¶ … old African-American male, the client represents a seriously underserved population cohort when it comes to providing effective substance abuse prevention and intervention support. According to Williams & Chang (2000), research on adolescent substance abuse treatment is sparse. Available evidence is even scantier when addressing the needs of non-white youth. Yet to be effective, interventions need to be tailored to the specific population.
Empirical evidence supporting a comprehensive and effective substance abuse intervention for the adolescent cohort began with an evaluation of the case. The client has experienced trauma, which should be taken into consideration while developing a treatment plan and during the course of treatment. At the age of twelve, the client's mother's sister in law and her two children -- the client's cousins -- were murdered. The client was deeply affected by the event, as was his family. It took a decade before the perpetrator of the crime was brought to justice, leading to many years of unresolved psychological pain for the entire family. The client admits that his unresolved bitterness adversely affected his behavior and likely led to his behavioral problems starting in adolescence soon after the crisis.
In addition to the personal experience with trauma, socio-cultural and socio-economic factors should be taken into consideration when developing a treatment plan and intervention. Unemployment, underemployment, poverty, and discrimination disproportionately affect the African-American communities in the United States and are linked, possibly causally, to the display of behavioral problems including substance use and abuse (Costen, 2009). Moreover, incarceration and the criminal justice system in general are used disproportionately for the young African-American male cohort, versus the use of substance use treatment and professional psychological interventions. Yet psychological interventions prove far more effective in reducing rates of relapse in substance abuse; research has shown that those who entered substance abuse programs on a doctor or other medical providers' recommendation tended to stay the longest in treatment and have the best outcomes (Cooper, MacMaster, & Rasch, 2009). Clients like these should be seeing psychologists instead of parole or corrections officers. Therefore, one of the core treatment goals will be to eliminate the time the client spends in the criminal justice system and maximize time spent in the care of qualified practitioners.
Strengths and protective factors in the African-American community can provide social support systems in lieu of, or in addition to, psychological counseling. The African-American community usually exhibits strong interdependence, including the use of extended family unit living that can provide ongoing social support. The client in this case should be encouraged to rely on the pre-existing social and family networks as part of the recovery process. At the same time, it is strongly recommended that the client have access to an initial in-patient treatment program. In-patient treatment programs provide the necessary separation from triggers and stressors and can therefore help the client to envision and practice a life without relying on substances to cope. It is then strongly recommended that the client have a structured exit strategy involving transitioning from the in-patient to outpatient status. This would involve ongoing therapy and heavy involvement in his community, ideally through his family's church.
It is strongly recommended that the client commit to a three-week in-patient treatment program followed by a minimum of one year in outpatient activities that include, but are not limited to, church-based activities and interventions. Research has shown that the more time a substance abuser spends in treatment the more successful s/he usually is at remaining in recovery (Cooper, MacMaster, & Rasch, 2009). For the client's treatment to be successful, he will need consistency in his case managers and continuity of care. For the client to "buy into" the treatment plan, he will need the support of his family, mentors, and ideally, peer group too. The client reports a healthy relationship with his family, including his parents and sister. He also attends church regularly.
Another way for the client to commit fully to his treatment program is through the creation of routine and structured leisure time. The client currently works in a steady job, which will provide some protective factors such as routine and time insulated from the triggers or temptations to use. He reports taking pleasure in his work as a mechanic and therefore, improving his skill levels and attaining career advancement will help improve the client's confidence and self-esteem, leading to a greater likelihood he can envision a life without depending on drugs for his identity or ability to cope. The client should be encouraged...
Other evidence suggests patterns of dependence symptoms and alcohol abuse may be linked with depressive or other disorders in adolescents, which may progress into adulthood leading to criminal activity (Martin, Kaczynski, Maisto & Bukstein, 1995; Kessler, et. al, 1996; Kilpatrick, et. al, 2000). Other evidence links aggressive behavior later in life with affective disorders in adolescence or young adulthood which may contribute to adult violent tendencies (Downey & Walker, 1992; Elze,
In G. Landsberg, M. Rock, & L. Berg (Eds.), Serving mentally ill offenders and their victims: Challenges and opportunities for social workers and other mental health professionals. New York, NY: Springer. Carroll K.M. (1997). Enhancing retention in clinical trials of psychosocial treatments: Practical strategies. In L. Onken, J. Blaine, & J. Boren, (Eds.), Beyond the therapeutic alliance: Keeping the drug-dependent individual in treatment. [NIDA Research Monograph Series #165, 4-24]. Washington,
Self-esteem and self-efficacy are issues that are of primary importance. These are affected by a number of environmental factors, including immediate family, but also the environment in which a person moves, as well as the wider social environment. Contextualism Contextualism was promoted in 1942 by S.C. Pepper, and was previously known as "pragmatism." This term was often used in the work of Charles S. Peirce, William James, Henri Bergson, John Dewey, and George
Researchers in Chicago found the following statistics in relation to NYC heavy users of drugs among those in detention in terms of gender, race and age. The following figures reveal what their findings were. Heavy Users in Detention All Detained Youth Gender Gender Male 82% Male 83% Female 18% Female 17% Race Race Black 64% Black 63% Hispanic 31% Hispanic 31% White 5% White 4% Other 0% Other 2% Ages Ages Source: Callahan (2001) Vera Institute of Justice Report Treatment Options Cognitive
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
However, conventional beliefs that there is low rate for African-American involvement in suicidal activities, there exists minimal focus on learning the possible suicide patterns among African-Americans. Social workers are not aware of the risks and protectiveness among African-Americans. This gives room for misinterpretation of facts concerning self-destructive activities of African-Americans. The research further stresses the importance of social workers to the study of suicide among African-Americans. They also have the
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