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0000-0003-0500-1865
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University of Wollongong
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Aboriginal and Torres Strait Islander Health | Social and Cultural Anthropology | Public Health and Health Services | Health and Community Services
Aboriginal and Torres Strait Islander Health - Determinants of Health | Expanding Knowledge through Studies of Human Society | Aboriginal and Torres Strait Islander Development and Welfare |
Publisher: Elsevier BV
Date: 10-2023
Publisher: Elsevier BV
Date: 2021
Publisher: Wiley
Date: 20-04-2020
DOI: 10.1111/DAR.13064
Publisher: BMJ
Date: 08-2020
Publisher: American Psychological Association (APA)
Date: 09-2022
DOI: 10.1037/CCP0000758
Abstract: The interpersonal theory of suicide (ITS) predicts perceived burdensomeness, thwarted belongingness, and hopelessness lead to suicidal ideation and recommends burdensomeness and belongingness should be the targets of treatment. Limited research has tested if burdensomeness and belongingness temporally predict suicidal ideation during treatment. This study examined the bidirectional relationships between burdensomeness, belongingness, hopelessness, depression, and suicidal ideation in young people seeking treatment for suicide-related behaviors. A s le of 638 Australian young people (69.3% females, Mage = 16.61 [SD = 2.99]) completed measures of burdensomeness, belongingness, hopelessness, depression, and suicidal ideation at each session of treatment (Msessions = 5.24 [SD = 2.16]). A random-intercept cross-lagged panel model examined the within-person direction of effects across the first five occasions of treatment. Autoregressive paths showed hopelessness had carryover effects across all time points. All other variables had carryover effects at four time points. Cross-lagged paths varied, with suicidal ideation predicting depression, burdensomeness, and hopelessness. Belongingness, burdensomeness, and hopelessness predicted suicidal ideation on one occasion. Hopelessness predicted burdensomeness and depression at three time points and predicted belongingness on one occasion. Results are partially consistent with the ITS, but in contrast to the theory, the most consistent predictor of suicidal ideation was prior suicidal ideation. Prior levels of hopelessness, belongingness, and burdensomeness did influence suicidal ideation at some time points, but the most consistent effects were from hopelessness toward burdensomeness. Theoretical and treatment implications for these findings are discussed, particularly the need to directly address hopelessness in treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Publisher: Springer Science and Business Media LLC
Date: 14-06-2016
Publisher: Wiley
Date: 06-10-2020
DOI: 10.1111/DAR.13183
Abstract: There has been a rapid increase in smoking crystalline meth hetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use meth hetamine. Participants ( N = 151) were dependent on meth hetamine, aged 18–60 years, enrolled in a pharmacotherapy trial for meth hetamine dependence, and reported either injecting ( n = 54) or smoking ( n = 97) meth hetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking meth hetamine and to compare the clinical characteristics of participants who smoked versus injected. Compared to participants who injected meth hetamine, those who smoked meth hetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked meth hetamine used meth hetamine on more days in the past 4 weeks than participants who injected meth hetamine (26 vs. 19 days, P = 0.001) they did not differ significantly in their severity of meth hetamine dependence, withdrawal, craving or psychiatric symptoms ( P 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = −1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = −1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = −1.1 (0.5), P = 0.022]. Smoking crystalline meth hetamine is associated with a younger less marginalised demographic profile than injecting meth hetamine, but a similarly severe clinical profile.
Publisher: Wiley
Date: 28-06-2022
DOI: 10.1111/DAR.13504
Abstract: Substance use disorders are associated with significant physical health comorbidities, necessitating an integrated treatment response. However, service fragmentation can preclude the management of physical health problems during addiction treatment. The aim of this systematic review was to synthesise the recommendations made by clinical practice guidelines for addressing the physical health of people attending alcohol and other drug (AOD) treatment. An iterative search strategy of grey literature sources was conducted from September 2020 to February 2021 to identify clinical practice guidelines. Content pertaining to physical health care during AOD treatment was extracted. Quality of guidelines were appraised using the Appraisal of Guidelines Research and Evaluation II (AGREE‐II) tool. Thirty‐three guidelines were included for review. Fourteen guidelines were considered high quality based on AGREE‐II scores. Neurological conditions (90.9%) and hepatitis (81.8%) were the most frequent health problems addressed. Most guidelines recommended establishing referral pathways to address physical health comorbidities (90.9%). Guidance on facilitating these referral pathways was less common (42.4%). Guidelines were inconsistent in their recommendations related to oral health, tobacco use, physical activity, nutrition and the use of standardised assessment tools. Greater consistency and specificity in the recommendations made for integrating physical health care within addiction treatment is needed. Ensuring that recommendations are applicable to the AOD workforce and to treatment services limited by funding and resource constraints should enhance implementation. Future guideline development groups should consider increased consultation with the AOD workforce and inclusion of clinical tools and decision aids to facilitate referral pathways.
Publisher: BMJ
Date: 02-2021
Abstract: A 75-year-old was treated for prostate adenocarcinoma with brachytherapy in September 2018. A routine follow-up chest radiograph 3 months later revealed a metallic object of the same dimensions as a brachytherapy pellet located in the right ventricle. Further imaging showed the brachtherapy pellet was located in the anterobasal right ventricular endocardium close to the tricuspid valve. Frequent asymptomatic premature ventricular contractions were observed with likely origin from the left ventricular outflow tract, an area remote from the site of the pellet. The patient remains asymptomatic and subsequent imaging shows that the position of the pellet has not changed.
Publisher: Informa UK Limited
Date: 11-2010
Publisher: Wiley
Date: 06-2017
DOI: 10.1111/DAR.12416
Abstract: The Self-Management and Recovery Training (SMART Recovery) program provides facilitated mutual aid for people with addictions. To date, little research has examined SMART Recovery. This paper examined participant and facilitator perceptions of the helpfulness of cognitive behaviour therapy tools in SMART Recovery groups. SMART Recovery's strengths and areas for improvement were also explored, as well as overall participant satisfaction with SMART Recovery. This exploratory study was conducted as part of the first national survey of SMART Recovery in Australia. Paper surveys were posted to all registered SMART Recovery groups for participants. SMART Recovery facilitators were emailed a link to an online survey. Overall, satisfaction with SMART Recovery was moderate to strong. Participants and facilitators perceived the cognitive behaviour therapy tools incorporated within SMART Recovery to be helpful. Participants and facilitators nominated the group experience and the SMART Recovery tools and strategies as helpful aspects of SMART Recovery. Participants and facilitators were concerned with improving public knowledge about SMART Recovery groups, updating the structure and content of SMART Recovery groups, and increasing training for facilitators. SMART Recovery displays strengths as communicated by those who utilise its services. However, there are opportunities to continue to improve SMART Recovery. Updating the training for facilitators and increasing communication between SMART Recovery Australia's head office and its facilitators may serve to improve service delivery. Future research should focus on examining the efficacy of SMART Recovery groups on participant outcomes.[Kelly PJ, Raftery D, Deane FP, Baker AL, Hunt D, Shakeshaft A. From both sides: Participant and facilitator perceptions of SMART Recovery groups. Drug Alcohol Rev 2017 :325-332].
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.DRUGALCDEP.2017.04.023
Abstract: Executive dysfunction is common in substance use disorder (SUD) populations and hinders treatment. We previously found that 50% of residents in SUD therapeutic communities had been hospitalized for head injuries this was a significant determinant of cognitive impairment. The current study aimed to establish whether cognitive remediation improves executive functions (EFs) and self-regulation in an ecologically valid s le of female residents attending SUD therapeutic community treatment, including those with past head injuries and psychiatric comorbidities. Controlled sequential groups design with residents (N=33, all female) receiving treatment as usual (TAU). The intervention group (n=16) completed four weeks of cognitive remediation (CR) and the control, TAU only (n=17). Outcome measures assessed pre- and post-intervention included both performance- and inventory-based measures of EFs, and self-reported self-regulation and quality of life. CR relative to TAU significantly improved performance-based assessment of inhibition (Color-Word Interference Test F=4.29, p=0.047), inventory-based assessment of EFs (Behavior Rating Inventory of Executive Function - Adult Version: Global Executive Composite F=6.38, p=0.017), impulsivity (Barratt Impulsiveness Scale F=4.61, p=0.040), self-control (Brief Self-Control Scale F=5.53, p=0.026), and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form F=7.68, p=0.010). Findings suggest that CR improves EFs in a heterogeneous s le of female residents in therapeutic community SUD treatment. Future research may explore the possibility of tailoring CR interventions for various SUD subgroups.
Publisher: Wiley
Date: 30-05-2023
DOI: 10.1111/ADD.16230
Abstract: To determine whether the risk of psychotic symptoms during weeks of meth hetamine use was dependent on, increased by, or independent of having a family history of psychosis. Secondary analysis of 13 contiguous 1‐week periods of data (1370 weeks). A risk modification framework was used to test each scenario. Geelong, Wollongong and Melbourne, Australia. Participants in a randomized controlled trial of treatment for meth hetamine dependence ( n = 148) who did not have a primary psychotic disorder on enrolment. Psychotic symptoms in the previous week were defined as a score of 3+ on any of the Brief Psychiatric Rating Scale items of hallucinations, unusual thought content or suspiciousness. Any (vs no) meth hetamine use in the previous week was assessed using the Timeline Followback method. Self‐reported family history of psychosis was assessed using the Diagnostic Interview for Psychosis. The risk of psychotic symptoms in the past week was independently associated with meth hetamine use in that week (relative risk [RR] = 2.3, 95% CI = 1.3–4.3) and with having a family history of psychosis (RR = 2.4, 95% CI = 0.9–7.0) the joint risk among participants with a family history of psychosis during weeks when they were using meth hetamine was large (RR = 4.0, 95% CI = 2.0–7.9). There was no significant interaction between a family history of psychosis and meth hetamine use in predicting psychotic symptoms (interaction RR = 0.7 95% CI = 0.3–1.8), but there was a small non‐significant excess risk due to the interaction (0.20 95% CI = −1.63 to 2.03). Among people dependent on meth hetamine, the relative risk of psychotic symptoms during weeks of meth hetamine use does not appear to be dependent on, or increased by, having a family history of psychosis. However, a family history of psychosis does appear to be an independent risk factor that contributes to the absolute risk of psychotic symptoms in this population.
Publisher: Wiley
Date: 30-04-2019
DOI: 10.1111/DAR.12931
Abstract: Meth hetamine (MA) use has increased markedly over the past decade, during which time there has been an increase in children in out of home care. This study explores whether MA use in parents attending residential treatment services for substance use issues is associated with higher proportions of children living out of the home. Data were collected from in iduals attending residential treatment centres provided by the Australian Salvation Army between 2009 and 2016. Centres provide residential alcohol and other substance use treatment in a modified therapeutic community. Trained staff administered sections of the Addiction Severity Index measuring substance use, legal and parenting status, and the Mental Health Screening Form-III at intake. Data were limited to those who had at least one child under 18 years final s le size was 2964. Of the 2964 parents, 36.3% nominated MAs use as a primary or secondary substance of use. Between 2011 and 2016, a significantly greater proportion of parents using MAs (86.1%), had at least one child not living at home compared to those using other substances (81.3% χ Given that MA use can result in increased risks of violence and neglect the increase in parents using the substance is concerning. The growing number of mothers in treatment warrants further investigation, particularly as women face inherent difficulties in seeking treatment with dependent children.
Publisher: Wiley
Date: 30-05-2017
DOI: 10.1111/DAR.12414
Abstract: Meth hetamine dependence is a growing problem in Australia and globally. Currently, there are no approved pharmacotherapy options for the management of meth hetamine dependence. N-acetylcysteine is one potential pharmacotherapy option. It has received growing attention as a therapy for managing addictions because of its capacity to restore homeostasis to brain glutamate systems disrupted in addiction and thereby reduce craving and the risk of relapse. N-acetylcysteine also has antioxidant properties that protect against meth hetamine-induced toxicity and it may therefore assist in the management of the neuropsychiatric and neurocognitive effects of meth hetamine. This commentary overviews the actions of N-acetylcysteine and evidence for its efficacy in treating addiction with a particular focus on its potential utility for meth hetamine dependence. We conclude that the preliminary evidence indicates a need for full-scale trials to definitively establish whether N-acetylcysteine has a therapeutic benefit and the nature of this benefit, for managing meth hetamine dependence. [McKetin R, Dean O, Baker A. L, Carter G, Turner A, Kelly P. J, Berk M. A potential role for N-acetylcysteine in the management of meth hetamine dependence. Drug Alcohol Rev 2017 :153-159].
Publisher: Springer Science and Business Media LLC
Date: 07-2004
Publisher: Springer Science and Business Media LLC
Date: 18-11-2011
Publisher: Informa UK Limited
Date: 19-09-2019
Publisher: Informa UK Limited
Date: 28-12-2022
Publisher: JMIR Publications Inc.
Date: 06-10-2021
DOI: 10.2196/25217
Abstract: Mutual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategies). Trained facilitators lead all SMART Recovery groups, providing an opportunity to implement ROM. The aim of this stage 1 pilot study is to explore the feasibility, acceptability, and preliminary outcomes of a novel, purpose-built mobile health ROM and feedback app (SMART Track) in mutual support groups coordinated by SMART Recovery Australia (SRAU) over 8 weeks. SMART Track was developed during phase 1 of this study using participatory design methods and an iterative development process. During phase 2, 72 SRAU group participants were recruited to a nonrandomized, prospective, single-arm trial of the SMART Track app. Four modes of data collection were used: ROM data directly entered by participants into the app app data analytics captured by Amplitude Analytics (number of visits, number of unique users, visit duration, time of visit, and user retention) baseline, 2-, and 8-week follow-up assessments conducted through telephone and qualitative telephone interviews with a convenience s le of study participants (20/72, 28%) and facilitators (n=8). Of the 72 study participants, 68 (94%) created a SMART Track account, 64 (88%) used SMART Track at least once, and 42 (58%) used the app for more than 5 weeks. During week 1, 83% (60/72) of participants entered ROM data for one or more outcomes, decreasing to 31% (22/72) by the end of 8 weeks. The two main screens designed to provide personal feedback data (Urges screen and Overall Progress screen) were the most frequently visited sections of the app. Qualitative feedback from participants and facilitators supported the acceptability of SMART Track and the need for improved integration into the SRAU groups. Participants reported significant reductions between the baseline and 8- week scores on the Severity of Dependence Scale (mean difference 1.93, SD 3.02 95% CI 1.12-2.73) and the Kessler Psychological Distress Scale-10 (mean difference 3.96, SD 8.31 95% CI 1.75-6.17), but no change on the Substance Use Recovery Evaluator (mean difference 0.11, SD 7.97 95% CI –2.02 to 2.24) was reported. Findings support the feasibility, acceptability, and utility of SMART Track. Given that sustained engagement with mobile health apps is notoriously difficult to achieve, our findings are promising. SMART Track offers a potential solution for ROM and personal feedback, particularly for people with substance use disorders who attend mutual support groups. Australian New Zealand Clinical Trials Registry ACTRN12619000686101 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336 RR2-10.2196/15113
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.JSAT.2018.08.007
Abstract: Quality of Life (QOL) is increasingly being recognised as an important indicator of recovery from substance use treatment. The current study aimed to determine if there are distinct subclasses of QOL among a broad range of people attending specialist non-government alcohol and other drug treatment services, and how QOL might be associated with substance use, mental health, treatment and demographic characteristics of these in iduals. The s le included 9958 in iduals attending specialist non-government treatment for alcohol or other substance use in New South Wales, Australia. Cross sectional data on quality of life, drug use, treatment variables, psychological distress and substance dependence severity was collected. Latent class analysis was conducted to identify quality of life classes within the s le. Regression analyses were then performed to identify which in idual, treatment and health outcomes were associated with these classes. Three distinct quality of life classes were identified, and termed low (n = 3048), moderate (n = 4211) and high quality of life (n = 2699). Classes differed across in idual characteristics, substance use and psychological distress. As hypothesised, greater substance use and higher distress was evident in the lowest quality of life class. Quality of life is an important measure of an in iduals' level of functioning during recovery from substance use. The identification of subgroups of in iduals with substance use disorders based on their quality of life classes may help guide interventions to improve their overall global functioning and treatment outcomes.
