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Biomedical subjects

A Copello

Publications and source records attributed to A Copello.

7 recordsLinked to original sources

Setting standards for training and competence: the UK alcohol treatment trial.

AIMS: To examine factors that influence the recruitment and training of therapists and their achievement of competence to practise two psychological therapies for alcohol dependence, and the resources required to deliver this. METHODS: The protocol for the UK Alcohol Treatment Trial required trial therapists to be competent in one of the two trial treatments: Social Behaviour and Network Therapy (SBNT) or Motivational Enhancement Therapy (MET). Therapists were randomised to practise one or other type of therapy. To ensure standardisation and consistent delivery of treatment in the trial, the trial training centre trained and supervised all therapists. RESULTS: Of 76 therapists recruited and randomised, 72 commenced training and 52 achieved competence to practise in the trial. Length of prior experience did not predict completion of training. However, therapists with a university higher qualification, and medical practitioners compared to other professionals, were more likely to complete. The average number of clients needed to be treated before the trainee achieved competence was greater for MET than SBNT, and there was a longer duration of training for MET. CONCLUSIONS: Training therapists of differing professional backgrounds, randomised to provide a specific therapy type, is feasible. Supervision after initial training is important, and adds to the training costs.

Adult↗

Drug and alcohol problems amongst individuals with severe mental health problems in an inner city area of the UK.

BACKGROUND: The extent and impact of drug and alcohol use among those with severe mental health problems has been well documented in the US. However, little is known of the nature of this problem in the UK, particularly in community treatment settings. This paper outlines findings from a large-scale survey conducted across community-based Mental Health and Substance Misuse services, which aimed to ascertain the prevalence of drug and alcohol problems among those with severe mental health problems. METHOD: An assessment instrument was completed by keyworkers for each of their clients, which included mental health diagnosis and an adapted version of the Clinician Rating Scales for Alcohol and Drug Use. RESULTS: From a sample of 3079 clients across services, 1369 clients were identified with a severe mental illness diagnosis. According to their key-workers, 24% of these clients (324/1369) had used alcohol and/or drugs problematically during the past year. These individuals were most likely to have a diagnosis within the schizophrenia cluster, were mainly white males in their mid-30s, and tended to be located within Mental Health services in Assertive Outreach teams and to be higher utilisers of crises/emergency services. CONCLUSIONS: It can be concluded that similar to other studies in inner city areas of the UK, problem substance use is common amongst those with severe mental health problems within Northern Birmingham.

Adolescent↗

Ways of coping and the health of relatives facing drug and alcohol problems in Mexico and England.

AIMS: To compare two contrasting socio-cultural groups in terms of parameters relating to the stress - coping - health model of alcohol, drugs and the family, and to test hypotheses derived from the model in each of the two groups separately. DESIGN: Cross-sectional, comparative and correlational, using standard questionnaire data, supplemented by qualitative interview data to illuminate the findings. PARTICIPANTS: One hundred close relatives, mainly partners or parents, from separate families in Mexico City, and 100 from South West England. Data sources. Coping Questionnaire (CQ), Family Environment Scale (FES), Symptom Rating Test (SRT), Semi-structured interview. FINDINGS: Mean symptom scores were high in both groups, and not significantly different. The hypothesis that relatives in Mexico City, a more collectivist culture, would show more tolerant - inactive coping was not supported, but there was support for the prediction that relatives in South West England would show more withdrawal coping. This result may be as much due to differences in poverty and social conditions as to differences in individualism - collectivism. As predicted by the stress - coping - health model, tolerant - inactive coping was correlated with symptoms, in both groups, after controlling for family conflict, but there was only limited support for a moderating role of coping. Wives of men with alcohol problems in Mexico City, and wives of men with other drug problems in South West England, reported particularly high levels of both engaged and tolerant - inactive coping. CONCLUSIONS: Tolerant - inactive coping may be bad for relatives' health: causality may be inferred but is not yet proved. Certain groups are more at risk of coping in this way. Qualitative data help understand the nature of tolerant - inactive coping and why it occurs despite the view of relatives themselves that it is counter-productive.

Adaptation, Psychological↗

The family and alcohol: effects of excessive drinking and conceptualizations of spouses over recent decades.

There is much debate in the addiction literature about the extent to which excessive drinking affects nondrinking family members. The issue is considered in this review by examining and evaluating research relating to the effects of drinking on children, family systems, and partners of drinkers. The latter group have, historically, been blamed and apologized for their partner's drinking, although more recent theories have adopted a stress and coping paradigm, thus normalizing individuals and their behaviors. Conceptualizations of spouses over the last five decades are described and evaluated in the second part of the review. Finally, the review considers the impact of the recent stress and coping paradigm on clinical interventions for excessive drinkers and their families, and suggestions are made for future research.

Adaptation, Psychological↗

Tolerate, engage or withdraw: a study of the structure of families coping with alcohol and drug problems in south west England and Mexico City.

AIMS: To explore the structure underlying individual differences in the ways family members cope with drinking or drug problems. DESIGN: Cross-sectional interview and questionnaire study of a series of family members in two contrasting socio-cultural groups. SETTING: Mexico City and South West England. PARTICIPANTS: Two hundred and seven family members from separate families, three-quarters women, one-quarter men, mostly partners or parents. DATA: Long semi-structured interviews; the Coping Questionnaire (CQ). FINDINGS: Factor and subscale analyses of the CQ data and textual analysis of the interview reports were used to test the hypothesis that the underlying structure to coping could be described in terms of eight or nine coherent and distinct ways of coping. Neither form of analysis gave strong support to this hypothesis. CONCLUSIONS: It is concluded that the structure of coping can best be described in terms of three broad coping positions: tolerating, engaging and withdrawing. These conclusions challenge some previous assumptions about functional and dysfunctional ways of coping with excessive appetitive behaviour in the family.

Adaptation, Psychological↗

[Esophageal involvement in progressive systemic sclerosis].

The authors present 17 patients with progressive systemic sclerosis studied at the Hospital Nacional de Gastroenterología "Dr. Carlos Bonorino Udaondo" (Buenos Aires), in the period between 1976-1980. Clinical, radiological, endoscopical and manometrical studies of the digestive tract was performed, showing frequent compromise in this collagen disease.

Adult↗