Alcohol_and_Drug_Class_chapter_10

download report

Transcript Alcohol_and_Drug_Class_chapter_10

Working with Selected
Populations: Treatment
Issues and Characteristics
Chapter 10
Felicia Pressley, LPC
Auburn University CED Teaching Intern
Chapter Objectives
•
Describe the risk and protective factors for substance use for children and
adolescents
•
Identify the barriers to substance abuse treatment for women
•
Describe the lengthy and often difficult process of forming a homosexual identity
•
Describe the effects of living with a disability and the effects on substance use.
•
Explain the relationship between aging, physical changes, mental changes, and
substance use.
•
Identify reasons for hopelessness and the effects on individuals and substance
use.
•
Present the experience of being marginalized as an oppressed group and the risk
factors associated with that experience.
Key Terms
•
Coming Out
•
Disability
•
GLBT
•
Handicap
•
Homeless
•
Enabling
•
Dysfunctional family systems
•
Economic independence
•
Identity
Most Common Marginalized Groups in
Society
•
Children & Adolescents
•
Women
•
Gay/ Lesbian/ Bisexual & Transgender (GLBT)
•
People with Disabilities
•
The Elderly
•
The Homeless Population
Children and Adolescents
Youths Aged 12 to 17
In 2008, 9.3 percent of youths aged 12 to 17 were current illicit drug users: 6.7 percent used
marijuana, 2.9 percent engaged in nonmedical use of prescription-type psychotherapeutics,
1.1 percent used inhalants, 1.0 percent used hallucinogens, and 0.4 percent used cocaine.
(Samhsa.gov)
Young Adults Aged 18 to 25
Rates of current use of illicit drugs in 2008 were higher for young adults aged 18 to 25 (19.6
percent) than for youths aged 12 to 17 (9.3 percent) and adults aged 26 or older (5.9
percent). Among young adults, 16.5 percent used marijuana in the past month, 5.9 percent
used prescription-type drugs nonmedically, 1.7 percent used hallucinogens, and 1.5 percent
used cocaine. (Samhsa.gov)
Risk factors
•
Transitions periods/Vulnerable life periods
•
•
•
•
Parental drug use during pregnancy
Enter school or new school
Peer introduction in middle school/ Social pressure
Adolescents with Conduct disorders and or other behavioral/temperament traits
Children and Adolescents
Individual Risk Factors
•
Antisocial problems
•
Alienation
•
Tolerance for deviance and need for independence
•
Psychopathology
•
Attitudes favorable to drug use
•
High-risk personality factors such as sensation seeking, low harm
avoidance and poor impulse control
Children and Adolescents
Family Factors
Environmental factors
•
Parental substance use and modeling
•
•
Poor family management and
parenting practices
Peer influence (rejection or low
acceptance)
•
Deficient cultural and social norms
•
Poor parent-child relationships
•
Extreme poverty
•
Family conflict
•
•
Physical abuse and sexual abuse
Neighborhood disorganization the
reduces the sense of community
•
Failure to achieve in school
•
Low school involvement
•
Negative school environment
Children and Adolescents
During assessment what are we also looking for?
Resiliency Factors in clients lives
•
Social competence
•
Able to problem solve
•
Autonomy
•
Sense of purpose and future
•
Educational aspirations
•
Optimism
•
Faith and Spirituality connectedness
•
Humor
Children and Adolescents
Effective treatment approaches
•
Designed to meet adolescents’ specific needs (Sanjuan and Langenbucher,
1999)
•
Nontraditional treatment programs/Avoid labeling youth (Jenson,
Howard, and Yaffe, 1995)
•
Community based programming with outpatient counseling, recreation,
education, medical and relapse prevention, school support, peer groups,
group therapy, vocational training and attendance in self-help groups.
Women
Updated from SAMHSA.gov
Although males were more likely than females to be current illicit
drug users in 2008, the rate of current illicit drug use among females aged
12 or older increased from 5.8 percent in 2007 to 6.3 percent in 2008.
However, the rate did not change significantly for males (10.4 and 9.9
percent for 2007 and 2008, respectively). Current marijuana use also
increased from 3.8 to 4.4 percent among females, but for males there was
no significant change (8.0 and 7.9 percent, respectively).
http://oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.pdf
Women
Risk Factors
•
Traumatic life events or Victimization
•
•
Physical and or sexual abuse, sudden illness, accident or family issues
Environmental factors
•
poverty
•
Marital status
•
Chronic Pain or Surgery
•
Low Self-Esteem
•
•
Mental health problems
•
•
Failure to achieve in school
Depression, anxiety, suicidal ideation, eating disorders and PTSD
Family/Job Stress
•
poor coping skills
Women
Conflicts for access to treatment
•
Guilt, stigma, and shame
•
Feeling helpless, powerless, defeated
•
Care and needs of children
•
Vocational and economic issues and limitations
•
Lack of transportation
•
Victimization in adulthood
•
Mental health problems
•
Impact on mother and fetus of drinking or using drugs during pregnancy
Women
Prevention and Intervention
•
