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Kjeldsen NB, Holm T, Oute J. "We are a rehabilitation unit, at least on paper" - Competing representations of recovery-oriented rehabilitation in dual diagnosis treatment policy and practice. Soc Sci Med 2024; 357:117160. [PMID: 39111261 DOI: 10.1016/j.socscimed.2024.117160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 09/07/2024]
Abstract
Within dual diagnosis treatment, principles of recovery are increasingly acknowledged. Nevertheless, recovery-oriented rehabilitation often becomes an abstract concept, leaving professionals in various dilemmas. This article examines competing representations of recovery-oriented rehabilitation across Danish dual diagnosis treatment policy and practice from a post-structural, analytical perspective inspired by governmentality and problematization studies. The empirical foundation consists of a qualitative ethnographic study including conducting and examining 12 national policies relevant to contemporary Danish dual diagnosis treatment practice and 23 interviews with health/welfare professionals employed at a Danish in-patient, dual diagnosis rehabilitation unit. The analysis points to a complexity between three sets of competing representations reflected in 1) the conceptual relationship between rehabilitation and recovery, 2) perceptions of knowledge based on experience or evidence, and 3) ideals of optimization and emancipation. Finally, the article discusses convergences between the competing and, at times, conflictual ideals, attempting to explain the conceptual fluffiness, discrepancies, and dilemmas experienced by professionals in dual diagnosis treatment within broader epistemological and ideological debates in social sciences and humanities.
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Affiliation(s)
- Natja Bech Kjeldsen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioral Science, School of Business and Social Sciences, Aarhus University, Denmark.
| | - Tine Holm
- Department of Clinical Medicine, Psychosis Research Unit, Aarhus University Hospital, Denmark
| | - Jeppe Oute
- Department of People and Technology, Roskilde University, Denmark
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Jørgensen K, Søren Hansen M, Bjerrum M, Hansen M, Watson E, Karlsson B. Healthcare Professionals' Experiences of Recovery-Oriented Collaboration Between Mental Health Centres and Municipalities: A Qualitative Study. Issues Ment Health Nurs 2024; 45:264-273. [PMID: 38232186 DOI: 10.1080/01612840.2023.2286477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Collaboration within mental health centres and with municipalities in Western European healthcare has presented challenges due to structural and cultural disparities. The Danish healthcare system faces obstacles that impact mental healthcare services, particularly in cross-sectorial cooperation. Our aim was to investigate healthcare professionals' experiences of recovery-oriented collaboration within a mental healthcare setting across hospitals and municipalities to gather a deeper understanding of this issue. Twenty-four employees were purposively sampled from mental health centres in Copenhagen and focus group interviews were conducted to explore their perceptions of working together. Inductive content analysis was used to analyse the data and identify themes and categories. The participants emphasised challenges in communication and coordination to improve collaboration within across the two sectors. This study can contribute to a greater understanding of collaboration between mental health centres and municipalities. It aims to inspire improvements in communication, coordination, and the optimisation of mental health service delivery across sectors.
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Affiliation(s)
- Kim Jørgensen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | | | - Merete Bjerrum
- Research Unit of Nursing and Healthcare, Institute of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Emma Watson
- Nottinghamshire Healthcare NHS Foundation Trust, Learning & Development, People and Culture Services, Nottingham, UK
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Bahl NKH, Nafstad HE, Blakar RM, Øversveen E, Brodahl M, Ness O, Prilleltensky I. How older adults recovering from substance use problems experience mattering. BMC Health Serv Res 2023; 23:1453. [PMID: 38129831 PMCID: PMC10740266 DOI: 10.1186/s12913-023-10413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
AIM Mattering (to feel valued and add value to self and others) is a fundamental human experience and mechanism in recovery. In this paper, we concern ourselves with the recovery of older adults with substance problems. This population is on the rise in many Western countries. To offer mattering enhancing programs for this group, more knowledge about later life mattering in service-assisted recovery processes is needed. This study aims to explore experiences of mattering in older adults receiving services to recover from substance use problems. METHODS A collaborative and deductive reflexive thematic approach was applied in analysing 23 interviews with participants using substance use services. Participants were recovering from different substance use problems: alcohol, medication and illegal substances. The participants were recruited from three different Norwegian social contexts: two urban and one medium size municipality. The age of the sample ranged from 65-80 years, with approximately equal numbers for those aged 60-69 (12 participants) and 70-80 (11 participants). Seven participants were women and 16 men. RESULTS Three main themes were identified in the analysis: "relational experiences of mattering and not mattering", "service-related experiences of mattering and not mattering" and "recovery and psychological sense of community as interrelated phenomena to experiences of mattering". The findings illustrate various nuanced experiences of mattering and not mattering in later life recovery processes. CONCLUSIONS Overall, the participants' mattering experiences rested on fair, healthy and positive community relationships and fair and attentive services, where participants could feel valued and also have a chance to add value to others. Experiences of not mattering were precipitated by lack of support, disrespect, devaluation and loss of relationships, and also by being ignored and not receiving fair treatment and help by professionals. Importantly, reciprocal and enhancing relations between mattering, recovery and relational PSOC seem to exist and to be significant for the older adults' access to substance use services. Several practical implications are suggested to promote the therapeutic and preventive potentials of later life mattering in recovery.
