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Biomedical subjects

M D Stanton

Publications and source records attributed to M D Stanton.

At least 19 recordsLinked to original sources
PubMed2000

Strength in numbers: the ARISE method for mobilizing family and network to engage substance abusers in treatment. A Relational Intervention Sequence for Engagement.

The model described in this paper takes into consideration two key findings: (a) In a given year, the vast majority (90-95%) of active substance abusers do not enter treatment or self-help groups, and (b) substance abusers have frequent contact with their families (60-80% either live with a parent or are in daily contact). This paper presents a method for mobilizing and collaborating with families and extended the support system toward working with resistance and getting the substance abuser into treatment. Principles and techniques are provided for convening and structuring intervention network meetings toward that end. This intervention network approach can be used either alone or as part of an overall model, ARISE (A Relational Intervention Sequence for Engagement). The ARISE model addresses both clinical and programmatic issues in treatment engagement for substance abusers.

Adult↗
PubMed2000

Family connectedness and women's sexual risk behaviors: implications for the prevention/intervention of STD/HIV infection.

The present study explores the relationship between connectedness with the intergenerational family and women's sexual risk-taking as a guide to the development of family-focused prevention and intervention. Cross-sectional interview data from a pilot study were analyzed for correlations between a number of self-reported, risky sexual practices, the range of extended family members with whom the respondent was in contact, and awareness of stories pertaining to intergenerational family history. Structured interviews were administered by female interviewers to 56 women from two contexts: a STD (sexually transmitted disease) Clinic (N = 26), and an inner-city, Hispanic Community Organization (N = 30). Knowledge of stories about grandparents or great-grandparents was a robust predictor of lower sexual risk-taking in the STD Clinic sample. This relationship persisted, but only at the trend level in the Community Organization sample. In both the total sample and the STD subsample, the number of categories of extended family members with whom a respondent was in at least monthly contact was correlated with less sexual risk-taking. Given the fundamental importance of the family system as the primary social unit, these findings argue for further family theory-based research and for its potential application in the development of health prevention and intervention. Implications for practice and future research are discussed.

Cross-Sectional Studies↗
PubMed1999

The "concerned other" call: using family links and networks to overcome resistance to addiction treatment.

Untreated chemical dependency costs the United States over $165 billion annually. Meanwhile, treatment offsets these costs by a ratio of $7 saved for every $1 spent. But the vast majority of chemically dependent people (CDPs) remain uninvolved in either treatment or self-help groups. It is therefore imperative that more effective ways be developed for therapeutically engaging them. One avenue is to maximize the opportunity presented when a "concerned other" (CO) person-such as a family member, friend, coworker, or clergy member-contacts a treatment agency to get help for a CDP. This paper provides a method for handling such calls. Specific guidelines are presented as to (a) the kind of information to b e gathered, (b) procedures to be followed, and (c) options to be offered toward mobilizing the CO and other family/social network members in successfully effecting CDP treatment engagement.

Adult↗
PubMed1997

Outcome, attrition, and family-couples treatment for drug abuse: a meta-analysis and review of the controlled, comparative studies.

This review synthesizes drug abuse outcome studies that included a family-couples therapy treatment condition. The meta-analytic evidence, across 1,571 cases involving an estimated 3,500 patients and family members, favors family therapy over (a) individual counseling or therapy, (b) peer group therapy, and (c) family psychoeducation. Family therapy is as effective for adults as for adolescents and appears to be a cost-effective adjunct to methadone maintenance. Because family therapy frequently had higher treatment retention rates than did nonfamily therapy modalities, it was modestly penalized in studies that excluded treatment dropouts from their analyses, as family therapy apparently had retained a higher proportion of poorer prognosis cases. Re-analysis, with dropouts regarded as failures, generally offset this artifact. Two statistical effect size measures to contend with attrition (dropout d and total attrition d) are offered for future researchers and policy makers.

Adult↗
PubMed1984

Fusion, compression, diversion, and the workings of paradox: a theory of therapeutic/systemic change.

This paper describes a geodynamic balance theory of family process. It attempts to synthesize temporal/spatial patterning, movement, interpersonal structure, and the family developmental process. The family system is portrayed in terms of the pattern of interpersonal orbits among its members and the interface between these and "external" systems such as friendship networks, neighborhoods, and therapists. It is proposed that therapeutic/systemic change can be induced through either of two interventional mechanisms: diversion (e.g., behavioral techniques, restructuring, differentiating) or compression (e.g., paradoxical technique, returning home, grief work). Such processes share a number of similarities with analogues from the physical sciences. These formulations may assist clinicians in determining the most appropriate operations and directions for treatment.

Adolescent↗
PubMed1981

Engaging "resistant" families in treatment.

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging "resistant" families. Part II presents 21 principles and a number of techniques and strategies that have been developed for successfully recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided.

Adult↗
PubMed1980

A critique of the Wells and Dezen review of the results of nonbehavioral family therapy.

