L R Chatham

Texas Christian University, Fort Worth, TX, United States

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Publications (20)17.11 Total impact

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    ABSTRACT: Women who enter drug abuse treatment programs are likely to report histories of sexual abuse that may impact psychosocial functioning, retention, and outcomes. This study investigates differences at admission between women with and without sexual abuse histories who entered an outpatient methadone treatment program in Texas. In a sample of 137 women, 39% reported prior sexual abuse. Findings show that women with sexual abuse histories were more likely also to have experienced physical and emotional abuse, to report poorer family-of-origin relationships, and to report more drug-related problems. These clients also reported more depression, anxiety, thoughts of suicide, trouble concentrating, and trouble controlling violent behavior. Results are discussed in terms of the need for adequate assessment of abuse history at intake and the need for targeted outcome studies to better define the impact of past abuse on treatment participation and outcome.
    Journal of psychoactive drugs 09/2011; 34(4):347-54. · 1.10 Impact Factor
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    ABSTRACT: Treating cocaine use by opiate-dependent clients in methadone programs is a well-documented challenge. Both behavioral (contingency management) and cognitive (relapse prevention) interventions have shown promise in helping engage these clients in treatment. In this study, the effectiveness of combining contingency management with a cocaine-specific relapse prevention counseling module was examined. Sixty-one cocaine-using methadone clients were randomly assigned to one of four treatment conditions to participate in the eight-week intervention and eight-week follow-up period. Using analysis of variance (ANOVA), differences in cocaine use and treatment retention were examined. Contingency management was significantly related to reductions in cocaine use and the counseling module was positively related to six-month retention rates. Both interventions were associated with positive treatment response but the effects were reflected in different behavioral outcomes.
    Journal of psychoactive drugs 04/2005; 37(1):75-84. · 1.10 Impact Factor
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    ABSTRACT: Abstract Women who enter substance abuse treatment with a history of sexual abuse often report more indicators of psychopathology, such as depression, anxiety, or symptoms of PTSD. This study investigates differences at admission between women with and without sexual abuse histories who entered an outpatient methadone treatment program in Texas. In a sample of 137 women, 39% reported prior sexual abuse. Using ANOVA and chi square analyses, we found that women with sexual abuse histories were more likely also to have experienced physical and emotional abuse, to report poorer family-of-origin relationships, and to report more drug-related problems. Sexual abuse patients also reported more depression, anxiety, thoughts of suicide, trouble concentrating, and trouble controlling violent behavior. Results support the need for screening for sexual abuse history during intake to assure adequate treatment planning. Bartholomew, et al., Characteristics of Women with Sexual Abuse Histories who...
    09/2000;
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    ABSTRACT: Greater improvement in posttreatment outcomes has been shown in programs that tailor frequency and type of services to unique client needs. Using a sample of 635 clients (199 females and 436 males) admitted to three community-based methadone treatment programs, this study examined gender differences in services needed and provided during the first 3 months of treatment. Results revealed that compared to males, women entered treatment with more psychological symptoms and AIDS/HIV-risky behaviors; they also presented with less criminal activity, less alcohol use, and higher motivation. Counselors addressed psychological and crisis issues more frequently with women, and counseling strategies were more often directed toward developing problem-solving and communication skills. Counselors also made more medical referrals and reported having better rapport with females. Attention to employment issues and HIV/AIDS sexual-risk behaviors did not differ by gender, even though women had more needs in these areas.
    Journal of Substance Abuse Treatment 08/2000; 19(1):7-14. · 3.14 Impact Factor
  • G A Rowan-Szal, L R Chatham, D D Simpson
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    ABSTRACT: Clients in outpatient methadone treatment (OMT) who abuse cocaine or alcohol are difficult to engage and retain in treatment. The impact a triple addiction to these drugs has on treatment was the focus of this study (N = 127). Admission characteristics, treatment response, and retention were compared among clients dependent on opiates only (O), opiates and alcohol (OA), opiates and cocaine (OC), or all three drugs (OAC). Findings indicate these groups differ in admission needs assessment, session attendance, issues discussed during treatment, and development of counselor rapport, with the OAC group being significantly more difficult to engage and retain in treatment.