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Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs hospital, Trondheim University Hospital, Klostergata 48, 7030, Trondheim, Norway.
| | - Hilde Eileen Nafstad
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Rolv Mikkel Blakar
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Emil Øversveen
- Department of Sociology and Political Science, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit On Concurrent Substance Abuse and Mental Health Disorders, Mental Health Division, Innlandet Hospital Trust, Divisjon Psykisk Helsevern, 2381, Brumunddal, Norway
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Isaac Prilleltensky
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
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Kerr-Little A, Bramness JG, Newberry RC, Biong S. Exploring dog ownership in the lives of people with substance use disorder: a qualitative study. Addict Sci Clin Pract 2023; 18:57. [PMID: 37759274 PMCID: PMC10523709 DOI: 10.1186/s13722-023-00411-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Recovery from substance use is commonly seen as a process of integrating social relationships and creating a sense of meaning in one's life. Dog owners describe a close relationship with their dog that impacts many aspects of their everyday life. Yet for individuals with substance use disorder (SUD), little is known about how dog ownership could affect their lives. The aim of this study was to explore how people living with SUD experience and describe their everyday life when owning a dog. METHOD Eight semi-structured in-depth individual interviews were conducted with people having personal experience of living with SUD and owning a dog. Data were gathered and analysed using qualitative content analysis. RESULTS The analysis yielded four categories, reflecting different aspects of dog ownership. Living with SUD and owning a dog was primarily something positive in their life. People increased their social connections personally and within society. They felt a belonging which gave a sense of agency and purpose, and they developed structure in their day and boundaries to their environment. Dog ownership, however, could hinder access to services which was found to be challenging for some participants. CONCLUSIONS The owning of a dog can lead to changes that parallel those of a recovery process. This finding adds to the research on the connection that dogs can provide and shows how pertinent this can be particularly for vulnerable persons such as those with SUD.
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Affiliation(s)
- Andi Kerr-Little
- Norwegian National Advisory Unit On Concurrent Substance Abuse & Mental Health Disorders, Hamar, Norway.
- Institute of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway.
| | - Jørgen G Bramness
- Norwegian National Advisory Unit On Concurrent Substance Abuse & Mental Health Disorders, Hamar, Norway
- Institute of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Dept of Alcohol Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Ruth C Newberry
- Department of Animal & Aquacultural Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, Ås, Norway
| | - Stian Biong
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway
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Marciuch A, Birkeland B, Benth JŠ, Solli KK, Tanum L, Mathisen I, Weimand B. Personal recovery among people with opioid use disorder during treatment with extended-release naltrexone. Heliyon 2023; 9:e17516. [PMID: 37449176 PMCID: PMC10336734 DOI: 10.1016/j.heliyon.2023.e17516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Background and aims Recovery from substance use disorders (SUD) has traditionally been equated with abstinence. "Personal recovery" however emphasizes recovery as a unique and personal process, supported by changes in connectedness, hope, identity, meaning and empowerment. This study aimed to examine personal recovery in people receiving extended-release naltrexone (XR-NTX); specifically investigate changes in personal recovery during treatment, identify groups of participants following distinct trajectories of recovery, and characteristics predicting group-belonging. Methods Overall change in recovery (Questionnaire about the Process of Recovery, QPR) score was assessed by linear mixed model in a subsample of 135 people with opioid use disorder (OUD) participating in a 24 + 28-week trial of XR-NTX. Growth mixture model was used to identify potential groups of people following distinct trajectories of personal recovery. Results Overall, there was a significant change in QPR score during treatment. Four groups with distinct recovery trajectories were identified: "initially low- increase" (G1), "initially average- no change" (G2), "initially high- no change" (G3) and "initially high- increase" (G4). The groups were different with regards to level of psychological distress, social support, and the use of benzodiazepines. In addition, previous participation in opioid agonist treatment programs, current pain, life satisfaction, employment, heroin craving and previous use of heroin also differed between groups. Conclusions Personal recovery among people receiving XR-NTX follows different trajectories, and various factors are associated with personal recovery. Particular attention regarding psychological distress, social support and heroin use among patients commencing XR-NTX treatment is important to facilitate successful recovery trajectories.
