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FAMILY VIOLENCE & SUBSTANCE USE

FAMILY VIOLENCE & SUBSTANCE USE. Kevin Oishi, RSW Alberta Health Services—Addiction and Mental Health Main Floor, Provincial Building 200 5 th Avenue South Lethbridge AB. AGENDA. ADDICTION: CONTINUUM OF USE CONTRAST TREATMENT FOCUS & DEMOGRAPHICS ASSESSMENT TOOLS IMPACT OF ADDICTIONS

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FAMILY VIOLENCE & SUBSTANCE USE

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  1. FAMILY VIOLENCE & SUBSTANCE USE Kevin Oishi, RSW Alberta Health Services—Addiction and Mental Health Main Floor, Provincial Building 200 5th Avenue South Lethbridge AB

  2. AGENDA • ADDICTION: CONTINUUM OF USE • CONTRAST TREATMENT FOCUS & DEMOGRAPHICS • ASSESSMENT TOOLS • IMPACT OF ADDICTIONS • TREATMENT METHODS: MOTIVATIONAL INTERVIEWING & STAGES OF CHANGE

  3. CONTINUUM OF USE

  4. WHAT YOU ARE ABOUT TO SEE • STATISTICS FROM ALBERTA HEALTH SERVICES ADDICTION RECORDS • COMPARISON OF 2009 v. 2010 DEMOGRAPHICS (April 1 – Sept 29) • N=49 for 2010 • N=80 for 2009

  5. ALCOHOL USE DISORDERS IDENTIFICATION TEST (AUDIT) • Developed by the World Health Organization. • Identify patterns of alcohol use that have a negative impact on the user. • Identify areas for intervention. • Score range is 0 – 40.

  6. AUDIT SCORING No – Low Risk 0 -- 7 Education & Awareness 8 --15 Brief Intervention 16 -- 19 Further Treatment 20+

  7. ALCOHOL DEPENDENCE SCALE(Skinner, 1984) DRUG ABUSE SCREENING TEST(Skinner, 1982)

  8. SOUTH OAKS GAMBLING SCREEN (SOGS)(Lesieur & Blume, 1987) • SCREENING INVENTORY BASED ON CRITERIA FOR PATHOLOGICAL GAMBLING FROM THE DSMIII-R. • 16-ITEM QUESTIONNAIRE. • ANSWERS PERTAIN TO THE LAST 12 MONTHS AND LIFETIME PRIOR TO THE PAST 12 MONTHS.

  9. ALCOHOL • 50% of batterers are heavy or binge drinkers. • Victims are 8 times more likely to be assaulted on days that batterers are drinking (Fals-Stewart & Kennedy, 2005). • Binge drinking, abstinence linked to FV (Leonard et al., 1988). • Victim’s drinking 2 times as common following an abusive attack (Barnett & Fagan, 1993).

  10. SUBSTANCES Stimulants (cocaine, dexedrine, meth.) • Female crack users at high risk for severe violence (Bury et al., 1999). • Likelihood of violence increases 16 times on days of use (Fals-Stewart, 2003). Cannabis (pot, hash, oil) • Cannabis withdrawal syndrome related to violence. CNS Depressants (Codeine, oxycodone, morphine, opium). • Victims: 75% more sedative use, 40% more sleeping pill use (Health Canada, 1994). Study: polydrug use very prevalent among batterers (Lee et al., 2007) • Women who combine crack and alcohol are 5x more likely to experience partner violence (El-Bassell et al., 2000).

  11. GAMBLING Intimate partners of problem gamblers are 10 times more likely to be treated in emergency departments for physical injuries caused by a violent episode (Muelleman et. al., 2002).

  12. FAMILY IMPACT • Approx. 40% of children from violent homes believe their father had a drinking problem and that they were more abusive when drinking (Roy, 1988). • Childhood physical abuse is associated with later substance abuse by youth (Dembo et al., 1987). • Substance abuse by one parent increases the likelihood that the substance-abusing parent will be unable to protect children if the other parent is violent (Reed, 1991). • More than half of defendants accused of murdering their spouses – as well as almost half of victims – had been drinking alcohol at the time of the incident (Bureau of Justice Statistics, 1994).

  13. WHY ADDICTIONS TREATMENT? • Addiction and FV share common features: perceived loss of control, ongoing use despite negative consequences, minimization, denial and rationalizing addictive behaviour (Muelleman et. al., 2002). • Interventions make a difference! • “Violence recidivism subsequent to batterer intervention was reduced by 30 – 40% if the individual obtained substance abuse treatment…” (Stuart, 2003). • Motivational interviewing successful with court-mandated clients (Kistenmacher et. al., 2008).

  14. STAGES OF CHANGE Pre-contemplation: not yet ready to change. Contemplation: beginning to think seriously about change (ambivalence). Preparation: getting ready to take action; treatment. Action: in the process of changing behaviour. Maintenance: working to maintain the changes. Relapse: falling back into old patterns.

  15. TASK OF COUNSELLOR

  16. QUESTIONS? REFERENCES AVAILABLE UPON REQUEST Kevin Oishi AHS-Addiction & Mental Health 403-381-5183 kevin.oishi@albertahealthservices.ca

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