Medical interventions for infectious diseases, treatment of general health, obstetrical
and gynecological services, and infant and child health services
•
Substance abuse counseling
•
Comprehensive assessment
•
Prevention education
•
Practical skills such as financial management, accessing services, stress management
and coping
•
Educational service and Vocational services
•
Child care and transportation
•
Legal services
•
Safe housing
•
Case management services and after care
Gay/ Lesbian/Bisexual/Transgender
Risks
•
GLBT are at a high risk than compared to heterosexual orientation persons for
drug and alcohol abuse
•
Self-blame for the victimization one has suffered
•
Negative self-concept as a result of negative messages about homosexuality
•
Anger directed inward resulting in destruction patterns such as substance abuse
•
Victim mentality or feelings of inadequacy, hopelessness, despair that interfere
with leading a fulfilling life
•
Self-victimization that may hinder emotional growth and development
Gay/ Lesbian/Bisexual/Transgender
Identity Development
•
Identity confusion
•
Identity comparison
•
Identity Tolerance
•
Identity acceptance
•
Identity pride
•
Identity synthesis
•
HBO
Gay/ Lesbian/Bisexual/Transgender
Risk Factors
•
Role of the gay bar as a primary socialization agent
•
Fewer family and societal supports
•
Socioeconomic and psychosocial conditions associated with minority
status
•
Stresses related to the developmental process of GLBT identity
formation and coming out
•
Internalized homophobia
Gay/ Lesbian/Bisexual/Transgender
Treatment Concerns
•
Environment that affirms GLBT lifestyles as positive
•
Self-awareness and self-acceptance as a sexual minority
•
Appropriate ways of coping with discrimination and rejection from family, society, and
others
•
Nontraditional family network
•
Integration of their sexuality into a philosophy based on sobriety, quality, spirituality,
and self-worth
•
Medical information that is tailored to their special needs
•
Role models who illustrarate the diversity of the GLBT
•
Social support networks
People with Disabilities
•
The United Stated has an estimate of 49.8 million people living with a
mental or physical disability
•
6 to 13 million Americans are estimated to be impacted by alcohol and
other drugs and are chemically dependent.
•
The Contract with American Amendment Act, 1996 eliminated substance
abuse as a basis for disability eligibility under SSI (Supplemental Security
Income)
People with Disabilities
Risk factors
•
The actual disability
•
Environment in which the disability is experienced
•
The individual’s response to the disability
•
The response of family members and others in the social environment
People with Disabilities
•
Intervention
•
Rehabilitation counseling assessment
•
Interventions designed to the specific persons disability
•
•
Accommodations (interpreters or audio tapes)
Developing new social networks
The Elderly
•
Population age 65 and older
•
Ranges
•
•
•
Young-old 65-74 years of age
Middle-old 74-85 years of age
Oldest-old 85 years and older
•
Drug misuse, alcohol use and abuse is increasing in this population
•
Early life onset Problems with substances before age 40 and continued
•
The midlife onset problems between ages 41 to 59.
•
Late-life onset group signs of problems staring at around age of 60.
The Elderly
Risk Factors
•
Physiological
•
Psychological
•
Social
•
Economic
•
Major Risk Factors
•
•
•
High sensitively to and toxicity to body and brain due to age
Change in social support and work related activates
Loss of family and friends
The Elderly
Prevention & Treatment
•
Education about life changes
•
Counseling on OTC medications and prescriptions and alcohol use
•
12 step meetings
•
Structured programs
•
More outpatient aftercare is essential
The Homeless Population
•
An estimate of 2 to 3 million are homeless each year
•
20% to 25% have a mental illness and half of the subgroup have an alcohol and or drug
problem.
•
In 2000, according to the census bureau 31.1 million people lived at or below the line of
poverty.
•
Reasons why children, youth and families fall into homeless situations
•
•
•
•
•
•
•
•
Lack of affordable housing
Unemployment/ underemployment
Physical, mental, and substance abuse
Mental illness
Lack of education
Lack of high –level job skills
Catastrophic physical illness
Natural disaster
The Homeless Population
•
Risk Factors and Barrier to Treatment
•
Lack of health insurance means limited access to assistance
•
Waiting lists for uninsured persons
•
Lack of transportation
•
Lack of supportive services
The Homeless Population
•
Treatment Difficulties
•
Refusal of assistance
•
Difficulty recruiting them for treatment
•
Continued homelessness make recovery out of reach
Questions & Concerns
•
Ask Now before the test!!
References
Substance Abuse and Mental Health Services Administration. (2009).
Results from the 2008 National Survey on Drug Use and Health: National Findings
(Office of Applied Studies, NSDUH Series H-36, HHS Publication No.
SMA 09-4434). Rockville, MD.
http://oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.pdf downloaded
6/29/2010.