The impact of continuing care adherence on environmental risks, substance use, and substance-related problems following adolescent residential treatment.

The effectiveness of adolescent treatment to reduce substance use has been demonstrated by a number of different literature reviews, yet longer term outcome studies have suggested that continued alcohol and other drug use is common. Participation in continuing care services and reductions in environmental risk factors (e.g., peer substance use or alcohol or drug use in the home) have both been found to be associated with improved posttreatment substance use. The authors conducted Path analysis to examine the experimental direct effect of the Assertive Continuing Care Protocol (S. H. Godley, M. D. Godley, & M. L. Dennis, 2001) on general continuing care adherence following residential treatment and the protocol's indirect effect (via general continuing care adherence) on social and environmental risk factors, as well as subsequent substance use and substance-related problems. Supporting previous findings, the final model indicates that greater adherence to continuing care is associated with reductions in environmental risk, which in turn is associated with reduced adolescent substance use and substance-related problems 9 months after discharge from residential treatment.     

Contingency Management for Attendance to Group Substance Abuse Treatment Administered by Clinicians in Community Clinics

Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were enrolled in the clinics when the CM treatment phase was in effect attended a significantly greater percentage of therapy sessions than patients who were enrolled in treatment when CM was not in effect. This study is one of the first to investigate CM in community settings implemented entirely by community clinicians, and results suggest that CM is effective in improving therapy attendance.     

Early exposure to violence,domestic violence,attachment representations,and marital adjustment

The present study investigates the effects of violent experiences in childhood on current domestic violence and marital adjustment, using adult attachment theory as a conceptual framework. A nonclinical sample of 644 Canadian adults in long‐term romantic relationships completed measures of adult romantic attachment, conflict tactics scales, and dyadic adjustment. Structural equation modeling revealed that early experiences of violence affect adults' intimate violence directly and indirectly through anxiety over abandonment and avoidance of intimacy. The actor–partner interdependence model illustrated the importance of early exposure to violence in predicting both partners' attachment representations, intimate violence, and couple adjustment. Findings are discussed with reference to the clinical issues surrounding minor violence against the intimate partner.