Social cognitive theory as a theoretical framework to predict sustained abstinence 6 months after substance use treatment

Faith-based intervention, change of religiosity, and abstinence of substance addicts

Objective:

To investigate the effects of developing religiosity on abstinence of substance abuse among recovering addicts in a faith-based and a secular-based treatment program.

Methods:

Religiosity of recovering addicts was measured using the 38-item Brief Multidimensional Measure of Religiousness/Spirituality at three points in time: at initiation of substance addiction treatment (wave 1), discharge from treatment (wave 2), and 6 months after treatment (wave 3). Latent growth curve modeling was used to assess the dynamic and developing effects of religiosity on after-treatment abstinence. Secular-based treatment emphasized the role of biological, psychological, and environmental determinants of substance abuse and provided detoxification interventions, such as counseling and group therapies, skill training, health care, and social support, however also relying on religious and spiritual growth to help recovery. Faith-based treatment fundamentally emphasized the Christian theory of addiction to consider substance abuse a sin caused by one’s spiritual void and separation from God, although it also acknowledged the importance of biological, psychological, and social needs of rehabilitants.

Results:

Recovering addicts in faith-based treatment had significantly higher levels of religiosity at each wave (intercept factor) and better religious development across the three waves (slope factor). This contributed to after-treatment abstinence and mediated the effect of treatment mode on after-treatment abstinence.

Conclusion:

Service practitioners and researchers should note the importance of dynamic and developing nature of religiosity in relation to the maintenance of abstinence after treatment is completed.

Social Cognitive Theory as a Theoretical Framework to Predict Sexual Risk Behaviors among Older Adults

OBJECTIVES

Older adults vary in their safe and unsafe sexual behaviors. While researchers are beginning to understand more about the sexual and intimate expression of older adults, only recently are they beginning to understand how older adults make decisions about sexual risk. Bandura's social cognitive theory offers a frame for understanding how self-efficacy, environmental factors, and goal motivation are related to sexual risk behaviors for older adults, including the interplay between these variables.

METHODS

Using a diverse sample of older adults (n = 720) age 50+ years, social cognitive theory was modeled to determine the relationship between environment variables (age, gender, and sexual health conversations with practitioners), behavioral variables (self-efficacy), and cognitive variables (importance of sexual wellness goals) with the outcome variable of sexual risk behaviors.

RESULTS

Self-efficacy had an indirect effect on sexual risk via sexual wellness goal motivation. Healthcare provider conversations had both direct and indirect effects on older adults' sexual risk through sexual wellness goal motivation. Models were similarly predictive for older men and women.

CONCLUSIONS

Sexual risk behaviors among older adults are more influenced by environmental factors in their healthcare settings and their perception and prioritization of sexual wellness goals.

CLINICAL IMPLICATIONS

Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy.

Substance use disorder patients’ expectations on transition from treatment to post-discharge period

Aim:

There is limited knowledge about how inpatients anticipate factors that facilitate the transition between specialised inpatient treatment for substance use disorder (SUD) and the post-discharge period. This study explores factors that inpatients anticipated would facilitate such a transition period.

Method:

A focus group study, consisting of four group interviews with individuals in inpatient SUD treatment, was conducted to explore their expectations for the transition and post-discharge period ahead of them. The transcribed interview material was analysed using thematic analysis.

Findings:

The analytical process led to three themes: “Belonging”, “Intrapersonal processes” and “Predictability”. Correspondence between inpatients’ expectations and the services they are offered in the transition and post-discharge period may serve as proper support for inpatients ahead of a vulnerable phase, such as the transition and post-discharge period.

Conclusions:

Findings from the current study highlight overarching elements that inpatients envisioned to be facilitating, such as social support, motivation, self-efficacy, self-awareness and predictability in basic elements such as employment, housing and personal finances. Findings from this study and previous ones imply that certain factors appear to facilitate in vulnerable phases, such as service level transitions. These facilitating factors should be taken into consideration and used as steppingstones through the transition and post-discharge period after inpatient SUD treatment.