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Affiliation(s)
- Anne Marciuch
- Department of Research and Development in Mental Health, Akershus University Hospital, Loerenskog, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente Birkeland
- Department of Psychosocial Health, University of Agder, Kristiansand, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Kristin Klemmetsby Solli
- Department of Research and Development in Mental Health, Akershus University Hospital, Loerenskog, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Norway
- Vestfold Hospital Trust, Toensberg, Norway
| | - Lars Tanum
- Department of Research and Development in Mental Health, Akershus University Hospital, Loerenskog, Norway
- Faculty for Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Ida Mathisen
- Faculty for Health Science, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
| | - Bente Weimand
- Department of Research and Development in Mental Health, Akershus University Hospital, Loerenskog, Norway
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway
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Skånland MS. Music therapy and social recovery in flexible assertive community treatment. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2116593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Bahl NKH, Øversveen E, Brodahl M, Nafstad HE, Blakar RM, Ness O, Landheim AS, Tømmervik K. In what ways do emerging adults with substance use problems experience their communities as influencing their personal recovery processes? JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3070-3100. [PMID: 35187694 PMCID: PMC9545888 DOI: 10.1002/jcop.22816] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/22/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Applying the multiple psychological sense of community concept (MPSOC), this study explored how emerging adults with substance use problems experience the influences of various senses of community and communities on their personal recovery processes. Semi-structured interviews with 21 emerging adults from different urban contexts in Norway were analysed using a collaborative, seven-step, deductive, and reflexive thematic approach. MPSOC is shown to be a key concept for achieving a broad, in-depth understanding of emerging adults' senses of community and personal experiences of community influences on recovery processes from substance use. Positive and negative senses of community in geographical, relational, substance use-related and ideal communities influence the potentials and challenges in emerging adults' recovery processes. Supportive and motivating community relationships, meaningful activities with peers, and distance from recovery-impeding communities were identified as important recovery components. To promote recovery and prevent substance use in emerging adults, community approaches and tools applied in substance use treatment have to take into account and utilise multidimensional and age group-specific aspects of belonging.
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Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction MedicineSt. Olavs University HospitalTrondheimNorway
| | - Emil Øversveen
- Department of Sociology and Political ScienceNorwegian University of Science and TechnologyTrondheimNorway
| | - Morten Brodahl
- Mental Health Division, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustBrumunddalNorway
| | | | | | - Ottar Ness
- Department of Education and Lifelong LearningNorwegian University of Science and TechnologyTrondheimNorway
| | - Anne S. Landheim
- Mental Health Division, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustBrumunddalNorway
- Campus ElverumInnlandet University of Applied SciencesElverumNorway
| | - Kristin Tømmervik
- Department of Research and Development, Clinic of Substance Use and Addiction MedicineSt. Olavs University HospitalTrondheimNorway
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Jørgensen K, Hansen M, Karlsson B. Recovery-Oriented Practices in a Mental Health Centre for Citizens Experiencing Serious Mental Issues and Substance Use: As Perceived by Healthcare Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10294. [PMID: 36011927 PMCID: PMC9408666 DOI: 10.3390/ijerph191610294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Recovery-oriented practices have become a means of promoting user recovery during hospitalisation, but we do not know much about the concrete means of practicing recovery-orientation for the most vulnerable users with serious mental difficulty and substance use. AIMS We investigated the concrete means of practicing recovery-orientation in care work and the elements, dimensions, outcomes, or steps of it in a special department of mental health centres. METHOD Focus group interviews were conducted with 16 health professionals with experience with users with serious mental difficulty and substance use. Qualitative content analysis was undertaken. RESULTS The main theme was "holistic recovery on structural terms" based on two themes and four subthemes. The first theme was "recovery based on an individual approach" with subthemes "detective-find hope" and "how to do recovery-oriented practice". The next theme was "recovery subject to structural framework" with subthemes "tension between different interests" and "symptoms as a barrier". CONCLUSIONS recovery-oriented practice is understood as an approach where health professionals emphasise forming relationships based on trust, being hopeful for the users' future, spending time with users, and respecting users' experiences and knowledge from their own life. There are cross-pressures between different interests. The desire to meet the users' perspectives and respect these perspectives but at the same time live up to mental health centre purposes to stabilise the users' health and achieve self-care.
