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  • 1.
    Armelius, Kerstin
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Armelius, Bengt-Åke
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Engström, Christer
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Brännström, Jan
    Nyström, Siv
    Brukarna är nöjda med missbruksvården - även om problemen inte förbättrats2014In: Socionomen, ISSN 0283-1929, no 7, p. 38-53Article in journal (Other academic)
  • 2.
    Engström, Christer
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Implementering och utvärdering av Addiction Severity Index (ASI) i socialtjänsten2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this dissertation is to examine the implementation of the Addiction Severity Index (ASI) in social services and how it affects the encounter between the clients and their social workers. As structured interviews are unusual in social service based addiction care there is concern that they will have negative consequences on the relation between the social workers and their clients. The first study therefore investigates the clients’ acceptance of the ASI. The results show that 95 % of the clients accepted the ASI and that 85% viewed it in positive terms. Approximately 8% reported feeling violated by one question without this having any negative effect on the relation to the social workers or confidence in the social services. The results did not give empirical support for negative effects of the ASI. In the second study a comparison was made between a group that had participated in an assessment session using the ASI and a group with which the ASI had not been used. The results show that there is no difference in perception of “the alliance” or “negative experiences” with or without the ASI, but that the clients’ feeling of “own competence” is lower when the ASI is employed. The question of whether the reduced feeling of own competence among the clients is an expression of greater realism and reduced denial or only the negative effect of increased helplessness on the clients’ self-esteem can not be resolved in this study. In the third study, based on the same groups participating in the second study, the social workers were also asked to judge how the clients experienced such assessment sessions. The results show that the social workers’ assessment of the clients’ experiences differed from the clients’ own experiences regarding the “alliance” and “clients’ own feelings of competence”. However, the social workers made a correct assessment of the clients’ “negative experiences” of the sessions. The two different forms of session, with or without the ASI, did not influence the social workers’ assessment of the clients’ perceptions. The fourth study presents the results of a national questionnaire completed by 555 members of staff in social services, the prison service, and addiction services. The results show that supervisors and bosses take an increasingly greater responsibility for ASI training and that opportunities for using the ASI varied according to the place of work. Differences can probably be explained by different services being in different phases of implementation at the time of the study. The ASI has primarily been used in direct client work and only to a minor extent for follow-ups and evaluation. The number of ASI interviews carried out is small especially for those trained prior to 1999.

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  • 3.
    Engström, Christer
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Social workers´ ability to assess how clients experience investigation sessions - with and without the ASI2009In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296X, Vol. 9, no 3, p. 309-321Article in journal (Refereed)
    Abstract [en]

    Summary: Two groups of social workers (n = 19, n = 13)carried out two different forms of assessment session, one involvingan ASI (Addiction Severity Index) interview (n = 40) and onewithout (n = 43). After the sessions the social workers wererequested to assess both the clients' experience and their ownexperience of the session. The clients also reported their ownexperience of the sessions.

    Findings: The results show that the social workers' assessmentof the clients' experience differs from the clients' own assessmentsregarding the sub-scales of alliance and the clients' senseof own competence. However, no difference was observed betweenthe social workers' assessment and the clients' negative experiencesof the sessions. The results show the importance of asking theclients for their views when testing new ways of working. Thiswill provide a more balanced picture as social workers are inclinedto perceive the negative aspects and misjudge other experiences.The two different forms of session, with or without the ASI,did not affect the social workers' assessment of the clients'experience of the sessions.

    Applications : Testing of new methods of working in socialwork.

  • 4.
    Engström, Christer
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Socialarbetarnas förmåga att bedöma hur klienterna upplever utredningssamtal - med och utan ASI.Manuscript (preprint) (Other academic)
  • 5.
    Engström, Christer
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Armelius, Bengt-Åke
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Experience of the relationship between social workers and clients with and without a structured interview (ASI).Manuscript (preprint) (Other academic)
  • 6.
    Engström, Christer
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Armelius, Bengt-Åke
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Implementering av en strukturerad intervju (ASI) i missbrukarvård och kriminalvård.2005In: Socialvetenskaplig tidskrift, ISSN 1104-1420, Vol. 12, no 1, p. 27-42Article in journal (Refereed)
  • 7.
    Engström, Christer
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Armelius, Bengt-Åke
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Klienters acceptans av strukturerade intervjuer i socialtjänsten.2002In: Nordisk sosialt arbeid, ISSN 0333-1342, E-ISSN 1504-3037, Vol. 22, no 4, p. 210-216Article in journal (Refereed)
    Abstract [en]

    Uppföljning och utvärdering är nu på agendan även för socialtjänstens vidkommande vilket ökar behovet av enkla användarvänliga och strukturerade dokumentationsmetoder. En viktig fråga i det sammanhanget är klientens acceptans för sådana inslag i det sociala arbetet. I följande studie har ASI-intervjun prövats med avseende på hur den påverkar relationen till socialarbetaren och klienternas förtroende för socialtjänsten.

  • 8. Engström, Christer
    et al.
    Brändström, Sven
    Sigvardsson, Sören
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Cloninger, C Robert
    Nylander, Per-Olof
    Bipolar disorder. III: harm avoidance a risk factor for suicide attempts2004In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 6, no 2, p. 130-138Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to examine whether personality, i.e. temperament and character influence suicide attempts in bipolar patients.

