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1.
Front Psychiatry ; 15: 1344020, 2024.
Article in English | MEDLINE | ID: mdl-39071224

ABSTRACT

Introduction: Persons with substance use disorders (SUD) make up a considerable proportion of mental health care service users worldwide. Since 2010, Belgian mental health care has undergone a nationwide reform ('Title 107') aiming to realize a mental health care system that fosters more intensive collaboration, strengthens the cohesion and integration across and between different services, and is more responsive to the support needs of all service users. Although persons with SUD were named as a prioritized target group, how this reform impacted the lives and recovery journeys of persons with SUD remains understudied. This study aims to investigate how persons with SUD, regardless of whether they have co-occurring mental health issues, experience the accessibility of mental health care in light of the 'Title 107' reform. Methods: Data were collected by means of in-depth interviews with a heterogeneous sample of persons with SUD (n=52), recruited from five regional mental health networks in Belgium. In-depth interviews focused on experiences regarding (history of) substance use, accessibility of services and support needs, and were analyzed thematically. Results: Five dynamic themes came to the fore: fragmentation of care and support, the importance of "really listening", balancing between treatment-driven and person-centered support, the ambivalent role of peers, and the impact of stigma. Discussion: Despite the 'Title 107' reform, persons with SUD still experience mental health care services as 'islands in the stream', pointing to several pressing priorities for future policy and practice development: breaking the vicious cycles of waiting times, organizing relational case management, tackling stigma and centralizing lived experiences, and fostering recovery-promoting collaboration.

2.
Subst Abuse Treat Prev Policy ; 19(1): 22, 2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38610049

ABSTRACT

INTRODUCTION: Research has established natural recovery (NR) as an important pathway to substance use recovery. Studies investigating correlates of NR have mainly focused on demographic and substance use variables rather than life circumstances. This study seeks to better understand the phenomenon of natural recovery by (i) validating the international scientific literature concerning demographic and substance use indicators of NR in Flanders and (ii) assessing the additional explanatory power of recovery strengths and barriers during active addiction, controlling for demographic and substance use covariates. METHODS: A total of 343 persons in recovery from alcohol or drug use problems (≥ 3 months) completed an online cross-sectional survey in Flanders. Participants in NR and in recovery after following treatment were compared using multivariate linear regression models. Reasons for not following treatment were analyzed using inductive thematic analysis. RESULTS: Higher education level, lower severity of dependence, and cannabis use as the main problem substance (vs. alcohol) were statistically significant (p < 0.05) correlates of NR. When scores for the number of barriers and strengths associated with active addiction were added, barriers (but not strengths) were significantly associated with NR. When barrier items were individually tested, having untreated emotional or mental health problems, having a driver's license revoked and damaging property were statistically significant correlates. The most reported reason for not entering treatment was not experiencing any need to do so. CONCLUSION: The results highlight the importance of a holistic approach to recovery support across multiple life domains. Limitations and opportunities for further research are discussed.


Subject(s)
Behavior, Addictive , Cannabis , Substance-Related Disorders , Humans , Cross-Sectional Studies , Ethanol , Substance-Related Disorders/epidemiology
3.
Front Psychiatry ; 15: 1352818, 2024.
Article in English | MEDLINE | ID: mdl-38577404

ABSTRACT

Background: Recovery-supportive interventions and strategies for people with substance use disorders are a cornerstone of the emergent recovery paradigm. As compared to other services, such approaches have been shown to be holistically focused and improve outcomes (e.g. substance use, supportive relationships, social functioning, and well-being). Even so, a comprehensive overview of the nature, extent, and range of research on the topic is lacking. Methods: A scoping review of the literature was conducted to characterize the main topics on recovery-supportive interventions. A systematic search was conducted in three databases: Scopus, Web of Science, and PubMed from January 2000 to July 2023 using the PRISMA-ScR. Twenty-five studies published between 2005-2022 met the inclusion criteria. Results: Most studies emanated from the United States, and we found a peak in publication frequency between 2018-2022 (n = 13) relative to other years. The most prominent lines of inquiry appear to concern recovery-oriented policies; principles of recovery-oriented services (challenges encountered when implementing recovery-oriented practices, relationships with service providers characterized by trust, and service user-service provider collaboration), and recovery capital (particularly recovery-supportive networks, employment, and housing). Seventeen studies addressed co-occurring disorders, and eight addressed substance use recovery. Conclusion: To advance the field, more context-specific studies are required on supporting peer professionals, (including enabling cooperation with service users, and hiring experts by experience as staff), and training of professionals (e.g., nurses, psychologists, social workers, physicians) in the principles of recovery.

