Bridges to Sobriety: Testing the Feasibility and Acceptability of a Mobile App Designed to Supplement an Adolescent Substance Use Disorder Treatment Program

Adolescent substance use is a growing problem that causes a myriad of negative outcomes. Using substances during adolescence can lead to decreased executive functioning and is correlated with the top three causes of deaths for adolescents. Treatment options vary and the impact on outcomes are mixed, with engagement being of the most important indicators. Gaming is a popular activity among adolescents, and yet smartphone applications are relatively unexplored within substance use disorder treatment programs. This paper explores the feasibility and acceptability of implementing a mobile application as a supplement to existing adolescent substance use disorder treatment in a behavioral health agency in eastern Missouri. Feedback was received from staff and clients to assess feasibility and acceptability of implementation with barriers discussed. Results indicate there is promise with incorporation of smartphone-based applications into existing interventions and act as recommendations for other providers.

Treatment resistant opioid use disorder (TROUD): Definition, rationale, and recommendations

The opioid overdose epidemic kills about 130 people a day in the United States and it is estimated that there are about 2.1 million people who suffer from an opioid use disorder (OUD). Academic neuroscientists, psychiatrists and the National Institute of Drug Abuse have spent the last forty-years establishing the foundation of addiction as a brain disorder. It is now clear that extended opioid use causes multiple important and at times, irreversible changes to the brain, especially to its dopamine and opioid systems. With our recognized criteria for diagnosis and the accepted multifaceted treatment approach of both professional psychotherapy and medications that assist treatments, treatment failures should be limited. Unfortunately, this is not the case. Slips, relapses, overdose and multiple failures are all too common. Similar to treatment resistant depression there is a subpopulation who do not respond to standard OUD treatments. However, the field has suggested that if a treatment does not work, it is either the patients fault, they have not hit bottom or simply we need to try the same treatment again. There is a rational to consider this a new category of OUD, treatment resistant opioid use disorder (TROUD). This paper explores past treatment attempts data from OUD patients entering traditional outpatient treatment and makes recommendations how TROUD can be defined. It challenges the addiction research and treatment providers to change its focus from individuals being resistant to the unique conditions associated with this brain disorder as being resistant to treatment as usual.

Evidence Mapping: Interventions for American Indian and Alaska Native Youth Mental Health

Background: Suicide is the second leading cause of death for Native youth aged 15-24. Similarly, Native youth have a suicide rate 1.5 times higher than the general population and are at higher risk for depression and substance use. A persistent need remains for culturally specific mental health interventions for American Indian youth.Methods: In response to the push for research-supported interventions, evidence mapping has emerged as systematic, rigorous, and replicable analysis of evidence. The overall goal of this study is to utilize evidence mapping for mental health interventions for American Indian youth.Results: A total of 9 interventions were mapped as research-supported interventions for American Indian mental health. The interventions fell into one or more of four main categories: school-based services, cultural adaptations, culture as treatment, and community involvement.Discussion: Results of this study demonstrate the strength of culturally specific mental health interventions for American Indian youth. Future research should seek to evaluate promising practices for American Indian youth in order to increase available research-supported interventions. Additionally, future endeavors should seek to combine both Indigenous and Western approaches to practice with a particular focus on holistic wellness.

Impact of Violence and Relationship Abuse on Grades of American Indian/Alaska Native Undergraduate College Students

Violence and relationship abuse are pervasive public health problems that have a range of negative effects, with exceptionally high prevalence among ethno-racial minority youth. This study assesses the prevalence of these types of violence among American Indian/Alaska Native (AI/AN) students and examines the impact of victimization on academic performance of AI/AN and non-AI/AN student populations using self-reported college health survey data. Results show that students who identified fully or partially as AI/AN reported markedly higher rates of all types of violence/abuse than did other students, and students who had experienced violence/abuse had lower grade point averages (GPAs) compared with those who had not. Recommendations for future research and direct practice with AI/AN students are discussed.

Are Grittier Front-Line Therapists More Likely to Implement Evidence-Based Interventions?

