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Connecting up the care: supporting London's children exposed to domestic abuse, parental mental ill-health and parental substance abuse
- Author:
- LONDON ASSEMBLY. Health Committee
- Publisher:
- London Assembly
- Publication year:
- 2020
- Pagination:
- 11
- Place of publication:
- London
Early neglect and trauma on children can have substantial negative outcomes later on in life. These potentially traumatic events are called Adverse Childhood Experiences (ACEs). This report from the London Assembly Health Committee examines three commonly co-occurring ACEs to assess their prevalence in London and how access to and support from services could be improved. The co-occurring ACEs are: domestic violence and abuse, parental mental ill-health and parental alcohol and drug misuse. Key findings of highlight the importance of: information sharing and data collection; multi-agency working; and the adoption of a trauma-informed approach to improve outcomes. (Edited publisher abstract)
Trauma, gender, and mental health symptoms in individuals with substance use disorders
- Authors:
- KEYSER-MARCUS Lori, et al
- Journal article citation:
- Journal of Interpersonal Violence, 30(1), 2014, pp.3-24.
- Publisher:
- Sage
The relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender were examined in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counselling and five methadone maintenance programmes were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) in the United States. Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index–Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma. (Edited publisher abstract)
Changes in treatment content of services during trauma-informed integrated services for women with co-occurring disorders
- Authors:
- CHUNG Sukyung, DOMINO Marisa Elena, MORRISSEY Joseph P.
- Journal article citation:
- Community Mental Health Journal, 45(5), October 2009, pp.375-384.
- Publisher:
- Springer
This study examined how an intervention targeted to provide women with trauma-informed integrated services in the treatment of co-occurring disorders changed the content of services reported by clients. It was found the intervention led to an increased provision of integrated services as well as services addressing each content area: trauma, mental health and substance abuse. There was no increase in service quantity from the intervention. Incorporation of trauma-specific element in the treatment of mental health and substance abuse may have been successfully implemented at the service level thereby better serve women with complex behavioural health histories.
The recovery paradigm in trauma work: approaches to healing psychiatric disability and substance abuse in women's lives
- Authors:
- BUSSEY Marian, WISE Judith Bula
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 7(3-4), 2008, pp.355-379.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Focusing on women with psychiatric disabilities and substance issues, particularly those who have histories of abuse, violence and trauma, this article addresses the importance of integrative treatment as a prerequisite for psychiatric rehabilitation and recovery. The authors discuss psychiatric rehabilitation, trauma, treatment philosophy, consumer empowerment and the concept of an integrated model of recovery. They describe three integrated trauma and alcohol and other drug models created primarily for women, and discuss their content, the challenges of system change and the results of the integrated model.
Assessing trauma, substance abuse, and mental health in a sample of homeless men
- Authors:
- KIM Mimi M., et al
- Journal article citation:
- Health and Social Work, 35(1), February 2010, pp.39-48.
- Publisher:
- Oxford University Press
This study of 329 homeless men examined the impact of physical and sexual trauma, using questionnaires that collected data on four types of trauma exposure: demographics; exposure to psychological trauma; physical health problems; mental health problems; and substance misuse. Binomial logistic regression analyses were used to investigate the significance of demographic factors and the four types of trauma exposure associated with three outcomes: mental health; substance abuse; and physical health problems. Findings indicate that trauma history was appreciably associated with mental health problems but was not associated with substance abuse problems for homeless men. This study reinforces service providers’ perceptions that many homeless men experience the long-term, harmful effects of not only various stressors, but also abuse and victimisation that often begin in childhood. The authors suggest that mentally ill, homeless men need proactive services that address the sequelae of abuse with care that is specialised and distinctly different from care for homeless adults with substance abuse or physical health care issues.
Mental health and substance abuse indicators among homeless youth in Denver, Colorado
- Authors:
- MERSCHAM Carrie, van LEEUWEN James M., McGUIRE Megan
- Journal article citation:
- Child Welfare Journal, 88(2), 2009, pp.93-110.