Although the Wells and Dezen review made many valuable points about family therapy outcome research, their handling of the various included studies appeared uneven. To test this impression, a content analysis was performed on the "favorableness" or "positiveness" of the statements made by Wells and Dezen about the studies they reviewed. The degree of positiveness was compared across studies with the Design Quality and with the level of sophistication of these studies. All of the statistical correlations were negative--half of them significantly so--a result completely opposite to what would be expected. We conclude that Wells and Dezen tended to give undue praise to many uncontrolled studies and inordinate criticism to more sophisticated and better-designed research. In addition, other inconsistencies in the evaluation of studies were noted. Further, specific studies were presented in a distorted and inacurate manner, and without proper attention to statistical principles. In sum, it appears that Wells and Dezen (a) have not been sufficiently careful in their analysis of the reviewed research, and (b) have, through their evaluative remarks, provided a biased review which obscures many important comparisons within this field.

Behavior Therapy↗
PubMed1980

A critique of Kaufman's "myth and reality in the family patterns and treatment of substance abusers".

In questioning many of the myths in this field, Kaufman has made an important contribution to the literature. Much of the material he presents deserves wider dissemination. However, at least four of his 21 "realities" are overstated, and another four are not well founded or are amenable to alternative explanations. The present paper is generally supportive of Kaufman's presentation while also attempting to place certain of the issues in perspective so as to avoid the creation of new myths.

Family↗
PubMed1980

Engaging "resistant" families in treatment. I. Getting the drug addict to recruit his family members.

For family therapy to have any effect on correcting drug problems, the family must obviously be involved. However, such families are often resistant to treatment. This paper describes techniques in working with the addicted member toward recruiting his family for therapy. A sequential approach to the initial interview is presented. Interview rationale, structure, and strategy are outlined, along with examples of common resistances and therapeutic counters. The model and techniques are potentially applicable to other types of symptomatic families as well.

Family Therapy↗
PubMed1979

Family treatment approaches to drug abuse problems: a review.

This review covers the literature that has emerged specifically on the family treatment of drug abuse problems. Following a brief discussion of patterns and structures prevalent in drug-abusing families, 68 different studies or programs (discussed in 74 papers) are compared as to their techniques and results. These are categorized within the following modalities: marital treatment, group treatment for parents, concurrent parent and identified patient treatment, treatment with individual families (both inpatient and outpatient), sibling-oriented treatment, multiple family therapy, and social network therapy. A table presents the various studies, along with the types of results they provide. Outcomes are contrasted for the 14 studies that quantified their results. The final section presents implications for the following areas: treatment activities (clarification of technique, family recruitment, direction and effectiveness of treatment, confidentiality, and treatment delivery systems), training, prevention, and future research (outcome, technique and responsibility). It is concluded that family treatment for drug abuse is gaining widespread acceptance and shows considerable promise for dealing effectively with problems of this type.

Child↗
PubMed1978

An index for measuring agency involvement in family therapy.

The Progress Index for Family Therapy Programs, an instrument for measuring the relative level of involvement in family therapy by treatment programs, is presented. It was developed as part of a national survey on the use of family therapy for treating drug abuse and includes data from 500 agencies, 76 of which were Community Mental Health Centers. The Index may be useful for assessing extent of family therapy involvement for differing agencies treating different populations.

Community Mental Health Centers↗
PubMed1978

Heroin addiction as a family phenomenon: a new conceptual model.

The chronic relapsing nature of heroin addiction can be explained from a family systems viewpoint. The addiction cycle is part of a family pattern involving a complex homeostatic system of interlocking feedback mechanisms. These serve to maintain the addiction and consequently the overall family stability. Drug-taking usually starts at adolescence. It is related to an intense fear of separation experienced by the family in response to the addict's attempts at individuation. The family becomes stuck at a particular developmental stage. Heroin provides a solution at several levels to the dilemma of whether or not to allow him independence. Paradoxically, it permits him to simultaneously be both close and distant, "in" and "out", competent and incompetent, relative to his family of origin. This is pseudoindividuation. An understanding of these concepts, and their integration into a homeostatic model, can provide the basis for effective treatment.

Adolescent↗
PubMed1977

The addict as savior: heroin, death, and the family.

The high mortality rate among drug addicts is seen as a suicidal phenomenon with a family basis. The death wish, or instruction for the addict to die, is often quite clearly expressed by the family. He is placed in the role of savior and martyr. His death is seen as a noble, cleansing sacrifice in which he is often a willing participant.

Adult↗
PubMed1977

Drug use surveys: method and madness.

There are many measurement problems inherent in the drug survey field, e.g., defining dosages and choosing user categories. This paper discusses the pros and cons of interview techniques, mailed questionnaires, and group-administered questionnaires. The particular importance of the social psychology of the data gathering process is noted, including the provision of anonymity for the respondents and the establishment of credibility for the investigators. Means for dealing with these and also for improving reliability and validity are discussed, along with reasons for performing a survey, the nature and intent of the questions asked, and some other political and ethical issues.

Health Surveys↗