Literacy-Free 12 Step Expressive Arts Curriculum Enhances Engagement and Treatment Outcomes for Dually Diagnosed Substance Use and Mental Health Disorders

ABSTRACT

This study evaluated the efficacy of the Literacy-Free 12 Step Expressive Arts Therapy© curriculum in enhancing personal change and treatment outcomes for populations dually diagnosed with substance use and mental health disorders. It supplemented standard rehabilitation treatment for 47 individuals in a U.S. facility by incorporating 12 Step guidelines, cognitive behavioral therapy, rational emotive behavior therapy, and expressive arts activities. Pre-session and post-session participant ratings revealed positive increases for commitment to recovery, attitude toward making lifestyle changes, and hopefulness. Compared to 101 inpatients at the same facility, curriculum participants evidenced less drop-out, higher treatment completion, and greater personal investment in recovery.     

Contribution of visual velocity and displacement cues to human balancing of support surface tilt

Vision helps humans in controlling bipedal stance, interacting mainly with vestibular and proprioceptive cues. This study investigates how postural compensation of support surface tilt is compromised by selectively reducing visual velocity cues by stroboscopic illumination of a stationary visual scene. Healthy adult subjects were presented with pseudorandom tilt sequences in the sagittal plane (tilt frequency range 0.017–2.2 Hz; velocity amplitude spectrum constant up to a frequency of 0.6 Hz, angular displacement amplitude spectrum increasing with decreasing frequencies). Center of mass (COM) sway responses were recorded for stroboscopic illuminations at 48, 32, 16, 8, and 4 Hz, as well as under continuous illumination and with eyes closed. With strobe duration (5 ms) and mean luminance (1 lx) kept constant, visual acuity and perceived brightness remained constant and the visual scene was perceived as stationary. Yet, tilt-evoked COM excursions increased with decreasing strobe frequency in a graded way, with largest effects occurring at tilt frequencies where large tilt velocities coincided with small displacements. In addition, COM excursions were reduced at the lowest strobe frequency compared to eyes closed, with the largest effect occurring at tilt frequencies where tilt displacements were large. We conclude that two mechanisms exist, a velocity mechanism that deals with tilt compensation and is foremost affected by the stroboscopic illumination and a displacement mechanism. This compares favorably to previous findings that, transferred to a stance control model, suggest a velocity mechanism for tilt compensation and a position mechanism for gravity compensation.