Publisher: SPIE
Date: 13-12-2020
DOI: 10.1117/12.2561930
Publisher: Cambridge University Press (CUP)
Date: 25-05-2018
DOI: 10.1017/S0033291718001125
Abstract: The mental and physical health of in iduals with a psychotic illness are typically poor. Access to psychosocial interventions is important but currently limited. Telephone-delivered interventions may assist. In the current systematic review, we aim to summarise and critically analyse evidence for telephone-delivered psychosocial interventions targeting key health priorities in adults with a psychotic disorder, including (i) relapse, (ii) adherence to psychiatric medication and/or (iii) modifiable cardiovascular disease risk behaviours. Ten peer-reviewed and four grey literature databases were searched for English-language studies examining psychosocial telephone-delivered interventions targeting relapse, medication adherence and/or health behaviours in adults with a psychotic disorder. Study heterogeneity precluded meta-analyses. Twenty trials [13 randomised controlled trials (RCTs)] were included, involving 2473 participants (relapse prevention = 867 medication adherence = 1273 and health behaviour = 333). Five of eight RCTs targeting relapse prevention and one of three targeting medication adherence reported at least 50% of outcomes in favour of the telephone-delivered intervention. The two health-behaviour RCTs found comparable levels of improvement across treatment conditions. Although most interventions combined telephone and face-to-face delivery, there was evidence to support the benefit of entirely telephone-delivered interventions. Telephone interventions represent a potentially feasible and effective option for improving key health priorities among people with psychotic disorders. Further methodologically rigorous evaluations are warranted.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.JSAT.2012.12.002
Abstract: Reductions in cravings have been associated with improved recovery from alcohol and other drug use problems. Self-report assessments of cravings provide a way of monitoring progress over the course of treatment particularly in residential settings. There is a need to develop brief craving measures suitable for repeat administration. The aim of the study was to assess the reliability and validity of a six-item version of the Desires for Alcohol Questionnaire (DAQ-6). In study 1 exploratory factor analysis involving 710 participants attending residential treatment revealed two factors: 'expectancy of negative reinforcement' and 'strong desires and intentions'. In study 2 confirmatory factor analysis replicated this factor structure in an independent s le of 116 participants. Both studies provided evidence for convergent and discriminant validity of the DAQ-6 when compared to other measures. The DAQ-6 shows promise as a brief self-report measure of cravings but the utility of the separate subscales in treatment contexts requires further research.
Publisher: SAGE Publications
Date: 2018
Abstract: Weight stigma is related to lower levels of motivation to exercise in overweight and obesity. This study explored the nature of the relationship between stigma, motivation to exercise and physical activity while accounting for gender differences. Participants were 439 adults with overweight and obesity (mean body mass index = 32.18 kg/m 2 , standard deviation = 4.09 kg/m 2 ). Females reported significantly more frequent stigma experiences than males. Mediation models found a conditional direct effect of weight stigma for males, with higher frequency of stigma experiences related to higher levels of walking and vigorous physical activity. A conditional indirect effect was found for females for walking, moderate and vigorous levels of physical activity, with higher weight stigma related to lower autonomous motivation, and lower levels of physical activity. Findings suggest that males and females are affected differently by weight-stigma experiences.
Publisher: Wiley
Date: 29-05-2023
DOI: 10.1111/DAR.13693
Abstract: To help reduce relapse rates following alcohol and other drug (AOD) treatment, continuing care interventions have been recommended. Previous continuing care interventions have incorporated telephone and face‐to‐face sessions to help promote participant engagement. The study was conducted as a randomised controlled feasibility study and examined a call centre delivered continuing care intervention for people leaving residential rehabilitation services. Participants were attending AOD residential treatment services in NSW, Australia ( N = 154). Participants were randomised to either 12‐ or 4‐sessions of continuing care. Follow up assessments were completed at 6‐months. The primary outcomes were demand and implementation. Secondary outcomes were AOD use, mental health and physical health at 6‐months. Interest in continuing care was high, with 93% of participants approached reporting an interest in being involved. Of the participants who completed the consent and baseline procedures, 29% of people were contacted post residential treatment and randomised. For those people randomised, the average number of sessions completed was 2.78 (SD = 1.65) for the 4‐session arm and 4.81 (SD = 4.46) for the 12‐session arm. Fidelity to the treatment manual was high. Both treatment arms showed higher complete abstinence at 6‐months compared to baseline (12‐session OR 28.57 [2.3, 353.8] 4‐session OR 28.11 [3.6, 221.2]). A major challenge associated with the call centre approach was re‐engaging participants once they left the residential facility and delivering the planned dose of treatment. Further work is required to promote greater uptake of these protocols once people leave residential treatment.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2020
DOI: 10.1186/S12889-020-8206-Y
Abstract: A priority area in the field of substance dependence treatment is reducing the rates of relapse. Previous research has demonstrated that telephone delivered continuing care interventions are both clinically and cost effective when delivered as a component of outpatient treatment. This protocol describes a NSW Health funded study that assesses the effectiveness of delivering a telephone delivered continuing care intervention for people leaving residential substance treatment in Australia. All participants will be attending residential alcohol and other drug treatment provided by The Salvation Army or We Help Ourselves. The study will be conducted as a randomised controlled trial, where participants will be randomised to one of three treatment arms. The treatment arms will be: (i) 12-session continuing care telephone intervention (ii) 4-session continuing care telephone intervention, or (iii) continuing care plan only. Baseline assessment batteries and development of the participants’ continuing care plan will be completed prior to participants being randomised to a treatment condition. Research staff blind to the treatment condition will complete follow-up assessments with participants at 3-months and 6-months after they have been discharged from their residential service. This study will provide comprehensive data on the effect of delivering the continuing care intervention for people exiting residential alcohol and other drug treatment. If shown to be effective, this intervention can be disseminated to improve the rates of relapse among people leaving residential alcohol and other drug treatment. Australian New Zealand Clinical Trials Registry, ACTRN12618001231235. Registered on 23rd July 2018. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375621& isReview=true
Publisher: MDPI AG
Date: 14-02-2022
DOI: 10.3390/IJMS23042092
Abstract: Rice (Oryza sativa), a staple crop for a substantial part of the world’s population, is highly sensitive to soil salinity however, some wild Oryza relatives can survive in highly saline environments. Sodium/hydrogen antiporter (NHX) family members contribute to Na+ homeostasis in plants and play a major role in conferring salinity tolerance. In this study, we analyzed the evolution of NHX family members using phylogeny, conserved domains, tertiary structures, expression patterns, and physiology of cultivated and wild Oryza species to decipher the role of NHXs in salt tolerance in Oryza. Phylogenetic analysis showed that the NHX family can be classified into three subfamilies directly related to their subcellular localization: endomembrane, plasma membrane, and tonoplast (vacuolar subfamily, vNHX1). Phylogenetic and structural analysis showed that vNHX1s have evolved from streptophyte algae (e.g., Klebsormidium nitens) and are abundant and highly conserved in all major land plant lineages, including Oryza. Moreover, we showed that tissue tolerance is a crucial trait conferring tolerance to salinity in wild rice species. Higher Na+ accumulation and reduced Na+ effluxes in leaf mesophyll were observed in the salt-tolerant wild rice species O. alta, O. latifolia, and O. coarctata. Among the key genes affecting tissue tolerance, expression of NHX1 and SOS1/NHX7 exhibited significant correlation with salt tolerance among the rice species and cultivars. This study provides insights into the evolutionary origin of plant NHXs and their role in tissue tolerance of Oryza species and facilitates the inclusion of this trait during the development of salinity-tolerant rice cultivars.
Publisher: Elsevier BV
Date: 06-2021
DOI: 10.1016/J.ADDBEH.2021.106840
Abstract: Although continuing care programs have been shown to improve alcohol and other drug (AOD) treatment outcomes, uptake of continuing care has been low. The current study aimed to determine predictors of participants' who both re-confirmed consent to engage in telephone-based continuing care and commenced continuing care once they left residential AOD treatment. These participants had initially consented to partake in continuing care during the course of their residential stay. Participants were 391 in iduals (232 males, 59% and 158 females, 40%) accessing therapeutic communities for AOD treatment provided by The Australian Salvation Army and We Help Ourselves (WHOS). Measures at baseline, collected during residential treatment, included demographics, primary substance of concern, abstinence goal, refusal self-efficacy, cravings for substances, mental health diagnoses, psychological distress, quality of life and feelings of loneliness. All measures were used as predictor variables to determine characteristics of participants who re-confirmed consent to engage in continuing care and commenced continuing care following residential AOD treatment. Completing residential treatment, being unmarried, and higher levels of loneliness predicted re-confirmation of consent to participate in continuing care following discharge from residential treatment. Participants who were Aboriginal and/or Torres Strait Islander were less likely to provide re-confirmation of consent. Participants were more likely to commence continuing care if they completed residential treatment, were older, and had longer years of substance use. Tailoring continuing care programs to reach a broader array of in iduals such as Indigenous populations and persons who exit treatment services early is needed to ensure these programs can reach all in iduals who might need them.
Publisher: Springer Science and Business Media LLC
Date: 06-07-2007
DOI: 10.1007/S10597-007-9097-4
Abstract: A survey was completed by 122 case managers describing the types of homework assignments commonly used with in iduals diagnosed with severe mental illness (SMI). Homework types were categorized using a 12-item homework description taxonomy and in relation to the 22 domains of the Camberwell Assessment of Need (CAN). Case managers predominately reported using behaviourally based homework tasks such as scheduling activities and the development of personal hygiene skills. Homework focused on CAN areas of need in relation to Company, Psychological Distress, Psychotic Symptoms and Daytime Activities. The applications of the taxonomy for both researchers and case managers are discussed.
Publisher: Informa UK Limited
Date: 24-10-2023
Publisher: Informa UK Limited
Date: 11-11-2021
Publisher: SAGE Publications
Date: 04-2019
DOI: 10.1080/08897077.2018.1528494
Abstract: Background: Routine outcome monitoring (ROM) is an important component of service provision and qualitity assurance procedures. However, a major logistical and financial challenge for organizations is successfully following up participants once they have left residential alcohol and other drug treatment. The aim of the current study was to assess the impact and effectiveness of an “early” follow-up contact and brief interview on subsequent 3-month ROM follow-up success. Methods: Participants were 800 clients attending specialist residential alcohol and other drug treatment provided by The Salvation Army. As part of routine outcome assessment procedures, all people attending these programs are asked to complete a 3-month follow-up assessment. Participants were randomly allocated either to the early contact condition (i.e., “early” 2-week follow-up contact prior to the 3-month follow-up assessment) or to the control condition (i.e., no “early” 2-week follow-up prior to the 3-month follow-up assessment). The primary outcomes were the proportion of participants who were followed up and surveyed at 3 months. Results: There were significantly higher follow-up rates at 3 months post discharge for participants in the early contact group (55.6%) compared with the control condition (46.1%). Although there were higher rates of 3-month follow-up for participants in the early contact group, rates of successful survey completion were not significantly different between the 2 groups. Conclusions: Including an early 2-week telephone call prior to the 3-month assessment increased the number of participants we were able to follow up at 3 months post discharge but did not improve the rate of survey participation at 3 months. The additional costs associated with this activity and the modest increase in follow-up rates need to be considered prior to organizations investing in these follow-up enhancement activities.
Publisher: Springer Science and Business Media LLC
Date: 04-06-2019
Publisher: Wiley
Date: 16-06-2021
DOI: 10.1111/DAR.13337
Abstract: Little is known about the experiences of continuing care workers (CCW) in the implementation of continuing care programs. The current study sought to understand CCWs and supervisor perceptions of the successes and challenges of implementing a telephone‐based continuing care intervention following residential alcohol and other drug treatment services. It also aimed to provide recommendations for treatment providers wishing to integrate continuing care into their treatment model, including the resources, training and supervision needs of CCWs. The participants were eight CCWs and two independent supervisors who completed semi‐structured interviews. Interview coding and analysis was guided by Iterative Categorisation procedures and an implementation framework. The Consolidated Framework for Implementation Research was used. Telephone delivery was advantageous, but even more enhanced, when there was a face‐to‐face session first to build rapport. Other key successes included CCWs who were confident and competent, as well as a match between the organisation's values and the philosophy of the continuing care program. Key challenges faced by CCWs related to a perceived lack of support from managers, difficulties accessing quiet office spaces and participant disengagement. Interviews revealed several factors that may influence successful delivery of continuing care as part of alcohol and other drug treatment. These included features of the intervention (e.g. telephone delivery, evidence‐based content), characteristics of the in idual CCWs (e.g. flexibility in delivery of the intervention while maintaining fidelity), organisational culture (e.g. alignment of organisational values with continuing care) and resources (e.g. office space, flexible work schedules).
Publisher: Alcohol Research Documentation, Inc.
Date: 03-2012
DOI: 10.15288/JSAD.2012.73.216
Abstract: Premature termination from treatment is a major factor associated with poorer drug and alcohol treatment outcomes. The present study investigated client-related baseline predictors of dropout at 3 months from a faith-based 12-step residential drug treatment program. Data were collected over a period of 14 months from eight residential drug and alcohol treatment programs run by The Australian Salvation Army. The final s le consisted of 618 participants, including 524 men (84.8%) and 94 women (15.2%). Predictor variables of interest were age, gender, primary drug of concern, criminal involvement, psychological distress, drug cravings, self-efficacy to abstain, spirituality, forgiveness of self and others, and life purpose. At 3 months, 264 participants (42.7%) remained in the treatment program, and 354 participants (57.3%) had dropped out. Binary logistic regression revealed that in iduals were more likely to drop out by the 3-month time frame if at intake their primary drug of concern was a drug other than alcohol or they reported greater forgiveness of self. To the authors' knowledge, this is the first study to examine forgiveness as a predictor of dropout from a drug treatment program. Assessing patient's primary drug of concern and levels of forgiveness may be useful for residential drug treatment providers in constructing programs that provide differential treatment based on the results of these assessments.
Publisher: BMJ
Date: 12-2015
Publisher: Elsevier BV
Date: 09-2015
Publisher: Australian Journal of Information Systems
Date: 03-10-2021
Abstract: Research undertaken by outsiders into issues of concern to Aboriginal communities frequently ignores community culture and the knowledge embedded within Aboriginal communities. Methodologies are adopted which perpetuate the colonialist mindset of non-indigenous Australians leading to failed solutions to Aboriginal problems. This paper describes an Aboriginal-led community-based research project, exploring the role of Aboriginal Australians in caring for, and transforming, their own communities. It focuses on the roles that Information Systems can play when providing an accessible platform for Aboriginal voices. The authors conducted an in-depth case study of one Aboriginal Community Controlled Organisation (ACCO), the Illawarra Koori Men’s Support Group (IKMSG). The research consisted of a social network analysis (SNA) of the inter-organisational links of the IKMSG interviews and focus groups with members of the IKMSG and the co-design of their first website. The prominence of the IKMSG in the SNA maps suggests that its work in the community is highly respected and that the model produced by this research can act as a guide for success in other ACCOs. The findings have been used to develop a theoretical model of Aboriginal community engagement and intervention. This model can enable authentic outcomes to projects which address Aboriginal concerns and support the conduct of community-led research in Aboriginal communities.
Publisher: Springer Science and Business Media LLC
Date: 06-01-2021
DOI: 10.1186/S13722-020-00212-8
Abstract: Mutual support groups are a popular treatment for substance use and other addictive behaviours. However, little is known about the cultural utility of these programmes for Indigenous peoples. A three-round Delphi study, utilising Indigenous research yarning methods was conducted to: (1) Obtain expert opinion regarding the cultural utility of an Indigenous SMART Recovery handbook (2) Gain consensus on areas within the SMART Recovery programme that require cultural modification and (3) Seek advice on how modifications could be implemented in future programme design and delivery. The panellists were 11 culturally, geographically, and professionally erse Indigenous Australian health and wellbeing experts. A group consensus level of 80% was set prior to each survey round. There was 100% participant retention across all three Delphi rounds. The panel reached consensus on five key programme modifications (composition of a separate facilitator and group member handbook culturally appropriate language, terminology, and literacy level culturally meaningful programme activities supplementary storytelling resources and customisation for erse community contexts). The panel also developed a series of practical implementation strategies to guide SMART Recovery through a modification process. The findings highlight the importance of involving Indigenous peoples in the design, delivery and validation of mainstream mutual support programmes. Indigenous-led programme modifications could help improve accessibility and usefulness of mutual support groups for Indigenous peoples worldwide. This study is an ex le of how Indigenous research methods can be used alongside the Delphi technique. This approach demonstrated a way that Indigenous peoples from culturally and geographically erse locations can participate in research anonymously, autonomously and without added burden on personal, community or professional obligations.
