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Narratives Of Illness, Difference, And Personhood, John P. Mctighe Jan 2015

Narratives Of Illness, Difference, And Personhood, John P. Mctighe

School of Social Work Faculty Publications

Using narrative theory, the chapter examines how ideas and attitudes about mental disorder are shaped by cultural values and stereotypes, and how the experience of trauma can shatter the narrative of self and world. Placing the question of illness, differentness, and personhood within a social justice perspective, it challenges clinicians to consider how the vocabulary of illness is used to frame experience and, in many cases, to minimize, marginalize, or discount the individual's own lived experience.


State Agency Promising Practice: Project Gate In Alabama - Creative Sequencing Of Funding, Susanne Freeze, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2015

State Agency Promising Practice: Project Gate In Alabama - Creative Sequencing Of Funding, Susanne Freeze, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Alabama has piloted the Gaining Access to Employment project, a collaborative effort between the state’s Department of Mental Health/ Developmental Disabilities (MH/DD) and its Department of Vocational Rehabilitation (VR). Through this project, known as Project GATE, the two agencies work together to help local service providers use funds to support integrated employment opportunities. MH/DD and VR have a long history of partnering, including joint efforts on a supported employment workgroup, due to the strong relationships between colleagues at each department.


State Agency Promising Practices: New Hampshire’S Employment Data Collection - The Power To Transform Communication, Partnership, And Service Delivery, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2015

State Agency Promising Practices: New Hampshire’S Employment Data Collection - The Power To Transform Communication, Partnership, And Service Delivery, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In 2010, when the New Hampshire Bureau of Developmental Services (BDS) received grant funds to strengthen multisystem service delivery, its administrators partnered with area agencies; community rehabilitation providers, or CRPs (employment providers); and other stakeholders to improve and streamline the process of collecting employment data. Originally a multi-system process, BDS continued the data-collection effort when other systems withdrew. BDS’s new data-collection system allows unprecedented access to clear data displays, as well as the ability to run a variety of detailed reports to guide the statewide promotion of integrated employment.


State Agency Promising Practice: Washington’S Investment In Robust Training And Technical Assistance, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2015

State Agency Promising Practice: Washington’S Investment In Robust Training And Technical Assistance, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In the mid-1980s, the state of Washington was awarded a five-year federal systems change grant to kick-start their supported employment efforts via the Washington State Employment Initiative. Funding from this grant was used to develop training on best practices and to generate high-quality integrated employment supports among agencies. At the end of this five-year period, with state funding and support from state leadership, the Washington State Employment Initiative re-formed as WISE, an independent training and technical assistance (TA) organization. WISE now contracts with the Washington Developmental Disabilities Administration to provide ongoing, high-quality training and TA across the state and to …


"I See Their Purpose": Looking At The Role Of Family Advocates In Partnering With Families And Advocating For Children In Guatemala City, Sierra K. Leonard Jan 2015

"I See Their Purpose": Looking At The Role Of Family Advocates In Partnering With Families And Advocating For Children In Guatemala City, Sierra K. Leonard

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

The purpose of this study was to get an in-depth, complete picture of a social worker and child/family advocate in Guatemala City, Guatemala. The intent was to study the participant’s work and responsibilities in order to examine how she processed and completed her dual role as social worker/advocate and mother to a group of children in a children’s home. A focus on responsibility, the effect of her dual role, and the influence of her personal and religious convictions emerged throughout the study. The participant’s unique position in a dual role offered insight into the various aspects of advocacy and intervention …


Exploring And Utilizing The Concept Of Setting Conditions In The Functional Assessment Process, Linda Aldridge, Richard Harrison, Kimberly Harrison, Cherie Blanchat Dec 2014

Exploring And Utilizing The Concept Of Setting Conditions In The Functional Assessment Process, Linda Aldridge, Richard Harrison, Kimberly Harrison, Cherie Blanchat

Journal of Adolescent and Family Health

Functional assessment is embedded in the Individuals with Disabilities Education Act (IDEA) (1997) and Positive Behavioral Supports (PBS) (Horner & Carr, 1997). While the process of functional assessment has helped many students become more successful in the educational setting, it is time to take a deeper look at those conditions from which behaviors originate. Such conditions, referred to in this article as setting conditions, often serve to initiate and sustain inappropriate behaviors that are the focus of the functional assessment. Unless directly analyzed, setting conditions weaken the impact of interventions focused solely upon those factors targeted in the Antecedent Behavior …


