Individual Critical Summary Paper (case study)

INDIVIDUAL CRITICAL SUMMARY PAPER

Individual Critical Summary Paper

Case study

Concordia University

        Alcohol abuse is a major problem for Aboriginal communities in Canada. The first article "An Alcohol Abuse Early Intervention Approach with Mi’kmaq Adolescents" written by Christopher J. et al. (2007) presents a culturally-appropriate project, which created an early intervention alcohol abuse program for at-risk Mi'kmaq school age youth in Nova Scotia. This intervention project was culturally adapted and approved by the Elders of the Mi'kmaq community. The Mi'kmaq youth were involved in all steps of the process.

        Qualitative interviews were used to discover young people's understanding of the reason for their drinking, and to combine stories and images in order to design manuals. A youth artwork based on story themes was included in the manual to convey spiritual responses to the topic. Based on the data there were three major personality types and drinking motives:

1. Anxiety sensitivity: the use of alcohol to escape the unpleasant feelings, to have comfort.

2. Sensation seeking: the use of alcohol to experience euphoric or/and intoxicating effect.

3. Hopelessness and/or negative thinking: the use of alcohol to reduce pain or/and hurt.

        The project has 41 participants aged 14 - 18 (12 of them were in the control group). They all had demographic questionnaires, Rutgers Alcohol Problem Index (RAPI; 23 item self-report questionnaire about drinking symptoms), and about the use of marijuana.

        The intervention adapted cultural and evidence-based science approaches, and the Cognitive-Behavioural model. All participants had one of three personality-matched brief (2*90 minute sessions). Outcomes were collected at four-month post-treatment follow-ups. The results demonstrated a decrease in drinking frequency and alcohol-related problems by the RAPI, alcohol abstinence, and marijuana use compared to the control group up to 30%. This project shows a positive outcome of early intervention and prevention of alcohol abuse in at-risk youth.

        Jean, the person from my case study, used alcohol as a coping mechanism to deal with her pain, in order to reduce negative feelings of adapting to life at college. I think that this intervention plan could help her to decrease the amount of alcohol consumption and alcohol related problems.

        In the second article "The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms" written by B. Calabria et al. (2008) authors pointed out that that Aboriginal Australians have high levels of alcohol-related problems compared to the Australian population. Family, community, and cultural approaches are very important factors in Cognitive-Behavioral Intervention. This article describes and evaluates two approaches:

1. A family focused version of the Community Reinforcement Approach (CRA)

2. A Community Reinforcement and Family Training (CRAFT)

        This study had 116 participants, including Aboriginal Australians and non-Aboriginal, who have Aboriginal relatives with alcohol use problems and had CRA/CRAFT treatment. The age of the participants was 18 - 72 years old. The sampling had 56 males, 48 females, and 1 participant did not answer. All participants had a test to measure their drinking risk status. To evaluate  the effectiveness of this intervention the researchers designed a survey as the "Treatment Acceptability Questionnaire" with space to include their own suggestions.

        The results of this study show the high level of acceptance of those interventions because it gives practical life skills, increases general knowledge about healthy lifestyles, and provides support to families. 95% of participants rated CRA as acceptable and 90%  CRAFT (more acceptable for relatives who wants to help). More than 50% of people would like to have 5 or more sessions with trusted counselors and follow up support.

        Jean has a very good relationship with her mother. In addition, her family would support her through all the steps of this treatment program. In my opinion, this Cognitive-Behavioral Intervention could help Jean overcome all her alcohol related problems.

        The authors of the third article "Mattagami First nations policy to reduce alcohol-related harm"  written by R. Lauzon et al. (1998) provided an example of the successful policy to manage alcohol abuse behavior in Mattagami First Nation (Reserve #71).

        This program includes: culturally appropriate control of alcohol use in different events (more access to low alcohol level and non-alcohol drinks, and control over the participants), provide information sessions within the community with a visual representation, and introducing  new laws which provide social control.The results of this program showed lower rates of anti-social behavior such as vandalism, sexual assaults, harassment and public complaint.

        In my opinion, if Jean lived her childhood in the community which used alcohol responsibly, without abusing it more likely she would not use alcohol as a way to escape her problems. This program promotes healthy life skills and norms for appropriate use of alcohol.

The fourth article " The Grog Mob: lessons from an evaluation of a multi-disciplinary alcohol intervention for Aboriginal clients" written by P. D'Abbs' et al. (2013), described the trial of a twelve month long evidence-based non-residential treatment program for Indigenous people with substance abuse problems. This program had three components:

1. Medical (pharmacotherapy): Participants had a  medication such as Naltrexone.

2. Psychological: Participant had Cognitive-Behavioral Therapy and other therapies, such as goal-setting, problem-solving skills over a 8 week period of weekly sessions.

3. Social support: Participants had social and cultural support provide by the different agencies.

        There were 129 people who had referrals from different agencies to participate in Gross Mob (51,2% males, 48,8% females with a median 38 years old). The program was sponsored by four different government departments. Due to this fact, this program had lots of challenges in its way (recruitment of the staff workers, changes in organizing and managing the process, and finding participants). 49 people actually took the part in this program. As a result of constant changes, this program lost a big part of the participant's data.

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