Publisher: Wiley
Date: 07-05-2017
DOI: 10.1111/DAR.12522
Abstract: The Client Satisfaction Questionnaire (CSQ-8) is one of a limited number of standardised satisfaction measures that have been used widely across mental health services. This study examined the CSQ-8 as a measure of general satisfaction within residential substance abuse treatment. It compared the CSQ-8 with another established measure of client satisfaction that was developed for substance abuse treatment settings (Treatment Perceptions Questionnaire, TPQ). It also sought to examine the relationship between the CSQ-8 and commonly used process measures. Cross-sectional data was collected from across 14 Australian residential medium-to-long term alcohol and other drug treatment facilities (N = 1378). Demographic, substance abuse and mental health characteristics were collected, as well as process measures of craving, general functioning, self-perceptions, recovery and symptom distress. A confirmatory factory analysis established that the CSQ-8 retains a single factor. The scale was strongly correlated with the TPQ, suggesting high concurrent validity. However, while the TPQ was normally distributed, the CSQ-8 was highly negatively skewed. Significant associations were found between the CSQ-8 and cross-sectional process measures. Results suggest that that CSQ-8 is an appropriate measure to be used in residential substance abuse treatment settings. However, because of the high levels of negative skew, it is likely that the TPQ is more accurate in capturing clients' dissatisfaction than the CSQ-8. Future research should include longitudinal studies of satisfaction in order to examine how changes in satisfaction may be related to client characteristics, outcome measures, dropout or re-engagement in treatment. [Kelly PJ, Kyngdon F, Ingram I, Deane FP, Baker AL, Osborne BA. The Client Satisfaction Questionnaire-8: Psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment. Drug Alcohol Rev 2018 :79-86].
Publisher: Elsevier BV
Date: 12-2021
Publisher: Informa UK Limited
Date: 29-04-2013
DOI: 10.3109/10826084.2013.782045
Abstract: This study collected data on drug and alcohol workers' (n = 55) and clients' (n = 139) perspectives on what constitutes a "recovery" from substance use disorder. Data were collected during 2010 from four residential faith-based treatment programs across the east coast of Australia. Self-report surveys specifically designed for this study were administered. Responses were compared using nonparametric test. Abstinence was seen as an important component of recovery but nonabstinent factors were also seen as having an important role. Staff placed more emphasis on clients taking responsibility for their problems and on the role of spiritual development. The importance of nonabstinence components was positively associated with a person's time in treatment and recovery. Implications, limitations, and future directions are noted.
Publisher: Wiley
Date: 19-07-2013
Publisher: Springer Science and Business Media LLC
Date: 07-2009
DOI: 10.1007/S10597-009-9217-4
Abstract: The current study explores the types of homework assignments used in a recovery orientated case management approach. It also examines the relationship between the types of homework used and the clients' area of need as rated on the CANSAS. There were 129 client and mental health case manager dyads that participated in the study. Written copies of all homework assignments administered during the 12-month research period were collected (N = 1,054). The homework assignments were categorised according to the 'type' and the 'need domain addressed by the task'. The majority of these tasks were behavioural in nature. On a group level homework tended to broadly address areas of need for clients in the study. Only 2 of the 1,054 homework assignments administered directly addressed areas of Intimate Relationships or Sexual Expression. The importance of addressing Intimate Relationship and Sexual Expression within mental health case management is discussed.
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.DRUGALCDEP.2017.10.008
Abstract: Difficulties in emotion regulation influence the development of substance use disorder (SUD), its severity, course, treatment outcomes, and relapse. Impaired executive functions (EFs) are common in SUD populations and may relate to emotion dysregulation. The current study tested whether performance on three basic EF tasks ('working memory', 'inhibition', and 'task-switching') and/or inventory-based assessment of EF were related to difficulties in emotion regulation in females attending residential SUD therapeutic community treatment. Cross-sectional design in which participants (N=50, all female) completed a questionnaire battery including the Difficulties in Emotion Regulation Scale (DERS) and Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A) was used. Participants also completed neuropsychological assessment of EF including the Working Memory Index (WMI Wechsler Adult Intelligence Scale), and measures of inhibition and task-switching (Color-Word Interference Test Delis-Kaplan Executive Function System). Executive dysfunction, as assessed by the Global Executive Composite (GEC BRIEF-A), and personality disorder indicators (Standardised Assessment of Personality - Abbreviated Scale SAPAS) were positively correlated with DERS scores. Sequential hierarchical regression indicated that task-switching, GEC, and SAPAS scores statistically predicted DERS scores, while working memory and inhibition did not. Mediation analysis indicated that there was a significant indirect effect of GEC scores and task-switching performance on DERS scores, through SAPAS scores. Impairment of EF, particularly task-switching, is related to difficulties in emotion regulation in a female s le attending residential SUD treatment. Cognitive training interventions that improve task-switching performance may be beneficial in promoting effective emotion regulation and improved SUD treatment outcomes.
Publisher: Informa UK Limited
Date: 28-11-2018
Publisher: Wiley
Date: 06-02-2023
DOI: 10.1111/DAR.13607
Abstract: Family members affected by another's substance use disorder experience physical health problems, breakdowns in relationships and reduced psychological wellbeing. This review examines the effectiveness of psychosocial interventions for improving the wellbeing of family members. A systematic review of randomised‐controlled trials (RCT), non‐RCTs and pre‐post studies examining group or in idual interventions for affected families. Five databases were searched (PubMed, PsycINFO, Medline, Web of Science, Cochrane Library). Outcomes included psychological functioning, quality of life, physical health and substance use, family functioning and coping. Outcomes were analysed by study design and mode of delivery (in idual or group). Risk of bias was assessed using the Cochrane tools (RoB2, ROBINS‐I). The review followed PRISMA reporting guidelines and was prospectively registered with the PROSPERO database (CRD42020200260). Nineteen studies were included ( k = 10 included in meta‐analyses). In k = 3 RCTs, in idually administered interventions significantly reduced depression (standardised mean difference [SMD] 0.50, 95% confidence interval [CI] 0.21, 0.79) and distress (SMD 0.28, 95% CI 0.03, 0.54). In k = 2 pre‐post studies, in idual interventions improved family functioning ( d = 0.51, 95% CI 0.28, 0.73) and coping ( d = 0.43, 95% CI 0.24, 0.61). In k = 3 non‐RCTs and k = 2 pre‐post designs group interventions significantly reduced depression ( d = 0.50, 95% CI 0.17, 0.82) and distress ( d = 0.44, 95% CI 0.13, 0.75), and improved coping ( d = 0.81, 95% CI 0.29, 1.33). This review summarises the contemporary literature evaluating interventions for affected families, with both in idual and group interventions demonstrating favourable outcomes. However, small s le sizes and methodologically weak‐quality studies limit conclusions.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2015
Publisher: American Psychological Association (APA)
Date: 12-2018
DOI: 10.1037/ADB0000237
Abstract: Clinical guidelines recommend Self-Management and Recovery Training (SMART Recovery) and 12-step models of mutual aid as important sources of long-term support for addiction recovery. Methodologically rigorous reviews of the efficacy and potential mechanisms of change are available for the predominant 12-step approach. A similarly rigorous exploration of SMART Recovery has yet to be undertaken. We aim to address this gap by providing a systematic overview of the evidence for SMART Recovery in adults with problematic alcohol, substance, and/or behavioral addiction, including (i) a commentary on outcomes assessed, process variables, feasibility, current understanding of mental health outcomes, and (ii) a critical evaluation of the methodology. We searched six electronic peer-reviewed and four gray literature databases for English-language SMART Recovery literature. Articles were classified, assessed against standardized criteria, and checked by an independent assessor. Twelve studies (including three evaluations of effectiveness) were identified. Alcohol-related outcomes were the primary focus. Standardized assessment of nonalcohol substance use was infrequent. Information about behavioral addiction was restricted to limited prevalence data. Functional outcomes were rarely reported. Feasibility was largely indexed by attendance. Economic analysis has not been undertaken. Little is known about the variables that may influence treatment outcome, but attendance represents a potential candidate. Assessment and reporting of mental health status was poor. Although positive effects were found, the modest s le and ersity of methods prevent us from making conclusive remarks about efficacy. Further research is needed to understand the clinical and public health utility of SMART as a viable recovery support option. (PsycINFO Database Record
Publisher: Informa UK Limited
Date: 12-2014
DOI: 10.1111/AP.12058
Publisher: Springer International Publishing
Date: 2022
Publisher: Wiley
Date: 11-2019
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.ADDBEH.2019.106038
Abstract: Addictions contribute significantly to the overall disease burden for Indigenous peoples of colonised countries. Mutual support groups are one of the most common addiction recovery resources, however their effectiveness for Indigenous peoples is unclear. A PRISMA-informed search was performed to retrieve empirical studies on addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. Databases searched were: MEDLINE, CINAHL Plus, PsychINFO, PsychARTICLES, SocINDEX, Cochrane Database of Systematic Reviews, PubMed, Scopus and UlrichsWeb, Informit Collections, Australian Indigenous HealthInfonet and Lowitja Institute electronic databases. Exclusion criteria were: 1) not an Indigenous focus 2) not an addiction focus (i.e. including alcohol, other drug, gambling) 3) not a mutual support group focus 4) not an original study 5) not a complete study 6) not published in English language. Four studies published between 2001 and 2006 met review criteria. All studies were conducted in the United States of America with Native American Indian peoples (n = 1600) and featured Alcoholics Anonymous only. Study designs were: a retrospective analysis of survey data, a cross-sectional survey report, a clinical case study and an ethnographic study. Methodological differences precluded meaningful translation of results. There is a lack of empirical knowledge on the acceptability and outcomes of addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. This review suggests recommendations for future research.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Wiley
Date: 11-2013
DOI: 10.1111/DAR.12077
Publisher: Elsevier BV
Date: 12-2021
Publisher: Frontiers Media SA
Date: 19-03-2019
Publisher: SAGE Publications
Date: 10-2007
DOI: 10.1177/00343552070510010601
Abstract: The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework administration practices. A survey examining attitudes toward the use of homework was completed by 122 Australian mental health case managers. Case managers who held more positive attitudes reported better client responses to homework. Systematic homework administration was predicted by the degree to which case managers felt that homework enhanced client outcomes and the importance that case managers placed on the use of homework for severe psychiatric disabilities. The use of training and supervision programs to promote systematic homework administration practice is discussed.
Publisher: Cambridge University Press (CUP)
Date: 2020
DOI: 10.1017/S1754470X20000112
Abstract: Exposure therapy is consistently indicated as the first-line treatment for anxiety-related disorders. Unfortunately, therapists often deliver exposure therapy in an overly cautious, less effective manner, characterized by using their own ‘therapist safety behaviours’. Cognitive behavioural models postulate that beliefs about therapist safety behaviours are related to their use however, little is known about the beliefs therapists hold regarding therapist safety behaviour use. The present study aimed to identify the beliefs exposure therapists have regarding the necessity of therapist safety behaviours and to examine the relationship between this construct and therapist safety behaviour use. Australian psychologists ( n = 98) completed an online survey that included existing measures of therapist safety behaviour use, therapist negative beliefs about exposure therapy, likelihood to exclude anxious clients from exposure therapy, and use of intensifying exposure techniques. Participants also completed the Exposure Implementation Beliefs Scale (EIBS), a measure created for the present study which assesses beliefs regarding the necessity of therapist safety behaviours. Beliefs about the necessity of therapist safety behaviours – particularly in protecting the client – significantly predicted therapist safety behaviour use. Findings suggest that exposure therapy training media should aim to decrease therapist safety behaviour use by addressing beliefs about the necessity of therapist safety behaviours, especially in protecting the client. (1) To understand what therapist safety behaviours are in the context of exposure therapy. (2) To identify common beliefs about therapist safety behaviours. (3) To understand how beliefs about therapist safety behaviours relate to therapist safety behaviour use. (4) To consider how exposure therapy delivery may be improved by modifying beliefs about therapist safety behaviours. (5) To explore how beliefs about therapist safety behaviours may be modified to reduce therapist safety behaviour use.
Publisher: Wiley
Date: 06-2018
DOI: 10.1002/JTS.22297
Abstract: Childhood maltreatment and interpersonal trauma experience is an important factor underpinning the apparent perpetuation of the cycle of social disadvantage experienced by homeless adults. This paper aimed to examine longitudinal patterns of psychological distress in a s le of 1,504 socially disadvantaged adult participants from the Journeys Home Study in Australia. The current paper utilized the "conservation of resources" theory and the concept of "risk factor caravans" to investigate the nature and implications of childhood trauma in the context of homelessness. Growth mixture modeling revealed four distinct trajectories of psychological distress as measured by the Kessler 6 across six time points (covering a period of 2.5 years): chronic, escalating, attenuating, and resistant. Our results also indicated that experiences of different types of trauma during childhood were associated with these psychological distress trajectories. In particular, adults experiencing chronic psychological distress were significantly more likely than those exhibiting distress resistance to have experienced multiple and varied childhood maltreatment, adjusted odds ratio (AOR) = 3.30, 95% CI [0.37, 6.05], p = .002. Furthermore, adult experiences of assault were found to be associated with psychological distress. These findings have important implications for mental health, as well as interventions aimed at breaking the cycle of urban poverty. Specific focus on interpersonal trauma vulnerabilities is important. Prioritizing socioecological stability, with mental health needs assessed on an in idual level, may be most appropriate. This work also highlights the need to direct future attention to barriers to access and facilitation of social support services.
Publisher: SAGE Publications
Date: 2014
DOI: 10.1080/08897077.2013.789815
Abstract: Telephone follow-up interviewing is one method of monitoring treatment outcomes of in iduals involved in drug and alcohol treatment programs. The present study is the first to examine the feasibility and generalizability of data obtained from telephone follow-up interviews after drug and alcohol treatment in Australia. Participants attended 1 of 8 Salvation Army Recovery Service Centres where staff administered outcome measures at intake. Three-month postdischarge telephone follow-up interviews were conducted by researchers from the Illawarra Institute for Mental Health, University of Wollongong. A s le of 700 clients was obtained for follow-up (582 males 118 females). A 51% follow-up rate was achieved at a cost of US$82 per completed interview. No significant differences in baseline characteristics between responding and nonresponding participants were found. Overall, the telephone methodology was shown to be feasible and relatively inexpensive. However, the introduction of outcome measures at the service level in parallel with follow-up data collection procedures complicated the collection of response data. The burden of introducing outcome measures in residential services may be reduced by utilizing a phased implementation strategy.
Publisher: Wiley
Date: 30-05-2023
DOI: 10.1111/DAR.13689
Abstract: Challenges associated with the integration of physical health within alcohol and other drug (AOD) treatment services persist. The construct of recovery capital has gained currency within the sector, however, its potential in understanding the integration of physical health within AOD treatment has not been examined. This study explores the role of physical health in the process of recovery, examining the potential of ‘recovery capital’ frameworks to enhance integrated care. Interviews were conducted with residential and outpatient AOD services across New South Wales, Australia. Qualitative data was collected from clients ( n = 20) and staff ( n = 13) and transcribed. Data were systematically coded and analysed using the iterative categorisation method. Unmanaged physical health issues compromised recovery, particularly when associated with hopelessness and pain. Improved physical health ameliorated sources of negative recovery capital such as boredom, social isolation and mental health symptoms. When addressed during treatment, physical health facilitated recovery capital resources through knowledge and skill acquisition, increased autonomy, enjoyment and immersive experience. Benefits extended to domains of ‘social capital’ (social connection) and ‘cultural capital’ (physical appearance). Physical health offers variegated pathways for building recovery capital. Findings support calls for a more assertive approach to addressing physical health when AOD treatment occurs outside of primary care settings. Future research should examine the potential of recovery capital as a heuristic for optimising care of physical health issues and health‐related behaviour within AOD treatment services.
Publisher: JMIR Publications Inc.
Date: 19-06-2019
Abstract: espite the importance and popularity of mutual support groups, there have been no systematic attempts to implement and evaluate routine outcome monitoring (ROM) in these settings. Unlike other mutual support groups for addiction, trained facilitators lead all Self-Management and Recovery Training (SMART Recovery) groups, thereby providing an opportunity to implement ROM as a routine component of SMART Recovery groups. his study protocol aims to describe a stage 1 pilot study designed to explore the feasibility and acceptability of a novel, purpose-built mobile health (mHealth) ROM and feedback app (Smart Track) in SMART Recovery groups coordinated by SMART Recovery Australia (SRAU) The secondary objectives are to describe Smart Track usage patterns, explore psychometric properties of the ROM items (ie, internal reliability and convergent and ergent validity), and provide preliminary evidence for participant reported outcomes (such as alcohol and other drug use, self-reported recovery, and mental health). articipants (n=100) from the SMART Recovery groups across New South Wales, Australia, will be recruited to a nonrandomized, prospective, single-arm trial of the Smart Track app. There are 4 modes of data collection: (1) ROM data collected from group participants via the Smart Track app, (2) data analytics summarizing user interactions with Smart Track, (3) quantitative interview and survey data of group participants (baseline, 2-week follow-up, and 2-month follow-up), and (4) qualitative interviews with group participants (n=20) and facilitators (n=10). Feasibility and acceptability (primary objectives) will be analyzed using descriptive statistics, a cost analysis, and a qualitative evaluation. t the time of submission, 13 sites (25 groups per week) had agreed to be involved. Funding was awarded on August 14, 2017, and ethics approval was granted on April 26, 2018 (HREC/18/WGONG/34 2018/099). Enrollment is due to commence in July 2019. Data collection is due to be finalized in October 2019. o the best of our knowledge, this study is the first to use ROM and tailored feedback within a mutual support group setting for addictive behaviors. Our study design will provide an opportunity to identify the acceptability of a novel mHealth ROM and feedback app within this setting and provide detailed information on what factors promote or hinder ROM usage within this context. This project aims to offer a new tool, should Smart Track prove feasible and acceptable, that service providers, policy makers, and researchers could use in the future to understand the impact of SMART Recovery groups. ustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000686101 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336. RR1-10.2196/15113
Publisher: Informa UK Limited
Date: 04-2013
DOI: 10.1080/10550887.2013.795470
Abstract: Although the Addiction Severity Index (ASI) is one of the most frequently used measures in alcohol and other drug research, it has rarely been used to assess clinical and reliable change. This study assessed clients' clinical and reliable change at The Salvation Army residential substance abuse treatment centers in Australia. A total of 296 clients completed ASI interviews on admission to treatment and 3 months after discharge from treatment. Clients demonstrated significant improvement on all seven ASI composites. The range of reliable change for each ASI composite varied from 30% to 70%. More than two-thirds of clients experienced clinically significant improvement for alcohol and drug problems. Psychiatric distress was clinically reduced in 44% of clients. This research indicates that residential substance abuse treatment can make important differences in client's lives at a clinical and functional level. However, the research highlights the challenge of effectively targeting psychiatric comorbidity within alcohol and other drug abuse populations.