4.
Drug Alcohol Rev ; 2024 Mar 19.
Article in English | MEDLINE | ID: mdl-38501257

ABSTRACT

ISSUES: Self-change from alcohol and drug use problems is increasingly acknowledged in research. Despite the growing number of published studies, the most recent broad review of this dispersed field dates back to 2010. The present review narratively synthesises key findings from empirical studies and critically identifies research gaps and directions for further research. APPROACH: Following the PRISMA guidelines for scoping reviews, a systematic search was conducted in multiple scientific databases, resulting in the identification of 56 relevant articles with explicit empirical results on self-change. KEY FINDINGS: The scoping review presents findings related to: (i) methods and definitions used; (ii) the prevalence of self-change; (iii) indicators of self-change; (iv) the process of self-change; and (v) population views on self-change. CONCLUSION: The review highlights the significant growth in research on self-change considering key themes as well as the need for a relational and time-bound approach to self-change in research and practice.

5.
J Int Assoc Provid AIDS Care ; 23: 23259582241236260, 2024.
Article in English | MEDLINE | ID: mdl-38446992

ABSTRACT

Adherence to antiretroviral therapy (ART) is lower in adolescents with HIV (AWH) than in any other age group, partly due to self-regulatory challenges during development. Mindfulness and acceptance training have been shown to support psychological flexibility, a self-regulatory skill that potentially improves adolescent adherence to medication. We assessed the effect of weekly group-based mindfulness and acceptance training sessions on ART adherence among older adolescents (15-19 years) in Kampala, Uganda. One hundred and twenty-two AWH (median age 17, range 15-19 years, 57% female) receiving care at a public health facility in Kampala were randomized 1:1 to receive 4 weekly 90-min group sessions facilitated by experienced trainers or standard-of-care ART services. The training involved (Session 1) clarifying values, (Session 2) skillfully relating to thoughts, (Session 3) allowing and becoming aware of experiences non-judgmentally, and (Session 4) exploring life through trial and error. At baseline, postintervention, and 3-month follow-up, psychological flexibility was measured using the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8), and self-reported ART adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8). At baseline, the intervention and standard-of-care arms had similar psychological flexibility (AFQ-Y8 score:15.45 ± 0.82; 15.74 ± 0.84) and ART adherence (MMAS-8 score: 5.32 ± 0.24; 5.13 ± 0.23). Retention through the study was moderate (71%). Completion of mindfulness and acceptance training was associated with a significant reduction in psychological inflexibility at the 3-month follow-up (AFQ-Y8 score: 12.63 ± 1.06; 14.05 ± 1.07, P = .006). However, no significant differences were observed in self-reported adherence to ART at the 3-month follow-up (MMAS-8 score: 5.43 ± 0.23; 4.90 ± 0.33, P = .522). Group-based mindfulness and acceptance training improved psychological flexibility in this population of adolescents on ART in Uganda but did not significantly improve ART adherence. Future research should explore integrated approaches that combine behavioral management training with other empowerment aspects to improve ART adherence among AWH.


Subject(s)
HIV Infections , Mindfulness , Humans , Adolescent , Female , Young Adult , Adult , Male , Uganda , HIV Infections/drug therapy , Awareness , Patient Compliance
6.
Front Psychiatry ; 14: 1205362, 2023.
Article in English | MEDLINE | ID: mdl-38076696

ABSTRACT

Introduction: Structural inequity and stigma impose barriers toward substance use prevention and recovery support for persons with an Islamic migration background in non-Islamic majority countries. Similar issues of differential power often keep them silenced in research. Therefore, we explore the continuum of care for substance use problems regarding persons with an Islamic migration background. Methods: We draw from a co-creative case study with Arafat, whose lived and professional experiences as a Muslim with a history of problem substance working in the field, were blended with academic literature through the process of 'plugging in'. Results: We discuss (1) culturally competent and selective substance use prevention, (2) facilitating access to adequate support services, (3) culturally competent substance use treatment and (4) supporting long-term recovery for persons with an Islamic background from a combined academic, professional and lived experiences perspective. Discussion: We discuss the need for tailored interventions that are able to overcome structural inequities and address ethnocultural sensitivities, needs and strengths. Intermediary community organizations, cultural competence of treatment and recovery-oriented systems of care may bridge the gaps between what is needed and what is available. However, it is important to be conscious that hands-on solutions at the personal level do not absolve the responsibility of searching for systemic solutions. Furthermore, awareness of the fine line between cultural competence and culturalization, taking into account the danger of essentializing, othering and overlooking other intersectional traits of diversity, is needed.

