACKGROUND

For adolescents who have criminal convictions, achieving a positive progress including desistance from offending may depend on a sense of well-being. Factors associated with growth in well-being are not widely researched, but there is some work that suggests that qualities in other internal states as well as in the environment may foster well-being.

AIMS

To examine the well-being of young male incarcerated offenders, and its relationship with frequency of contacts with the family, perceptions of socio-educational environment, feelings about the future and self-efficacy.

METHODS

Participants were recruited from three secure education institutions in the Federal District of Brasília, Brazil, under the management of the Secretariat of Justice. They were invited to complete anonymous self-report questionnaires, which included the Psychological Well-Being Scale, the Perception of the Socio-Educational Environment Scale, the Feelings about the Future Scale and the Multidimensional Scale of Perceived Self-Efficacy, and to provide limited sociodemographic data.

RESULTS

195 young male offenders participated and their mean age was 16.8 years (SD = 1.58, range 14-20). There was a positive correlation between well-being and perceptions of the socio-educational environment, positive feelings about the future and self-efficacy self-ratings. Multiple linear regression analyses confirmed that the frequency of family contacts, positive perceptions of the socio-educational environment, positive feelings about the future, and self-efficacy in leisure and social activities independently contributed to the well-being of young offenders.

CONCLUSION

Although well-being has been associated with desistance from committing crimes, the factors that may predispose to well-being have been researched less and never before examined among inmates in Brazil. While longitudinal work is needed to be certain of the direction of the relationship, the fact that the results are broadly consistent with a similar study carried out on the other side of the world is encouraging in terms of indicating ways forward in rehabilitation. It is necessary to develop interventions that support family relationships and promote personal relationships and personal development, not only of useful skills but also of personal confidence in those skills.

Desistance from Crime among Chinese Delinquents: The Integrated Effects of Family Bonding, Prosocial Models, and Religious Bonding

Desistance from crime is a popular topic in global criminological research; however, few studies have focused on desistance among delinquent youth, particularly in non-Western societies. This study extends the current knowledge by examining pathways of youth desistance in Hong Kong. Thirty delinquent youth and six parent-child dyads were interviewed, and the study found that filial piety significantly impacts the process of youth desistance. Three main forms of social capital were closely associated with youth desistance: the revival of reciprocal family bonding, the presence of a prosocial role model, and religious bonding. An interactive model was constructed to illustrate the seven stages of desistance and highlight the key elements for successful desistance among youth delinquents in Hong Kong.

Volunteer Recovery Support for Adolescents: Using propensity score based methods to understand dosage effects within a randomized controlled trial

BACKGROUND

In a recently published randomized controlled trial (RCT) of Volunteer Recovery Support for Adolescents (VRSA), a secondary finding indicated that better adherence to planned VRSA telephone session frequency resulted in significantly higher remission rates relative to lower session adherence. However, interpretation of this dose-response relationship may have been confounded by participant characteristics such as baseline levels of substance use and mental health problems.

METHODS

The present study used statistical methods designed to approximate RCTs when comparing more than two nonequivalent groups that include an assessment of the potential impact of omitted variables. Classification and Regression Tree (CRT) analysis was used to establish the cut-point between high (H) and low (L) VRSA dosage groups. Because we were interested in generalizing to youth with poor attendance, the L-VRSA group served as the reference group. Balancing weights for H-VRSA and a services as usual (SAU) control group were calculated to ensure similarity of baseline pretreatment characteristics to the reference group, and sensitivity of findings to unobserved confounding variables was assessed.

RESULTS

Findings suggested that superior remission rates at the end of the intervention phase were the result of high adherence to planned VRSA session frequency. Recommendations to achieve high VRSA participation among a larger segment of youth and to test whether longer VRSA duration improves the stability of recovery outcomes are provided.

CONCLUSION

Few published dose-response studies have adequately controlled for selection confounds from both observed and unobserved confounding. As such, the present study aims to both assess the impact of different dosage levels of VRSA and provide a template for how to apply state-of-the-art statistical methods designed to approximate randomized controlled trials to such studies.

Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse

This study reviews the voluminous empirical evidence on faith's contribution to preventing people from falling victim to substance abuse and helping them recover from it. We find that 73% of addiction treatment programs in the USA include a spirituality-based element, as embodied in the 12-step programs and fellowships initially popularized by Alcoholics Anonymous, the vast majority of which emphasize reliance on God or a Higher Power to stay sober. We introduce and flesh out a typology of faith-based substance abuse treatment facilities, recovery programs, and support groups. This typology provides important background as we then move on to make an economic valuation of nearly 130,000 congregation-based substance abuse recovery support programs in the USA. We find that these faith-based volunteer support groups contribute up to $316.6 billion in savings to the US economy every year at no cost to tax payers. While negative experiences with religion (e.g., clergy sex abuse and other horrendous examples) have been a contributory factor to substance abuse among some victims, given that more than 84% of scientific studies show that faith is a positive factor in addiction prevention or recovery and a risk in less than 2% of the studies reviewed, we conclude that the value of faith-oriented approaches to substance abuse prevention and recovery is indisputable. And, by extension, we also conclude that the decline in religious affiliation in the USA is not only a concern for religious organizations but constitutes a national health concern.

Religious Involvement, Moral Community and Social Ecology: New Considerations in the Study of Religion and Reentry

OBJECTIVES

To examine the link between an individual's religious involvement in prison and recidivism and assess how macro-level conditions in the counties to which individuals return shape this relationship.

METHODS

Using data from 1362 previously incarcerated people, a series of hierarchical generalized linear models are used to examine the extent to which an individual's religious involvement in prison relates to recidivism post-release. We also examine how county-level religious adherence, economic disadvantage, and potential social service assistance directly affect recidivism, and how each shape the relationship between religious involvement and recidivism.

RESULTS

Findings show that county-level religious adherence was directly associated with lower recidivism, but individual-level religious involvement was not when assessing recidivism over longer periods of time post-release. Cross-level interactions revealed that county-level resource deprivation conditions the effect of individual religious involvement.

CONCLUSIONS

Findings have theoretical implications for the study of religion and reentry. Methodologically, failing to account for the religious context of counties, in addition to micro-macro linkages, harms individual level research on religion and reentry.

During, After, or Both? Isolating the Effect of Religious Support on Recidivism During Reentry

OBJECTIVES

To examine the independent and interdependent roles of baseline religious support during incarceration and within-individual changes in religious support on recidivism during the prisoner reentry process.

METHODS

Using data from the Serious and Violent Offender Reentry Initiative, cross-lagged dynamic panel models are used to examine the respective roles of baseline differences and within-individual changes in religious support on two variety indices encompassing substance use and criminal offending while simultaneously controlling for pre-incarceration levels of substance use and offending.

RESULTS

Findings show that within-individual increases in religious support protect against substance use post-release, while baseline levels of religious support do not significantly influence substance use. Additionally, baseline levels of religious support fail to condition this relationship. Findings assessing criminal offending demonstrate that baseline religious support and within-individual changes in religious support fail to relate to offending independently. However, an interaction term reveals that the combination of the two relates to significantly lower levels of offending post-release.

CONCLUSIONS

Findings offer encouragement for those involved in the work of providing religious support to ex-offenders in the community, reaffirming that tailoring support programs to the religious or spiritual ways individuals make meaning in their lives can improve reentry outcomes. Methodologically, failing to distinguish between baseline levels of religious support and post-release changes in religious support fails to capture the complexity of religiosity on the reentry process.

Religion and desistance from substance use among adolescent offenders: The role of cognitive functioning

BACKGROUND

Religious beliefs and practices have been shown to have some association with desistance from offending, as have cognitive processes, including emotion regulation, self-control, reasoning, learning, and empathy. Religious behaviours may, however, be moderated or mediated by cognitive abilities, but few studies take this into account.

AIM

The aim of this study was to assess the role of cognitive ability in any relationship between religious beliefs and behaviours and desistance from substance use among adolescents.

METHOD

Data were extracted from the Pathways to Desistance Study dataset (n = 1,354). Religious measures were self-rated importance of religion, helpfulness of religion in dealing with problems, and attendance at religious services. Cognitive measures were the Wechsler Abbreviated Scale of Intelligence and Trail Making Tests. A count of numbers of mind-altering substances used constituted the main substance measure. Control variables included sex, age, and age of onset of offending.

RESULTS

Mixed-effects longitudinal analyses revealed that religious behaviours did constitute a significant predictor of lower substance use for young people after a criminal conviction, after controlling for changes in employment, social support, and delinquent peer association, but only among those with average or above cognitive function.

CONCLUSIONS

These findings may explain why there have been some discrepancies in previous studies of religion and substance misuse. They may also have important implications for the training of anyone delivering programmes to young people in prison that have faith-based elements, including community faith group leaders and volunteers.

