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How important are counselor and client characteristics in determining overall client satisfaction with 12-step focused community counseling groups?
Abstracts / Drug and Alcohol Dependence 146 (2015) e202–e284
Developmental heritability of internalizing symptoms and cigarette use co-occurrence Cristina B. Bares 1 , Kenneth S. Kendler 3,2 , Judy Silberg 2 1 School of Social Work, Virginia Commonwealth University, Richmond, VA, United States 2 Department of Human Genetics, Virginia Commonwealth University, Richmond, VA, United States 3 Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
Aims: Previous research with adult twins has indicated that additive genetic factors contribute substantially to the association between adult internalizing symptoms and cigarette use. This study was conducted to examine how the contribution of genetic and shared environmental factors to the co-occurrence between internalizing symptoms and cigarette use among adolescent twins change during adolescence. Methods: Adolescent twin pairs (n = 1258) came from the population-based Virginia Twin Study of Adolescent Behavioral Development. Age-specific bivariate twin modeling was performed of the highest number of cigarettes smoked and a composite measure of anxious and depressive symptoms from the Child and Adolescent Psychiatric Assessment. Saturated bivariate Cholesky models for two age groups (14- to 15-, and 16- to 17-year-olds) were compared to reduced models where additive genetic and shared environmental influences were systematically removed and the fit of the nested models compared using OpenMx. Results: Compared to the saturated bivariate Cholesky, including three sources of genetic variance, a model dropping shared environmental effects caused a reduction in model fit for both groups (x2 (3, n = 582) = 10.73, p < .01; x2 (3, n = 676) = , p < .01). The best fitting models indicated that 40.9% (for 14 to 15-y-o) and 37.5% (for 16- to 17-y-o) of the total variance was explained by shared environmental factors common to both cigarette use and internalizing symptoms. Conclusions: The co-occurrence between internalizing symptoms and cigarette use among a sample of adolescent twins appears to result from decreasing shared environmental factors that influence the risk to both traits. Financial support: Funding for Dr. Bares’ work comes from Dr. James Anthony’s R25 DA030310. Funding for the Virginia Twin Study of Adolescent Behavioral Development comes from the following NIH grant, MH-45268. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.057 How important are counselor and client characteristics in determining overall client satisfaction with 12-step focused community counseling groups? Rita Baroni 1 , Douglas Boyd 1 , Adam Christmann 1 , Emily Hutz 1 , Carolyn M. Carpenedo 1 , Adam C. Brooks 1 , Alexandre B. Laudet 2 , K.C. Kirby 1,3 1 Treatment Research Institute, Philadelphia, PA, United States 2 National Development and Research Institutes, New York, NY, United States 3 University of Pennsylvania School of Medicine, Philadelphia, PA, United States
Aims: Research indicates that client satisfaction at end of treatment is associated with successful treatment outcomes. The
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present study examines client satisfaction in community counseling groups and counselor and client characteristics associated with increased satisfaction. Methods: In a pre-intervention phase of a large, multi-phase, multi-site clinical trial, 80 counselors completed a background form and agreed to run five group sessions on 12-step facilitation (12SF) topics, with minimal training and covering the content to the best of their current knowledge and ability. 700 clients in the counselors’ groups also agreed to participate and completed a background form prior to attending groups. After the fifth session, clients rated their satisfaction with the 12SF groups on both general and 12SF specific items. Results: Binary logistic regression for general satisfaction showed that clients under judicial pressure to be in treatment were 46.3% less likely to be very satisfied (OR = .573, p = .003), whereas clients whose counselors had more years of experience were more likely to be very satisfied (OR = 1.04, p = .007). For 12S specific satisfaction, clients under judicial pressure were 44.9% less likely to be very satisfied (OR = .551, p = .000) and clients who had counselors that identified as being in recovery were 80fl more likely to be very satisfied (OR = 1.80, p = .037). Conclusions: These results suggest that certain client and counselor characteristics are associated with client satisfaction with group counseling, and thus could influence client outcome. Treatment providers may need to (1) develop different strategies to foster higher satisfaction among criminal justice populations, and (2) focus on providing additional training on 12SF to less experienced counselors or those not in recovery in order to increase satisfaction. Financial support: NIAAA R01 AA017867. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.058 Substance use and mental health consequences of childhood trauma: An epidemiological investigation Emma L. Barrett, Maree Teesson, Cath Chapman, Tim Slade, Natacha Carragher, Katherine Mills National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia Aims: Exposure to childhood trauma (CT) can have very serious and enduring effects including the development of mental health disorders. Few studies, however, have examined associations between CT and mental health disorders in the general population. The aim of this epidemiological study is to identify the substance use and mental health consequences of CT using data collected as part of the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). Methods: The 2007 NSMHWB was a nationally representative survey of 8841 adult Australians. CT exposure and lifetime DSMIV substance use and mental health disorders were assessed using the World Mental Health Composite International Diagnostic Interview. Analyses were weighted to provide population estimates. Results: 41% of Australian adults were exposed to a traumatic event during their childhood (before 17 years of age) and 20% experienced their first trauma prior to 9 years of age. The most common CTs were sexual assault, witnessing serious injury or death, and the unexpected death of a loved one. Half of those who experienced CT (53%) met DSM-IV criteria for a lifetime mood, anxiety or substance use disorder (compared to 24% of those who never experienced trauma). The most commonly experienced disorders were alcohol use disorder (29%), major depressive disorder (21%)