7.
Drug Alcohol Depend ; 253: 111017, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-37995391

ABSTRACT

BACKGROUND: Substance use disorders (SUD) pose significant challenges for healthcare systems, and there is a need to monitor the provision of effective, individualized care to persons accessing treatment. Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) are increasingly used in healthcare services to measure treatment outcomes and quality of care as perceived by patients, and to guide service improvement. OBJECTIVES: This review aims to identify and characterize international developments regarding the use and systematic implementation of PROMs and PREMs in SUD treatment services. METHODS: A scoping review was conducted searching multiple databases to identify studies on the use and routine implementation of PROMs and PREMs in SUD treatment services. RESULTS: 23 articles were selected, all dating from 2016 onwards. There was large variation in the patient-reported measures that were used, how they were developed and how and when patient-reported data were collected. Treatment providers identified leadership support, the presence of an integrated electronic patient record, and regular feedback to be the most important facilitators of successful implementation of patient-reported measures into clinical practice, whilst treatment dropout and burden to staff and patients were the most important barriers to consider. CONCLUSIONS: PROMs and PREMs are increasingly used in SUD treatment services, but guidance is needed to support researchers and clinicians in selecting and implementing valid, meaningful, and comparable measures if we want to understand the effects of PROM and PREM data collection and feedback on treatment quality and results.


Subject(s)
Substance-Related Disorders , Humans , Treatment Outcome , Data Collection , Substance-Related Disorders/therapy , Patient Reported Outcome Measures
8.
Subst Abuse Treat Prev Policy ; 18(1): 40, 2023 07 05.
Article in English | MEDLINE | ID: mdl-37408038

ABSTRACT

BACKGROUND: Much remains unknown about the dynamics of substitute behaviors during addiction recovery among persons attending recovery support groups. Insight into the nature, motives for, and course of substitute behaviors could help to shape recovery support and harm reduction services. METHODS: Twenty-three semi-structured in-depth interviews (n = 14 males and n = 9 females) were conducted with a convenience sample of Narcotics Anonymous attendees from a number of groups in the Western Cape, South Africa. Participants ranged in age from 22-55 years (M = 39.3, SD = 9.35). RESULTS: Thematic analysis yielded four themes: (i) substance-to-substance substitution; (ii) substance-to-behavior substitution; (iii) substitute behaviors and harm (reduction) and (iv) support needs to manage and resolve substitute behaviors. According to the study, participants' substitute behaviors developed across recovery stages; were temporary or long-term replacements for substance use disorders and were engaged for distraction, isolation from others, calming, assuaging boredom, keeping occupied, filling a perceived experiential void, modifying mood and to self-medicate. While substitutes were utilized for harm reduction or relapse prevention, the potential for ostensibly healthy behaviors to threaten recovery and lead to relapse was also recognized. CONCLUSIONS: Self-monitoring, ongoing vigilance, and awareness of when substitutes become genuine addictions are critical for timely, suitable interventions.


Subject(s)
Substance-Related Disorders , Male , Female , Humans , Young Adult , Adult , Middle Aged , South Africa , Substance-Related Disorders/therapy , Self-Help Groups , Motivation , Narcotics
9.
Int J Drug Policy ; 118: 104087, 2023 08.
Article in English | MEDLINE | ID: mdl-37307786

ABSTRACT

BACKGROUND: The number of migrants in the European Union (EU) has been growing, including migrants at risk of using drugs. Little information is available on the actual drug use among first-generation migrants who use drugs in the EU, nor on their access to drug dependency services. This study aims to reach consensus among experts in the EU on the current situation regarding vulnerable migrants who use drugs in the EU and to develop a set of actionable recommendations. METHODS: Between April and September 2022, a panel of 57 experts on migration and/or drug use, working in 24 countries, participated in a three-stage Delphi study to develop statements and recommendations about drug use and access to healthcare services for migrants who use drugs in the EU. RESULTS: High levels of agreement were reached on the 20 statements (mean=98.0%) and 15 recommendations (mean=99.7%). The recommendations focus on four main topics; 1) increasing data availability and quality, to inform guidelines; 2) increasing the availability of drug dependency services for migrants, including screening for mental health issues and involving migrants who use drugs in the development of services; 3) eliminating country and service level barriers for accessing these services, as well as providing migrants who use drugs with suitable information, and combating stigma and discrimination; 4) the need for increased collaboration among and within EU countries regarding healthcare for migrants who use drugs, at the policy level as well as the service level, including civil society organisations, peer navigation and multilingual cultural mediators. CONCLUSION: Policy action and increased collaboration are required by the EU as a whole and by individual EU member states, in addition to collaboration among healthcare providers and social welfare services, to increase access to healthcare services for migrants who use drugs.


