The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-white, non-heterosexual populations.
The benefits of high-quality father-child relationships for fathers and children alike are well documented. While evidence suggests parenting programs can improve the quality of father-child relationships, few fathers participate in such programs. This qualitative study aims to fill the gap in knowledge on best practices for recruiting urban African American fathers, a group of fathers with unique parenting challenges, to parenting programs. Focus groups were conducted with 29 fathers to gain their perspectives on recruitment strategies. Semi-structured interviews were also conducted with a nationwide sample of 19 fatherhood program providers to learn about their most successful recruitment strategies. Recruitment strategies based on emergent themes from the focus groups and interviews are presented here. Themes included using word-of-mouth recruitment, increasing advertising, targeting advertising specifically to urban African American fathers, providing transportation and incentives, recruiting through the courts, collaborating with other community agencies, and offering parenting programming along with other programming valued by fathers such as employment assistance. Implications for developing strategies for recruiting urban African American fathers to parenting programs are discussed.
Background
Children with developmental disabilities are at heightened risk for maltreatment. However, little is known regarding the prevalence of maltreatment among specific groups, such as autism spectrum disorder (ASD) and/or intellectual disability (ID). Information about maltreatment in these groups can aid in the development of supports and prevention strategies for vulnerable children and their families.
Methods
Using record linkage between the Department of Social Services (DSS) and the Autism and Developmental Disabilities Monitoring (ADDM) network, this study compares the prevalence and characteristics of maltreatment among children with ASD‐only (n = 316), ASD and comorbid ID (ASD+ID; n = 291), ID‐only (n = 1,280), and controls (n = 3,101). Behavioral correlates of maltreatment are examined.
Results
Controlling for demographic factors, this study found significantly higher odds of reported and substantiated maltreatment among children with ASD‐only (odds ratio = 1.86 for reported, 1.51 for substantiated), ASD+ID (odds ratio = 2.35 for reported, 1.97 for substantiated), and ID‐only (odds ratio = 2.45 for reported, 2.49 for substantiated) relative to a population control group, with large effects. In particular, children with ASD+ID and ID‐only were between two and three times more likely to experience maltreatment. All groups were more likely to experience physical neglect, and children in the ASD+ID and ID‐only groups were more likely to experience all forms of abuse. Children in the ASD‐only group were more likely to experience physical abuse. Maltreated children in the ASD‐only and ID‐only groups experienced more cases of physical abuse and neglect, and were victimized by more perpetrators compared to other maltreated youth. Maltreatment was associated with higher likelihood of aggression, hyperactivity, and tantrums for children with ASD.
Conclusions
Children with ASD and/or ID are at heightened risk for maltreatment. Empirically‐supported assessment and intervention approaches for identifying and addressing traumatic stress related to maltreatment in ASD are urgently needed.
This qualitative study examines low-income African American fathers’ perceptions of their parenting role and the strategies they employ to bring up children in poor urban neighborhoods. Focus groups and individual interviews were conducted with 36 fathers who had contact with their children at least twice a month. Men in the study expressed conventional views of their fathering roles as provider, nurturer, and teacher, but placed the most emphasis on “being there” for their children, as their financial circumstances limited other forms of involvement. Many fathers felt their circumstances to be exacerbated by a hostile child-support system. They desired to teach their children alternatives to the negative practices and values they saw in their urban neighborhoods and to have the skills to prosper in mainstream society. Overall, the findings suggest that many low-income urban fathers already desire to be responsible fathers but see themselves as limited by material and structural challenges. Services and policies that promote the economic stability of low-income fathers are recommended.
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