Substance abuse is a significant problem for all Americans. Research has revealed increased risk factors including exposure to drugs among African-American males, making a race-specific intervention program necessary to ensure recovery success rates (Wallace & Muroff, 2002). Moreover, psychological counseling and intervention programs need to be culturally sensitive if they are to be successful. Variables such as communication styles, worldviews, family values, gender roles and norms, urban vs. rural living environment, and socio-economic class status will all impact attitudes toward treatment, treatment decisions, and treatment outcomes. Moreover, comorbidity issues also vary by racial category, including comorbidity with alcohol abuse, anxiety, depression, personality disorders, and affective disorders (Ziedonis, Rayford, Bryant & Rounsaville, 1994). Research comparing prevalence of substance abuse between white and black patients is contradictory in nature, with Nauert (2011) claiming that "substance abuse issues are more prevalent among African-Americans than other groups," but Broman, Neighbors & Jackson (2008) finding contrary results. Broman, Neighbors & Jackson (2008) found that, "Whites have higher prevalence rates of substance abuse disorders than do other racial and ethnic groups, but racial and ethnic minorities have been shown to have substance abuse disorders that persist for longer periods of time," (p. 2). Regardless, the African-American community is in need of culturally relevant treatment interventions.
However, there is a relative lack of research considering the unique factors that might make a treatment intervention more effective for African-American males. Recent research is filling the gap in evidence, especially with regards to using motivational enhancement therapy. Motivational enhancement therapy is based on cognitive behavioral theories, and is built on the assumption that treatment prognosis is influenced by motivation to change. Nauert (2011) defines motivational enhancement therapy as "behavioral change approach that assesses an individual's readiness to live a substance-free life or whether they're against any treatment," (p. 1). Carroll (2009) found that motivational enhancement therapy was effective for Hispanic alcohol abusers, showing that the treatment can be adapted for cultural and linguistic relevance. Hettema, Sorensen, Uy & Jain (2009) also found that motivational enhancement therapy was effective for specific population groups.
The treatment process used in motivational enhancement therapy addresses ambivalence, and takes into account the person's positive behavioral reinforcements for using drugs and alcohol, such as anxiety reduction or social anxiety reduction. Many users might believe that the positive effects of using drugs do not outweigh the negative effects, or they might not care enough about the negative consequences of using drugs. Motivational enhancement therapy is designed to help the individual realize what negative effects drug use is and will have on the user. Research by Crits-Christoph, et al. (2009), Walker, et al., (2011), Montgomery et al. (2011) and others highlight the importance of incorporating group therapies that utilize motivational enhancement therapy into anti-recidivism programs for African-American males. Among at-risk males, motivational enhancement therapy can not only improve outcomes with regards to substance abuse, but also lead to transformative behavioral changes that reduce recidivism and promote re-integration in the community.
Proposed Intervention
With the ultimate goal of reducing recidivism, this proposed treatment program addresses the needs of African-American males aged 21 to 42. The target population has a history of criminal activity as well as substance abuse. Based on the research, it is believed that the African-American male participants in motivational enhancement therapy will have better long-term treatment outcomes and reduced rates of recidivism after release from prison.
A total of 150 males between the ages of 21 and 42 are included in the current treatment intervention. Therapy will focus on both individual and group meetings, with greater emphasis on group meetings. Groups will contain no more than twelve individuals plus the facilitator at any given session. Sessions of group therapy will take place twice weekly. Individualized counseling using motivational enhancement therapy will take place one every two weeks. The meeting location will be at community centers located in strategic locations to ensure that all participants can easily make it to the meetings.
To focus on re-integration in the community, the group leaders will also invite members of the community without criminal records to participate in the motivational enhancement therapy. These participants will have substance abuse problems, and therefore participate in the group therapy with their shared values, beliefs, and stories. However, it is critical that the participants develop strong networks of supportive individuals when working on a concerted program of recovery. Reducing recidivism cannot emphasize just staying sober. The process of re-integration in the community is also dependent on building and strengthening social skills, and working with community leaders...
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