Subject(s)
Substance-Related Disorders , Transients and Migrants , Humans , European Union , Health Services Accessibility , Europe , Health Services , Substance-Related Disorders/epidemiology
10.
Psychosoc Interv ; 32(1): 21-31, 2023 01.
Article in English | MEDLINE | ID: mdl-37361629

ABSTRACT

Quality of life (QOL) has gained increased interest as a critical pathway to better understanding the lives and circumstances of children and adolescents in both the general population and among specific populations. Yet, QOL assessment among youngsters in youth care services remains a highly under-researched topic. This study examines the suitability and psychometric properties of a new QOL self-report scale for adolescents between 12 and 18 years old in youth care: the Quality of Life in Youth Services Scale (QOLYSS). The provisional version of the QOLYSS was pre-tested in a sample of 28 adolescents in youth care to examine its applicability and feasibility. Next, a comprehensive evaluation of the psychometric properties of the field-test version was conducted in a sample of 271 adolescents in youth care in Flanders, Belgium (M = 15.43, SD = 1.73). Classical item and factor analyses were carried out per subscale, (test-retest) reliability and item-discriminant validity of the subscales were examined, convergent validity was explored, and confirmatory factor analysis was used to examine the goodness-of-fit of different measurement models. Reliability measures of the scale are satisfactory, results are indicative of convergent validity, and confirmatory factor analysis provides evidence for the eight correlated factors model. Future lines of research concerning the ongoing development and application of the QOLYSS are discussed.


La calidad de vida (CV) ha despertado un mayor interés como un modo esencial de comprender mejor la vida y circunstancias de niños y adolescentes tanto en población general como específica. No obstante, la evaluación de la CV de los jóvenes en servicios de atención juvenil sigue siendo un tema poco investigado. El presente studio analiza la adecuación y las propiedades psicométricas de una nueva escala de autoinforme de la CV para adolescentes entre los 12 y 18 años de edad en servicios para jóvenes: la Escala de Calidad de Vida en los Servicios Juveniles (QOLYSS, según sus siglas en inglés). Se realizó una prueba piloto con la versión provisional de la QOLYSS con una muestra de 28 adolescentes en servicios de atención a jóvenes para ver en qué medida era aplicable y factible. Luego se llevó a cabo una evaluación general de las propiedades psicométricas de la versión de campo de la prueba con una muestra de 271 adolescentes en servicios de atención a jóvenes en Flandes, Bélgica (M = 15.43, SD = 1.73). Se llevó a cabo un análisis clásico de ítems y análisis factoriales por subescalas, se examinó la fiabilidad (test-retest) y la validez discriminante de los ítems por subescalas, se exploró la validez convergente y se utilizó análisis factorial confirmatorio para analizar el ajuste de diferentes modelos de medida. Las medidas de fiabilidad de la escala son satisfactorias y los resultados son indicativos de validez convergente, a la vez que el análisis factorial confirmatorio muestra un modelo de ocho factores correlacionados. Se discute sobre las futuras líneas de investigación en relación con el desarrollo actual y aplicación de la QOLYSS.