Service Provider Promising Practice: Job Squad, Inc. (West Virginia) - A Blog That Conveys The Importance Of Community Employment, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jul 2014

Service Provider Promising Practice: Job Squad, Inc. (West Virginia) - A Blog That Conveys The Importance Of Community Employment, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Job Squad is a medium-sized CRP that provides services to individuals in 13 counties within West Virginia. In 2005, responding to customer demands, executive director Brenda Hellwig and her staff received training from Griffin Hammis Associates to offer community employment services. Once trained, the career counselors at Job Squad found that their most successful jobs were matches between job seekers and small businesses that needed their skills and could provide natural supports. The team then started the Community Economic Development blog at http:// jobsquadinc.blogspot.com/. This is a platform to communicate with employers,


Service Provider Promising Practice - Via Of The Lehigh Valley (Pennsylvania): Partnership With Local Schools To Provide Customized Employment, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

Service Provider Promising Practice - Via Of The Lehigh Valley (Pennsylvania): Partnership With Local Schools To Provide Customized Employment, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Via of the Lehigh Valley is a CRP headquartered in Bethlehem, PA. Since 2008, Via and local high schools have provided customized employment services so that transition-age students graduate into well-matched, meaningful careers. Via’s transition program is supported by funds from the Pennsylvania Department of Education. The energy of students and their families has also driven the search for innovative employment services. Via’s work with schools began with hosting weekend trainings for families, sponsored by the Pennsylvania DD Council. Families learned systems navigation and advocacy skills, and followed up with special education directors at their children’s high schools to advocate …


Service Provider Promising Practice - Work Inc. (Massachusetts): Using Data To Track Job Development Activities During Organizational Change, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

Service Provider Promising Practice - Work Inc. (Massachusetts): Using Data To Track Job Development Activities During Organizational Change, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Work Inc. is a medium-sized CRP in Massachusetts that has served people with IDD for the last 32 years. Over the last 15 years, since Work Inc. began tracking employment services data, its approach to employment supports in the community has evolved. The agency’s data-tracking methods have both guided and developed alongside this change process.


State Agency Promising Practice: Oregon’S Keys For Case Managers Initiative - Ensuring Case Manager Technical Capacity, Investment, And Engagement In Employment First, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

State Agency Promising Practice: Oregon’S Keys For Case Managers Initiative - Ensuring Case Manager Technical Capacity, Investment, And Engagement In Employment First, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

After the adoption of the Employment First policy in Oregon in 2010, state administrators identified the critical role of case managers for people on the support services waiver, and acknowledged the need for their buy-in and investment in the Employment First agenda. The case managers’ knowledge of the individuals they serve, the conversations they have with individuals and their families, and their knowledge of the community are critical to each individual’s success in finding employment, as well as to the forward movement of the Employment First initiative. At that time, the state agency serving individuals with intellectual/developmental disabilities IDD conducted …


State Agency Promising Practice: Wisconsin’S Community Conversations - Building A Youth Employment Coalition Through Structured Opportunities To Communicate, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

State Agency Promising Practice: Wisconsin’S Community Conversations - Building A Youth Employment Coalition Through Structured Opportunities To Communicate, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Wisconsin’s Developmental Disabilities Services agency and Vocational Rehabilitation agency, in conjunction with the Wisconsin Board for People with Developmental Disabilities and Wisconsin’s University Center for Excellence in Developmental Disabilities, implemented a series of community conversations to build dialogue and create a coalition around employment for youth with intellectual and developmental disabilities (IDD). Through this initiative, a range of community members came together in structured forums to discuss ways to improve integrated employment outcomes for youth.