    American Journal on Addictions 02/2000; 9(1):38-50. · 1.74 Impact Factor
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    ABSTRACT: Greater improvement in posttreatment outcomes has been shown in programs that tailor frequency and type of services to unique client needs. Using a sample of 635 clients (199 females and 436 males) admitted to three community-based methadone treatment programs, this study examined gender differences in services needed and provided during the first 3 months of treatment. Results revealed that compared to males, women entered treatment with more psychological symptoms and AIDS/HIV-risky behaviors; they also presented with less criminal activity, less alcohol use, and higher motivation. Counselors addressed psychological and crisis issues more frequently with women, and counseling strategies were more often directed toward developing problem-solving and communication skills. Counselors also made more medical referrals and reported having better rapport with females. Attention to employment issues and HIV/AIDS sexual-risk behaviors did not differ by gender, even though women had more needs in these areas.
    Journal of Substance Abuse Treatment - J SUBST ABUSE TREAT. 01/2000; 19(1):7-14.
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    ABSTRACT: Although one-third of clients enrolled in methadone treatment in the United States are female, few studies have looked at gender differences at admission and follow-up. Using interview data from 435 clients (31% female) collected at admission and approximately 1 year after discharge, females were found to have more dysfunctional families of origin and greater prior and current psychological and medical problems. Both genders improved following treatment, as evidenced by reduced illicit drug, tobacco, and alcohol use, criminal involvement, and HIV/AIDS-risky behaviors. Females were more likely to seek further help for both drug misuse and psychological problems subsequent to discharge.
    Substance Use &amp Misuse 07/1999; 34(8):1137-65. · 1.11 Impact Factor
  • D K Knight, P E Hood, S M Logan, L R Chatham
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    ABSTRACT: The Salvation Army First Choice Program, located in Fort Worth, Texas, provides comprehensive-as well as gender-specific-treatment for addicted women while providing child care and therapeutic services for children. Specific program attributes (including therapeutic interventions, community linkages, and staffing patterns) are described, and the five-year evaluation initiative, designed to examine relationships between client characteristics, program participation, and client progress is outlined. Findings from initial analyses examining correlates of 90-day dropout suggest a complex interaction among specific problems a woman brings to treatment, her level of dysfunction at treatment entry, how much social support is available to her, and what services she receives.
    Journal of psychoactive drugs 01/1999; 31(4):339-51. · 1.10 Impact Factor
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    ABSTRACT: A 17-item simpatia scale was developedfor use with Hispanic substance abusers using confirmatoryfactoranalytic techniques in a sample of 144 daily opioid users. The overall scale had good internal consistency and demonstrated convergent and discriminant validity. The simpatia scale was constructed to examine social attributes reflecting agreeableness, respect of others, and politeness. The Agreeableness subscale addressed issues related to agreeing with others, similarity of opinions between self and others, and if clients openly disagreed with others. The Respect subscale addressed issues related to saying good things about others, trusting others, and treating others with respect. The Politeness subscale addressed issues related to avoiding conflict with others, doing favors, and treating others as equals. A cross-validation study demonstrated that simpatia was positively related to social support, social conformity, treatment service satisfaction, and client rating of counselor skills, whereas it was negatively related to hostility.
    Hispanic Journal of Behavioral Sciences - HISPAN J BEHAV SCI. 01/1998; 20(4):468-482.
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    ABSTRACT: This study of methadone-maintenance clients interviewed approximately 1 year after discharge from treatment revealed that outcomes differed between heavy-drinking clients who are alcohol dependent and those who are not. Alcohol-dependent clients seem to benefit more from treatment but continue to have severe cocaine-use problems, suggesting they also may be cocaine dependent. The results emphasized the value in differentiating between these types of drinking clients, and they suggest that failure to do so may account for earlier contradictory results about the role alcohol consumption has in treatment outcomes for methadone-maintenance clients.