11.
J Subst Use Addict Treat ; 148: 209025, 2023 05.
Article in English | MEDLINE | ID: mdl-36935065

ABSTRACT

BACKGROUND: The COVID-19 pandemic and measures have placed various burdens on societies and individuals. Emerging evidence suggests that people in drug addiction recovery were negatively affected. This study investigates whether risk and protective factors associated with return to problematic substance use differed between the periods before and during the pandemic for those in recovery. METHODS: A convenience sample of persons in drug addiction recovery for at least three months completed an assessment at baseline before the pandemic (T0, N = 367) and at two consecutive follow-ups 12 months apart (T1, N = 311; T2, N = 246). The final follow-up took place during the pandemic (2020-2021). We analyzed rates and predictors of problematic substance use in both periods, and whether relations between predictors and problematic use differed between the periods. RESULTS: Rates of problematic use did not differ significantly before and during the pandemic for those who were followed-up. However, the relationship between problematic use and commitment to sobriety differed between both periods (OR = 3.24, P = 0.010), as higher commitment was only associated with lower odds of problematic use during (OR = 0.27, P < 0.001), but not before, the pandemic (OR = 0.93, P = 0.762). In both periods, persons who were engaged in psychosocial support had lower odds of problematic use. CONCLUSIONS: The COVID-19 pandemic was not followed by significant return to problematic substance use in a cohort of people who were already in drug addiction recovery for some time before the pandemic. However, with restricted access to environmental resources, they may have been more dependent on internal motivations. Targeting personal recovery resources with interventions could therefore reduce the chances of return to problematic substance use during a pandemic.


Subject(s)
COVID-19 , Substance-Related Disorders , Humans , Prospective Studies , Belgium/epidemiology , Netherlands/epidemiology , COVID-19/epidemiology , Substance-Related Disorders/epidemiology , United Kingdom/epidemiology
12.
PLOS Glob Public Health ; 3(3): e0001605, 2023.
Article in English | MEDLINE | ID: mdl-36963093

ABSTRACT

The dual burden of living with HIV and negotiating life stage changes has been identified as a contributing factor to lapsed adherence among adolescents with HIV in sub-Saharan Africa. While psychosocial support can promote medication adherence, most interventions in use with adolescents were originally developed for the general population creating a gap in appropriate support. Life-stage-appropriate, evidence-based psychosocial support interventions have been used with young people in high-income contexts, prompting interest in their use in low-income contexts. However, many interventions are less effective when implemented outside of their original settings, hence the need for modifications before implementation. We aimed to culturally adapt an evidence-based psychosocial support intervention designed to improve the mental health of young people for use among adolescents with HIV in a sub-Saharan African context and to explore the acceptability of the adapted intervention among adolescents. We engaged thirty stakeholders (n = 30) in Kampala, Uganda including psychologists, psychiatrists, social workers, HIV counselors, religious leaders and adolescent peers from December 2021 to April 2022 to modify an evidence-based intervention for adolescents. Key adaptations included simplifying the language, adding local practices, integrating locally relevant slang and stories into therapy, introducing racially-congruent visuals and cards representing emotions, and adjusting therapy materials for use in resource-constrained settings. We then tested the acceptability of the intervention in a small sample of service users using a qualitative approach. We recruited nine adolescents with HIV from a participating clinic in Kampala, delivered six 90-minute sessions of the adapted intervention across three weeks and conducted in-depth interviews to assess the acceptability of the intervention. We used thematic analysis to analyze the qualitative data. The adapted intervention was perceived as acceptable among adolescents with HIV, with many stating that it helped them overcome fears, increased their self-acceptance, and gave them the confidence to make careful health-enhancing decisions.

13.
Arch Womens Ment Health ; 26(1): 11-27, 2023 02.
Article in English | MEDLINE | ID: mdl-36689029

ABSTRACT

Chewing khat during pregnancy adversely affects maternal and fetal health, but available studies are scarce and inconsistent, and it is difficult to conclude the relationship between khat consumption and perinatal outcomes. We aimed to investigate the available studies on the effect of khat use during pregnancy on perinatal and maternal outcomes. For this meta-analysis, we conducted a thorough search of articles published in PubMed, Embase, Scopus, and Web of Science up to the date this search was undertaken (03.01.2022). We used random effect model with the Mantel-Haenszel method to calculate the pooled odds ratio and mean difference. We found that khat use during pregnancy was significantly associated with increased odds of low birth weight (OR:2.51; 95% CI: 1.60 to 3.94), congenital anomalies (OR:3.17; 95% CI: 1.30 to 7.73), premature rupture of membrane (OR: 1.99; 95% CI: 1.59 to 2.50), perinatal mortality (OR: 1.95; 95% CI: 1.26 to 3.03), and lower APGAR scores at the fifth minute (MD: -1.7; 95% CI: -2.32 to -1.07). Also, increased odds for developing maternal psychological stress and anemia were reported in women using khat during pregnancy. There were no statistically significant differences in stillbirth and preterm birth between women using khat during pregnancy and their counterparts. Since prenatal khat use is associated with adverse perinatal and maternal outcomes, we strongly recommend equitable and easily accessible health services through the implementation of integrated addiction treatment with maternity services to address khat use during pregnancy and encourage the practice of healthy behavior of women.


