Search Results

AbstractOver the past 15 years, the high prevalence of the comorbidity of “substance use disorders/post-traumatic stress disorder” has brought a growing number of researchers to look at the consequences of this dual diagnosis on treatment. The empirical data from these studies demonstrates that the clinical profile of persons who consult for alcoholism and drug addiction is more deteriorated when the substance use disorder is combined with a post-traumatic stress disorder. Moreover, these persons usually derive less benefit from the addiction treatment.Integrated treatment programs seem promising in treating both disorders but do not appear to rule out the dropout problem. Even though no study has been specifically designed to identify the factors involved in the process, a review of the literature reveals many cues which suggest three hypotheses : self-medication, the weakness of the therapeutic alliance and lack of social support not to mention the potential contribution of practical obstacles such as the lack of transportation and financial constraints. These hypotheses should orient future research in order to determine the essential elements in designing treatment programs that are better adapted to the reality of trauma survivors.

Keywords: troubles liés à l'utilisation d'une substance, état de stress post-traumatique, co-morbidité, persévérance en traitement, toxicomanie, addiction, substance use disorders, post-traumatic stress disorder, comorbidity, perseverance in treatment, addiction, problemas relacionados con el consumo de una sustancia, estado de estrés postraumático, comorbididad, perseverancia en el tratamiento, toxicomanía, adicción

The gaming industry has expanded considerably over the past years. During this time, governments have invested a lot in research and development for treatment programs to help problem gamblers. Despite the diversity of treatments offered, there are currently no data that enable us to determine the best practises in terms of treatment for pathological gambling. There are methodological flaws in the evaluative studies involving pathological gamblers, so treatment effectiveness cannot be determined. Nevertheless, some approaches used with adults appear promising. Notably, the cognitive behavioural approach and Gamblers Anonymous (GA) support groups stand out in terms of maintaining abstinence from gambling. Other recent research shows encouraging results using the pharmacological approach. It appears that administering Naltrexone to pathological gamblers would help reduce the obsessive desire to gamble. Also gaining recognition is the definite contribution of the transtheoretical model of change and couple-therapy approaches to keeping gamblers in treatment. For adolescents, treatment options are less developed. Intervention program initiatives for youths exhibiting a gambling problem are still at the embryonic stage and borrow paradigms from the cognitive behavioural approach. Thought must be given to determining which criteria correspond to the success of a treatment, whether for adults or adolescents. Complete abstinence from all gambling may not be the only indicator of recovery.

Keywords: Jeu pathologique, prévalence, traitement, adultes, adolescents, Pathological gambling, prevalence, treatment, adults, youths, Juego patológico, prevalencia, tratamiento, adultos, adolescentes

This article reports on six evaluative research projects led by a research team at the RISQ (Recherche et intervention sur les substances psychoactives – Québec) on treatments offered in Quebec, mainly in public rehabilitation centres, between 1991 and 2005. Objectives: The goal of these studies was to evaluate: 1) whether the participants from drug addiction treatment centres in Quebec improved their situation during and after their treatment; 2) the spheres of life in which these improvements occurred; and 3) whether there was a relationship between the changes observed and the participants' exposure to the treatment. Method: The method is referred to as a “naturalist” approach: participants were exposed to the regular treatment offered in the centres where they were followed. By means of the ASI-IGT, their situation concerning consumption of psychoactive substances and their bio-psychosocial condition were evaluated at three measurement times, on their arrival in treatment, then at intervals of approximately 6 and 12 months. Measurements also included the quantity (hours of exposure to treatment) and the duration of the intervention they received. Results: In the six groups under study, a constant improvement of the participants on the ASI-IGT “alcohol” and “drug” scales was observed as well as most of the dimensions evaluated by this tool in time 1 and time 2, and maintenance of this improvement in time 3. There was no significant difference between the participants who had little or no treatment and those who had a great deal. Interpretation: The meaning and the extent of these results are discussed by the authors, particularly in relation to the limitations of these studies. Research strategies developed thereafter to respond to the questions raised by these studies are also presented.

Keywords: toxicomanie, recherches évaluatives, traitement, réadaptation, Québec, drug addiction, evaluative research, treatment, rehabilitation, Quebec, toxicomanía, investigaciones evaluativas, tratamiento, readaptación, Quebec