    Addictive Behaviors 01/1997; 22(1):69-80. · 2.02 Impact Factor
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    ABSTRACT: In response to increasing problems associated with drug-abusing offenders, the 1991 Texas Legislature provided a statutory foundation for the development of a comprehensive drug treatment program within the state's criminal justice system. In an effort to assess the impact of the prison-based treatment component of this legislative mandate, the Texas Commission on Alcohol and Drug Abuse funded the Institute of Behavioral Research at Texas Christian University to conduct a comprehensive prison-based treatment assessment (PTA) including studies of the In-prison Therapeutic Community (ITC) treatment process and posttreatment outcomes. This article provides an overview of the research project and findings from the 6-month follow-up study. Preprison and during-treatment information was collected from 293 ITC program participants. Six-month follow-up interviews were completed with 222 ITC program graduates and compared with a comparison sample of 75 parolees who were eligible but not sent to ITC treatment. Results showed that 80% of the inmates referred to the ITC during this study graduated, and that program graduates demonstrated marked reductions in their criminal and drug use activity from the 6 months before entering prison to the 6 months after leaving prison. Finally, ITC graduates-particularly those who completed the first phase of their aftercare program-had lower relapse and recidivism rates in the 6 months after prison than did the parolees in comparison sample. They also reported highly favorable opinions about both the program and the counselors. Implications of these findings are discussed; and longer term follow-up evaluations are in progress.
    Journal of Offender Rehabilitation. 01/1997; 24:75-100.
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    ABSTRACT: Provides an overview of a comprehensive, prison-based treatment assessment, including a six-month follow-up study. Results show that 80% of the inmates referred to the program graduated. Graduates demonstrated marked reductions in criminal and drug-use activity and had lower relapse and recidivism rates when compared to other parolees. (RJM)
    Journal of Offender Rehabilitation 12/1996;
  • L R Chatham, K Knight, G W Joe, D D Simpson
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    ABSTRACT: Previous work has shown that suicide is a significant cause of death among substance abusers, including methadone-maintained clients, and that the prediction of suicidal ideation and behavior is difficult. Preliminary review of data collected at admission on a population of 438 methadone-maintained clients found 55 expressing some level of suicidal behaviors during the course of treatment. These clients were compared with a randomly selected comparison group of 55 nonsuicide clients matched for gender and race/ethnicity on measures of psychological dysfunction, drug use, family dysfunction, and help-seeking behaviors. Results showed that at time of admission suicidal clients reported: 1) more psychological dysfunction as evidenced by higher levels of depression, social dysfunction, hostility, risk-taking, and previous thoughts of suicide; 2) less family support at the present time and during childhood; and 3) more help-seeking behavior as evidenced by self-referral, number of previous treatment episodes, attendance at self-help meetings, and higher scores on motivational measures of desire for help. Differences in preadmission drug-using behaviors were not found between the two groups.
    The American Journal of Drug and Alcohol Abuse 09/1995; 21(3):345-61. · 1.55 Impact Factor
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    ABSTRACT: The purpose of this study was to clarify the relationship between heavy use of alcohol and response to methadone treatment. A sample of clients showing three or more DSM-III-R symptoms (n = 79) were identified and compared with a sample of heavy-drinking clients (n = 108) with less than three alcohol dependency symptoms on admitting characteristics and on tenure in treatment. As expected, clients meeting DSM-III-R dependency criteria were significantly more likely to show evidence of psychological problems and dysfunction of family and peer relations at admission. An unexpected finding was that they were also more likely to remain in treatment longer than drinking clients who did not report dependency. Alcohol dependent clients were significantly more likely to have prior experience with self-help groups, which may reflect less denial and therefore relatively better ability to focus on opiate dependency problems. Failure to differentiate between alcohol dependent and nondependent groups of drinkers enrolled in methadone treatment may help account for reported differences in treatment outcome studies. Recognizing these different types of drinkers also may help clinicians plan more effective treatments.
    Journal of studies on alcohol 08/1995; 56(4):417-22.
  • D. Dwayne Simpson, Lois R. Chatham, Barry S. Brown
    Current Directions in Psychological Science - CURR DIRECTIONS PSYCHOL SCI. 01/1995; 4(4):123-126.