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Affiliation(s)
- Kim Jørgensen
- Science in Nursing Department of Public Health, Bartholins Allé 2, 8000 Aarhus, Denmark
| | - Morten Hansen
- Psychiatric Outpatient Clinic Ishøj, Bostedsteamet, Store Torv 20, 2635 Ishøj, Denmark
| | - Bengt Karlsson
- Center for Mental Health and Substance Abuse, Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of Southeastern Norway, Postbox 7053, 3007 Drammen, Norway
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Wangensteen T, Hystad J. Trust and collaboration between patients and staff in SUD treatment: A qualitative study of patients’ reflections on inpatient SUD treatment four years after discharge. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:418-436. [PMID: 36003119 PMCID: PMC9379296 DOI: 10.1177/14550725221082366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background and aim: Substance use disorder (SUD) is multifactorial, complex, and involves the severe problematic use of alcohol, prescription drugs, and other substances. People with SUD have long histories of perceived stigma, marginalisation, exclusion, social isolation, and shame. Moreover, patients with SUD are often treated as untrustworthy and incapable of actively participating in their treatment planning, even by healthcare and social services workers. Methods: Through in-depth interviews with former patients who have undergone SUD treatment, we explored their reflections on the treatment content. Interpretative phenomenological analysis revealed that some informants experienced aspects of the treatment as valuable, whereas others considered the same treatment useless or harmful. Results: Essential aspects of treatment were developing self-esteem and optimism about the future, developing strategies for coping with stress and challenging emotions and situations, developing relationships with family and friends, and preparing for life after inpatient treatment. Relationships with staff were described as crucial in all parts of the treatment. Conclusion: In conclusion, we suggest that a transition to a more collaborative treatment philosophy would be ethically and professionally valuable for providing support and treatment and enhancing patients’ perceptions of empowerment, inclusion, participation, and well-being on their terms, in cooperation with supportive others.
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"It's More Than Just Exercise": Tailored Exercise at a Community-Based Activity Center as a Liminal Space along the Road to Mental Health Recovery and Citizenship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910516. [PMID: 34639815 PMCID: PMC8507912 DOI: 10.3390/ijerph181910516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/26/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Abstract
Mental health care policies call for health-promoting and recovery-oriented interventions, as well as community-based programs supporting healthier habits. The purpose of this study was to explore how individuals facing mental health challenges experienced participating in tailored exercise at a community-based activity center, and what role tailored exercise could play in supporting an individual’s process of recovery. Data were collected through in-depth interviews with nine adults experiencing poor mental health who engaged in exercise at the activity center. Interviews were audio-recorded, transcribed verbatim and analyzed using systematic text condensation. Participants spoke about the community-based program being a safe space where they could “come as they are” (Theme 1). Taking part in the program was “more than just exercise” and allowed them to connect with others (Theme 2). The experiences they gained from exercise also helped with other areas in life and provided them with a safe space to build their confidence towards the “transition back to the outside” (Theme 3). We summarized the findings into one overall theme: “inside vs. outside”. In conclusion, a community-based activity center acted as a liminal space that aided mental health recovery by allowing participants to feel safe, accepted and supported, as well as experience citizenship. The findings highlight the need to treat mental health challenges as a contextual phenomenon and creating arenas for community and citizenship in society.