Subject(s)
Premature Birth , Pregnancy , Infant, Newborn , Female , Humans , Premature Birth/epidemiology , Catha/adverse effects , Stillbirth , Infant, Low Birth Weight , Prenatal Care/methods , Pregnancy Outcome/epidemiology
14.
Interv. psicosoc. (Internet) ; 32(1): 21-31, enero 2023. tab, graf
Article in Spanish | IBECS | ID: ibc-214948

ABSTRACT

Quality of life (QOL) has gained increased interest as a critical pathway to better understanding the lives and circumstances of children and adolescents in both the general population and among specific populations. Yet, QOL assessment among youngsters in youth care services remains a highly under-researched topic. This study examines the suitability and psychometric properties of a new QOL self-report scale for adolescents between 12 and 18 years old in youth care: the Quality of Life in Youth Services Scale (QOLYSS). The provisional version of the QOLYSS was pre-tested in a sample of 28 adolescents in youth care to examine its applicability and feasibility. Next, a comprehensive evaluation of the psychometric properties of the field-test version was conducted in a sample of 271 adolescents in youth care in Flanders, Belgium (M = 15.43, SD = 1.73). Classical item and factor analyses were carried out per subscale, (test-retest) reliability and item-discriminant validity of the subscales were examined, convergent validity was explored, and confirmatory factor analysis was used to examine the goodness-of-fit of different measurement models. Reliability measures of the scale are satisfactory, results are indicative of convergent validity, and confirmatory factor analysis provides evidence for the eight correlated factors model. Future lines of research concerning the ongoing development and application of the QOLYSS are discussed. (AU)


La calidad de vida (CV) ha despertado un mayor interés como un modo esencial de comprender mejor la vida y circunstancias de niños y adolescentes tanto en población general como específica. No obstante, la evaluación de la CV de los jóvenes en servicios de atención juvenil sigue siendo un tema poco investigado. El presente studio analiza la adecuación y las propiedades psicométricas de una nueva escala de autoinforme de la CV para adolescentes entre los 12 y 18 años de edad en servicios para jóvenes: la Escala de Calidad de Vida en los Servicios Juveniles (QOLYSS, según sus siglas en inglés). Se realizó una prueba piloto con la versión provisional de la QOLYSS con una muestra de 28 adolescentes en servicios de atención a jóvenes para ver en qué medida era aplicable y factible. Luego se llevó a cabo una evaluación general de las propiedades psicométricas de la versión de campo de la prueba con una muestra de 271 adolescentes en servicios de atención a jóvenes en Flandes, Bélgica (M = 15.43, SD = 1.73). Se llevó a cabo un análisis clásico de ítems y análisis factoriales por subescalas, se examinó la fiabilidad (test-retest) y la validez discriminante de los ítems por subescalas, se exploró la validez convergente y se utilizó análisis factorial confirmatorio para analizar el ajuste de diferentes modelos de medida. Las medidas de fiabilidad de la escala son satisfactorias y los resultados son indicativos de validez convergente, a la vez que el análisis factorial confirmatorio muestra un modelo de ocho factores correlacionados. Se discute sobre las futuras líneas de investigación en relación con el desarrollo actual y aplicación de la QOLYSS. (AU)


Subject(s)
Humans , Adolescent , Quality of Life , Adolescent
15.
Int J Offender Ther Comp Criminol ; 67(6-7): 618-639, 2023 05.
Article in English | MEDLINE | ID: mdl-34114487

ABSTRACT

In recent years, a growing trend to consider strengths and protective factors in studies on desistance from crime has emerged. The present study explores three formerly detained adolescents' narratives, aiming to tease out how Quality of Life (QoL) and desistance interact in pathways towards a "better life." The narratives suggest that the journey towards a better life is highly individual, and may unfold via multiple pathways characterized by an ambivalent relationship between QoL and desistance. Alongside the importance of individual aspects and social support, societal barriers and opportunities play a significant role in creating new chances to re-build a life and prosocial identities. This reflects earlier findings that desistance is not an individual responsibility. It is essential to support young people to overcome societal barriers that impede participation in society and living a good life. This research adds to growing evidence of strengths-based approaches to rehabilitation, such as the Good Lives Model (GLM).