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    ABSTRACT: A lo largo de los últimos 20 años, se recomendó a las mujeres químicamente dependientes realizar una programación especializada para mejorar el funcionamiento psicosocial y la permanencia en el tratamiento. Este estudio examina el impacto que ha tenido en un grupo de trabajo estructurado sobre la asertividad y sexualidad en mujeres de tres comunidades basadas en programas de mantenimiento con metadona de 6 semanas de duración. Los resultados obtenidos indican que las mujeres que participaban con frecuencia en grupos de mujeres (de cuatro a seis sesiones) presentaban un aumento mayor en la autoestima y la cognición si las comparamos con las mujeres que no participaban con igual frecuencia (de una a tres sesiones). Además, el nivel de participación se asoció de manera positiva, con el tiempo de permanencia en el programa de tratamiento una vez finalizado el grupo de trabajo. Palabras clave : intervención, mantenimiento con metadona, permanencia, autoestima, tratamiento, mujer. (Journal of Psychoactive Drugs. Vol.26(3) 1994)
    01/1994;
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    ABSTRACT: Over the past 20 years, specialized programming for chemically dependent women has been recommended for improving psychosocial functioning and retention in treatment. This study examined the impact of a structured, six-week assertiveness and sexuality workshop for women at three community-based methadone maintenance programs. Results indicated that women who participated frequently in the women's groups (four to six sessions) showed greater increases in self-esteem and knowledge compared to women who participated infrequently (one to three sessions). In addition, level of participation was positively associated with length of stay in the treatment program after completing the workshop.
    Journal of psychoactive drugs 01/1994; 26(3):249-55. · 1.10 Impact Factor
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    ABSTRACT: Clients in a community-based methadone treatment program earned stars for attending counseling sessions as scheduled and for providing clean urines. These stars were later redeemed for contingent rewards (food or gas coupons or bus tokens) according to one of three randomly assigned reward schedules, including high reward (four stars per prize), low reward (eight stars per prize), or delayed reward (those who had to wait 3 months to earn a prize). Clients in the high-reward condition showed a pattern of increasing the number of stars earned for group sessions and clean urines across the 3-month intervention. All clients, independent of reward condition, attended significantly more group counseling sessions during the months that contingent reinforcers were available than in the months prior to, and after, the intervention. Finally, urinalysis data indicated that, in the postintervention period, high-reward clients had fewer dirty urines than did low-reward or delayed-reward clients. This study suggests that a simple system of recognizing client progress with stars and modest prizes for performing specific behaviors can be an effective tool in increasing clinic attendance rates and reducing positive urines.
    Journal of Substance Abuse Treatment 01/1994; 11(3):217-23. · 3.14 Impact Factor
  • D. Dwayne Simpson, Lois R. Chatham, George W. Joe
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    ABSTRACT: the purpose of the DATAR [Drug Abuse Treatment for AIDS Risks Reduction] project is to improve treatment retention, reduce drug abuse relapse rates, and improve psychosocial adjustment of IVDUs [intravenous drug users] through enhanced intervention strategies / enhancements to the therapeutic process have been conceptualized in terms of a comprehensive intervention sequence based on some of the most promising strategies available and incorporating "cognitive learning" principles mapping as a cognitive enhancement to counseling / components of the intervention process [background and psychosocial assessments, AIDS psychoeducation, cognitive assessments and goal setting, behavioral intervention techniques, life skills and maintenance training] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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    ABSTRACT: This study examined the role of total session exposure on during-treatment outcomes in a sample of 298 methadone maintained clients. The total number of minutes actually spent in counseling sessions during a 6-month period was used to create a measure of client exposure to treatment. Clients were divided into three groups: low (< 270 minutes), medium (270-399 minutes), and high (400+ minutes). Results supported the hypothesis that clients in the low exposure group did not develop as much rapport or “bond” as well with their counselors as clients in the higher treatment exposure groups. Several factors predicted which clients spent more time in counseling sessions, namely: being female, heavy alcohol use, a history of childhood problems, higher metha-done dosage, and structured counseling sessions. Among these, the most significant predictor of clients being in the high treatment exposure group was participation in structured counseling sessions. This finding supports the use of structured treatment interventions as a method of improving client/counselor relationships and better during-treatment outcomes through increased treatment exposure time.