SummaryIn the new information-centered economies, professions related to engineering, information technologies, management of information systems and R&D are becoming increasingly important. It is therefore not surprising that organizations consider these professionals a strategic resource that enhances their competitiveness. This phenomenon has engendered employers' preoccupation with topics such as motivation or career management of engineers (Igbaria, Kassicieh and Silver, 1999). The fact that Schein's career anchor model (1978) allows a better understanding of this new management challenge explains researchers' growing interest in the concept of career anchors. Schein's career anchor model (1978) is considered a major contribution to the understanding of individual career paths. A total of eight anchors have been defined: (1) functional/technical competence, (2) managerial competence, (3) autonomy/independence, (4) security/stability, (5) entrepreneurial creativity, (6) sense of service, (7) pure challenge and (8) lifestyle. This theory rests on the implicit postulate that an individual has only one dominant anchor. This phenomenon of dominance is known as “differentiation”. Moreover, numerous researchers extrapolate from Schein that only the career anchor with the highest score should be retained to operationalize the concept of dominance or differentiation. However, some individuals exhibit several high anchors, which raises the question of the multiplicity of anchors, here referred to “undifferentiation”.In addition to verifying the existence of multiple career anchors, four sets of formal hypotheses were tested: (1) career outcomes (career satisfaction, job success, financial success, hierarchical success or relationship success) are poorer for engineers that have undifferentiated profiles than for those that have differentiated profiles, (2a) the managerial anchor is associated with the managerial path, (2b) the technical anchor is associated with the technical path and anchors not related to managerial and (2c) technical talents are associated with non-traditional paths (hybrid and project-based), (3) an engineer pursuing a non-traditional path is more differentiated than an engineer who pursues a traditional path and (4) a stable career choice is associated with traditional paths and vice versa (an unstable choice with non-traditional paths). New measures of differentiation as well as multiplicity of anchors (e.g., a measure of dominance based on standard error of measurement) were used.This study is based on a survey administered by questionnaire to Quebec engineers. The data was collected on two occasions. First, questionnaires were sent to engineers belonging to three organizations (two private companies and one municipality). From this mailing of 720 questionnaires, 374 were used, equal to a response rate of 54.2%. The second set of data was collected from the Quebec Engineer's Institute. A random sample of 808 men was selected, which provided a return rate of 147 usable questionnaires. In parallel with this mailing, another mailing was sent to all the female members of the Institute in order to adjust the proportion of women in our sample to offset the masculinity of the profession. Of the 1295 questionnaires distributed, 379 usable questionnaires were received. The response rates to these mailings are respectively 18.2% and 29.3%. Note that the response rate obtained in the first phase is higher than that of the second phase owing to the co-operation of the organizations involved in the project. Overall, the response rate for this study is 32% with a usable sample of 900 engineers. According to statistics compiled by the Québec Engineers Institute, our sample is highly representative of the population in several respects. For instance, the average age in the sample is 38, compared with 40.3 for the population. No significant difference was detected for other variables such as seniority or degrees obtained. Lastly, all of the statistical analyses were performed with SPSS (t-test, exploratory factor analysis, discriminant analysis) and AMOS software (confirmatory factor analysis). It should also be noted that the questionnaire was pretested and that the data was verified before the analyses were performed.This study shows that “undifferentiation” is more frequent than previously believed, that it is not a pathological phenomenon and that it allows better identification of a poorly understood career path, namely the hybrid path. First, very few studies have investigated in depth the possible existence of multiple anchors. Our results show that the multiplicity of anchors is a more frequent phenomenon than the literature implies: nearly 70% of our sample are undifferentiated versus 30% reported by some authors. Second, our research findings indicate that the multiplicity of anchors is not necessarily a pathological phenomenon, in contrast with the views of several authors. The fact that no significant difference was found between differentiation and the career outcome seems to indicate that it is equally satisfying to possess several anchors and a single anchor (first hypothesis). Naturally, these results must be confirmed by other studies, because the link between differentiation and the success variables remains poorly understood. The third contribution of this research is that it helps shed light on a yet to be clarified path, namely the hybrid path. Results show that engineers pursuing a technical path have a stronger technical anchor than do those in the hybrid and managerial paths combined (3.97 versus 3.51 for the technical anchor, t test significant at p < 0.000), which verifies hypothesis 2(b). It is interesting to note that engineers that pursue hybrid or managerial paths have a higher managerial anchor than do those in the technical path (3.77 versus 3.25; t test significant at p < 0.000). The hybrid path may therefore attract individuals who aspire to managerial positions. Hypothesis 2(a) is consequently partly verified, because the managerial anchor is not intended to predict the hybrid path. Lastly, Hypothesis 2(c), whereby anchors not related to talents are more strongly associated with non-traditional paths, is only partly verified. In effect, engineers that pursue a project-based path have a lifestyle anchor that is stronger than those in the hybrid path (3.87 versus 3.57; t test significant at p < 0.004), which confirms the hypothesis. However, the security anchor is more strongly associated with the technical path than the non-traditional path (a security anchor of 3.78 for engineers in a technical path versus 3.46 for those in the hybrid path and managerial path combined; t test significant at p < 0.000). Hypothesis 3 is verified for the hybrid path, but not for the project-based path, which is also a non-traditional path. Hypothesis 4 is verified solely for the managerial path. It should also be noted that engineers pursuing a hybrid path are more differentiated than those who pursue a managerial path (5.71 versus 5.11; t test significant at p < 0.015). It is interesting to note that undifferentiation and the stability of career choices allow distinction of the hybrid path from the managerial path. Engineers that pursue the managerial path are less differentiated and demonstrate greater stability of career choice.

An analysis of «reflexive work», in which the practitioner provides a direct service to persons, cannot afford to leave out of the reckoning the professional logic developed in response to that of the social management Systems. From this viewpoint, we have developed a typology of the professional referents of practitioners in a social services institution. These referents are both poôles for the integration of practices, and innovative sources of intervention. The possibility for a number of these workers to register themselves as autonomous subjects in their practices brings into play the professional identity crisis of social workers.

This article brings to light the historic break in the field of managing juvenile delinquency represented by the Boscoville re-education centre, founded in the early 1940s in the Montréal area. Based on the writings of the main founders of the psycho-educational approach, this analysis highlights theoretical and clinical innovations developed in this internationally recognized residential centre for delinquents, during the first few decades of its existence. The Boscoville experience confirms the crumbling of a disciplinarian model of reform for juvenile delinquents that focused on physical restraint, on putting them to work and on religious observance. It also contributed to a shift in social regulation modes that fostered the deployment of a new approach to human intervention emphasizing the dimension of the psyche.