Can Family-Focussed Interventions Improve Problematic Substance Use in Aboriginal Communities? A Role for Social Work

Munro, A.; Allan, Julaine

doi:10.1080/0312407x.2010.508841

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…Some social work studies have critically examined individualised approaches to drug and alcohol intervention that locate the problem and the solution within the substance user. For example, scholars emphasise the need for family-focussed and culturally specific drug and alcohol interventions, especially for First Nation communities (Munro and Allan, 2011). This includes examining individual and group ‘treatment’ outcomes for Aboriginal and Non-Aboriginal women (Allan and Kemp, 2011).…”

Section: Introductionmentioning

confidence: 99%

Questioning policy representations of women’s alcohol consumption: Implications for social work

Smith

Zufferey

Bilic

et al. 2021

Qualitative Social Work

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This study draws on Carol Bacchi’s What’s the problem represented to be? (WPR) framework, to deconstruct policy discourses of women’s alcohol consumption. It examines Australian policies such as in the National Alcohol Strategy (2019–2028) and Australian Guidelines to Reduce Health Risks from Drinking Alcohol ( NHMRC, 2009, 2020 ). It found that policy discourses particularly focus on the effects of women’s alcohol consumption as ‘harms’ to unborn children, by emphasising women’s assumed reproductive roles, such in pregnancy and when breastfeeding. Social policy tends to reproduce medicalising and normative gendered discourses about women’s alcohol consumption, with disempowering effects on women. This discourse analysis of drug and alcohol policies can contribute to broadening how social workers understand policy representations and the effects of policy discourses on women. The disciplinary power of the medicalisation and acceptable/unacceptable categorisation of women’s alcohol consumption means that women can internalise shame and stigma, which is often an obstacle for women attempting to seek assistance. More research is needed about how social workers can co-design policies and research projects with women of diverse sexualities and cultural backgrounds who have been subjugated by these policy discourses.

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Section: Introductionmentioning

confidence: 99%

Questioning policy representations of women’s alcohol consumption: Implications for social work

Smith

Zufferey

Bilic

et al. 2021

Qualitative Social Work

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“…For individuals in the general population seeking treatment, cognitive-behavioral and motivational enhancement therapy (Copeland et al, 2014) and contingency management (Copeland & Swift, 2009), with treatment for concurrent substance misuse (Banbury et al, 2013;Copeland & Swift, 2009), can support cannabis cessation. In contrast with tobacco smoking, where a focus on individual behavior (Marley et al, 2014), supported in health clinics (Eades, Sanson-Fisher, & Panaretto, 2013), could be effective when oriented towards groups and families (McCalman et al, 2012;Munro & Allan, 2011), few studies have addressed cannabis demand and harm reduction or treatment strategies for Indigenous Australians (Bohanna, Bird, Copeland, Roberts, & Clough, 2014;. To plan for harm reduction approaches and treatments in such settings, improved understandings of the specific social and attitudinal context of substance misuse are essential (Pawson, 2006;Poland, Frohlich, & Cargo, 2009).…”

Section: Introductionmentioning

confidence: 99%

“Need Everyone Helping to Keep Off Because Everyone Helping to Keep On” – Reducing Harms from Cannabis use in Remote Indigenous Australian Communities Involves More Than Just Users

