Compared to the general population, persons entering addiction treatment are three to four times more likely to be tobacco dependent and even addiction treatment staff members are two to three times more likely to be tobacco dependent. In these settings, tobacco use continues to be the norm; however addiction treatment programs are increasingly aware of the need to assess for and treat tobacco dependence. The problem is a cultural issue that is so ingrained that assumptions about tobacco use and dependence in addiction treatment are rarely questioned. Denial, minimization, and rationalization are common barriers to recovery from other addictions; now is the time to recognize how tobacco use and dependence must be similarly approached. This article describes the Addressing Tobacco through Organizational Change (ATTOC) model which has successfully helped many addiction treatment programs to more effectively address tobacco use. The article will review the six core strategies used to implement the ATTOC intervention, the 12-Step approach guiding the model, and describe a case study where the intervention was implemented in one clinic setting. Other treatment programs may use the experience and lessons learned from using the ATTOC organizational change model to better address tobacco use in the context of drug abuse treatment.
Thirty female subjects were followed up an average of 4.6 years after being hospitalized for anorexia nervosa. Insight into illness, symptoms, and treatment was rated for index hospitalization and assessed at follow up using the Schedule for Assessment of Insight. In addition, subjects were interviewed and assessed for level of function, symptoms of eating disorders, and the presence of significant psychopathology. The Insight Rating at index hospitalization was correlated with the Global Insight Score at follow up and with EAT score at follow up. Subjects with longer lengths of stay and greater increase in Body Mass Index during index hospitalization had higher levels of insight at both times of measurement. At followup, both Global Insight Score and assessment of subjects' ability to acknowledge illness were correlated with a variety of positive outcome measures, suggesting that insight may be an important therapeutic factor to consider in assessment and treatment of anorexia nervosa.
Objective: The current study sought to examine the relationships among mental health/substance use severity, self-esteem, and components of self-stigma among individuals with co-occurring schizophrenia-spectrum and substance use disorders. Stereotype concurrence, or the internalization of negative preconceptions associated with membership in a stigmatized group, was hypothesized as a mediator. Methods: Forty-nine subjects with co-occurring schizophrenia-spectrum and substance use disorders completed self-stigma, mental health, substance use, and self-esteem assessments. A multiple regression was employed to identify direct effects. Bootstrap mediator analyses were used to identify indirect effects through the hypothesized mediator: stereotype concurrence. Results: Aside from polysubstance dependence (49%), most subjects had a diagnosed co-occurring alcohol use disorder (43%). Dysphoria and alcohol severity were negatively related to self-esteem. Stereotype concurrence mediated the relationship between autistic preoccupation and self-esteem. Conclusions: Self-stigma was related to decreased self-esteem in individuals with a diagnosed co-occurring schizophrenia-spectrum and substance use disorder, which is consistent with previous findings that have linked self-stigma to decreased self-esteem in individuals with either disorder alone. Decreased self-esteem has been linked to treatment noncompliance and relapses, impeding recovery, while improvements in self-esteem have been shown to be an important consequence of stigma reduction. Treatment implications are discussed
Introduction: Individuals with chronic mental illness and addiction have poorer health outcomes than the general population, largely because of preventable medical conditions. Early onset and heightened incidence of chronic disease—such as type two diabetes, chronic obstructive pulmonary disease, and hypertension—might limit behavioral health consumers’ quality life years and ultimately lead to early mortality. These health risks are exacerbated by coinciding poor health correlates such as low socioeconomic status, disrupted cycles of care, and substance use. Primary and Behavioral Health Care Integration (PBHCI) initiatives address these compounding health disparities by improving access to quality primary care and wellness services inside of behavioral health centers. As opposed to traditional integrated care models in which behavioral health services are co-located in medical settings, reverse integration targets consumers with serious and persistent mental illness who are more likely to frequent behavioral health care settings. Recently, this model of reverse integrated care delivery has been on the rise because of its unique capacity to meet the complex needs of behavioral health consumers... The current study employs semi-structured individual interviews to assess behavioral health consumers’ perceived barriers to and engagement in PBHCI services at an urban community mental health center
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.