Service Provider Promising Practice: Launchability Academy Training Program (Texas) - On-Site Training To Improve Employment Outcomes, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

Service Provider Promising Practice: Launchability Academy Training Program (Texas) - On-Site Training To Improve Employment Outcomes, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

LaunchAbility is a CRP that serves people with IDD in several locations throughout North Texas. LaunchAbility’s employment services program offers placement exclusively in the community. The LaunchAbility Academy Training Program was established in collaboration with the Department of Assistive and Rehabilitative Services (DARS) as a way to engage employers and prepare job seekers for employment. Program administrators at LaunchAbility developed the Academy model inspired by their work with Walgreens and the Project Search program www.projectsearch.us/. The Academy offers a combination of on-site direct work experience and workplace culture, etiquette, and behavior training (also known as soft skills) to people with …


State Agency Promising Practice - Missouri: Using A Regional Technical Assistance Infrastructure To Promote Employment First, Allison Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

State Agency Promising Practice - Missouri: Using A Regional Technical Assistance Infrastructure To Promote Employment First, Allison Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Case management services in Missouri’s Division of Developmental Disabilities underwent a shift from a state structure to a regional structure. Within this structure, 12 regions each serve approximately 12–15 counties. Each region has a technical assistance (TA) position designed to support each of the designated priority work areas. These include self-determination, family supports, individual supports and services, Employment First, and accessible housing. When the change from a state to regional structure occurred, administrators had to look for staff who could support those priorities. In addition, they created a central technical assistance staff person to act as the state content expert …


Service Provider Promising Practices: Lcs In Wisconsin - An Organizational Investment In Capacity-Building And Staff Training, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

Service Provider Promising Practices: Lcs In Wisconsin - An Organizational Investment In Capacity-Building And Staff Training, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Over the last five years, LCS, a provider in Racine, Wisconsin, has developed the capacity of its staff to expand integrated employment service options. LCS has hired and retained staff who are passionate about integrated employment, and has invested in supporting them to deliver high-quality integrated employment services. Through state-of-the-art training and other resources, LCS has navigated internal and external challenges to building staff competencies, and has solidified its mission of sustaining highly qualified staff.


Service Provider Promising Practice - Able Opportunities And The Work Independence Network (Washington): Creating An Individual Placement Model Focusing On The Needs Of Both Job Seekers And Employers, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2014

Service Provider Promising Practice - Able Opportunities And The Work Independence Network (Washington): Creating An Individual Placement Model Focusing On The Needs Of Both Job Seekers And Employers, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Able Opportunities is a certified vendor for the state of Washington’s Department of Vocational Rehabilitation, Developmental Disabilities Administration, Division of Developmental Disability, and Department of Labor and Industry. The Work Independence Network (WIN) began in 2005 as a partnership between Able Opportunities, Harrison Medical Center, and Kitsap County Developmental Disabilities to help people with intellectual and developmental disabilities (IDD) find jobs. Through WIN, Able Opportunities strives to meet the needs of both job seekers and employers through the use of innovative business model tools, including cost-benefit analysis and production charts. WIN’s goal is to help people with disabilities find meaningful …


Service Provider Promising Practice: Kfi In Maine - Making Mission-Driven Choices About Funding And Service Innovation, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jul 2013

Service Provider Promising Practice: Kfi In Maine - Making Mission-Driven Choices About Funding And Service Innovation, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Katahdin Friends, Inc. (KFI), headquartered in the small rural community of Millinocket, Maine, has been a service provider in this community and surrounding regions for the last 54 years. After providing segregated services for its first 20 years, KFI became an early adopter of supported employment. In the 1980s, staff members started attending conferences to learn about better, cheaper ways to serve their customers. They were profoundly influenced by the integration approach to community and employment support espoused by other innovative service providers across the country


Journal Of The American Deafness And Rehabilitation Association Year 2011, Volume 44, Number 3 Complete Apr 2011

Journal Of The American Deafness And Rehabilitation Association Year 2011, Volume 44, Number 3 Complete

JADARA

Upload of old JADARA issue for digital access


Foster Care & Disability, Tina M. Anctil Peterman, Clayton Rees Apr 2011

Foster Care & Disability, Tina M. Anctil Peterman, Clayton Rees

Counselor Education Faculty Publications and Presentations

The presentation explores the education instability of children in foster care


State Agency Promising Practice: New Hampshire - Translating Research Into A Position Statement About Integrated Employment, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2011

State Agency Promising Practice: New Hampshire - Translating Research Into A Position Statement About Integrated Employment, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

New Hampshire’s Bureau of Developmental Services, Department of Vocational Rehabilitation, other state and local service providers, advocates, and families are committed to increasing the employment rate and the quality of employment outcomes for people with developmental disabilities. These stakeholders met to craft an employment position statement. They framed their discussions according to factors that research has found to be common to “high-performing” states in providing integrated employment opportunities. Then they developed an employment position statement that satisfied all the groups involved, and communicated their shared belief in the importance of integrated employment as a means toward community inclusion.