Publisher: Elsevier BV
Date: 2022
DOI: 10.2139/SSRN.4121575
Publisher: Elsevier BV
Date: 2017
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJOPEN-2017-019874
Abstract: To design a questionnaire and use it to explore unmet needs with practical aspects of medicine taking after stroke, predictors of medicine taking and to estimate the proportion of survivors who get support with daily medication taking. Four workshops with stroke survivors and caregivers to design the questionnaire. A cross-sectional postal questionnaire in primary care. 18 general practitioner practices in the East of England and London. Questionnaires posted between September 2016 and February 2017. 1687 stroke survivors living in the community outside institutional long-term care. The proportion of community stroke survivors receiving support from caregivers for practical aspects of medicine taking the proportion with unmet needs in this respect the predictors of experiencing unmet needs and missing taking medications. A five-item questionnaire was developed to cover the different aspects of medicine taking. 596/1687 (35%) questionnaires were returned. 56% reported getting help in at least one aspect of taking medication and 11% needing more help. 35% reported missing taking their medicines. Unmet needs were associated with receiving help with medications (OR 5.9, P .001), being on a higher number of medications (OR 1.2, P .001) and being dependent for activities of daily living (OR 4.9, P=0.001). Missing medication was associated with having unmet needs (OR 5.3, P .001), receiving help with medications (OR 2.1, P .001), being on a higher number of medicines (OR 1.1, P=0.008) and being older than 70 years (OR 0.6, P=0.006). More than half of patients who replied needed help with taking medication, and 1 in 10 had unmet needs in this regard. Stroke survivors dependent on others have more unmet needs, are more likely to miss medicines and might benefit from focused clinical and research attention. Novel primary care interventions focusing on the practicalities of taking medicines are warranted.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.ADDBEH.2019.106144
Abstract: Previous research has reported on the benefits of mutual support groups. However, such groups do not routinely collect data on participant outcomes. Moreover, the effect of collecting outcomes measures on these groups is unknown. The objective of this mixed methods study was to elicit participant views on using a novel, purpose built digital platform for routine outcome monitoring (ROM) as a standard component of a mutual support group. SMART Recovery, or the Self-Management and Recovery Training program, is group-based and uses professional clinicians to facilitate discussion and foster mutual support for a range of addictive behaviours, alongside Cognitive Behavioural Therapy and Motivational Interviewing techniques. This paper reports on the qualitative component of this study and how participants perceive ROMs, and the potential shift to technological resources. Twenty semi-structured telephone interviews were conducted with participants from SMART Recovery groups across New South Wales, Australia. Participants discussed their use of mutual support within group meetings to manage their recovery, including: naming their goals in front of peers learning from clinicians and group discussion and developing reciprocal and caring relationships. They also described any previous experience with routine outcomes measures and how digital technologies might enhance or hinder group function. Participants valued mutual support groups and reported that digital technologies could be complementary to physical, weekly group meetings. They were also concerned that the introduction of technological resources might pose a threat to physical meetings, thereby risking their access to mutual support. Findings have implications for the implementation of ROM when delivered via digital mechanisms, and indicate threats and opportunities that warrant consideration for future initiatives.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Frontiers Media SA
Date: 18-06-2021
DOI: 10.3389/FPSYT.2021.677637
Abstract: Background: Routine outcome monitoring (ROM) has been implemented across a range of addiction treatment services, settings and organisations. Mutual support groups are a notable exception. Innovative solutions are needed. SMART Track is a purpose built smartphone app designed to capture ROM data and provide tailored feedback to adults attending Australian SMART Recovery groups for addictive behaviour(s). Objective: Details regarding the formative stage of app development is essential, but often neglected. Improved consideration of the end-user is vital for curtailing app attrition and enhancing engagement. This paper provides a pragmatic ex le of how principles embedded in published frameworks can be operationalised to address these priorities during the design and development of the SMART Track app. Methods: Three published frameworks for creating digital health technologies (“Person-Based Approach,” “BIT” Model and IDEAS framework) were integrated and applied across two stages of research to inform the development, design and content of SMART Track. These frameworks were chosen to ensure that SMART Track was informed by the needs and preferences of the end-user (“Person-Based”) best practise recommendations for mHealth development (“BIT” Model) and a collaborative, iterative development process between the multi-disciplinary research team, app developers and end-users (IDEAS framework). Results: Stage one of the research process generated in-depth knowledge to inform app development, including a comprehensive set of aims (clinical, research/organisation, and usage) clear articulation of the target behaviour (self-monitoring of recovery related behaviours and experiences) relevant theory (self-determination and social control) appropriate behavioural strategies (e.g., behaviour change taxonomy and process motivators) and key factors that may influence engagement (e.g., transparency, relevance and trust). These findings were synthesised into guiding principles that were applied during stage two in an iterative approach to app design, content and development. Conclusions: This paper contributes new knowledge on important person-centred and theoretical considerations that underpin a novel ROM and feedback app for people with addictive behaviour(s). Although person-centred design and best-practise recommendations were employed, further research is needed to determine whether this leads to improved usage outcomes. Clinical Trial Registration: Pilot Trial: anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336 .
Publisher: Springer Science and Business Media LLC
Date: 08-06-2012
Publisher: Hindawi Limited
Date: 30-10-2019
DOI: 10.1017/JSC.2019.20
Abstract: Hard-core smokers have been identified as a potential public health challenge. The trans-theoretical model lacks the specificity to identify hard-core smokers. The precaution adoption process model (PAPM) is a stage-based behaviour change model which includes ‘no intent to quit’ as a distinct stage and so may be useful in identifying hard-core smokers. The aim of this study was to apply the PAPM to a community based s le of smokers to determine whether it provides a useful approach to identifying hard-core smokers. We surveyed smokers in Australia who were recruited through social media and an online data collection agency. The s le included 336 current smokers, 11.9% were in Stage 4 of the PAPM – i.e. had decided not to quit. Stage 4 smokers are more resistant to quitting and marked by their similarities to hard-core smokers. This is further lified when addressing Stage 4 smokers with no previous quit attempt. Stage 4 smokers with no previous quit attempts are aligned with a hard-core smoker profile with higher levels of nicotine dependence, greater cigarette consumption and low socio-economic status. Further research is required to determine if PAPM is a valid predictive model for identifying hard-core smokers in clinical practice.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.PSYCHRES.2014.06.035
Abstract: The study objective was to evaluate the feasibility of a telephone delivered intervention consisting of motivational interviewing and cognitive behavioural strategies aimed at improving diet and physical activity in people diagnosed with psychotic disorders. Twenty participants diagnosed with a non-acute psychotic disorder were recruited. The intervention consisted of eight telephone delivered sessions targeting fruit and vegetable (F&V) consumption and leisure screen time, as well as smoking and alcohol use (as appropriate). F&V frequency and variety, and overall diet quality (measured by the Australian Recommended Food Score, ARFS), leisure screen time, overall sitting and walking time, smoking, alcohol consumption, mood, quality of life, and global functioning were examined before and 4-weeks post-treatment. Nineteen participants (95%) completed all intervention sessions, and 17 (85%) completed follow-up assessments. Significant increases from baseline to post-treatment were seen in ARFS fruit, vegetable and overall diet quality scores, quality of life and global functioning. Significant reductions in leisure screen time and overall sitting time were also seen. Results indicated that a telephone delivered intervention targeting key cardiovascular disease risk behaviours appears to be feasible and relatively effective in the short-term for people diagnosed with psychosis. A randomized controlled trial is warranted to replicate and extend these findings.
Publisher: Wiley
Date: 02-2022
DOI: 10.1111/DAR.13432
Abstract: Aboriginal Community Controlled Organisations (ACCO) have an important role in the Australian health‐care sector. However, there has been a lack of research evaluating ACCOs in the treatment of alcohol and other drug (AOD) use. Using a benchmarking approach, the present study examined within treatment changes on measures of wellbeing for people attending a residential AOD ACCO. The study focused on The Glen, an AOD residential treatment service that is managed by the Ngaimpe Aboriginal Corporation ( n = 775). The Glen is a male‐only service and provides treatment to both Indigenous and non‐Indigenous men. The evaluation focused on measures of wellbeing (i.e. symptom distress and quality of life) collected at intake, 30 and 60 days during the person's stay. Comparative benchmarking was conducted with a cohort of men who were attending non‐ACCO residential AOD treatment services ( n = 4457). The Glen participants demonstrated statistically significant improvements on measures of wellbeing. The Glen participants were more likely to complete treatment than participants attending non‐ACCO services. Likewise, Indigenous people attending The Glen were more likely to complete treatment (compared to Indigenous people attending non‐ACCO services). Rates of reliable and clinically significant change suggested that changes in quality of life were largely equivalent between The Glen and non‐ACCO services, while participants attending The Glen tended to demonstrate larger reductions in symptom distress compared to the non‐ACCO services. The study provides further support for the important role that ACCOs play in supporting Indigenous people in their recovery.
Publisher: Wiley
Date: 11-2014
DOI: 10.1111/DAR.12222
Publisher: Springer Science and Business Media LLC
Date: 19-02-2020
DOI: 10.1186/S12889-020-8328-2
Abstract: It was highlighted that in the original article [1] author Amanda Baker was erroneously omitted from the authorship during the copy editing stage.
Publisher: Wiley
Date: 19-08-2010
DOI: 10.1111/J.1465-3362.2010.00215.X
Abstract: The Dual Diagnosis Capability of Addiction Treatment (DDCAT) index is used to assess the capacity of substance abuse services to work with in iduals with co-occurring mental health problems. The current study aimed to: (i) examine the dual diagnosis capability of residential substance abuse programs in Australia (ii) identify managers' perceptions regarding both priorities and confidence for change following the completion of the DDCAT and (iii) to examine the usefulness of the DDCAT to residential substance abuse programs. The DDCAT was completed across 16 residential substance abuse units. An external researcher administered and scored the DDCAT. A Unit Manager from each site completed the Comorbidity Priorities and Confidence Survey following the completion of the DDCAT review. This survey examined the usefulness of the DDCAT, and the unit's priorities to improve its capability, and confidence to improve its DDCAT score. Across the services, program structure and staff training were the DDCAT domains that required the most improvement. While training was the highest endorsed priority area for improvement, program structure was the lowest priority. Overall the Unit Managers reported positive attitudes towards use of the DDCAT and were confident that their unit could improve their DDCAT scores. DDCAT scores of Australian residential substance abuse programs are comparable with previous published results. However, there is still substantial work required to improve the capability of these programs. Future research should examine strategies to promote sustained improvements in the capability of residential substance abuse programs.
Publisher: Informa UK Limited
Date: 25-04-2011
Publisher: Wiley
Date: 14-10-2022
DOI: 10.1111/SJOP.12869
Abstract: Personality traits play a role in prosocial behavior in relation to containment measures intended to tackle the COVID-19 pandemic. Empirical findings indicated that in iduals high in socially aversive traits such as callousness are less compliant with containment measures. This study aimed to add cross-cultural data on the relationship between antisocial traits and adherence to COVID-19 containment measures. The s le consisted of 4,538 adults recruited by convenience in nine countries (Australia, Brazil, England, Iraq, Iran, Italy, Jordan, Saudi Arabia, and the United States). Statistical analyses indicated two latent profiles from our s le, empathic and antisocial, and six COVID-19 containment-measure-related factors using measures covering antisocial traits (PID-5), empathy (ACME), global personality pathology (LPFS-BF), and COVID-19 behaviors and beliefs. Through MANCOVA, the antisocial profile consistently showed less compliance and concern about the COVID-19 containment measures, even when controlling for demographics and local pandemic covariables. The network analysis indicated a lack of empathy and callousness as crucial traits of the predisposition to non-compliant behavior. In elaborating on prosocial c aigns in community emergencies, our cross-cultural findings would need to consider personality traits that focus on antisociality, anticipating similar associations and potential impacts in future disease outbreaks.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.SLEH.2018.05.008
Abstract: To evaluate whether the prospective association between insomnia and mental illness in the general population remained after controlling for multiple confounders, or whether this represented partly remitted prior mental illness. Cohort study. Australian general population. The participants were 10,444 people aged 15 or older in the Household, Income and Labour Dynamics in Australia (HILDA) survey who did not meet K10 criteria for likely mental illness at baseline (2013-14). The prospective associations of insomnia (yes/no) at baseline with mental illness (yes/no) approximately 2 years later (2015-16), determined from scores on the K10, were evaluated using logistic regression. These were then adjusted for potential confounders including sociodemographic factors, physical health and health behaviors, and baseline and past mental health. Insomnia at baseline increased risk of mental illness onset at two-year follow up (OR 2.23, 95% CI 1.91-2.59, P < .001). This relationship was attenuated but still significant after adjustment for confounding variables (OR 1.72 95% CI 1.46-2.02). Accounting for reverse causality from prior mental ill health and baseline symptoms reduced this further but the relationship remained (OR 1.30, 95% CI 1.09-1.55, P = .003). This effect appeared more robust among those <65 years of age. Insomnia has a consistent prospective relationship with mental illness at two-year follow-up. Insomnia did not appear to be simply a symptom of past, or baseline subclinical, mental illness. This supports the specific targeting of insomnia symptoms in selective preventive mental health initiatives, particularly among those under 65 years of age.
Publisher: Springer Science and Business Media LLC
Date: 03-03-2021
Publisher: Informa UK Limited
Date: 02-01-2017
DOI: 10.1080/15504263.2017.1287456
Abstract: Smoking continues to be a major health concern for people with a history of alcohol or other substance use problems. The current research is aimed to (1) describe the prevalence of smoking in residential addictions treatment services and (2) compare characteristics of people who had or had not quit smoking. Participants were attending residential substance abuse treatment provided by the Australian Salvation Army. These programs are up to 10 months in length and offer a range of low-intensity smoking cessation supports. Measures of smoking, substance use, and clinical characteristics were collected from 2008 to 2015 at baseline and three months post-discharge from treatment (N = 702). At baseline, 86% of people were smokers (n = 606). At follow-up, only 48 participants who were smokers at baseline (7%) had quit smoking. Participants who had quit smoking at follow-up also reported higher rates of abstinence from alcohol or other substances at follow-up (72%) than people who had not quit smoking (46% OR = 2.95, 95% CI [1.52, 5.74]). There is potential for smoking cessation to be better addressed as part of routine care in substance abuse treatment settings. Future research should evaluate the provision of more systematic smoking cessation interventions within these settings.
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.14219/JADA.ARCHIVE.2006.0347
Abstract: The authors evaluated temporomandibular disorder (TMD) outcomes in general dental practice one year after treatment with stabilizing splints (SS) or nonoccluding control splints (CS). Seventy-two randomly allocated subjects completed initial treatment. The outcomes measures were a pain visual analog scale (VAS), muscle tenderness, temporomandibular joint (TMJ) tenderness, interincisal opening, TMJ clicks and headaches. After initial treatment, 81 percent of the subjects were found to have been treated satisfactorily. The dentists referred the remaining subjects to a dental hospital. At one year, the authors recalled 52 of the original subjects for evaluation. Improvements after initial treatment were maintained at one year for all outcomes, except for TMJ clicking, which returned to pretreatment levels. Eighty-one percent of the subjects rated their treatment as either good or excellent in reducing jaw pain. The authors found that subjects were aware of more of their TMJ clicks than dentists observed at the one-year clinical examination, but most subjects thought their clicking or the associated pain had been reduced. Fifty-five percent subjects had used their splints in the previous six months, but only 31 percent of these had done so daily. There were no significant differences between splint groups. At one year, a good response to TMD treatment in general practice had been maintained, but many subjects still had clicking TMJs. Trained dentists can manage TMD satisfactorily, with only a small proportion of patients needing specialist attention.