Developmental heritability of internalizing symptoms and cigarette use co-occurrence Cristina B. Bares 1 , Kenneth S. Kendler 3,2 , Judy Silberg 2 1 School of Social Work, Virginia Commonwealth University, Richmond, VA, United States 2 Department of Human Genetics, Virginia Commonwealth University, Richmond, VA, United States 3 Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
Aims: Previous research with adult twins has indicated that additive genetic factors contribute substantially to the association between adult internalizing symptoms and cigarette use. This study was conducted to examine how the contribution of genetic and shared environmental factors to the co-occurrence between internalizing symptoms and cigarette use among adolescent twins change during adolescence. Methods: Adolescent twin pairs (n = 1258) came from the population-based Virginia Twin Study of Adolescent Behavioral Development. Age-specific bivariate twin modeling was performed of the highest number of cigarettes smoked and a composite measure of anxious and depressive symptoms from the Child and Adolescent Psychiatric Assessment. Saturated bivariate Cholesky models for two age groups (14- to 15-, and 16- to 17-year-olds) were compared to reduced models where additive genetic and shared environmental influences were systematically removed and the fit of the nested models compared using OpenMx. Results: Compared to the saturated bivariate Cholesky, including three sources of genetic variance, a model dropping shared environmental effects caused a reduction in model fit for both groups (x2 (3, n = 582) = 10.73, p < .01; x2 (3, n = 676) = , p < .01). The best fitting models indicated that 40.9% (for 14 to 15-y-o) and 37.5% (for 16- to 17-y-o) of the total variance was explained by shared environmental factors common to both cigarette use and internalizing symptoms. Conclusions: The co-occurrence between internalizing symptoms and cigarette use among a sample of adolescent twins appears to result from decreasing shared environmental factors that influence the risk to both traits. Financial support: Funding for Dr. Bares’ work comes from Dr. James Anthony’s R25 DA030310. Funding for the Virginia Twin Study of Adolescent Behavioral Development comes from the following NIH grant, MH-45268. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.057 How important are counselor and client characteristics in determining overall client satisfaction with 12-step focused community counseling groups? Rita Baroni 1 , Douglas Boyd 1 , Adam Christmann 1 , Emily Hutz 1 , Carolyn M. Carpenedo 1 , Adam C. Brooks 1 , Alexandre B. Laudet 2 , K.C. Kirby 1,3 1 Treatment Research Institute, Philadelphia, PA, United States 2 National Development and Research Institutes, New York, NY, United States 3 University of Pennsylvania School of Medicine, Philadelphia, PA, United States
Aims: Research indicates that client satisfaction at end of treatment is associated with successful treatment outcomes. The
e217
present study examines client satisfaction in community counseling groups and counselor and client characteristics associated with increased satisfaction. Methods: In a pre-intervention phase of a large, multi-phase, multi-site clinical trial, 80 counselors completed a background form and agreed to run five group sessions on 12-step facilitation (12SF) topics, with minimal training and covering the content to the best of their current knowledge and ability. 700 clients in the counselors’ groups also agreed to participate and completed a background form prior to attending groups. After the fifth session, clients rated their satisfaction with the 12SF groups on both general and 12SF specific items. Results: Binary logistic regression for general satisfaction showed that clients under judicial pressure to be in treatment were 46.3% less likely to be very satisfied (OR = .573, p = .003), whereas clients whose counselors had more years of experience were more likely to be very satisfied (OR = 1.04, p = .007). For 12S specific satisfaction, clients under judicial pressure were 44.9% less likely to be very satisfied (OR = .551, p = .000) and clients who had counselors that identified as being in recovery were 80fl more likely to be very satisfied (OR = 1.80, p = .037). Conclusions: These results suggest that certain client and counselor characteristics are associated with client satisfaction with group counseling, and thus could influence client outcome. Treatment providers may need to (1) develop different strategies to foster higher satisfaction among criminal justice populations, and (2) focus on providing additional training on 12SF to less experienced counselors or those not in recovery in order to increase satisfaction. Financial support: NIAAA R01 AA017867. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.058 Substance use and mental health consequences of childhood trauma: An epidemiological investigation Emma L. Barrett, Maree Teesson, Cath Chapman, Tim Slade, Natacha Carragher, Katherine Mills National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia Aims: Exposure to childhood trauma (CT) can have very serious and enduring effects including the development of mental health disorders. Few studies, however, have examined associations between CT and mental health disorders in the general population. The aim of this epidemiological study is to identify the substance use and mental health consequences of CT using data collected as part of the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). Methods: The 2007 NSMHWB was a nationally representative survey of 8841 adult Australians. CT exposure and lifetime DSMIV substance use and mental health disorders were assessed using the World Mental Health Composite International Diagnostic Interview. Analyses were weighted to provide population estimates. Results: 41% of Australian adults were exposed to a traumatic event during their childhood (before 17 years of age) and 20% experienced their first trauma prior to 9 years of age. The most common CTs were sexual assault, witnessing serious injury or death, and the unexpected death of a loved one. Half of those who experienced CT (53%) met DSM-IV criteria for a lifetime mood, anxiety or substance use disorder (compared to 24% of those who never experienced trauma). The most commonly experienced disorders were alcohol use disorder (29%), major depressive disorder (21%)