State Agency Promising Practice: Oregon’S Employment Support Website - Communicating The Employment First Policy, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2011

State Agency Promising Practice: Oregon’S Employment Support Website - Communicating The Employment First Policy, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In 2009, the state of Oregon adopted its Employment First policy. When Oregon’s Office of Developmental Disabilities Services (DDS) decided to promote the implementation of this policy, it began by updating its existing employment website. The redesigned website (http:// www.dhs.state.or.us/dd/supp_emp/) emphasizes the value of integrated employment over other outcomes, and the importance of building community-wide conversations, with the goal of achieving integrated employment for people with developmental disabilities. The website shares the value of integrated employment with all targeted audiences by highlighting resources and illustrating employment successes. It was also designed to share information on the Oregon’s progress and concrete …


State Agency Promising Practice: Iowa’S Governance Group: Facilitating Partnerships That Support Integrated Employment, Allison Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2011

State Agency Promising Practice: Iowa’S Governance Group: Facilitating Partnerships That Support Integrated Employment, Allison Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In 1998, five state agencies formed the Governance Group. Partner agencies included: Iowa Workforce Development, Department of Human Services, Department of Education, Iowa Vocational Rehabilitation Services and Department of Human Rights. The group was developed in response to a Rehabilitation Services Administration (RSA) request for proposals that included an advisory group for systems change efforts to expand employment opportunities to individuals with disabilities. By 2000, the five original partners had expanded their efforts by agreeing to provide oversight and consultation to a Department of Labor (DOL) Work Incentive Grant and brought on two additional partners, the Department for the Blind …


State Agency Promising Practice: Nevada’S Regional Forums - Creating A Shared Responsibility For Improving Employment, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2011

State Agency Promising Practice: Nevada’S Regional Forums - Creating A Shared Responsibility For Improving Employment, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Nevada Governor’s Council on Developmental Disabilities sought to engage community stakeholders and acquire knowledge to further the employment agenda by funding three regional summits. Using the State Employment Leadership Network’s (SELN)* selfassessment preliminary findings as a basis, the summit steering committee created a framework for summit participants. Through a rigorous planning process and comprehensive 2-day summits in three regions of the state, Nevada was able to create a shared, multistakeholder plan of action with the goal of improving the current employment support system for individuals with developmental disabilities.


Effectiveness Of The Whytry Curriculum With Adults Participating In A Vocational Training Program, Erika Kern Jan 2011

Effectiveness Of The Whytry Curriculum With Adults Participating In A Vocational Training Program, Erika Kern

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research project is to evaluate the effectiveness of the WhyTry curriculum with adults participating in a vocational training program specifically to develop retail skills. WhyTry is an interactive, multisensory program used to motivate participants to change patterns of indifference by using analogies, videos, and music to stimulate and inspire them to succeed. The curriculum has elements of Solution Focused Brief Therapy, Social and Emotional Intelligence, and multi-sensory learning (WhyTry, 2011). My research question is as follows: Is the WhyTry curriculum effective in increasing self-esteem and self-efficacy with adults who are participating in a vocational training program? …


A Need Assessment For People Who Have Multiple Sclerosis And Their Support Groups, Eric Lee Markley Jan 2010

A Need Assessment For People Who Have Multiple Sclerosis And Their Support Groups, Eric Lee Markley

Theses Digitization Project

This paper discusses the problem the researcher finds in the lack of information on what people with Multiple Sclerosis (MS) are looking for in support groups that are designed around specifically for people with MS. This paper discusses what MS is, the reasoning on designing a study on this topic, and the significance of the project to social work. The type of research design that was used to find this information was a survey questionaire. Theoretical within the context of a social comparison model. A total of 58 people completed the survey.


