Predictors of Readiness to Exit Commercial Sexual Exploitation Among Women in India and the U.S.

Exiting commercial sexual exploitation (CSE) is a difficult and prolonged process. This study examines the predictors of readiness to exit CSE, using the stages of change model as an underlying framework, among women in India (n=163) and the U.S. (n=87). Constructs such as years of schooling, residence, unemployment, age of entry, causes of entry, types of exploitation, addictions, presence of perpetrator, culture – individualistic and collectivistic, stigma, social support, empowerment, and current involvement in CSE were assessed. Results of a multi-group analysis indicated significant differences in the relationships between readiness to change and the predictor measures. For the Indian sample, years of schooling, economic conditions/abuse/runaway behavior as reasons for entry, individualistic and collectivistic culture approaches, and stigma were associated with readiness to change. For the U.S. sample, living by oneself, abuse/runaway behavior as reasons for entry, indoor experiences of exploitation, substance abuse problems, collectivist cultural approach, social support, and current involvement in CSE were associated with readiness to change. However, some similarities were also found. The findings suggest that service provision must focus on addressing the constructs that increase the readiness to exit, while also being culturally competent

Graduate Student Impairment: The Impact on Counselor Training Programs

This article focuses on the issue of student impairment in graduate level counselor training programs and the factors that affect it, including: A definition of graduate student impairment; the prevalence of student impairment in counselor training programs; an explanation of the legal consequences when addressing student impairment; organizational issues in universities dealing with this issue; and, the impact of graduate student impairment on the counseling professions

The geographic distribution of nurse practitioners in the United States

This study analyzed the geographic distribution of nurse practitioners in the United States. Primary data on nurse practitioners were obtained from State Boards of Nursing and the District of Columbia in the spring of 1994. At the state level, nurse practitioners were more concentrated in urban areas than their physician counterparts. Of the 33,094 certified nurse practitioners, 85% were in metropolitan areas. Results from the dissimilarity indices between nurse practitioners and general populations showed that a greater supply of nurse practitioners in a state may not necessarily lead to an equitable distribution across counties. At both the state and county levels, the supply of nurse practitioners was positively associated with the supply of primary care physicians. Results from multivariate analyses show that nurse practitioners were more likely to locate in a county where state laws allowed independent practice. States that allow independent practice and direct third-party reimbursement will likely have greater availability and a larger supply of nurse practitioners in rural counties. © 1997 John Wiley & Sons, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/35206/1/5_ftp.pd

Examining Factors in the Research Institute on Addictions Self-Inventory (RIASI): Associations with Alcohol Use and Problems at Assessment and Follow-Up

Impaired driving is a leading cause of alcohol-related deaths and injuries. Rehabilitation or remedial programs, involving assessment and screening of convicted impaired drivers to determine problem severity and appropriate programs, are an important component of society’s response to this problem. Ontario’s remedial program, Back on Track (BOT), involves an assessment process that includes administration of the Research Institute on Addictions Self-Inventory (RIASI) to determine assignment to an education or treatment program. The purpose of this study is to identify factors within the RIASI and examine how factor scores are associated with alcohol use and problem indicators at assessment and six-month follow-up. The sample included 22,298 individuals who completed BOT from 2000 to 2005. Principal component factor analysis with varimax rotation was conducted on RIASI data and an eight factor solution was retained: (1) Negative Affect, (2) Sensation Seeking, (3) Alcohol-Quantity, (4) Social Conformity, (5) High Risk Lifestyle, (6) Alcohol Problems, (7) Interpersonal Competence, and (8) Family History. Regression analyses were conducted to examine associations between factors and alcohol and problem measures obtained at assessment and at follow-up. Most factors, except for Interpersonal Competence, were associated with more alcohol use and problems at assessment. A similar pattern was observed at 6-month follow-up, but interestingly some factors (Negative Affect, Sensation Seeking, Alcohol-Quantity and Family History) predicted fewer days of alcohol use. The Interpersonal Competence factor was associated with significantly lower levels of alcohol use and problems at both assessment and follow-up. This work suggests that the RIASI provides information on several domains that have important relationships with alcohol problem severity and outcomes

