Using Drugs or Non-Drugs Alternatives to Alter Mental States in the Online, Virtual Era.

Background: In the 1970s a body of literature was generated advocating the alternatives approach for drug misuse prevention and rehabilitation which encouraged healthy nonchemical behaviors leading to reinforcing moods. Although this behaviorally oriented approach was overshadowed with the popularity of cognitive therapy in the 1980s, many of the recommended alternative behaviors remain embedded in cognitive approaches for drug misuse prevention and rehabilitation. One objective of the present study was to replicate, in part, two studies conducted in the 1970s which examined usage patterns of non-drug alternatives. A second objective was to explore of the use of newer technologies like the internet and the smartphone to alter emotional states. A third objective was to examine perceived stress and discrimination experiences on preferences for drug and non-drug alternatives. Methods: Three questionnaires were administered: use of drugs and non-drug alternatives in response to everyday emotions; the Everyday Discrimination Scale; and the Perceived Stress Scale. A total of 483 adults participated; their mean age was 39 years. Results: The results revealed that non-drug alternatives were preferred to drugs in treating experiences of anxiety, depression, and hostility, and to induce pleasure. Drugs were used most often to deal with pain. Experiences of discrimination increased perceptions of stress, and stress, in turn, affected the use of drugs to cope with a range of emotions. Social media and virtual activities were not preferred methods for altering negative moods. Conclusions: Social media may actually be a contributor or cause of distress, rather than a means for reducing it.

Attitudes toward psychotropic medications.

Attitudes and beliefs towards psychotropic medication were evaluated among psychiatric outpatients, patients receiving buprenorphine treatment for substance abuse, and a group who reported never having used psychotropic medications (non-users). The Drug Attitude Inventory scale and the Beliefs about Medicines Questionnaire General were used to assess attitudes and beliefs of 49 participants. Non-users exhibited more negative attitudes and beliefs toward psychotropic medication than both psychiatric groups.

Beyond point and level systems: moving toward child-centered programming.

Many residential treatment facilities and child inpatient units in the United States have been structured by way of motivational programming such as the point and/or level systems. On the surface, they appear to be a straightforward contingency management tool that is based on social learning theory and operant principles. In this article, the authors argue that the assumptions upon which point and level systems are based do not hold up to close empirical scrutiny or theoretical validity, and that point and level system programming is actually counterproductive with some children, and at times can precipitate dangerous clinical situations, such as seclusion and restraint. In this article, the authors critique point and level system programming and assert that continuing such programming is antithetical to individualized, culturally, and developmentally appropriate treatment, and the authors explore the resistance and barriers to changing traditional ways of "doing things." Finally, the authors describe a different approach to providing treatment that is based on a collaborative problem-solving approach and upon which other successful models of treatment have been based.

Accuracy in communication. A contextual approach to child behavior assessment.

This article analyzes the problem of accuracy of communication in clinical settings and argues that clinical language is replete with theoretical constructs that may not have shared meaning among speakers and listeners in mental health settings. It is suggested that mental health providers be trained in a contextually based data language. The value of such a data language employed in behavioral assessment is emphasized. The authors contend that events and behavior are products of the contextual environment; contextual variables are more accurately identified and agreed on; and the use of contextual variables in treatment intervention increases consequential validity. A developmental ecological approach, coupled with applied behavior analysis, are discussed and offered as a foundation on which clinical interventions should be planned and assessed. Using objective methods that yield demonstrable and meaningful outcomes can help improve children's mental health service delivery and the lives of children.