    Methods: Bipolar patients were recruited from lithium dispensaries. Temperament and character inventory (TCI) was administered to 100 euthymic bipolar patients and 100 controls.

    Results: Age of onset was significantly lower in patients with suicide attempts in the total bipolar group (I and II) and bipolar I patients compared with patients without suicide attempts. Bipolar (I and II) and bipolar I patients with suicide attempts were significantly higher in harm avoidance (HA) and reward dependence compared with patients without suicide attempts. Patients (I and II) with suicide attempts had significantly more anticipatory worry, fatigability and asthenia than patients without suicide attempts. Bipolar I patients with suicide attempts had significantly more fatigability and asthenia and were more dependent than patients without suicide attempts. HA was lowest in patients with no suicide attempts and no family history of suicide, higher in patients with family history of suicide or patients with suicide attempts, and significantly highest in patients with suicide attempts and family history of suicide. Patients with suicide attempts and family history of suicide had more anticipatory worry, fatigability and asthenia. Bipolar disorder was significantly correlated to HA and suicide attempts to HA and PS. Family history of suicide and gender were significantly correlated to suicide attempts.

    Conclusions: Age of onset, HA, PS, gender and family history of suicide had a moderate to very strong effect on suicide attempts in bipolar patients.

  • 9.
    Engström, Christer
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Åström, Monica
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nordqvist-Karlsson, Barbro
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nylander, Per- Olof
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Relationship between prophylactic effect of lithium therapy and family history of affective disorders.1997In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 42, no 6, p. 425-433Article in journal (Refereed)
    Abstract [en]

    Lithium therapy response and age of onset (AOO) were studied in 98 patients with bipolar affective disorder (BPAD) who were divided into subgroups depending on type of family history of affective disorders. The highest (33.0 years) and lowest (25.5 years) age of onset were found in nonfamilial patients and in familial patients with a first-degree relative of BPAD, respectively. Nonfamilial patients showed the best response to lithium. There were 0.9 episodes/year off lithium compared to 0.3 episodes/year on lithium (an 88% decrease). A poorer response (a 71% decrease; a reduction from 1.39 episodes per year off lithium to 0.65 on lithium) was found in familial patients with a first-degree relative of BPAD. Differences in serum lithium values between the groups could not explain the observed differences. Thus, familial patients showed a more severe manifestation of the disease with an earlier AOO and a lower prophylactic effect of lithium.

  • 10. Mendlewicz, Julien
    et al.
    Souery, Daniel
    Del-Favero, Jurgen
    Massat, Isabelle
    Lindblad, Kerstin
    Engström, Christer
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Van den Bossche, Dirk
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Schalling, Martin
    Van Broeckhoven, Christine
    Expanded RED products and loci containing CAG/CTG repeats on chromosome 17 (ERDA1) and chromosome 18 (CTG18.1) in trans-generational pairs with bipolar affective disorder2004In: American Journal of Medical Genetics, ISSN 0148-7299, E-ISSN 1096-8628, Vol. 128B, no 1, p. 71-75Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to further test if expanded CAG repeats detected by the repeat expansion detection (RED) method in bipolar affective disorder (BPAD) are correlated with ERDA1 (17q21.3) and/or CTG18.1 (18q21.1) loci expansions, and changes of phenotype severity in successive generations (anticipation). The sample was designed to analyze ERDA1 and CTG18.1 expansions in trans-generational pairs of affected individuals (parent-offspring pairs: G1 and G2). Clinical and genetic information was available on 95 two-generations pairs. We found in our sample no one patient.

  • 11.
    Tengvald, Karin
    et al.
    Centre for Evaluation of Social Services, Swedish National Board of Health and Welfare, Stockholm, Sweden.
    Andrén, Anders
    Centre for Evaluation of Social Services, Swedish National Board of Health and Welfare, Stockholm, Sweden, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Bergman, Hans
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Engström, Christer
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Implementering the Addiction Severity Index (ASI) in Swedish human services sectors: Experiences, problems and prospects2004In: Journal of Substance Use, ISSN 1465-9891, E-ISSN 1475-9942, Vol. 9, no 3-4, p. 163-171Article in journal (Refereed)
    Abstract [en]

    In Sweden, agencies within both the health services and the social services sectors are responsible for treatment, rehabilitation and care of persons with substance‐abuse problems. Also in the prison and probation system such problems are common among clients. The article describes how a Swedish version of the Addiction Severity Index (ASI) was developed and introduced in these three systems in the late 1990s and the extent of its implementation in regular practice. The ASI is now used for treatment‐planning and outcome‐evaluation purposes and not only for research purposes in Swedish substance‐abuse treatment agencies. A comparison of the implementation of the ASI in the three human services sectors indicates that the top‐down implementation strategies used in the prison and probation system have some important benefits, when compared with bottom‐up strategies, although such strategies are more conducive to dissemination in more decentralized human services systems. But several implementation barriers are common in all three services sectors—for example, high levels of staff turnover and competition with other structured assessment instruments. It is concluded that the prospects for a more widespread use of the ASI in the future depends—in all three human services sectors—both on the external demands for effectiveness and transparency and on internal, particularly managerial, commitment to effective services and evidence‐based practice.

1 - 11 of 11
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