Publisher: Informa UK Limited
Date: 22-06-2023
Publisher: SAGE Publications
Date: 23-06-2023
DOI: 10.1177/00048674231181039
Abstract: The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment (‘Quitlink’) among people receiving support for mental health conditions. We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our ‘Quitlink’ intervention. Both conditions received a brief intervention delivered by a peer researcher. Control participants received no further intervention. Quitlink participants were referred to a tailored 8-week quitline intervention delivered by dedicated Quitline counsellors plus combination nicotine replacement therapy. The primary outcome was self-reported 6 months continuous abstinence from end of treatment (8 months from baseline). Secondary outcomes included additional smoking outcomes, mental health symptoms, substance use and quality of life. A within-trial economic evaluation was conducted. In total, 110 participants were recruited over 26 months and 91 had confirmed outcomes at 8 months post baseline. There was a difference in self-reported prolonged abstinence at 8-month follow-up between Quitlink (16%, n = 6) and control (2%, n = 1) conditions, which was not statistically significant (OR = 8.33 [0.52, 132.09] p = 0.131 available case). There was a significant difference in favour of the Quitlink condition on 7-day point prevalence at 2 months (OR = 8.06 [1.27, 51.00] p = 0.027 available case). Quitlink costs AU$9231 per additional quit achieved. The Quitlink intervention did not result in significantly higher rates of prolonged abstinence at 8 months post baseline. However, engagement rates and satisfaction with the ‘Quitlink’ intervention were high. While underpowered, the Quitlink intervention shows promise. A powered trial to determine its effectiveness for improving long-term cessation is warranted.
Publisher: Informa UK Limited
Date: 2006
Publisher: Wiley
Date: 08-03-2021
DOI: 10.1111/DAR.13264
Abstract: SMART Recovery is a popular mutual support group program. Little is known about its suitability or perceived helpfulness for Indigenous peoples. This study explored the cultural utility of SMART Recovery in an Australian Aboriginal context. An Indigenous‐lensed, multi‐methods, exploratory study design was used to develop initial evidence of: (i) attributes of Aboriginal SMART Recovery facilitators and group members (ii) characteristics of Aboriginal‐led SMART Recovery groups (iii) perceived acceptability and helpfulness of SMART Recovery and (iv) areas for potential improvement. Data were collected by synthesising Indigenous qualitative methods (research topic and social yarning) with western qualitative and quantitative methods (participant surveys, program adherence rating scale, group observations and field notes). Data were analysed using thematic analysis. Participants were a culturally erse s le of male and female Aboriginal facilitators ( n = 10) and group members ( n = 11), aged 22–65 years. Aboriginal‐led SMART Recovery groups were culturally customised to suit local contexts. Program tools ‘goal setting’ and ‘problem solving’ were viewed as the most helpful. Suggested ways SMART Recovery could enhance its cultural utility included: integration of Aboriginal perspectives into facilitator training creation of Aboriginal‐specific program and marketing materials and greater community engagement and networking. Participants proposed an Aboriginal‐specific SMART Recovery program. This study offers insights into Aboriginal peoples' experiences of SMART Recovery. Culturally‐informed modifications to the program were identified that could enhance cultural utility. Future research is needed to obtain erse community perspectives and measure health outcomes associated with group attendance.
Publisher: BMJ
Date: 05-2016
Publisher: Elsevier BV
Date: 08-2021
Publisher: Annual Reviews
Date: 06-01-2018
DOI: 10.1146/ANNUREV-PHARMTOX-010716-105029
Abstract: Natural products (NPs) have been used as traditional medicines since antiquity. With more than 10 60 estimated compounds with molecular weights less than 500 Da representing chemical space, NPs occupy a very small percentage however, they are significantly overrepresented in biologically relevant chemical space. The classical approach concentrates on identifying one or more NPs with biological activity from a source organism. There is much more to be learned from NPs than we can discover this narrow view. In this review, we discuss ways to harness the global properties of NPs.
Publisher: Wiley
Date: 14-09-2022
DOI: 10.1111/DAR.13544
Abstract: The COVID‐19 pandemic prompted the transition of Australian Self‐Management and Recovery Training (SMART) Recovery mutual support groups to virtual delivery. This study examined the self‐reported experience of online SMART Recovery groups for people seeking support for meth hetamine use (alone or in combination with other behaviours) compared to those who did not endorse meth hetamine use as a reason for seeking support. An online survey invitation was embedded in the post‐group exit page. Items assessed participant demographic characteristics, experience, engagement and perceived contribution of the online group to recovery. Unique responses ( n = 1414) were analysed using chi‐square. After alcohol, meth hetamine use was the second most common behaviour to prompt online SMART Recovery group attendance ( n = 205, 14.5%). People attending for meth hetamine use were more likely to endorse multiple addictive behaviours ( n = 137, 66.8% vs. n = 371, 30.7%, p 0.001). Irrespective of whether people attended for meth hetamine use or not, participant ratings of experience, engagement and perceived contribution to recovery were positive and largely comparable. People attending for meth hetamine use were significantly less likely to set a 7‐day plan (72.7% vs. 81.9% χ 2 = 9.47, p = 0.002). Findings support the acceptability of online SMART Recovery groups for people experiencing addictive behaviours, including meth hetamine use. To maximise the benefits of these groups, further evidence on how best to support people to develop a change plan within a time‐limited, online group setting is needed. Online mutual support groups may help to reach and support people who might not otherwise engage in treatment and support, including people who use meth hetamine.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Wiley
Date: 30-09-2015
DOI: 10.1111/DAR.12332
Abstract: Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, in idual factors and constructs based on motivational and volitional models of health behaviour were examined as predictors of post-detoxification treatment attendance. The s le consisted of 220 substance-dependent in iduals participating in short-term detoxification programs provided by The Australian Salvation Army. The Theory of Planned Behaviour and Implementation Intentions were used to predict attendance at subsequent treatment. Follow-up data were collected for 177 participants (81%), with 104 (80%) of those participants reporting that they had either attended further formal treatment (e.g. residential rehabilitation programs, outpatient counselling) or mutual support groups in the 2 weeks after leaving the detoxification program. Logistic regression examined the predictors of further treatment attendance. The full model accounted for 21% of the variance in treatment attendance, with attitude and Implementation Intentions contributing significantly to the prediction. Findings from the present study would suggest that assisting clients to develop a specific treatment plan, as well as helping clients to build positive perceptions about subsequent treatment, will promote greater attendance at further treatment following detoxification. [Kelly PJ, Leung J, Deane FP, Lyons GCB. Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions. Drug Alcohol Rev 2016 :678-685].
Publisher: Informa UK Limited
Date: 02-10-2021
Publisher: Oxford University Press (OUP)
Date: 04-2018
Publisher: JMIR Publications Inc.
Date: 22-11-2020
Abstract: utual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategies). Trained facilitators lead all SMART Recovery groups, providing an opportunity to implement ROM. he aim of this stage 1 pilot study is to explore the feasibility, acceptability, and preliminary outcomes of a novel, purpose-built mobile health ROM and feedback app ( i SMART Track /i ) in mutual support groups coordinated by SMART Recovery Australia (SRAU) over 8 weeks. lt i SMART Track /i was developed during phase 1 of this study using participatory design methods and an iterative development process. During phase 2, 72 SRAU group participants were recruited to a nonrandomized, prospective, single-arm trial of the i SMART Track /i app. Four modes of data collection were used: ROM data directly entered by participants into the app app data analytics captured by Amplitude Analytics (number of visits, number of unique users, visit duration, time of visit, and user retention) baseline, 2-, and 8-week follow-up assessments conducted through telephone and qualitative telephone interviews with a convenience s le of study participants (20/72, 28%) and facilitators (n=8). f the 72 study participants, 68 (94%) created a i SMART Track /i account, 64 (88%) used i SMART Track /i at least once, and 42 (58%) used the app for more than 5 weeks. During week 1, 83% (60/72) of participants entered ROM data for one or more outcomes, decreasing to 31% (22/72) by the end of 8 weeks. The two main screens designed to provide personal feedback data ( i Urges /i screen and i Overall Progress /i screen) were the most frequently visited sections of the app. Qualitative feedback from participants and facilitators supported the acceptability of i SMART Track /i and the need for improved integration into the SRAU groups. Participants reported significant reductions between the baseline and 8- week scores on the Severity of Dependence Scale (mean difference 1.93, SD 3.02 95% CI 1.12-2.73) and the Kessler Psychological Distress Scale-10 (mean difference 3.96, SD 8.31 95% CI 1.75-6.17), but no change on the Substance Use Recovery Evaluator (mean difference 0.11, SD 7.97 95% CI –2.02 to 2.24) was reported. indings support the feasibility, acceptability, and utility of i SMART Track /i . Given that sustained engagement with mobile health apps is notoriously difficult to achieve, our findings are promising. i SMART Track /i offers a potential solution for ROM and personal feedback, particularly for people with substance use disorders who attend mutual support groups. ustralian New Zealand Clinical Trials Registry ACTRN12619000686101 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336 R2-10.2196/15113
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.ADDBEH.2019.106249
Abstract: To reduce smoking and improve other health behaviours of people living with severe mental illness, healthy lifestyle interventions have been recommended. One approach to improving the availability of these types of interventions is to utilise the mental health peer workforce. The current study aimed to evaluate the feasibility of peer-workers facilitating a telephone delivered healthy lifestyle intervention within community based mental health settings. The study also examined preliminary outcomes of the intervention. The study was conducted as a randomised controlled feasibility trial. In addition to treatment as usual, participants randomised to the Treatment Condition were offered BHC. This was an 8-session telephone delivered coaching intervention that encouraged participants to decrease their smoking, increase their intake of fruit and vegetables, and reduce their leisure screen time. Participants in the waitlist Control Condition continued to complete treatment as usual. All participants were engaged with Neami National, an Australian community mental health organisation. Peer-workers were also current employees of Neami National. Forty-three participants were recruited. The average number of sessions completed by participants in the Treatment Condition was 5.7 (SD = 2.6 out of 8-sessions). Seventeen participants (77%) completed at least half of the sessions, and nine participants (40%) completed all eight sessions. Participant satisfaction was high, with all participants followed up rating the quality of the service they received as 'good' or 'excellent'. When compared to the Control Condition, people in the Treatment Condition demonstrated greater treatment effects on smoking and leisure screen time. There was only a negligible effect on servings of fruit and vegetable. Results were promising regarding the feasibility of peer-workers delivering BHC. Good retention rates and high consumer satisfaction ratings in the Treatment Condition demonstrated that peer-workers were capable of delivering the intervention to the extent that consumers found it beneficial. The current results suggest that a sufficiently powered, peer delivered randomised controlled trial of BHC is warranted. Australian New Zealand Clinical Trials Registry (ANZCTR Trial ID ACTRN123615000564550).
Publisher: Elsevier BV
Date: 11-2021
Publisher: Wiley
Date: 18-08-2021
DOI: 10.1111/DAR.13375
Abstract: Substance use is increasingly prevalent among women. Little research examines subgroups of women with substance use issues to identify their characteristics and thus enable treatment recommendations. The present study used latent class analysis to identify subgroups of substance use among women in substance‐use treatment based on use in the 30 days prior to intake and examined changes in mental health and treatment outcomes following 60 days of treatment. Participants were women ( N = 493) attending specialist non‐government substance use treatment services in New South Wales, Australia. Four distinct classes of substance users were identified: (i) Amphetamine Type Stimulants (ATS) Polysubstance (40.6%, n = 200) (ii) Alcohol Only (33.1%, n = 163) (iii) Cannabis and Alcohol (17.0%, n = 84) and (iv) Other Polysubstance (9.3%, n = 46). Women in the ATS Polysubstance class were the youngest and those in the Alcohol Only class were the oldest. Findings show that classes with high polysubstance use ( ATS Polysubstance ) differed from the single‐substance use class ( Alcohol Only ). The ATS Polysubstance class had significantly greater improvements in health outcomes after 60 days compared to the Alcohol Only class. These findings suggest that although women with polysubstance use can benefit from substance use treatment, younger women ( ATS Polysubstance ) may benefit even more than older women ( Alcohol Only ). Future research should utilise a longitudinal design and examine additional psychosocial characteristics to extend on current findings.
Publisher: Emerald
Date: 08-06-2021
Abstract: Substance use disorder (SUD) frequently co-occurs with other psychological conditions, such as eating disorders (EDs). Psychological factors such as emotional dysregulation, rash impulsivity (RI) and reward sensitivity (RS) play a role in the etiology of each disorder, yet little is known about the combined effects of these on comorbid SUDs and EDs or disordered eating behaviours (DEBs). This study aims to examine the role of these psychological factors in comorbid DEBs and SUDs among in iduals in treatment for SUDs. The role of gender is tested as a moderator. A cross-sectional self-report survey was completed by 131 participants attending Australian residential substance use treatment centres. A binomial logistic regression analysis was performed to examine the effects of emotional dysregulation, RI and RS on comorbid DEB and SUD. Further, moderation analyses were used to examine the moderating effect for gender on the relationship between these three personality variables and comorbidity. The most commonly reported primary substance of use was alcohol (43.5%), followed by hetamines (38.6%). Findings showed that emotional dysregulation and RI were significantly related to an increase in comorbidity likelihood however, RS was not. Gender moderated the relationship between comorbidity and RI only. The significant positive relationship found between RI and comorbidity for females only was a novel finding for the current study. Further research is needed to develop an understanding of the etiology of comorbidity.
Publisher: Wiley
Date: 17-06-2022
DOI: 10.1111/AJR.12887
Abstract: The rates of family violence within some rural communities are higher than that of metropolitan areas. The extent to which these rural communities know about and access family violence support services is not well understood. Local health services often play a role in providing information and support for community members at risk of, or experiencing family violence. For a rural community in Victoria, the study aimed to: (a) determine community members' knowledge of family violence services, (b) explore community members' help seeking behaviour for family violence, (c) identify perceived barriers and enabling factors to accessing family violence services and (d) explore community members' expectations of, and preferences for, family violence support provided by local health services. A cross‐sectional, anonymous, mixed‐methods online survey. A rural community in Victoria's Western District, Australia. Ninety‐nine residents, over 18 years of age. The majority of respondents had been exposed to family violence. There were varying knowledge levels of family violence support services as well as a number of barriers identified that directly impacted community members seeking help. There were clear expectations about the role of the local health service in family violence identification and response. There are particular challenges for rural communities in providing support for family violence. Valuable insights can be gained from local communities about their knowledge of services and help seeking behaviours. Evidence generated by this study will inform future strategic planning for family violence services and the local health service.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.ADDBEH.2017.02.006
Abstract: The injection of hetamine is becoming increasingly common. However, there has been a lack of research examining people who inject hetamine as the primary drug of use, limiting the potential to ensure services address the unique needs of this group. The current study used latent class analysis to identify classes of polydrug use among people who report injecting hetamine during the past 12months. It also examined differences between classes and drug use patterns, injecting practices, quality of life and psychological distress. Participants who were attending non-government specialist alcohol and other drug treatment across New South Wales, Australia and had identified hetamine as their principle drug of concern and reported injecting hetamine in the previous 12months were included in the current study (N=827). Latent class analysis was performed to identify polydrug profiles of participants. The large majority of people in the current study (85%) demonstrated low probability of heroin or other opiate use. Three distinct classes of polydrug use were identified: (1) Low-polydrug (n=491), (2) Opiates-polydrug (n=123), and (3) Alcohol-polydrug (n=213). There was a trend for the Low-polydrug class to demonstrate better functioning and safer injecting practices than the Opiates-polydrug and Alcohol-polydrug classes. The results suggest that the majority of people accessing treatment who inject hetamine as their primary drug of choice have a low probability of heroin or other opiate use. It is important that future research consider whether traditional harm minimisation strategies are appropriate for people who primarily inject hetamine.
