Mutual dependence and the “Goldilocks group”: exploring service user dependency on mutual aid recovery groups

Barriers and Facilitators to Treatment Engagement Among Clients in Inpatient Substance Abuse Treatment

There is a call for drawing on client voice to provide a rich, nuanced understanding of factors influencing substance treatment engagement as to maximizing treatment benefits. We interviewed 60 clients in a short-term inpatient substance treatment program and examined facilitators and barriers to treatment engagement. Thematic analysis yielded four themes, including perceived treatment needs, trust and counselor rapport, peer inspiration, and organizational factors. Perceived treatment needs serve as both a facilitator and a barrier wherein the acknowledgment of needs led to greater treatment engagement whereas a lack of perceived needs hindered treatment engagement. The establishment of trust and counselor rapport and peer inspiration facilitated treatment engagement. Clients rated several organizational factors including a lack of treatment provision, gender-responsive treatment and infrastructure, and ineffective communication with nonclinical staff as barriers to treatment engagement. Clinical implications include enhancing treatment motivation and counselor rapport, establishing gender-responsive treatment programs, and providing trainings for staff.

Two buses and a short walk: the place of geography in recovery

Purpose

– As UK substance misuse policy has increasingly focused on the concept of recovery, policymakers, service providers and service users have found “recovery capital” a useful concept to understand the barriers to and facilitators of recovery from substance misuse. There is a rich strand of research that considers the composition of recovery capital in terms of the relevance of resources such as access to mutual aid, familial support and friendship networks, stable housing, structured psychosocial support and education, training and employment. However, such general accounts have tended not to engage with the potential spatial element of recovery capital; that is, how location contributes to the acquisition and management of recovery capital. The purpose of this paper is to add nuance to more generalised accounts through a critical interrogation, exploration and analysis of the role of geography in recovery.

Design/methodology/approach

– The paper draws on in-depth interviews with service users and service providers in a predominantly rural county in the south-west of England.

Findings

– The ability to build and sustain recovery capital is shown to be marked by a complex web of social and spatial inclusions/exclusions.

Originality/value

– This paper makes three important contributions to prevailing understandings of recovery capital. First, it shows how narratives of recovery are intimately tied to perceptions and experiences of place. Second, it reveals some of the important challenges and complex dilemmas that local drug and alcohol commissioners face in designing and delivering recovery-orientated treatment systems. Third, and finally, it argues that there is a pressing need for a more nuanced appreciation of the social and spatial dynamics of recovery capital.