The self-medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self-medication factors occur in a context of self-regulation vulnerabilities--primarily difficulties in regulating affects, self-esteem, relationships, and self-care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self-medication hypothesis of addictive disorders. The cause-consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self-medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.

The Self-medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications

Motivational Interviewing: Preparing People for Change

We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.

A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems

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The Role of the Physical Environment in the Hospital of the 21 st Century: A Once-in-a-Lifetime Opportunity

The upshot of these needs for change is both dismaying and exciting, both disturbing in the destruction of long-familiar patterns of dealing with human suffering, and paradoxically hopeful in raising the possibility that significant failures in our health care systems of the past — limited access to medical care and grossly inadequate public sector “non-systems”, for example — may now be addressed more successfully.

Administration and policy in mental health

Over the last 15 years, social scientists increasingly have used focus groups as a method for collecting qualitative data. With focus groups, a moderator uses the group process with a small number of participants to stimulate discussion and obtain information on the beliefs, attitudes, or motivations of participants on a specific topic. Based upon a review of a sample of social work articles, researchers used focus groups to study a wide range of topics, with diverse and vulnerable populations, and in combination with other qualitative or quantitative methods. Although focus groups have limitations, they have the potential to be an important qualitative data collection method to capture information about the variety of issues and populations dealt with by the social work profession. In addition, social work researchers have the potential to further develop focus groups as a qualitative research method.

A Review of the Use and Potential of Focus Groups in Social Work Research

Participation in treatment planning can be one means of empowering clients. However, significant barriers exist to empowering people with severe mental illness through treatment planning. This qualitative study reviewed documents and conducted focus groups with clients and staff of a public psychiatric hospital to identify barriers to empowerment and the conditions that must be present for client empowerment to occur through treatment planning. The conditions for empowerment were based on both psychological and organizational factors. For empowerment to occur, clients need psychiatric stability and decision-making skills. Organizations promote empowerment by ensuring that clinical staff have the time to involve clients in treatment planning, promoting staff attitudes that are respectful of clients' ability to participate in treatment planning, providing clients with a range of treatment options, designing programs that have a strong philosophical commitment to client empowerment, and implementing programs properly.

Opportunities and Barriers to Empowering People with Severe Mental Illness through Participation in Treatment Planning

Mental health courts have recently emerged as one means to reduce the number of persons with mental illness in the criminal justice system. Using a post-test only comparison group design, this study examined rearrest rates for 1 year post discharge among three groups meeting admission criteria for a municipal mental health court. The rearrest rate of defendants who successfully completed the program (N = 351) was 14.5%, compared to 38% among defendants negatively terminated from the program (N = 137), and 25.8% among defendants who chose not to participate (N = 89). This positive result held even when controlling for a range of variables in a Cox regression survival analysis. Factors associated with rearrest are identified for each of the three groups.

Recidivism Outcomes for Suburban Mental Health Court Defendants

This study examines 122 ex-offenders who participated in Project ReConnect, a 6-month, voluntary, prisoner-reentry program for inmates who served their maximum prison sentence. The needs most frequently self-identified by program participants prior to their return into the community included transportation, clothing, food, housing, and employment or vocational training. To help address these needs, program participants had access to US$3,000. These funds were largely directed toward the self-identified needs, with the greatest portion of expenditures applied to housing. Social outcomes, including employment, housing, and substance abuse, are examined for program participants. The study found that many ex-offenders will seek assistance through reentry programs, even when participation is voluntary, and that they are capable of self-identifying their service needs.

https://journals.sagepub.com/doi/pdf/10.1177/0032885511409896

A Description of the Self-Identified Needs, Service Expenditures, and Social Outcomes of Participants of a Prisoner-Reentry Program

Forensic patients are occupying an increasingly large number of beds in state psychiatric hospitals. The presence of these mentally ill offenders has raised concerns about the risk they present to nonforensic patients. This study compared the rate of assaults and factors associated with assaultive behavior among 308 nonforensic patients and two groups of forensic patients including 469 patients found not guilty by reason of insanity and 76 pretrial patients. Consistent with other studies, nonforensic patients had higher rates of assaults than either group of forensic patients. However, being a forensic patient did not affect the odds of assault when controlling for the effects of demographic and clinical variables in a multivariate logistic regression analysis. Factors associated with assaults in each of the three patient groups were identified using multivariate analyses. Implications are presented for treatment of assaultive behavior, mixing of forensic and nonforensic patients within state hospitals, forensic release policies, and future research.

Donald M. Linhorst

Papers

A Review of the Use and Potential of Focus Groups in Social Work Research

Opportunities and Barriers to Empowering People with Severe Mental Illness through Participation in Treatment Planning

Recidivism Outcomes for Suburban Mental Health Court Defendants

A Description of the Self-Identified Needs, Service Expenditures, and Social Outcomes of Participants of a Prisoner-Reentry Program

Assaultive Behavior in State Psychiatric Hospitals Differences Between Forensic and Nonforensic Patients