Subject(s)
Crime , Quality of Life , Humans , Adolescent , Social Support , Social Behavior
16.
Adicciones ; 0(0): 1891, 2023 Nov 29.
Article in English, Spanish | MEDLINE | ID: mdl-39033521

ABSTRACT

Quality standards have been recognized as an important tool for improving the quality of drug use prevention, treatment, and harm reduction services and for bridging the gap between science and practice. The aim of this paper is to describe the state of implementation of quality standards in drug demand reduction in the European Union and to identify barriers, needs, and challenges to implementation and future pathways. Between June and November 2021, an online survey (n = 91) and follow-up interviews (n = 26) were conducted with key informants - experts in drug demand reduction and quality assurance. Data were analyzed using descriptive statistics and thematic analysis. The survey showed that most countries have implemented the European Drug Prevention Quality Standards (EDPQS) in the prevention domain and the Minimum Quality Standards (MQS) in drug demand reduction. A variety of standards are applied in the treatment area and the EQUS minimum quality standards are widely known. The application of quality standards is least reported in the harm reduction service area. Mentioned challenges and barriers to implementation included lack of funding, unrecognized importance of evaluation, professional competencies, and system fragmentation. Mentioned supportive factors included appropriate materials and training, as well as political support and professional networks. The study shows that quality standards are inconsistently implemented in all areas of drug demand reduction. According to respondents, implementation could be improved by advocating for the need to implement quality standards, ensuring sustainable funding for interventions, and providing education and training.


Los estándares de calidad constituyen una herramienta para mejorar la calidad de la prevención, el tratamiento, y la reducción de daños del uso de drogas y para unificar ciencia y práctica. Este artículo tiene como objetivo describir el estado de la implementación de los estándares de calidad en la reducción de la demanda de drogas en la Unión Europea e identificar las barreras, las necesidades y los desafíos para su implementación. Entre junio y noviembre (2021) se realizó una encuesta en línea (n = 91) y entrevistas de seguimiento (n = 26) con informantes clave, expertos en reducción de la demanda de drogas y sistemas de garantías de calidad. Se emplearon estadísticos descriptivos y análisis temáticos. La mayoría de los países ha implementado los Estándares europeos de calidad en prevención de drogas (EDPQS) en el ámbito de la prevención y las Normas mínimas de calidad (MQS) en la reducción de la demanda de drogas. En el área de tratamiento, los estándares mínimos de calidad EQUS son ampliamente conocidos. La aplicación de estándares de calidad es menor en la reducción de daños. Se identificaron distintos retos y barreras: la falta de financiación e importancia concedida a la evaluación, las competencias profesionales y la fragmentación del sistema. Los factores de apoyo fueron materiales y formación, apoyo político y redes profesionales. Los estándares de calidad no se implementan en todas las áreas de reducción de la demanda de drogas. Los informantes clave sugirieron la necesidad de fomentar la implementación de los estándares de calidad, asegurar financiación y formación.

17.
Article in English | MEDLINE | ID: mdl-36554272

ABSTRACT

This study investigated whether drug dealing juvenile offenders in Belgium differ from non-drug dealers in levels of violent and non-violent offending behaviors, aggression, substance use, and mental health needs. The current study examined data from 226 16- to 17-year-old male juvenile offenders. Information relating to drug dealing, substance use, and mental health needs were collected through self-report questionnaires. A structured diagnostic interview was used to collect information about past violent and non-violent behaviors. Chi-square tests and multivariate analysis of variance compared non-dealers and dealers and explored if hard-drug dealers and soft-drug dealers differed from each other. Relative to non-drug dealers, drug dealers engaged in more violent offending behaviors, exhibited higher levels of aggression, substance use and oppositional defiant problems, and displayed lower levels of anxiety. Soft- and hard-drug dealers did not differ from each other. To conclude, detained drug dealers are characterized by severe antisocial behavior.


