Biomedical subjects

M L Hiller

Publications and source records attributed to M L Hiller.

11 recordsLinked to original sources

PubMed2000

Effectiveness of communication and relationship skills training for men in substance abuse treatment.

Although the importance of gender-sensitive programming for women has been acknowledged, few studies have examined outcomes from male-centered interventions in substance abuse treatment programs. Data were collected from 122 male clients in a court-mandated residential treatment program who participated in a study of a psychoeducational group intervention for men. The intervention (Time Out! For Men) addressed communication skills, sexuality, gender socialization, and intimacy. Participation in the training resulted in significant increases in knowledge and social conformity, along with reductions in attitudes that may be associated with rigid socialization and gender-role conflict. The results provide support for the utility of male-targeted programming in substance abuse treatment settings.

Adolescent↗

PubMed2000

Measuring self-efficacy among drug-involved probationers.

Self-efficacy has been shown to be related to outcomes from interventions for alcohol and tobacco abuse but relatively little attention has been focused on it in evaluations of treatment for illicit drug abuse. Almost no research has examined offenders involved with drugs. The current study, therefore, adapted the Alcohol Abstinence Self-efficacy Scale of DiClemente, Carbonari, Montgomery, and Hughes and administered it to 250 probationers mandated to 6 months of residential treatment. With some modifications, confirmatory factory models replicated four previously reported dimensions, e.g., Negative Affect, Social/Positive, Physical and Other Concerns, Cravings and Urges. Findings also indicated high construct validity for the Alcohol Abstinence Self-efficacy Scale as adapted here. Studies are needed to examine the use of self-efficacy as a prospective measure of treatment progress and to explore its association with outcomes from corrections-based treatment.

Adolescent↗

PubMed1999

Prison-based substance abuse treatment, residential aftercare and recidivism.

AIMS: This study examined the impact of residential aftercare on recidivism following prison-based treatment for drug-involved offenders. DESIGN: A matched group quasi-experimental design. Survival regression analyses were used to predict time until rearrest. A logistic regression model was constructed for predicting aftercare completion. SETTING: A 9-month in-prison therapeutic community (ITC) and several community-based transitional therapeutic communities (TTCs). PARTICIPANTS: Data were collected from 396 male inmates (293 treated, 103 untreated). MEASUREMENTS: Background information (gender, ethnicity, age, education level, criminal history and risk for recidivism) was abstracted from the state criminal justice databases and a structured interview led by clinical staff. During treatment process measures were based on inmate self-ratings of their counselors, program and peers. A post-treatment interview conducted by field research staff assessed satisfaction with transitional aftercare. Post-release recidivism was based on state-maintained computerized criminal history records. FINDINGS: ITC treatment, especially when followed by residential aftercare, was effective for reducing post-release recidivism rates. Lower satisfaction with transitional aftercare treatment was associated with not completing the residential phase of community-based aftercare. CONCLUSIONS: Corrections-based treatment policy should emphasize a continuum of care model (from institution to community) with high quality programs and services.

Adult↗

PubMed1999

Gender differences at admission and follow-up in a sample of methadone maintenance clients.

Although one-third of clients enrolled in methadone treatment in the United States are female, few studies have looked at gender differences at admission and follow-up. Using interview data from 435 clients (31% female) collected at admission and approximately 1 year after discharge, females were found to have more dysfunctional families of origin and greater prior and current psychological and medical problems. Both genders improved following treatment, as evidenced by reduced illicit drug, tobacco, and alcohol use, criminal involvement, and HIV/AIDS-risky behaviors. Females were more likely to seek further help for both drug misuse and psychological problems subsequent to discharge.

Acquired Immunodeficiency Syndrome↗

PubMed1998

The validity of self-reported cocaine use in a criminal justice treatment sample.

Recent studies comparing self-admitted cocaine use with hair and urine test results have raised concerns about underreporting due to variations across situations and settings. Because of the frequent need for self-report data in conducting treatment evaluations, more information is needed on factors that affect the credibility of this information. The present study examines records of cocaine use collected as part of an evaluation of prison-based treatment (N=396). Specifically, self-reported cocaine use from 6-month postrelease follow-up interviews, completed with treatment graduates and a comparison sample of parolees who were eligible but not sent to treatment, was examined in relation to urine and hair test results. Overall, cocaine use was underreported when compared to hair test results, but underreporting was lower for program graduates than for the untreated comparison group. Furthermore, program graduates originally admitted to prison on a drug-related arrest were the most likely to underreport cocaine use, seemingly due to a heightened concern about potential consequences, such as returning to prison on another drug-related charge. Given that the validity of self-report for high-risk individuals varies greatly and is difficult to predict across studies, future research with criminal justice samples should continue to assess the validity of these measures under specific research conditions and for diverse types of individuals.