Publisher: SAGE Publications
Date: 04-2020
DOI: 10.1080/08897077.2019.1671940
Abstract: Background: Patient-centered care is strongly advocated as a key for improving the quality of healthcare. Research examining the impact of patient-centered care in healthcare has concluded that there are demonstrable albeit inconsistent relationships between patient experience, quality of care, and healthcare outcomes. Knowledge of the impact of patient-centered care in the treatment of substance use disorder is limited. The aim of this review was to assess relationships between indicators of patient-centered care (satisfaction and patient-reported experience measures) and patient outcomes (substance use, psychological wellbeing, and service use) among people attending treatment for substance use disorder. Methods: A systematic electronic literature search of a range of databases was conducted with variations of the search terms ‘patient-centered care’, ‘substance use disorders’, and residential or community specialist ‘treatment’. The populations, interventions and outcomes were summarized and described according to the PRISMA statement. Results: A total of 25 articles were identified, of which only five included a patient-centered indicator other than satisfaction. Indicators of patient-centered care showed a generally positive association with improved outcomes, particularly between satisfaction with treatment and substance use. Nonetheless, mixed and contradictory results were not uncommon, more so for psychological wellbeing outcomes. Conclusions: There were demonstrable relationships between patient-centered indicators and outcomes for people receiving treatment for substance use disorder. However, conclusions are limited due to underrepresentation of patient-reported experience measures. Further research in the area is needed involving comparisons of patient centered indicators with outcomes and use of patient-reported experience measures together with satisfaction. Registration number: CRD42018092829
Publisher: Springer Science and Business Media LLC
Date: 17-05-2023
DOI: 10.1186/S13722-023-00379-W
Abstract: SMART (Self-Management and Recovery Training) Recovery is a mutual-aid program informed by cognitive behaviour therapy and motivational interviewing that provides support for a range of addictive behaviours. SMART Recovery has not been adapted to target young people with addictive behaviours despite the potential to overcome important barriers affecting youth engagement in other addiction programs. This study aimed to engage young people and SMART Recovery facilitators in qualitative interviews and focus groups to explore the potential of such a program and gain specific insights for its development. We conducted qualitative interviews and a focus group with five young people (aged between 14 and 24 years) and eight key stakeholders (including seven SMART Recovery facilitators) to obtain recommendations on how best to reach, engage, and support young people with addictive behaviours in a tailored SMART Recovery program. Qualitative data was transcribed and analysed using iterative categorization. Five key themes were identified when developing and delivering youth-targeted SMART Recovery. [1] ‘Discussing personal experiences to promote a shared identity’ refers to the benefits of creating a forum where personal stories are used to connect with others and validate one’s experiences. [2] ‘Flexible and patient approach’ emphasises a preference for facilitators to take a more gentle, less direct approach that allows for discussion beyond addictive behaviours. [3] ‘Balancing information and skills with the space for discussion’ acknowledges that youth want to connect in a variety of ways, beyond discussion of addictive behaviours, and that they wish to lead skill sharing and development. [4] ‘Conveying a community for youth through language’ highlighted the need to focus on connecting youth and to avoid the use of generic language to engage young people. [5] ‘Group logistics and competing demands’ refers to the logistical considerations of implementing a group program for youth that takes into account their competing demands and group accessibility. The findings point to considerations for developing youth specific mutual-aid groups, in particular a youth-targeted SMART Recovery program, such as by ensuring the conversation is youth-led and with an informal and flexible approach to guide group discussion.
Publisher: Springer Science and Business Media LLC
Date: 22-07-2019
Publisher: Informa UK Limited
Date: 06-2016
DOI: 10.3109/10826084.2016.1170144
Abstract: There is a growing body of research linking sedentary behavior with increased risk of chronic disease and all-cause mortality. It is increasingly recommended that service providers address the multiple behavioral risk factors associated with these chronic diseases as part of routine substance abuse treatment. The study objective was to investigate rates of physical activity and sedentary behavior in a residential substance abuse population. In addition, efficacy of a sedentary behavior intervention, "Sit Switch," was examined for feasibility in this context. Participants (n = 54) were residents of The Salvation Army Recovery Service Centres located in Canberra and on the Gold Coast, Australia. Actigraph GT3X+ accelerometers were used to measure rates and patterns of sedentariness and physical activity. A nonrandomized controlled study of a single-session group intervention aimed at decreasing prolonged sitting ("Sit Switch") was conducted. Education, motivational-interviewing, and goal setting components underpinned the "Sit Switch" intervention. In iduals were highly sedentary, spending 73% of daily activity at sedentary intensity engaged in inadequate levels of moderate physical activity (6.6%/day). The single session educational program did not lead to any significant changes in sedentary behavior. Conclusion/Importance: High levels of sedentariness and low levels of physical activity engagement are evident in residents in substance abuse treatment programs. It is strongly recommended that sedentariness, a modifiable risk behavior with independent consequences for cardiovascular disease and cancer, be addressed within residential programs.
Publisher: Research Square Platform LLC
Date: 14-12-2022
DOI: 10.21203/RS.3.RS-2250527/V1
Abstract: Background Recruiting young people to addiction research trials poses considerable challenges. Multiple referral pathways across a range of systems, financial incentives, and social media advertisements can improve recruitment outcomes in youth research. In this study, we aimed to assess the feasibility of recruitment to a youth-targeted addiction behaviour change program. Methods Our target s le size was 20 participants. We recruited via a youth mental health treatment service and paid Facebook advertisements with financial compensation for completion of baseline and post-intervention assessments. The program was a youth-tailored version of Self-Management and Recovery Training (SMART Recovery) that was based on our program development work that included interviews with SMART Recovery facilitators and young people. We assessed feasibility of recruitment as the as primary outcome. Results During the recruitment period (October 1 st and October 28 th , 2021) we recruited one young person. Due to funding-related constraints on timing and staffing, we abandoned the trial. Conclusions Our recruitment efforts failed to enrol sufficient participants required for successful trial delivery. A critique of our recruitment procedures identified multiple factors that help explain these poor outcomes, including that we engaged only one referring service and did not assess buy-in among clinicians at this service our program may have attempted to reach too broad an audience by targeting health behaviour change rather than specific addictive behaviours and that we did not mention the financial incentives of participation in our Facebook advertisements. This study provides important insights to guide future recruitment efforts targeting young people to addiction treatment trials. Trial registration The trial was registered with Australian and New Zealand Clinical Trial Registry prior to recruitment (ACTRN12621001283864).
Publisher: Elsevier
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 04-05-2020
Publisher: Elsevier BV
Date: 08-2021
Publisher: Wiley
Date: 27-09-2012
DOI: 10.1002/PON.3188
Abstract: Although effective treatments for pain and distress are available, many patients do not access them. Improved understanding of patients' desire for help may improve uptake of services. Data were collected as part of the QUICATOUCH screening program at an Australian regional hospital. Patients over threshold for pain were asked if they would like help with their pain and those over threshold for distress were asked if they would like help with their distress. Multivariate logistic regression analyses were conducted to identify independent predictors of desire for help. Of 305 patients over threshold for pain 59% wanted help, increasing from 13% at a pain score of one to 90% at a pain score of 10. Of 274 patients over threshold for distress, 30% wanted help, increasing from 21% at a distress score of four to 41% at a distress score of 10. Pain score was the only significant independent predictor of desire for help with pain, with an odds ratio (OR) of 1.50 (95%CI 1.33-1.70) for every point increase in pain score. Distress score was the only significant independent predictor of desire for help with distress with an OR of 1.29 (95%CI 1.11-1.50) for every point increase in distress score. Although desire for help with pain and distress increased with respective symptom intensity, many patients indicated they did not want help with these symptoms. Patient reluctance to seek help may constitute a barrier to realising the full potential of screening programs in reducing pain and distress.
Publisher: Wiley
Date: 08-07-2019
DOI: 10.1111/DAR.12965
Abstract: A growing body of literature supports the use of patient-reported experience measures (PREMs) to monitor the provision of patient-centred care to people accessing health services. However, there is an absence of research into PREMs in the alcohol and other drugs (AOD) field. The aim of this study was to explore patient experiences of AOD care and to develop a PREM for AOD treatment settings. Five focus groups were conducted with people accessing AOD treatment services in New South Wales, Australia (N = 39). Data were analysed using iterative categorisation. A draft PREM was developed based on focus group findings and was modified following a subsequent review by consumers and service providers. Participants emphasised the importance of timely access to integrated care delivered in a structured program by staff members who genuinely care. Furthermore, participants described positive experiences when services addressed the problems that maintain addiction, held them responsible for themselves and facilitated self-reflection. The PREM for Addiction Treatment (PREMAT) is a 33-item measure that captures what participants said regarding their experience of patient-centred care in AOD treatment. The experiences of people accessing AOD treatment provided useful feedback that can be translated into service improvements and that informed the design of a PREM for AOD treatment settings. Future research is necessary to further investigate the validity of the PREMAT.
Publisher: Wiley
Date: 23-07-2019
DOI: 10.1111/DAR.12966
Abstract: Insight is a multi-dimensional construct that predicts treatment outcomes of people with mental illness. Research into insight in substance dependent populations is limited and measures of cognitive insight have not been validated for this population. A cross sectional survey was conducted with residents of nine residential substance dependence treatment facilities in Australia. Cognitive insight was assessed using the Beck Cognitive Insight Scale (BCIS). Psychological distress was assessed using the Kessler 6 (K6). Participants (N = 312) were primarily male (68.6%), with an average age of 37.51 years (SD = 9.85). Meth hetamine (45.2%) and alcohol (35.9%) were the primary substances of use. A confirmatory factor analysis confirmed the two-factor model of the BCIS (CMIN/DF = 2.91, CFI = 0.84). Removing two items from the Self-Reflection subscale improved model fit (CMIN/DF = 2.71, CFI = 0.84, Χ We found that a 12-item version of the BCIS had good psychometric properties in this substance-using population. Further research is needed to explore whether insight can predict treatment outcomes for substance use.
Publisher: Frontiers Media SA
Date: 26-05-2022
DOI: 10.3389/FPSYT.2022.869169
Abstract: One of the most challenging aspects of conducting intervention trials among people who experience severe mental illness (SMI) and who smoke tobacco, is recruitment. In our parent “QuitLink” randomized controlled trial (RCT), slower than expected peer researcher facilitated recruitment, along with the impact of COVID-19 pandemic restrictions, necessitated an adaptive recruitment response. The objectives of the present study were to: (i) describe adaptive peer researcher facilitated recruitment strategies (ii) explore the effectiveness of these strategies (iii) investigate whether recruitment strategies reached different subgroups of participants and (iv) examine the costs and resources required for implementing these strategies. Finally, we offer experience-based lessons in a Peer Researcher Commentary. People were included in the RCT if they smoked at least 10 cigarettes a day and were accessing mental health support from the project's two partnering mental health organizations in Victoria, Australia. The majority of people accessing these services will have been diagnosed with SMI. Recruitment occurred over 2 years. We began with peer facilitated recruitment strategies delivered face-to-face, then replaced this with direct mail postcards followed by telephone contact. In the final 4 months of the study, we began online recruitment, broadening it to people who smoked and were accessing support or treatment (including from general practitioners) for mental health and/or alcohol or other drug problems, anywhere in the state of Victoria. Differences between recruitment strategies on key participant variables were assessed. We calculated the average cost per enrolee of the different recruitment approaches. Only 109 people were recruited from a target of 382: 29 via face-to-face (March 2019 to April 2020), 66 from postcards (May 2020 to November 2020), and 14 from online (November to December 2020 and January to March 2021) strategies. Reflecting our initial focus on recruiting from supported independent living accommodation facilities, participants recruited face-to-face were significantly more likely to be living in partially or fully supported independent living ( n = 29, & .001), but the s les were otherwise similar. After the initial investment in training and equipping peer researchers, the average cost of recruitment was AU$1,182 per participant—~US$850. Face-to-face recruitment was the most expensive approach and postcard recruitment the least (AU$1,648 and AU$928 per participant). Peer researcher facilitated recruitment into a tobacco treatment trial was difficult and expensive. Widely dispersed services and COVID-19 restrictions necessitated non-face-to-face recruitment strategies, such as direct mail postcards, which improved recruitment and may be worthy of further research. The trial is registered with ANZCTR ( www.anzctr.org.au ): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines. The trial sponsor was the University of Newcastle, NSW, Australia.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Wiley
Date: 31-08-2015
DOI: 10.1111/DAR.12322
Abstract: The aim of this study was to explore beliefs about tobacco dependence treatment from the perspective of staff and clients in addiction treatment settings. A qualitative study was conducted between August and November 2013 using grounded theory methodology. Participants were recruited from four government-funded drug and alcohol services in a regional centre of New South Wales, Australia. Treatment centre staff (n = 10) were interviewed using a semistructured interview guide and two focus groups (n = 5 and n = 6) were held with clients of the same treatment centres. Both clients and staff wish to do more about tobacco use in addiction treatment services, but a number of barriers were identified. Staff barriers included lack of time, tobacco-permissive organisational culture, lack of enforcement of smoke-free policies, beliefs that tobacco is not a treatment priority for clients and that clients need to smoke as a coping strategy, and perceptions that treatment was either ineffective or not used by clients. Clients reported smoking as a habit and for enjoyment or stress relief, seeing staff smoking, nicotine replacement therapy unaffordability and perceptions that nicotine replacement therapy may be addictive, and inability to relate to telephone cessation counselling as barriers to quitting smoking. Client and staff perceptions and attitudes about the treatment of tobacco, particularly those relating telephone support and nicotine replacement therapy, provided information, which will inform the design of smoking cessation programs for addiction treatment populations. [Wilson AJ, Bonevski B., Dunlop A., Shakeshaft A, Tzelepis F., Walsberger S., Farrell M., Kelly PJ, Guillaumier A. 'The lesser of two evils': A qualitative study of staff and client experiences and beliefs about addressing tobacco in addiction treatment settings. Drug Alcohol Rev 2015].
Publisher: Informa UK Limited
Date: 30-09-2011
DOI: 10.3109/09638237.2011.577845
Abstract: The majority of mental health clinicians report the use of homework to support their case management, but practitioner surveys indicate that homework is not routinely used. To examine barriers that mental health case managers experience in implementing homework and to identify strategies to promote successful homework administration. One hundred thirty-four surveys were completed by mental health case managers. The survey examined their use of homework for in iduals diagnosed with a severe mental health problem. It also asked them to identify barriers to regularly implement homework and describe strategies to promote more regular use of homework. On average, homework was used at 50% of clinical contacts. The primary reasons for not using homework included allocating insufficient time at appointments, perceived client resistance for using homework and concerns that the client was too unwell. Strategies used to overcome these difficulties included prioritising the use of homework and ensuring that homework assignments were achievable. Clinicians are able to identify a range of practical strategies to promote the use of homework. Discussion focuses on the application of the suggested strategies to promote regular use of homework. This includes discussion of possible training approaches to enhance systematic homework administration.
Publisher: Informa UK Limited
Date: 09-12-2009
DOI: 10.3109/10826080802486723
Abstract: The purpose of this study was to examine the relationship of spirituality, religiosity and self-efficacy with drug and/or alcohol cravings. A cross-sectional survey was completed by 77 male participants at an Australian Salvation Army residential rehabilitation service in 2007. The survey included questions relating to the participants' drug and/or alcohol use and also measures for spirituality, religiosity, cravings, and self-efficacy. The s le included participants aged between 19 and 74 years, with more than 57% reporting a diagnosis for a mental disorder and 78% reporting polysubstance misuse with alcohol most frequently endorsed as the primary drug of concern (71%). Seventy-five percent of the clients reported that spirituality and religious faith were useful components of the treatment program. A multivariate multiple regression analysis identified that spirituality and self-efficacy have significant relationships with cravings. Self-efficacy mediated the relationship between spirituality and drug and/or alcohol cravings. The limitations of this study included its cross-sectional design and a s le that was drawn from a faith-based program. Future research would benefit from the longitudinal examination of the relationship between spirituality, self-efficacy, and cravings the exploration of a broader range of client-specific and interpersonal variables and the inclusion of a control group from a secular treatment facility.
Publisher: Wiley
Date: 19-07-2013
Publisher: Wiley
Date: 30-11-2020
DOI: 10.1111/EIP.13090
Abstract: Health literacy is one's ability to use cognitive and social skills to access, understand and appraise health information. Despite poor health outcomes of people living with mental illness there is limited research assessing their health literacy. This systematic review aims to synthesise research on health literacy rates, conceptualizations, and outcomes of people living with mental illness, including substance use disorders. This will provide insights into how health literacy might be targeted to reduce these health inequities. A search of published literature in multiple databases up until February 2019 was conducted. One reviewer screened the titles, abstracts and keywords of identified publications and the eligibility of all full‐text publications were assessed for inclusion along with a second reviewer. Both reviewers independently rated the quality of the included studies. Fourteen studies were included in the review. Rates and measures of health literacy varied. Low health literacy and health literacy weaknesses were identified. There is a lack of research on the relationship between health literacy and other outcomes, particularly health service engagement. The review highlights the high rates of low health literacy within this population compared with general populations. Most studies used a functional health literacy measure, despite its limitations, with only a few using multidimensional measures. Overall, there is limited research examining the impact that this populations health literacy has on their recovery and how it affects them over time. The review emphasizes the importance of practitioners assessing and targeting health literacy needs when working with this population.