Subject(s)
Criminals , Juvenile Delinquency , Substance-Related Disorders , Humans , Male , Adolescent , Criminals/psychology , Belgium/epidemiology , Mental Health , Jails , Violence , Aggression , Substance-Related Disorders/epidemiology , Juvenile Delinquency/psychology
18.
Int J Ment Health Syst ; 16(1): 50, 2022 Oct 14.
Article in English | MEDLINE | ID: mdl-36242059

ABSTRACT

BACKGROUND: The recovery processes of persons with complex mental health needs take a slow and unpredictable course. Despite the fact that a number of essential building blocks of recovery in this population have been identified (e.g. social relationships, treatment, personal beliefs), the actual process of recovery in persons with complex mental health needs largely remains a black box. The aim of this study was to gain insight into how the recovery processes of persons with complex mental health needs take place, by applying a relational geographical approach and scrutinizing the place-making dynamics of one low-threshold meeting place in Belgium engaging with this group. METHODS: Data collection took place during the height of the COVID-19 pandemic by means of 11 in-depth interviews with different involved actors (service users, staff members, volunteers) and analyzed thematically. RESULTS: Results showed how the daily practice of the meeting place is continuously reproduced through place-making rituals that create an inclusive space of hospitality, are fueled by creative processes and form an indispensable counterweight for service users' mental health needs. CONCLUSIONS: To further open up the 'black box' of recovery in persons with complex mental health needs, it is vital to focus our analytic gaze onto recovery as a dynamic and relational practice.

19.
Front Psychiatry ; 13: 941384, 2022.
Article in English | MEDLINE | ID: mdl-36111302

ABSTRACT

Background: Gender inequity is a pervasive challenge to health equity on a global scale, and research shows the impact of sex and gender on substance use regarding for example epidemiology, treatment needs, treatment admission and treatment outcomes. The gender-transformative approach to action and health indicates that health interventions may maintain, exacerbate or reduce gender-related health inequalities, depending on the degree and quality of gender-responsiveness within the programme or policy. However, research shows a lack of gender-responsive initiatives in the alcohol and drug addiction field. Aims: The purpose of this study is to explore in depth how alcohol and drug treatment can be made more sensitive to female users' treatment needs from the perspective of service providers. Consequently, study findings can inform the development of gender-responsive treatment options and aid to a deeper understanding of how these trends are designated on the continuum of approaches to action and health in the alcohol and drug field. Methods: Four focus groups were organized across different regions in Belgium with a total of 43 participants, including service providers, policy makers and women who use(d) drugs. Results: The perspective of the participants on substance use prevention and treatment for female users incorporates some crucial gender-specific and gender-transformative features. Next to implementing mother-child options, a holistic approach, experts by experience and empowering women in treatment, professionals report the relevance of awareness raising campaigns targeting all levels and sectors in society. Also, recurring attention was given to the role of men in the narratives of female users. Conclusion: Study findings show that the field of alcohol and drug prevention and treatment is being looked at through the lens of gender-responsiveness. However, to achieve improvement in the lives of both women and men, and hence creating more equal chances and opportunities in substance abuse treatment, the gender-transformative approach in addiction care needs to be further explored, criticized and established in practice and future research.

20.
Subst Abuse Treat Prev Policy ; 17(1): 21, 2022 03 14.
Article in English | MEDLINE | ID: mdl-35287696

ABSTRACT

BACKGROUND: There is growing evidence on the importance of a gendered understanding of recovery. Gender differences have been reported in relation to the nature and extent of substance use, pathways to and through substance use disorder and recovery capital acquisition and maintenance. There is little existing research on factors associated with recovery capital growth by gender. METHODS: The current paper uses the European Life in Recovery database to assess specific domains of the Strengths and Barriers Recovery Scale (SABRS) that best predict growth of recovery capital amongst people in recovery from drug addiction. The 1313 participants were drawn from the REC-PATH study and recruited by the Recovery Users Network (RUN) from across Europe. Bivariate and multivariate analyses were performed to identify relationships between specific SABRS items and gender, as well as differences in the dimensions of the SABRS scale most likely to predict recovery capital growth by gender. RESULTS: Between their time in active addiction and in recovery, females show greater growth in strengths, despite females reporting fewer recovery strengths during active addiction than males, and males have greater reductions in barriers to recovery compared to females. Multivariate analyses show that strengths specifically related to prosocial meaningful activities are found to be highly significant for growth of recovery capital amongst males, whereas strengths related to both prosocial meaningful activities and general health management seem particularly relevant for growth of recovery capital amongst females. CONCLUSIONS: We conclude that this further demonstration of gender differences in recovery pathways should suggest gender-specific approaches adopted in recovery community organisations to address these different needs.


Subject(s)
Behavior, Addictive , Substance-Related Disorders , Europe , Female , Humans , Male , Sex Factors , Substance-Related Disorders/epidemiology
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