Factors contributing to enrollment in a family treatment court

Background: The literature has shown that standard drug courts have had some success in reducing recidivism. As a result of drug court success, there has been an extension of therapeutic courts into other areas, including family courts. Characteristics that identify those who are likely to refuse entering a Family Treatment Court (FTC) can provide insight into how refusal rates may be decreased. Objectives: This study evaluated FTC enrollment to identify predictors that may aid in the development of interventions to decrease refusal rates. Methods: A total of 229 referrals to the FTC were included in this study. Comparisons were made across a number of factors between those who chose to enroll in the FTC and those who did not. Binary logistic regression modeled the effect of independent variables on the probability of enrollment. Results: There were high rates of mental health problems, with high rates of trauma exposure in the sample, consisting mostly of females. Race, government assistance, severity of substance use problems, motivation to change substance use behavior, and parent†child interactions were significant predictors of enrollment. Conclusions and Scientific Significance: The results for the study point out the need for possible specialized treatments and a need to consider how motivational elements may be addressed during the intake assessment to aid in decreasing refusal rates. Additionally, the results point toward a need for consideration of family system approaches when working with FTC participants as well as the need for further work with motivational elements and drug court participants. © 2011 Informa Healthcare USA, Inc

Creating a Trauma-Informed Community Through University-Community Partnerships:An Institute Agenda

The impact of trauma on wellness has been identified as a community health crisis. The alliance of universities and communities is a plausible response to address the scope of the problem given their wealth of resources. The Institute on Trauma and Trauma-informed Care (ITTIC) is an exemplar of a university-community partnership and unique approach that has fostered a common language within and between organizations to foster at the community level an awareness and understanding of trauma. The present article provides an overview of university-community partnerships and their importance to social work practice. It describes the formation of the Institute and discusses its model and contributions to the local community and abroad. The implications of ITTIC for the School, University and community are discussed. An iterative process that includes active engagement, evaluation, and reflection, is recommended for the integration and advancement of trauma-informed care through university-community partnerships

Examining the relationship between psychological functioning, childhood trauma, and types of perceived coercion among drug court enrollees: Results from a pilot study

Background: Drug court interventions produce positive results—especially among mandated populations. Many criminal justice-involved persons, including drug court enrollees, have co-occurring substance abuse and childhood trauma disorders associated with psychological dysfunction. Given the coercive nature of mandated drug court treatment, it is important to understand whether childhood trauma and psychological functioning influence perceived coercion to enter treatment. Objectives: The purpose of this study was to describe the degree to which adverse childhood trauma and psychological functioning were associated with six domains of perceived coercion—self, family, legal, financial, health, and work—among a population of drug court enrollees. Methods: Data from 54 enrollees in a drug court pilot study were used to examine the relationship between childhood trauma, psychological functioning, and perceived coercion. Results: The pilot study data showed that psychological dysfunction and traumatic experiences in childhood were associated with higher perceived coercion to treatment, explaining 29% of the variance in coercion, controlling for gender and pre-arrest alcohol and drug use. Results indicated that the associations between psychological dysfunction and trauma were driven by non-legal types of coercion. In particular, childhood trauma was correlated with family (r = 0.32), financial (r = 0.32), and health (r = 0.47) types of coercion. Conclusions: Based on these preliminary findings, drug court practitioners are urged to assess perceived coercion, in addition to the behavioral health and childhood trauma of their clients, and to utilize non-legal types of coercion such as family, health, and financial impact to enhance treatment engagement

An Association Between Implementing Trauma-Informed Care and Staff Satisfaction

Despite its widespread adoption there is limited research on the influence of trauma-informed care (TIC). The current study examined the impact of implementing TIC on the satisfaction of agency staff by comparing the results of a satisfaction survey taken in January of 2014, a month prior to the agency's implementation of TIC, and again twelve months later. As collaboration, empowerment, and self-care are primary components of a TIC organizational approach, its implementation was expected to increase staff satisfaction. Following the implementation of TIC, agency staff reported higher scores on all but one of the six satisfaction survey factors. Increases in staff satisfaction have been associated with better staff retention rates, increased organizational commitment and better performance. In consequence, TIC implementation is associated with increased staff satisfaction, and may positively influence organizational characteristics of significance to social service agencies