The Impact Of Counselor Recovery Status, Disclosure, Education, And Experience On The Working Alliance In The Treatment Of Substance Use Disorders, Brian D. Roland Jan 2010

The Impact Of Counselor Recovery Status, Disclosure, Education, And Experience On The Working Alliance In The Treatment Of Substance Use Disorders, Brian D. Roland

Legacy Theses & Dissertations (2009 - 2024)

Although evidence shows that between 30 and 75 percent of alcohol and other drug (AOD) counselors are themselves in recovery from a substance use disorder, dated research comparing the effectiveness of recovering and non-recovering counselors failed to control for education, experience, and use of disclosure. Given that the strength of the working alliance between client and counselor is highly predictive of outcome and utilizing interpersonal influence theory as an organizing framework, a path model was hypothesized which posited (a) counselor recovery status and its disclosure impact counselor attractiveness which, in turn, impacts working alliance; (b) counselor education impacts counselor expertness …


State Agency Promising Practice: Massachusetts - Using A Collaborative, Person-Centered Planning Approach To Facilitate Community Employment, Jennifer Bose, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2010

State Agency Promising Practice: Massachusetts - Using A Collaborative, Person-Centered Planning Approach To Facilitate Community Employment, Jennifer Bose, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Northeast Region Supported Employment Project was developed by the North Shore area office of the Massachusetts Department of Developmental Services in 2007. This pilot program, open to any individual with ID/DD who wanted to work, emphasized a person-centered planning approach to achieving the individuals’ goals for employment in the community. The project emphasized the individual’s choice of employment providers, collaboration with the Massachusetts Rehabilitation Commission (MRC), and use of an independent facilitator to support career and life planning. The project was spearheaded by two DDS administrators dedicated to communicating the value of community-based employment to the Department.


State Agency Promising Practice: Maryland - Collaborating To Promote Self-Employment For People With Intellectual/Developmental Disabilities, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2010

State Agency Promising Practice: Maryland - Collaborating To Promote Self-Employment For People With Intellectual/Developmental Disabilities, Jennifer Bose, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Self-employment has emerged as a viable option for individuals with intellectual or developmental disabilities (IDD). To meet increased self-employment demands, Maryland’s Developmental Disabilities Administration (DDA), in collaboration with the Maryland Division of Rehabilitation Services (DORS), adapted services offered through the Reach Independence through Self Employment (RISE) program. The RISE program, funded by DORS, provides technical assistance and financial support to people starting their own businesses. DDA’s role in this self-employment initiative has helped people with IDD start a wide variety of businesses and achieve meaningful employment.


State Agency Promising Practice: Michigan’S Job Development Incentive, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston Jan 2010

State Agency Promising Practice: Michigan’S Job Development Incentive, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Michigan’s Department of Community Health, Mental Health and Substance Abuse Administration (MDCH) has expressed a strong desire to improve the state’s employment outcomes among people with intellectual and developmental disabilities (IDD). Set against this desire is a major obstacle: Michigan is among the states hardest hit by the continuing economic recession, with the highest unemployment rate in the nation. MCDH delivers supports through local Community Mental Health Services Programs (CMHSPs). These CMHSPs not only experience differences in employment rates but also have high variability in their funding levels and structures, payment methodologies, and reimbursement mechanisms. Local CMHSPs individualize their contracts …


Using A Structured Decision Making Protocol To Stratify Caseloads In The Child Support Program, Steven J. Golightly Jan 2010

Using A Structured Decision Making Protocol To Stratify Caseloads In The Child Support Program, Steven J. Golightly

Walden Dissertations and Doctoral Studies

Although structured decision making and risk assessment protocols have successfully been used in human service programs, little research has been done on their applicability in the child support program. In this study, problems identified with child support case management were examined, along with positive and negative attributes of various risk assessment tools utilized in other arenas. The overall research problem asserted that there are no structured decision making protocols in the child support program to support case assignment by enforcement difficulty. The primary research question asked whether or not a process stratified by risk and level of enforcement difficulty could …


Influences On Job Retention Among Homeless Persons With Substance Abuse Or Psychiatric Disabilities, Russell K. Schutt, Norman C. Hursh Dec 2009

Influences On Job Retention Among Homeless Persons With Substance Abuse Or Psychiatric Disabilities, Russell K. Schutt, Norman C. Hursh

The Journal of Sociology & Social Welfare

Job retention is an important psychosocial rehabilitation goal, but one that is not often achieved. We investigate facilitators of and barriers to employment retention among homeless individuals with psychiatric and substance abuse diagnoses who were re-interviewed eight or more years after participating in a traditional vocational rehabilitation program. Most program graduates who maintained employment had secured social support from a variety of sources; personal motivation was also a critical element in job retention and compensated in some cases for an absence of social support. Both the availability of social support contacts and personal motivation influenced likelihood of maintaining sobriety. Physical …