Initial development of a healthy living curriculum within family behavior therapy for substance abuse

A mother referred for child maltreatment and substance abuse treatment after her son tested positive for methamphetamines at birth participated in an in-home Family Behavior Therapy-Healthy Lifestyle intervention to eliminate substance use, improve parenting behaviors, lose weight, and develop better exercise habits. Twenty sessions were completed in 6 months that targeted familial communication, self-control, goal setting with contingency management, job getting skills, and stimulus control techniques. Upon termination from treatment, the participant’s self-report and urine testing was consistent with substance cessation, and she evidenced substantial improvements in her level of stress, family communication and relationships, and child maltreatment potential. She was able to maintain her weight, and body mass index, and reported engaging in more frequent healthy behaviors. Further, the participant reported more satisfaction with her appearance. Validity indices were mixed with some indicating the participant may have been attempting to present herself favorably

Incorporando un plan de Vida Saludable en la Terapia Familiar Conductual: Ejemplificando un Caso Clínico de una Mujer con historial de Violencia Doméstica, Negligencia Infantil, Abuso de Drogas y Obesidad

Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems. This research was supported by a grant from the National Institute on Drug Abuse (1R01DA020548-01A1) awarded to Brad Donohue. The authors wish to thank Sally K. Miller, PhD, APN, FAANP and Associate Professor, UNLV School of Nursing for her work in completing the initial in-home health evaluation/physical for the current project.Las mujeres reportadas a las agencias de servicios de protección infantil, con frecuencia presentan problemas que interfieren con la salud y el bienestar de ellas y de sus hijos. Los programas de intervención conductual parecen ser eficaces en el manejo de problemas coexistentes como: la violencia doméstica y el abuso de drogas. Sin embargo, los tratamientos cuya eficacia ya ha sido demostrada en ocasiones anteriores, rara vez se han puesto en práctica en casos clínicos complicados, sobre todo en los centros de asistencia a menores. Por lo tanto, en este caso clínico, se describe el proceso de adaptación de un tratamiento eficaz para ayudar a controlar los problemas coexistentes de salud de una mujer acusada de negligencia infantil y abuso de drogas. Al finalizar el tratamiento, la participante informó sobre la mejoría en sus relaciones familiares, sobre su consumo de drogas y la negligencia infantil; aunque otros resultados relacionados con su salud no quedaron completamente claros. Gran parte de las mejorías se mantuvieron hasta 4 meses  después de haber concluido el tratamiento. Antes de implementar cada fase del tratamiento, discutimos los  contextos de la comunidad, aumentando así la probabilidad de obtener resultados positivos y respetando la integridad y el ajuste del tratamiento estándar para evitar que se presenten problemas en un futuro.Esta investigación se financió gracias a una subvención del Instituto Nacional de Drogodependencia (1R01DA020548-01A1) otorgada a Brad Donohue. Los autores desean agradecer a Sally K. Miller, PhD, APN, FAANP y Profesora Asociada de la Escuela de Enfermería de La Universidad de Nevada Las Vegas, por el examen físico inicial que se llevó a cabo en el domicilio de la participante de este proyecto

Incorporating a Healthy Living Curriculum within Family Behavior Therapy: A Clinical Case Example in a Woman with a History of Domestic Violence, Child Neglect, Drug Abuse, and Obesity

Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems. This research was supported by a grant from the National Institute on Drug Abuse (1R01DA020548-01A1) awarded to Brad Donohue. The authors wish to thank Sally K. Miller, PhD, APN, FAANP and Associate Professor, UNLV School of Nursing for her work in completing the initial in-home health evaluation/physical for the current project

Incorporando un plan de Vida Saludable en la Terapia Familiar Conductual: Ejemplificando un Caso Clínico de una Mujer con historial de Violencia Doméstica, Negligencia Infantil, Abuso de Drogas y Obesidad

Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems. This research was supported by a grant from the National Institute on Drug Abuse (1R01DA020548-01A1) awarded to Brad Donohue. The authors wish to thank Sally K. Miller, PhD, APN, FAANP and Associate Professor, UNLV School of Nursing for her work in completing the initial in-home health evaluation/physical for the current project.Las mujeres reportadas a las agencias de servicios de protección infantil, con frecuencia presentan problemas que interfieren con la salud y el bienestar de ellas y de sus hijos. Los programas de intervención conductual parecen ser eficaces en el manejo de problemas coexistentes como: la violencia doméstica y el abuso de drogas. Sin embargo, los tratamientos cuya eficacia ya ha sido demostrada en ocasiones anteriores, rara vez se han puesto en práctica en casos clínicos complicados, sobre todo en los centros de asistencia a menores. Por lo tanto, en este caso clínico, se describe el proceso de adaptación de un tratamiento eficaz para ayudar a controlar los problemas coexistentes de salud de una mujer acusada de negligencia infantil y abuso de drogas. Al finalizar el tratamiento, la participante informó sobre la mejoría en sus relaciones familiares, sobre su consumo de drogas y la negligencia infantil; aunque otros resultados relacionados con su salud no quedaron completamente claros. Gran parte de las mejorías se mantuvieron hasta 4 meses  después de haber concluido el tratamiento. Antes de implementar cada fase del tratamiento, discutimos los  contextos de la comunidad, aumentando así la probabilidad de obtener resultados positivos y respetando la integridad y el ajuste del tratamiento estándar para evitar que se presenten problemas en un futuro.Esta investigación se financió gracias a una subvención del Instituto Nacional de Drogodependencia (1R01DA020548-01A1) otorgada a Brad Donohue. Los autores desean agradecer a Sally K. Miller, PhD, APN, FAANP y Profesora Asociada de la Escuela de Enfermería de La Universidad de Nevada Las Vegas, por el examen físico inicial que se llevó a cabo en el domicilio de la participante de este proyecto