- Publisher:
- Child Welfare League of America
The results of mental health evaluations from 182 homeless youth residing in a Denver, Colorado, shelter are reported. The literature on homeless youth, although developing, is still somewhat limited as it relates to mental health, substance abuse, and trauma. This study was motivated by clinically observed high rates of mental illness, trauma, dangerousness issues, and drug and alcohol abuse. Using archival data from mental health evaluations conducted over two years, variables including gender, age, ethnicity, primary diagnosis, drug of choice, trauma history, suicidal ideation, homicidal ideation, and legal history were assessed. Results discovered significantly higher than expected diagnoses of mental illness and associations between drug of choice and diagnosis, trauma history and suicidal ideation, and trauma history and diagnosis. Results suggest a strong need for co-occurring treatment, trauma-focused therapy, and attention to both mental illness and substance abuse in homeless youth.
Building trauma informed practice: appreciating the impact of trauma in the lives of women with substance abuse and mental health problems
- Authors:
- SAVAGE Andrea, et al
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 7(1/2), 2007, pp.91-116.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper examines the lifetime interpersonal abuse experienced by a substance abuse treatment sample of 1,955 women in the United States with co-occurring disorders. Substantial rates of intimate and community based interpersonal abuse and other life stressors are documented. Regression analysis shows that while trauma severity is significantly related to trauma distress, its impact on psychological symptom distress and drug severity is quite modest. The implementation of a trauma informed approach featuring trauma-specific treatment, service integration and consumer empowerment is described as a promising practice model for assisting women seeking help in substance abuse treatment programs. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Women, trauma histories, and co-occurring disorders: assessing the scope of the problem
- Authors:
- NEWMANN Joy Perkins, SALLMANN Jolanda
- Journal article citation:
- Social Service Review, 78(3), September 2004, pp.466-499.
- Publisher:
- University of Chicago Press
Presents findings from one site in a federal study of services for women with co-occurring mental health and substance use problems and histories of physical or sexual abuse. Among sampled women with 2 or more publicly funded substance abuse or mental health treatment episodes in 1998, one-third reported co-occurring mental health and substance use problems. Compared to other sample members, they reported greater numbers of abuse experiences and other adverse life circumstances and had more complex diagnostic and treatment histories. They also show a greater tendency to suicidal ideation and are more likely to use prescription medications.
The toxic trio, adverse childhood experiences and the Family Court
- Author:
- WEBB Sheena
- Journal article citation:
- Seen and Heard, 31(2), 2021, pp.56-67.
- Publisher:
- NAGALRO
- Place of publication:
- Esher
The author suggests that while professionals working in the family courts are very aware of the historical adversity experienced by the parents and the children involved in care proceedings the way professionals assess and intervene with parents within care proceedings does not reflect our understanding of the role that trauma plays in parental difficulties. The author poses the question, why do we keep doing the same thing when we know it does not work? The article also considers what the toxic trio really tells us. The toxic trio refers to problems with substance misuse, domestic abuse and mental health difficulty. The author suggests that parents are sent to different services to deal with each of the trio separately, so it is less likely that complex trauma is addressed and since the issues are interdependent, treating them separately is not effective. The author suggests that recent research points to the need for comprehensive services that are targeted to a family's multiple needs regardless of the chosen therapeutic model. The article also discusses why parents don't engage and the need for emotional safety as a prerequisite for effective psychosocial treatment. In addition, the role of diagnosis and struggle to access trauma therapy are considered along with a consideration of adversarial proceedings versus Family Drug and Alcohol Court approach. The article concludes that reframing engagement problems as trauma-related responses gives us more scope to overcome them effectively. (Edited publisher abstract)
Understanding models of support for people facing multiple disadvantage: a literature review
- Authors:
- McCARTHY Lindsey, et al
- Publisher:
- Sheffield Hallam University. Centre for Regional Economic and Social Research
- Publication year:
- 2020
- Pagination:
- 44
- Place of publication:
- Sheffield
This literature review brings together broad, multidisciplinary evidence about access to services, transitions within services, and understanding about how the system behaves for people facing multiple disadvantage, including homelessness, mental health, substance misuse, and offending. The review sought to produce a more detailed understanding about how particular groups within the Fulfilling Lives target population have different experiences due to the diverse effects of social and cultural factors. The review considers systemic barriers to accessing support for people facing multiple disadvantage and factors which help facilitate this access; explores support journeys of particular populations and how these are influenced by pervasive social and cultural norms; discusses how trauma-informed care practices are implemented in services, and how these are gender and culturally-sensitive; presents specific good practice examples of trauma-informed care practices from services working with people facing multiple disadvantage; and concludes by outlining the key gaps identified in the literature reviewed. (Edited publisher abstract)