Adult↗

PubMed1997

Peer, family, and motivational influences on drug treatment process and recidivism for probationers.

Treatment efforts appear to be effective in reducing crime among drug using individuals, but components of the treatment process associated with client improvement need to be identified. Furthermore, these elements of treatment may play an intermediate role in the connection between client background characteristics and later criminal activity. The current study examines a structural equation model including client perceptions of their drug related problems, peer deviance, and family dysfunction as influences upon the formation of therapeutic relationships during treatment and rearrests following treatment. Results showed therapeutic relationships were positively associated with recognition of drug related problems and negatively related to rearrest. Peer deviance also was positively related to rearrest.

Adolescent↗

PubMed1996

Effectiveness of a specialized women's intervention in a residential treatment program.

"Time Out! For Me," a specialized psychoeducational treatment found to be effective with women in an outpatient methadone clinic, was tested for generalizability to a residential drug user treatment program. The 6-session module was first given to an experimental group (n = 11) and compared to a control group (n = 10). The treatment was associated with increases in knowledge of human sexuality, assertiveness and communication skills, more positive attitudes toward being assertive and practicing safer sex, and increased self-esteem. Thus, "Time Out" appears to be an effective treatment enhancement for women in residential treatment.

Adult↗

PubMedDate not supplied

Drug treatment process indicators for probationers and prediction of recidivism.

Research has shown that substance abuse treatment is associated with reduced criminal activity as well as reduced drug use. An increasingly important aspect of treatment evaluation, however, is understanding more about the therapeutic process involved. Based on a sample of 279 probationers assigned to residential treatment for drug use problems, the purpose of this study is to examine several elements of treatment process and how they influence recidivism. Rearrest rate during a 2-year follow-up study period was 36%, and survival analysis showed it was directly related to poorer during-treatment ratings by probationers of self-esteem, counselor competence, and peer support from others in the treatment program. These were better predictor measures than background and demographic characteristics generally used in other studies, suggesting the role of therapeutic engagement in the recovery process.

Adolescent↗

PubMedDate not supplied

Posttreatment outcomes for substance-abusing probationers mandated to residential treatment.

This article presents an initial evaluation of a community-based substance abuse treatment program for probationers described in a previous issue of the Journal of Psychoactive Drugs [27(1): 39-47]. Posttreatment outcomes for 492 probationers remanded to a six-month residential facility were assessed. Based on official state records, 9% of the probationers were rearrested in the six months following discharge from treatment. Those who graduated from the program were significantly less likely to be rearrested during the follow-up interval than were program expulsions and transfers to other programs. Also, program graduates who attended a specialized residential aftercare program were more likely to remain drug-free and be employed after treatment than were those who did not attend the specialized aftercare program. Collectively, results suggest that lower rearrest rates may be associated with the provision of residental treatment to substance-abusing probationers.

Adolescent↗

PubMedDate not supplied

Evaluating corrections-based treatment for the drug-abusing criminal offender.

The recent increase in drug abusers in the criminal justice system has led to the expansion of corrections-based drug treatment facilities. Although three key evaluations have provided consistent support for the effectiveness of drug treatment within the criminal justice system, direct comparisons of outcomes across these evaluations are limited by variations in their measurement systems and the structure of official records on which they are based. This article addresses some of the issues relating to the assessment of treatment outcomes for the drug-abusing offender and provides several recommendations for future research.

Crime↗

PubMedDate not supplied

Therapeutic communities: diversity in treatment elements.

This study addresses the need to describe the diversity of therapeutic community (TC) programs. The Survey of Essential Elements Questionnaire (SEEQ) was used to develop a typology of TC programs based on 19 programs that identified themselves as traditional or modified TCs in the Drug Abuse Treatment Outcome Studies (DATOS). These traditional and modified TCs differed in adherence to the elements of TC treatment, on operational characteristics, and in client mix. Differences in treatment philosophy and approach included the emphasis on self-reliance, and the use of work as a therapeutic agent for traditional TCs. There were also trends for traditional TC programs to utilize community-as-method, provide educational and vocational training, and include family members as part of therapy. Modified programs showed a greater tendency to rely on counselors. Implications of the findings for program quality, health care policy, and research are discussed.

Combined Modality Therapy↗