When helping helps: exploring health benefits of cancer survivors participating in for-cause physical activity events

BACKGROUND

Over 15.5 million Americans live with cancer and 5-year survival rates have risen to 69%. Evidence supports important health benefits of regular physical activity for cancer survivors, including increased strength and quality of life, and reduced fatigue, recurrence, and mortality. However, physical activity participation among cancer survivors remains low. Cancer organizations provide various resources and support for cancer survivors, including emotional, instrumental, informational, and appraisal support. Many cancer organizations, like the LIVESTRONG Foundation, support the cancer community by sponsoring and hosting for-cause physical activity events, providing opportunities for anyone (including cancer survivors) to "help"/support those living with cancer. The concept of helping others has been positively related with wellbeing, physical activity, and multiple health behaviors for those helping. However, the role of helping others has not been examined in the context of being physically active to help others or its relationship with overall physical activity and quality of life among those helping. Therefore, we developed a path model to examine relationships between cancer survivors' (1) desire to help others with cancer, (2) physically active LIVESTRONG participation to help others, (3) regular physical activity engagement, and (4) quality of life.

METHODS

In 2010, 3257 cancer survivors responded to an online survey sent to all people involved with the LIVESTRONG organization at any level. The hypothesized path model was tested using path analysis (Mplus 8).

RESULTS

After list-wise deletion of missing responses, our final sample size was 3122 (61.8% female, mean age: 48.2 years [SD = 12.7]). Results indicated that the model yielded perfect fit indexes. Controlling for age, sex, income, and survivorship length, desire to help was positively related with physically active LIVESTRONG participation (β = .11, p < .001), which was positively related with regular physical activity (β = .30, p < .001), and regular physical activity was positively related with quality of life (β = .194, p < .001).

CONCLUSIONS

Results suggest that cancer survivors can benefit from participating in for-cause physical activity events, including more regular physical activity. Researchers need to further investigate the role of helping others when examining health behaviors and outcomes, and cancer organizations should continue encouraging cancer survivors to help others by participating in physical activity events.

Smoking Cessation and Adolescent Treatment Response With Comorbid ADHD

Minors entering treatment for alcohol and other drug (AOD) use disorders tend to smoke at high rates, and many have comorbid attention deficit hyperactivity disorder (ADHD). Clear-air laws force patients to refrain from smoking on the premises of AOD treatment facilities, which may hinder the progress of treatment-seeking populations who smoke and struggle with ADHD comorbidity in particular. This study explores clinical characteristics associated with smoking among youths presenting for residential treatment, clinical characteristics associated with smoking cessation, and the impact of smoking cessation with ADHD comorbidity on AOD treatment response. Participants were 195 adolescents (52% female, aged 14-18 years) court-referred to residential treatment. Data were collected at intake, prospectively each week for the 10-week treatment period, and at discharge. Two-thirds (67%) of the enrollment sample entered treatment smoking half a pack a day on average, a large proportion (50%) of which did not smoke during treatment. ADHD patients were more likely to smoke before and during treatment except for those who got active in service and step-work. Quitting smoking did not adversely affect AOD outcomes and was associated with better prognosis of lowered AOD cravings for youths with and without ADHD. Smoking cessation during adolescent AOD treatment is recommended with provision of pharmaceutical and/or behavioral modalities that reduce nicotine withdrawal.

Humility and 12-Step Recovery: A Prolegomenon for the Empirical Investigation of a Cardinal Virtue in Alcoholics Anonymous

Alcoholics Anonymous (AA) offers a live stage to study how humility is worn by thousands for another day of sobriety and more freedom from the bondage of self. It has been the coauthors' intent to emphasize the significance of humility as a cardinal virtue across the 12-Step program and as essential to all its key elements. The coauthors have placed this emphasis in the context of a wider theological history of thought as this converged on Bill W. and AA. In addition, the coauthors have offered a constructive developmental interpretation of the 12 Steps that relies on a model of four modulations of humility. Finally, the coauthors have reviewed in brief some approaches to the measurement of humility in this context, and suggest several aims for future research.

Positive Criminology and Rethinking the Response to Adolescent Addiction: Evidence on the Role of Social Support, Religiosity, and Service to Others

Adolescent addiction has emerged as a major public health problem. The greatest increase in alcohol and other drug use disorders can be found among youth. Concurrently, technological advances in policing coupled with aggressive prosecuting and sentencing practices have contributed to the growth of America's correctional system. The assertive response of policing, courts, and corrections, however, have not prevented the dramatic rise of adolescent addiction. Unfortunately, there is no national data tracking addicted youth in the criminal justice system to evaluate what works when it comes to youth with addiction. This article reviews justice system responses to adolescent offenders with addiction, and promising approaches engaging juveniles in programmatic components of Alcoholics Anonymous (AA). This study highlights the role of spirituality, service to others, and social support in maintaining sobriety, reducing arrests, and lowering recidivism for adolescents court-referred to treatment. Recommendations for improving the response to adolescent offenders with addiction are offered.