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.JSAT.2014.07.016
Abstract: Co-occurring substance use and mental health disorders (CODs) are common. However, very little is known about in iduals' recognition of, and perception of the relationship between these disorders. The current study aimed to examine problem recognition, perceived disorder relationships, treatment intentions, and treatment preferences of in iduals attending Australian detoxification facilities. Questionnaires were completed by 225 participants, including the Mental Health Screening Form III and the Treatment Preferences Questionnaire. Results indicated that 56.4% of participants screened positive for CODs, with only 4.2% failing to recognise their mental health problems. Participants perceived a functional relationship between disorders, where improvement/deterioration of one disorder leads to the improvement/deterioration of the other. Recognition of mental health problems and perception of a functional relationship between disorders, predict high mental health treatment intentions. These findings have important clinical implications when planning treatment programs and counselling in iduals with CODs.
Publisher: Emerald
Date: 15-05-2017
Abstract: The purpose of this paper is to investigate Keyes’ (2007) model of mental health, the presence (flourishing) or absence (languishing) of social, emotional and psychological wellbeing, in the context of drug and alcohol misuse and the frequency and pattern of community participation (engaging in society). Participants were 1,815 in iduals (70 per cent male) who entered residential substance misuse treatment provided by The Salvation Army. Questionnaires were completed at intake assessments with The Salvation Army staff. The data were compared with population norms of community participation utilising t -tests, while multiple linear regression was used to examine continuous mental health. Although participants have lower levels of community participation compared to Australian population norms, those participants who were experiencing flourishing mental health had higher rates of community participation than Australian norms. Keeping in touch with friends and family was the most common form of participation. Informal social connectedness and civic engagement were the strongest predictors of mental health over and above more traditional substance use outcomes such as cravings. This is one of the first studies to describe the relationships between community participation, substance use and mental health in participants seeking treatment for substance misuse. Despite having a drug or alcohol addiction requiring treatment, those participants with flourishing mental health have higher levels of community participation than community norms. Furthermore, community participation predicts mental health. This offers promise for interventions that increase community participation but further research using longitudinal designs is needed to replicate and clarify the direction of these relationships.
Publisher: Informa UK Limited
Date: 28-09-2018
DOI: 10.1080/15504263.2018.1498565
Abstract: Loneliness is a distressing emotional experience that is likely to be prevalent among people accessing treatment for substance dependence problems. The first aim of the current study was to report on the validity of the Social and Emotional Loneliness Scale for Adults-Short Version (SELSA-S), a multidimensional measure of loneliness, for use in substance-dependent treatment populations. In order to further the understanding of loneliness among this population, loneliness was examined in relation to demographic, physical, and mental health variables. Participants were attending Australian residential substance dependence treatment services provided by two nongovernmental organizations (The Salvation Army and We Help Ourselves). Participants completed cross-sectional surveys (N = 316) consisting of measures of demographics, substance use, loneliness, and physical and mental health. Confirmatory factor analysis revealed high factor loadings and a moderate degree of concurrent and discriminant validity and internal consistency for the SELSA-S however, model fit indices did not meet prespecified cutoff criteria. Loneliness was deemed to be a serious problem for 69% of respondents, and 79% reported feeling lonely at least once per month. Findings of this study suggest the need for further research into the validity of the SELSA-S for use with substance-dependent populations. In addition, it may be beneficial to test a range of loneliness measures in order to determine whether other measures of loneliness may be more favorable for use across this population.
Publisher: Wiley
Date: 06-01-2020
DOI: 10.1111/ADD.14911
Abstract: Aims were to test the effectiveness of an organizational change intervention integrating smoking cessation treatment into usual alcohol and other drug (AOD) treatment, compared with usual care, on (1) 7‐day point prevalence abstinence (PPA) at 8 weeks follow‐up (2) prolonged abstinence (3) cigarettes smoked per day (4) number of quit attempts and (5) offer and use of nicotine replacement therapy (NRT). All outcomes were assessed at 8 weeks and 6.5 months follow‐up. Cluster‐randomized controlled trial, with AOD service as unit of randomization, conducted January 2015–March 2016. Thirty‐two eligible services (provided face‐to‐face client sessions to ≥ 50 clients/year) in Australia were randomized to control (usual care n = 15) or intervention ( n = 17) groups by an independent blinded biostatistician. Eligible participants (≥ 16 years, current smoker) completed surveys at the service at baseline ( n = 896) and telephone follow‐up surveys (conducted by blinded assessors) at 8 weeks ( n = 471 53%) and 6.5 months ( n = 427 48%). Intervention services received an intervention to establish routine screening, assessment and delivery of smoking cessation care. Primary outcome was biochemically verified 7‐day PPA at 8‐week follow‐up. Secondary outcomes included verified and self‐reported prolonged abstinence, self‐reported 7‐day PPA, cigarettes/day, quit attempts and offer and use of NRT. Intention‐to‐treat analyses were performed, assuming missing participants were not abstinent. At 8 weeks, the findings in verified 7‐day PPA between groups [2.6 versus 1.8%, odds ratio (OR) = 1.72, 95% confidence interval (CI) = 0.5–5.7, P = 0.373] were inconclusive as to whether a difference was present. Significantly lower mean cigarettes/day were reported in the intervention group compared to the usual care group at 8 weeks [incidence rate ratio (IRR) = 0.88, 95% CI = 0.8–0.95, P = 0.001] but were similar at 6.5 months (IRR = 0.96, 95% CI = 0.9–1.02, P = 0.240) follow‐up. At both follow‐ups the intervention group reported higher rates of NRT use. Integrating smoking cessation treatment into addiction services did not significantly improve short‐term abstinence from smoking.
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.IJPSYCHO.2013.04.011
Abstract: This study aimed to replicate findings that alcohol consumption and positive implicit beer-related cognitions can be reduced using inhibitory control (IC) training, with the addition of an active training control. Frontal EEG asymmetry, an objective psychophysiological index of approach motivation, was used as a dependent measure to examine training outcomes. Participants were randomly assigned to one of two IC training conditions (Beer NoGo or Beer Go) or a Brief Alcohol Intervention (BAI) (i.e. the active training control). The IC training tasks consistently paired a stimulus that required a response with images of water (Beer NoGo) or images of beer (Beer Go). Alcohol consumption and implicit beer-related cognitions were measured at pre-training, post-training and at one week follow-up. Frontal EEG asymmetry was recorded during a passive image viewing task that presented neutral, healthy, and beer stimuli - at pre-training, post-training and follow-up. Participants in the Beer NoGo and BAI conditions consumed less beer in a taste test immediately after training than Beer Go participants, suggesting that IC training may be as effective as the already established BAI. The taste test findings were in line with the frontal EEG asymmetry data, which indicated that approach motivation for beer stimuli was altered in the expected directions. However, the positive correlation between post-training frontal EEG asymmetry data and taste test consumption was not significant. While there were no significant changes in implicit beer-related cognitions following training, a trending positive relationship between implicit beer-related cognitions at post-training and taste test consumption was reported. Further exploration addressing the limitations of the current study is required in order to clarify the implications of these findings.
Publisher: Elsevier
Date: 2013
Publisher: Wiley
Date: 07-2020
DOI: 10.1111/DAR.13120
Publisher: Springer Science and Business Media LLC
Date: 02-10-2023
Publisher: Wiley
Date: 07-2020
DOI: 10.1111/DAR.13121
Publisher: Informa UK Limited
Date: 26-12-2017
Publisher: Informa UK Limited
Date: 2006
Publisher: Elsevier BV
Date: 04-2021
Publisher: Wiley
Date: 09-02-2021
DOI: 10.1111/DAR.13249
Abstract: In iduals with substance use problems are at greater risk of chronic diseases due to their unhealthy lifestyle behaviours (e.g. alcohol use, smoking, physical inactivity, poor nutrition). There is increasing evidence that health risk communication is crucial in improving risk perception and knowledge of chronic diseases, and both factors are associated with health behaviour change. The aim of this systematic review is to provide a comprehensive overview of the current state of evidence on health risk communication on people with substance use problems. A systematic search identified peer reviewed studies from the databases MEDLINE, PsycINFO, CINAHL and Scopus. Data were extracted from the included studies and a narrative synthesis of the results was conducted. Eight articles, representing five unique studies, were included in the review. The overall risk of bias of the included studies was considered to be low. The studies evaluated the use of message framing and personalised/customised recommendations across smoking cessation and patient engagement with methadone maintenance treatment. Results revealed that message framing, specifically gain-framed messages, had a positive impact on smoking cessation. Risk perception, sex and level of nicotine dependence were also found to be associated with smoking cessation. The limited number of studies provides preliminary evidence that health risk communication promotes smoking cessation. However, studies included in the review were characterised by heterogeneous methods and measures. Further investigation of health risk communication using adequately powered randomised controlled trial is warranted.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.JSAT.2014.10.008
Abstract: SMART Recovery groups are cognitive-behaviorally oriented mutual support groups for in iduals with addictions. The aim of the study was to assess the extent to which the quality of group facilitation, group cohesion and the use of between session homework activities contribute to self-rated use of cognitive-behavioral skills amongst group participants. Participants attending SMART Recovery groups in Australia completed a cross sectional survey (N=124). The survey included measures of cognitive and behavioral skill utilization, group cohesion, quality of group facilitation and a rating of how frequently participants leave group meetings with an achievable between session homework plan. On average, participants had been attending SMART Recovery meetings for 9 months. Participants were most likely to attend SMART Recovery for problematic alcohol use. Regression analyses indicated that group cohesion significantly predicted use of cognitive restructuring, but that only provision of homework at the end of each group session predicted self-reported behavioral activation. Both group cohesion and leaving a group with an achievable homework plan predicted participant use of cognitive behavioral skills. The concrete actions associated with homework activities may facilitate behavioral activation. There is a need for longitudinal research to examine the relationship between the utilization of cognitive and behavioral skills and participant outcomes (e.g. substance use, mental health) for people attending SMART Recovery groups.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.JSAT.2018.10.009
Abstract: Health literacy refers to the degree to which people can access and understand health information, as well as communicate their health needs to service providers. Whilst health literacy is increasingly being examined within general community s les, there is limited research focused on substance use disorders where the need for health literacy is likely to be high. The aim of this study was to examine the health literacy profiles of people attending substance use disorder treatment and to examine how these profiles were related to measures of quality of life, mental health, and physical health. Participants were attending specialist non-government substance use disorder treatment across New South Wales, Queensland, and the Australia Capital Territory, Australia (N = 298). Participants completed the Health Literacy Questionnaire, a multi-dimensional measure of health literacy. Latent profile analysis was conducted to identify profiles of health literacy within the s le. Three distinct health literacy profiles were identified, and termed low (24.2%), moderate (62.8%) and high health literacy (13.1%). Participants with lower levels of health literacy had lower levels of social support in their home environment outside of treatment, as well as lower levels of quality of life, higher levels of psychological distress, and poorer mental health. There was no difference between the three profiles on measures of physical health. The current study found that low to moderate health literacy levels were common for those attending residential substance abuse treatment. Participants with lower health literacy tended to have poorer quality of life and mental health. Future research should examine strategies to improve health literacy amongst people attending alcohol and other drug treatment. It may also be useful for service providers to consider ways to minimise the impact of low health literacy on the health needs and outcomes of this vulnerable population.
Publisher: Elsevier BV
Date: 10-2009
Publisher: Informa UK Limited
Date: 08-05-2015
Publisher: Elsevier BV
Date: 10-2017
Publisher: Informa UK Limited
Date: 24-05-2019
Publisher: Elsevier BV
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 08-01-2013
Publisher: Informa UK Limited
Date: 03-04-2018
DOI: 10.1080/15504263.2018.1442951
Abstract: Nicotine replacement therapy (NRT) is recommended as a frontline smoking cessation tool for people attending mental health and substance dependence treatment services. Previous research suggests that NRT is underutilized in these settings. To improve the use of NRT among people attending residential treatment for substance use disorders, it is important that the factors influencing smokers' decisions to use NRT are understood. The study aimed to examine (1) smoking cessation strategies used by participants in previous quit attempts, (2) participants' attitudes toward NRT (i.e., safety concerns and perceived efficacy), and (3) the predictors of participants' intention to use NRT to support future quit attempts. Participants completed a cross-sectional survey that examined their smoking behaviors, previous experiences using smoking cessation strategies, attitudes and beliefs regarding NRT, and intention to use NRT as part of future quit attempts (N = 218). All participants were attending residential treatment for substance use disorders provided by We Help Ourselves, a large provider of specialist alcohol and other drug treatment in Australia. The majority of respondents (98%) reported that they had smoked regularly in their lifetime, and 89% were current smokers. Forty-five percent of the current smokers reported that they had previously used NRT to support a quit attempt, with 54% reporting that they intended to use NRT to support a future quit attempt. Intentions to use NRT were not related to the participants' mental health status or the participants' perceptions regarding the safety or potential drawbacks associated with using NRT. However, participants were more likely to report that they would use NRT to support future quit attempts if they were female, had previously used NRT, and perceived NRT to be effective. Improving the use of evidence-based smoking cessation strategies within substance use treatment continues to be a priority. To enhance the use of NRT among consumers attending mental health and addiction treatment services, NRT should be universally offered. Future research should consider strategies that help to improve participants' positive perceptions regarding the efficacy of NRT.
Publisher: Informa UK Limited
Date: 09-05-2019
Publisher: Frontiers Media SA
Date: 06-10-2022
DOI: 10.3389/FPSYT.2022.868032
Abstract: People experiencing severe mental illness (SMI) smoke at much higher rates than the general population and require additional support. Engagement with existing evidence-based interventions such as quitlines and nicotine replacement therapy (NRT) may be improved by mental health peer worker involvement and tailored support. This paper reports on a qualitative study nested within a peer researcher-facilitated tobacco treatment trial that included brief advice plus, for those in the intervention group, tailored quitline callback counseling and combination NRT. It contextualizes participant life experience and reflection on trial participation and offers insights for future interventions. Qualitative semi-structured interviews were conducted with 29 participants in a randomized controlled trial (intervention group n = 15, control group n = 14) following their 2-month (post-recruitment) follow-up assessments, which marked the end of the “Quitlink” intervention for those in the intervention group. Interviews explored the experience of getting help to address smoking (before and during the trial), perceptions of main trial components including assistance from peer researchers and tailored quitline counseling, the role of NRT, and other support received. A general inductive approach to analysis was applied. We identified four main themes: (1) the long and complex journey of quitting smoking in the context of disrupted lives (2) factors affecting quitting (desire to quit, psychological and social barriers, and facilitators and reasons for quitting) (3) the perceived benefits of a tailored approach for people with mental ill-health including the invitation to quit and practical resources and (4) the importance of compassionate delivery of support, beginning with the peer researchers and extended by quitline counselors for intervention participants. Subthemes were identified within each of these overarching main themes. The findings underscore the enormity of the challenges that our targeted population face and the considerations needed for providing tobacco treatment to people who experience SMI. The data suggest that a tailored tobacco treatment intervention has the potential to assist people on a journey to quitting, and that compassionate support encapsulating a recovery-oriented approach is highly valued. The Quitlink trial was registered with ANZCTR ( www.anzctr.org.au ): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines.
Publisher: Informa UK Limited
Date: 26-08-2010
Publisher: Informa UK Limited
Date: 13-09-2019
Publisher: Elsevier BV
Date: 10-2020
Publisher: American Psychological Association (APA)
Date: 06-2019
DOI: 10.1037/PRJ0000335
Abstract: Our goal was to develop and pilot a methodology that could reliably identify therapeutic homework tasks that are coherent with the goals of in iduals receiving mental health recovery support. The content of goals and therapeutic homework tasks of 66 clients were classified using the Camberwell Assessment of Need Goal-Action Plan (CAN-GAP) taxonomy. Goal-homework pairs were considered coherent if the content of the homework and goal were both independently assigned the same content domain. The content of the goals and homework tasks were found to be highly coherent, with a 75% match in categories. It is possible to simply, and reliably, determine whether the content of goals and homework tasks are coherent. Lower coherence would require support workers to spend more time making the connection between homework and goals more explicit. Future research should determine whether higher coherence leads to greater goal attainment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Publisher: Elsevier BV
Date: 06-2000
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.JSAT.2016.03.002
Abstract: Retaining clients in residential alcohol and other drug (AOD) treatment is difficult and cognitive impairment has been identified as a significant predictor of treatment dropout. The application of extensive screening for cognitive impairment is cost-prohibitive for most AOD treatment services. The current study aimed to explore cognitive functioning and impairment-associated factors in a typical s le of residential AOD clients using a free brief screening tool that could be utilised by front-line AOD services. Residents of an AOD therapeutic community (n=128) and a non-substance using control group (n=37) were administered a brief cognitive screening measure, the Montreal Cognitive Assessment (MoCA). MoCA total and domain scores were compared between these groups and within the AOD group examined in association with primary substance of misuse, severity of dependence, gender, psychological distress, and history of head injury. Almost half (43.8%) of the AOD s le were identified as cognitively impaired, compared to 16.2% of the control group. Furthermore, 67.2% of the AOD s le had sustained head injuries and 50% of the s le required hospitalization for head injury. History of head injury was a significant determinant of cognitive impairment, and associated with greater levels of psychological distress. There are high rates of inter-related cognitive impairment, head injuries, and psychological distress among clients in residential AOD treatment. Routine screening of clients at intake for cognitive impairment by means of a brief screening measure such as the MoCA, in combination with the assessment of history of head injuries and comorbid psychological disorders, could inform treatment modifications or adjunct interventions to increase retention and improve long-term outcomes.