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Brekke E, Clausen HK, Brodahl M, Lexén A, Keet R, Mulder CL, Landheim AS. Service User Experiences of How Flexible Assertive Community Treatment May Support or Inhibit Citizenship: A Qualitative Study. Front Psychol 2021; 12:727013. [PMID: 34566813 PMCID: PMC8457351 DOI: 10.3389/fpsyg.2021.727013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to explore and describe service user experiences of how receiving services from a Flexible Assertive Community Treatment (FACT) team may support or inhibit citizenship. Within a participatory design, individual interviews with 32 service users from five Norwegian FACT teams were analyzed using thematic, cross-sectional analysis. The findings showed that FACT may support citizenship by relating to service users as whole people, facilitating empowerment and involvement, and providing practical and accessible help. Experiences of coercion, limited involvement and authoritarian aspects of the system surrounding FACT had inhibited citizenship for participants in this study.
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Affiliation(s)
- Eva Brekke
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
| | - Hanne K. Clausen
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
- Department of Research and Development, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
| | - Annika Lexén
- Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
| | - Rene Keet
- Flexible, Innovative Top-ambulatory Academy of Community Mental Health Service, Geestelijke Gezondheidszorg Noord-Holland-Noord, Heerhugowaard, Netherlands
| | - Cornelis L. Mulder
- Department of Psychiatry, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anne S. Landheim
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Brumunddal, Norway
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Part I: Dynamics of Recovery: A Meta-Synthesis Exploring the Nature of Mental Health and Substance Abuse Recovery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157761. [PMID: 34360054 PMCID: PMC8345607 DOI: 10.3390/ijerph18157761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022]
Abstract
Recovery-oriented care has become a leading vision across countries. To develop services and communities in more recovery-oriented directions, enhanced understandings of recovery in terms of personal and social contexts are important prerequisites. The aim of this study is to explore the nature and characteristics of the experiences of recovery. The method used is a form of qualitative meta-synthesis that integrates the findings from multiple qualitative studies published by one research group. Twenty-eight empirical papers with a focus on recovery as personal and contextual experiences were included in this meta-synthesis. Five meta-themes were developed: (a) being normal, (b) respecting and accepting oneself, (c) being in control, (d) recovery as intentional, and (e) recovery as material and social. The themes describe how recovery encompasses dynamics between personal experiences and contextual dimensions. This meta-synthesis consolidated an understanding of recovery as dynamics of the self and others, and as dynamics of the self and material resources. This understanding of recovery suggests the need to work not only with the person, but also with families, networks, social systems, and local communities, thus developing mental health and substance abuse services in more collaborative, open-ended, and context-sensitive directions.
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Sommer M, Biong S, Borg M, Karlsson B, Klevan T, Ness O, Nesse L, Oute J, Sundet R, Kim HS. Part II: Living Life: A Meta-Synthesis Exploring Recovery as Processual Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116115. [PMID: 34204024 PMCID: PMC8201104 DOI: 10.3390/ijerph18116115] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Abstract
Recovery, a prominent concern in mental health care worldwide, has been variously defined, requiring further clarification of the term as processual. Few studies have comprehensively addressed the nature of recovery processes. This study aims to explore the nature and characteristics of experiences of recovery as processual. The method used is a form of qualitative meta-synthesis that integrates the findings from 28 qualitative studies published during the past 15 years by one research group. Three meta-themes were developed: (a) recovery processes as step-wise, cyclical, and continuous, (b) recovery as everyday experiences, and (c) recovery as relational. These themes describe how recovery is intertwined with the way life in general unfolds in terms of human relationships, learning, coping, and ordinary everyday living. This meta-synthesis consolidates an understanding of recovery as fundamental processes of living in terms of being, doing, and accessing. These processes are contextualized in relation to mental health and/or substance abuse problems and highlight the need for support to facilitate the person's access to necessary personal, social, and material resources to live an ordinary life in recovery.
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Affiliation(s)
- Mona Sommer
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
- Correspondence:
| | - Stian Biong
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Marit Borg
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Bengt Karlsson
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Trude Klevan
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, 7042 Trondheim, Norway;
| | - Linda Nesse
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences (NMBU), 1430 Ås, Norway;
| | - Jeppe Oute
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Rolf Sundet
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Hesook Suzie Kim
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
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