Substance use disorder remains a pervasive problem in the U.S. and elsewhere. Recent scholarship has explored therapist characteristics and evidence based intervention implementation in an attempt to improve client outcomes. One such construct that has received considerable attention is grit. People with high levels of grit tend to remain determined despite setbacks. This study sought to elucidate the relationship of grit to therapeutic alliance and attitudes towards evidence-based interventions in a sample of front-line therapist (n = 240). Grit was found to be positively associated with therapeutic alliance and correlated with favorable attitudes towards using proven practice. Findings suggest that gritty therapists may sustain the use of evidence based interventions in their usual services and have better client outcomes.

The new social work

Social work practice is an industry based mostly on therapist intuition and gut feelings. There are virtually no real-time, reliable data showing the performance of any patient outcomes or on therapists providing treatment services. In this paper a new system is recommended, performance-based practice. In the future, the New Social Work proposed will not operate as a system in which patients enter community facilities to sit in waiting rooms and interact with a randomly assigned therapist for one hour a few times weekly. Social service building will transform into technology centers where therapists use tools to measure and intervene with patients in real-time. The New Social Work will finally understand that people do not recover or learn how to recover in therapist's offices-but in their own communities-with assistance from high-performance professional therapists interacting in the moment.

Do organizational expectations influence workers' implementation perceptions?

The purpose of this article is to report on the use of empirically supported treatments (ESTs) among clinical addiction workers, in order to relate the use of ESTs to both perceived agency expectations and worker-level attitudes. We recruited a convenience sample of 120 frontline workers within 4 agencies providing addiction services in St. Louis. The results found that agency expectations were related to clinician's reported use of ESTs, but were unrelated to clinician attitudes. The regression results revealed that reported use of ESTs was associated with openness to ESTs, but was not associated with favoring clinical experience. Organizational leaders interested in using ESTs should send clear, strong messages that they expect workers to use ESTs during clinical practice. (PsycINFO Database Record

Speaking out about physical harms from tobacco use: response to graphic warning labels among American Indian/Alaska Native communities

OBJECTIVE

This study is the first to explore the impact of graphic cigarette labels with physical harm images on members of American Indian/Alaska Native (AI/AN) communities. The aim of this article is to investigate how AI/AN respond to particular graphic warning labels.

METHODS

The parent study recruited smokers, at-risk smokers and non-smokers from three different age groups (youths aged 13-17 years, young adults aged 18-24 years and adults aged 25+ years) and five population subgroups with high smoking prevalence or smoking risk. Using nine graphic labels, this study collected participant data in the field via an iPad-administered survey and card sorting of graphic warning labels. This paper reports on findings for AI/AN participants.

RESULTS

After viewing graphic warning labels, participants rated their likelihood of talking about smoking risks to friends, parents and siblings higher than their likelihood of talking to teachers and doctors. Further, this study found that certain labels (eg, the label of the toddler in the smoke cloud) made them think about their friends and family who smoke.

CONCLUSIONS

Given the influence of community social networks on health beliefs and attitudes, health communication using graphic warning labels could effect change in the smoking habits of AI/AN community members. Study findings suggest that graphic labels could serve as stimuli for conversations about the risks of smoking among AI/AN community members, and could be an important element of a peer-to-peer smoking cessation effort.

Toward a culturally informed rehabilitation treatment model for American Indian/Alaska Native veterans

American Indians and Alaska Natives (AI/AN) have a long tradition of military service, allying with Western forces in North America since the 1700s. It is hardly surprising, therefore, that AI/AN veterans experience higher rates of overall disability and service-related disability than veterans of other races and ethnicities. It is not clear, however, that AI/AN veterans with disabilities are receiving effective, culturally informed rehabilitation services. This article examines the incidence of disability among contemporary AI/AN veterans, considers barriers to effective treatment, and points out model programs tailored to the particular needs of this population, with attention to the historical and cultural context of AI/AN military service.

Motivational interviewing in permanent supportive housing: the role of organizational culture

This study evaluated motivational interviewing (MI) in a permanent supportive housing agency. The agency's contradictory social service and business missions resulted in an incompatible organizational culture theorized to diminish MI's effectiveness. A combination of observational, interview, and archival data collected over 3 years were used to examine MI implementation within an incompatible supportive housing agency. Two major themes arose: how MI is used to categorize and change clients in permanent supportive housing and how worker-worker relationships affect MI implementation. The results suggest that within incompatible organizational environments, key elements of effective MI implementation are greatly weakened.