Publisher: American Psychological Association (APA)
Date: 2012
DOI: 10.1037/A0027887
Abstract: There is considerable discrepancy between what is considered evidence-based practice (EBP) and what is actually delivered in substance abuse treatment settings. The Theory of Planned Behavior (TpB) is a well-established model that may assist in better understanding clinician's intentions to use EBPs. A total of 106 residential substance abuse workers employed by The Salvation Army participated in the current study. The workers completed an anonymous survey that assessed attitudes toward EBP and examined the constructs within the TpB. A linear regression analysis was used to predict clinicians' intentions to use EBPs. Overall, the model accounted for 41% of the variance in intentions, with attitudes, subjective norms, and perceived behavioral control all significant predictors. The discussion highlights the potential for social reinforcement in the workplace to promote the implementation of EBPs.
Publisher: Informa UK Limited
Date: 26-12-2019
Publisher: Wiley
Date: 23-10-2020
DOI: 10.1111/DAR.13197
Publisher: Elsevier BV
Date: 2022
Publisher: Elsevier BV
Date: 05-2017
Publisher: Wiley
Date: 12-01-2023
DOI: 10.1111/DAR.13591
Abstract: Assessing drug and alcohol inpatient withdrawal treatment programs is important, as these represent a first step of treatment among people with alcohol and drug problems. However, there are many ways of measuring outcomes making it difficult for service providers to decide which domains and methods to use. This narrative review aims to clarify frequencies of the domains and methods used to assess withdrawal treatment outcomes. We reviewed published studies that examined outcomes of inpatient drug and alcohol withdrawal treatment. The types of outcome measures used and the frequency of use were summarised. The review showed that assessment of withdrawal treatment outcomes goes beyond traditional abstinence measures. Outcomes mainly focus on biological and psychological outcomes, with social outcomes rarely measured. Even within outcome domains (e.g., cravings), there were many assessment methods. The review provides service providers with an outline of common outcome domains and measures. Given the importance of social functioning to recovery from alcohol and drug problems, greater emphasis on such measures is desirable. Future research could develop greater consensus on outcome measures for use in withdrawal management services to facilitate clarity around factors associated with treatment success. Outcome assessment in withdrawal treatment goes beyond abstinence to include holistic measurement of biological, psychological and some social outcomes but more work needs to be done to cohere the different assessment methods and broaden the scope to include social functioning.
Publisher: Research Square Platform LLC
Date: 25-04-2020
DOI: 10.21203/RS.3.RS-24274/V1
Abstract: Background Client centered care is strongly advocated as key to improving the quality of health care. However, there is a notable absence of research about the acceptability and feasibility of a client centered approach in substance dependence treatment settings. The aim of this study was to explore client and staff perspectives of a new client centered model of care implemented at Kedesh Rehabilitation Services, a residential substance dependence treatment service.Methods Participants were client and staff at Kedesh between April 2018 and April 2019. Clients were invited to take part in a focus group and staff in in idual interviews. Questions elicited client and staff experience of client centered care at Kedesh, including advantages and disadvantages. Staff were also asked to describe how they would define the client centered model. Thematic analysis was conducted on transcriptions of audio recordings.Results Four focus groups were conducted amongst 18 clients and 8 in idual interviews amongst staff. Staff identified the defining features of client centered care as that which is flexible, comprehensive, open-minded and inclusive. Clients and staff shared predominantly positive views on the client centered model, with an emphasis on the satisfaction in providing and receiving what felt like more authentic and comprehensive care. Shared themes emerged for clients and staff on the challenge of striking a balance between flexibility and structure, and managing comprehensive and in idualized care within existing knowledge, skills and resources.Conclusions Client centered care encourages health care organisations and providers to strive for a more holistic and empowering standard of care. Results support the acceptability of client centered care in residential substance dependence treatment settings for both clients and staff. Future research is needed to develop knowledge in interpreting, implementing, and assessing client centered care in the treatment of substance dependence.
Publisher: American Psychiatric Association Publishing
Date: 10-2009
Publisher: Informa UK Limited
Date: 08-03-2011
Publisher: Wiley
Date: 22-04-2012
DOI: 10.1111/J.1465-3362.2012.00461.X
Abstract: Although smoking rates among mental health/substance abusing populations are very high, the focus of treatment and research has tended to be on substances other than tobacco. A range of harm-reduction strategies is needed, including long-term nicotine maintenance, smokeless tobacco and 'clean' nicotine products. For those who cannot or will not quit, assistance in reducing smoking should be given. Interventions for smoking among people with mental health/substance use problems may best be delivered by addressing multiple health-risk behaviours, especially physical activity, around the same time.
Publisher: Frontiers Media SA
Date: 03-09-2019
Publisher: Springer Science and Business Media LLC
Date: 19-09-2022
DOI: 10.1007/S11469-022-00915-W
Abstract: Health literacy comprises an in idual’s ability to adequately access, understand and utilise health information, enabling effective navigation of the healthcare system. Low health literacy is a problem for people living with substance use disorders (SUDs). This study aims to examine whether health literacy changes for people discharged from specialist SUD treatment services. Two hundred thirty-one people recruited from residential SUD treatment services across New South Wales, Australia, completed a questionnaire upon entry into the service and again at 6 months post-treatment. Treatment outcomes were also measured. Three health literacy profiles were identified: lowest ( n = 52, 22.5%), moderate ( n = 111, 48.1%) and highest health literacy ( n = 68, 29.4%). Lowest and moderate profiles showed improved health literacy at 6 months. However, the lowest profile still had significantly lower health literacy, quality of life and higher levels of psychological distress compared with participants in the highest profile at 6 months. People within the lowest health literacy profile improved, although they continued to experience lower health literacy and some poorer treatment outcomes. Health literacy interventions tailored for people within lowest health literacy profiles should be implemented and assessed for effectiveness within specialist SUD treatment services.
Publisher: Springer Science and Business Media LLC
Date: 24-06-2015
DOI: 10.1038/NCOMMS8553
Abstract: There is increasing evidence from genome-wide association studies for a strong inherited genetic basis of susceptibility to acute lymphoblastic leukaemia (ALL) in children, yet the effects of protein-coding variants on ALL risk have not been systematically evaluated. Here we show a missense variant in CDKN2A associated with the development of ALL at genome-wide significance (rs3731249, P =9.4 × 10 −23 , odds ratio=2.23). Functional studies indicate that this hypomorphic variant results in reduced tumour suppressor function of p16 INK4A , increases the susceptibility to leukaemic transformation of haematopoietic progenitor cells, and is preferentially retained in ALL tumour cells. Resequencing the CDKN2A – CDKN2B locus in 2,407 childhood ALL cases reveals 19 additional putative functional germline variants. These results provide direct functional evidence for the influence of inherited genetic variation on ALL risk, highlighting the important and complex roles of CDKN2A – CDKN2B tumour suppressors in leukaemogenesis.
Publisher: Cambridge University Press (CUP)
Date: 12-04-2019
DOI: 10.1017/S1352465819000298
Abstract: Background: Safety behaviours are ubiquitous across anxiety disorders and are associated with the aetiology, maintenance and exacerbation of anxiety. Cognitive behavioural models posit that beliefs about safety behaviours directly influence their use. Therefore, beliefs about safety behaviours may be an important component in decreasing safety behaviour use. Unfortunately, little empirical research has evaluated this theorized relationship. Aims: The present study aimed to examine the predictive relationship between beliefs about safety behaviours and safety behaviour use while controlling for anxiety severity. Method: Adults with clinically elevated levels of social anxiety ( n = 145) and anxiety sensitivity ( n = 109) completed an online survey that included established measures of safety behaviour use, quality of life, and anxiety severity. Participants also completed the Safety Behaviour Scale (SBS), a measure created for the current study which includes a transdiagnostic checklist of safety behaviours, as well as questions related to safety behaviour use and beliefs about safety behaviours. Results: Within both the social anxiety and anxiety sensitivity groups, positive beliefs about safety behaviours predicted greater safety behaviour use, even when controlling for anxiety severity. Certain beliefs were particularly relevant in predicting safety behaviour use within each of the clinical analogue groups. Conclusions: Findings suggest that efforts to decrease safety behaviour use during anxiety treatment may benefit from identifying and modifying positive beliefs about safety behaviours.
Publisher: Wiley
Date: 30-05-2012
DOI: 10.1111/J.1465-3362.2012.00465.X
Abstract: People attending substance abuse treatment have an elevated risk of developing cardiovascular disease (CVD) and cancer. Consequently, there have been increasing calls for substance abuse treatment services to address smoking. The current study examined smoking behaviours of people attending residential substance abuse treatment. Additionally, the study examined rates of other potentially modifiable health risk factors for the development of CVD and cancer. A cross-sectional survey was completed by participants attending Australian Salvation Army residential substance abuse treatment services (n = 228). Rates of smoking, exercise, dietary fat intake, body mass index and depression were identified and compared with representative community populations. The relationship between length of treatment and changes in these variables was also examined. When compared with the Australian population, participants were much more likely to be current smokers. They also showed higher rates of dietary fat intake, and having had a previous diagnosis of a depressive disorder. Encouragingly, participants were more likely to be engaging in regular exercise. Over a third of all smokers reported having increased their smoking since attending the residential program, with correlational analysis suggesting that nicotine dependence was increasing the longer participants were in treatment. People attending substance abuse treatment show extremely high rates of smoking (77%). With the large majority of participants showing multiple risk factors for CVD, it is important that residential services consider strategies to address smoking and the other potentially modifiable health risk factors in an integrated fashion.
Publisher: Wiley
Date: 16-09-2023
DOI: 10.1111/DAR.13752
Publisher: Informa UK Limited
Date: 17-10-2014
Publisher: Springer Science and Business Media LLC
Date: 13-02-2019
Publisher: JMIR Publications Inc.
Date: 09-07-2020
DOI: 10.2196/15113
Abstract: Despite the importance and popularity of mutual support groups, there have been no systematic attempts to implement and evaluate routine outcome monitoring (ROM) in these settings. Unlike other mutual support groups for addiction, trained facilitators lead all Self-Management and Recovery Training (SMART Recovery) groups, thereby providing an opportunity to implement ROM as a routine component of SMART Recovery groups. This study protocol aims to describe a stage 1 pilot study designed to explore the feasibility and acceptability of a novel, purpose-built mobile health (mHealth) ROM and feedback app (Smart Track) in SMART Recovery groups coordinated by SMART Recovery Australia (SRAU) The secondary objectives are to describe Smart Track usage patterns, explore psychometric properties of the ROM items (ie, internal reliability and convergent and ergent validity), and provide preliminary evidence for participant reported outcomes (such as alcohol and other drug use, self-reported recovery, and mental health). Participants (n=100) from the SMART Recovery groups across New South Wales, Australia, will be recruited to a nonrandomized, prospective, single-arm trial of the Smart Track app. There are 4 modes of data collection: (1) ROM data collected from group participants via the Smart Track app, (2) data analytics summarizing user interactions with Smart Track, (3) quantitative interview and survey data of group participants (baseline, 2-week follow-up, and 2-month follow-up), and (4) qualitative interviews with group participants (n=20) and facilitators (n=10). Feasibility and acceptability (primary objectives) will be analyzed using descriptive statistics, a cost analysis, and a qualitative evaluation. At the time of submission, 13 sites (25 groups per week) had agreed to be involved. Funding was awarded on August 14, 2017, and ethics approval was granted on April 26, 2018 (HREC/18/WGONG/34 2018/099). Enrollment is due to commence in July 2019. Data collection is due to be finalized in October 2019. To the best of our knowledge, this study is the first to use ROM and tailored feedback within a mutual support group setting for addictive behaviors. Our study design will provide an opportunity to identify the acceptability of a novel mHealth ROM and feedback app within this setting and provide detailed information on what factors promote or hinder ROM usage within this context. This project aims to offer a new tool, should Smart Track prove feasible and acceptable, that service providers, policy makers, and researchers could use in the future to understand the impact of SMART Recovery groups. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000686101 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336. PRR1-10.2196/15113
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JSAT.2021.108542
Abstract: In iduals with substance use disorders (SUD) are at an elevated risk for suicide. Abstinence and drug-related treatment outcomes remain integral to SUD treatment, but recovery incorporates more than just the absence of substance use or mental illness and including positive mental health indices in assessment and treatment of suicidality is needed. The current study investigates the role of traditional indicators of recovery, as well as positive psychology constructs, in predicting suicidal ideation following residential SUD treatment. The study utilized a longitudinal design with baseline and 3-month postdischarge follow-up assessments of 791 in iduals who attended residential SUD treatment in Australia. Rates of suicidal ideation decreased from baseline to follow-up, and the magnitude of change in most indices was associated with suicidal ideation at follow-up assessment. In a hierarchical logistic regression, baseline suicidal ideation, as well as a reduction in psychological distress, increase in refusal self-efficacy, and increase in self-forgiveness, emerged as significant predictors of follow-up suicidal ideation. The final model correctly classified 98.8% of participants as not experiencing SI, and 8.7% of participants as experiencing SI at follow-up, resulting in a total predictive accuracy of 86.9%. The results suggested that changes in traditional recovery indices may facilitate reductions in suicidality. As a whole, changes in positive psychology indices did not add to the ability to predict suicidal ideation once traditional indices had been accounted for, but this does not preclude the importance of these indices to SUD treatment and suicide prevention efforts.
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670903107591
Abstract: Objective: Therapeutic homework has been recommended for use by mental health case managers to help patients with severe mental illness (SMI). The current research examined the actual use of homework by case managers working in clinical practice. Method: Case managers were trained in a systematic approach to homework administration and were provided with carbonized homework administration pads to assist with homework implementation. Hierarchical linear modelling was used to examine the relationship between homework and outcome for participants in the study (n = 129). Results: The total number of homework assignments administered to each patient predicted improvement on the Health of the Nation Outcome Scale (HoNOS) and Kessler 10. How well the homework was completed also predicted improvements on the HoNOS. The relationship between homework and recovery-orientated outcome measures was not significant. Conclusion: The present study provides preliminary support for the use of a systematic approach to homework administration procedures when working with SMI. Future research should examine strategies to promote the regular use of systematic homework administration procedures by mental health case managers.
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.PSYCHRES.2019.112499
Abstract: Health literacy comprises cognitive and social skills that enable people to understand health information and maintain good health. Research examining the health literacy of people living with mental illness is scarce. The aim of the present study was to identify distinct subgroups of health literacy in in iduals attending mental health treatment and determine if profiles and health literacy levels differ from other populations accessing healthcare services and on health characteristics. Participants (N = 325) were attending Neami National Australia services. Participants completed the multidimensional Health Literacy Questionnaire. Latent profile analysis was conducted to identify health literacy profiles. Participants reported lowest health literacy scores in appraising health information, navigating the healthcare system, and finding good health information. Three health literacy profiles were identified low (20.4%), moderate (61.3%), and high (18.3%). Compared to the other populations (i.e. private hospital patients, men with prostate cancer, older in iduals with diabetes, general population, people attending substance dependence treatment), the current s le tended to have lower health literacy scores. The findings highlight the need to increase overall health literacy and consider an in idualised approach to enhance specific health literacy domains.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.CHIABU.2016.10.001
Abstract: Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged in iduals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative s le of in iduals experiencing low housing stability. Data on adverse childhood experiences, adulthood interpersonal trauma and relevant covariates were collected through interviews at baseline (Wave 1). Latent class analysis (LCA) was conducted to identify distinct classes of childhood trauma history, which included physical assault, neglect, and sexual abuse. Multinomial logistic regression investigated childhood relevant factors associated with class membership such as biological relationship of primary carer at age 14 years and number of times in foster care. Of the total s le (N=1682), 99% reported traumatic adverse childhood experiences. The most common included witnessing of violence, threat/experience of physical abuse, and sexual assault. LCA identified six distinct childhood trauma history classes including high violence and multiple traumas. Significant covariate differences between classes included: gender, biological relationship of primary carer at age 14 years, and time in foster care. Identification of six distinct childhood trauma history profiles suggests there might be unique treatment implications for in iduals living in extreme social disadvantage. Further research is required to examine the relationship between these classes of experience, consequent impact on adulthood engagement, and future transitions though homelessness.
Publisher: Wiley
Date: 05-11-2020
DOI: 10.1111/DAR.13191
Publisher: Elsevier BV
Date: 12-2022
Publisher: Springer Science and Business Media LLC
Date: 10-02-2012
Start Date: 04-2019
End Date: 12-2023
Amount: $498,000.00
Funder: Australian Research Council
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