Graham

Clough

2019

Substance Use & Misuse

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Background: Heavy cannabis use in remote Indigenous Australian communities potentially contributes to existing health disparities. Community members' perceptions of cannabis harms will support harm-minimization in these settings. Objective: To describe perceived cannabis harms reported by a cohort of Indigenous Australians living in small, isolated communities as an indication of their existing resources for change. Method: Inductive thematic analysis of 407 semi-structured interviews with participants in a cohort study in three remote communities in Cape York in far north Queensland (Australia) revealed major areas of concern about cannabis. Three attitudinal categories were defined according to reported cannabis impacts and urgency for change: 1-"LOW CONCERN" said cannabis was a low priority community issue; 2-"SOME CONCERN" tolerated cannabis use but identified personal or community-level concerns; and 3-"HIGH CONCERN" expressed strong aversion to cannabis and identified serious personal or community-level harms. The characteristics and the patterns of concerns were summarized across the groups. Results: "Category 1-LOW CONCERN" (n ¼ 107), mostly current users, emphasized personal "financial impacts" and "stress." "Category 2 -SOME CONCERN" (n ¼ 141) perceived community level impacts warranting systematic action, particularly on "employment"; and "Category 3 -HIGH CONCERN" (n ¼ 159), most of the never users, emphasized concerns for families and youth. Irrespective of use history, the cohort reported financial and abstinence-related stress, overlapping alcohol issues and generally endorsed alleviating impacts on children and youth. Conclusion: Nearly ubiquitous experience with cannabis harms and impacts in this cohort suggests resources for harm reduction including family and cultural obligation, stress relief, financial management, and engagement are available across all community members, not just users.

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“…There is no simple way to reduce the burden of substance-related harm experienced by Aboriginal Australians [8] and, as such, a range of effective and culturally safe approaches are required. Gray et al [9] identify appropriate strategies including: acute treatment (sobering-up centres, detoxification) [10]; counselling and residential treatment [11][12][13][14]; support services (health services, accommodation, crisis care) and prevention (health promotion, cultural initiatives, supply reduction) [4,15,16]. Regardless of the strategy, access to Aboriginal community-controlled health services is vital to an Aboriginal person's right to selfdetermination [13,17], even if some Aboriginal patients prefer to access non-Aboriginal-specific services [18].…”

Section: Introductionmentioning

confidence: 99%

Understanding remote Aboriginal drug and alcohol residential rehabilitation clients: Who attends, who leaves and who stays?

Munro

Shakeshaft

Breen

et al. 2018

Drug and Alcohol Review

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Introduction and AimsAboriginal residential rehabilitation services provide healing for Aboriginal people who misuse substances. There is limited available research that empirically describes client characteristics of these services. This study examined 5 years of data of a remote Aboriginal residential rehabilitation service.Design and MethodsRetrospective analysis of 329 client admissions to Orana Haven Drug and Alcohol Rehabilitation Centre from 2011 to 2016. Multinomial and binary logistic regressions were conducted to identify trends in the data.ResultsThere were 66 admissions recorded annually, of which most identified as Aboriginal (85%). Mean length of stay was 56 days, with one in three (36%) discharging within the first month. A third (32%) completed, 47% self‐discharged and 20% house‐discharged from the program. Client age significantly increased over time (P = 0.03), with most aged from 26 to 35. Older clients were significantly more likely to readmit (P < 0.002) and stay longer than 90 days (P = 0.02). Most clients were referred from the criminal justice system, significantly increasing from 79% (2011–2012) to 96% (2015–2016) (P < 0.001) and these clients were more likely to self‐discharge (P < 0.01). Among a subset of clients, most (69%) reported concerns with polysubstance use and half (51%) reported mental illness.Discussion and ConclusionsThe current study makes a unique contribution to the literature by empirically describing the characteristics of clients of a remote Aboriginal residential rehabilitation service to more accurately tailor the service to the client's needs. Key recommendations include integrating these empirical observations with staff and client perceptions to co‐design a model of care, standardise data collection, and routinely following‐up clients to monitor treatment effectiveness.

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Can Family-Focussed Interventions Improve Problematic Substance Use in Aboriginal Communities? A Role for Social Work

Cited by 8 publications

References 30 publications

Questioning policy representations of women’s alcohol consumption: Implications for social work

Questioning policy representations of women’s alcohol consumption: Implications for social work

“Need Everyone Helping to Keep Off Because Everyone Helping to Keep On” – Reducing Harms from Cannabis use in Remote Indigenous Australian Communities Involves More Than Just Users

Understanding remote Aboriginal drug and alcohol residential rehabilitation clients: Who attends, who leaves and who stays?

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