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Mustapha SZ, Ahmad Y, Aziz NA, Abd Hamid SNF. Cure & Care 1Malaysia Clinics: Measuring the Effectiveness via Dyads Lens Involving Receivers and Providers. J Patient Exp 2023; 10:23743735231179070. [PMID: 37332831 PMCID: PMC10272645 DOI: 10.1177/23743735231179070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023] Open
Abstract
Drug treatment and rehabilitation programs are one of the initiatives to alleviate the global epidemic of drug addiction. The efforts were undertaken by everyone, particularly the government. However, the rising number of drug relapses among patients or clients ponders the effectiveness of the drug treatment and rehabilitation programs implemented in the country. This paper aims to study the drug relapse prevention initiatives and the effectiveness of the center in dealing with drug addiction issues. A case study of 4 drug treatment and rehabilitation centers, namely Cure & Care 1Malaysia Clinics in Selangor, Malacca, Penang, and Kelantan, was selected. In-depth interviews were conducted with 37 participants-26 clients and 11 providers, and the data were analyzed using thematic analysis and NVivo version 12. The findings indicate that relapse prevention initiatives are a signal for the effectiveness of the center to reduce drug relapse cases. The implementation of drug treatment and rehabilitation programs was effective based on key aspects consisting of (1) knowledge and life skills learned; (2) staff reception; (3) individual changes; and (4) client acceptance. Therefore, by experiencing relapse prevention activities, it helps to improve the effectiveness of the implementation of drug treatment and rehabilitation programs.
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Affiliation(s)
- Siti Zulaikha Mustapha
- Faculty of Administrative Science and Policy Studies, Universiti Teknologi MARA Kelantan, Machang, Malaysia
| | - Yarina Ahmad
- Faculty of Administrative Science and Policy Studies, Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Nur Amalina Aziz
- Faculty of Business and Management, Universiti Teknologi MARA Segamat, Malaysia
| | - Siti Nur Fathanah Abd Hamid
- Faculty of Administrative Science and Policy Studies, Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, Shah Alam, Malaysia
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Smith E, Carter M, Walklet E, Hazell P. Investigating recovery from problem substance use using digital photovoice. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1378-1393. [PMID: 36306505 DOI: 10.1002/jcop.22957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
This study investigates the complex process of recovery from problem substance use using a visual research method known as 'Photovoice'. Seven service users from a harm reduction drug service were given digital cameras and asked to photograph 'people, places, and things' meaningful to them in their recovery. These photographs were then used as a catalyst for discussion during two in-depth interviews. This study demonstrates the nuanced experiences of recovery as some participants expressed feeling isolated while others reflected upon their access to various forms of social capital. These findings recognise the link between social capital and recovery outcomes, while also reflecting upon how services might imbed the need for relationship quality within artificial recovery networks. The use of photographs is a novel way of providing voice to the lived experience of service users and adds to the discussion and debate concerning how recovery services may develop.
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Affiliation(s)
- Emma Smith
- Institute of Psychiatry and Neuroscience, Kings College London, London, UK
| | - Melody Carter
- School of Nursing and Midwifery, University of Worcester, Worcester, UK
| | - Elaine Walklet
- School of Psychology, University of Gloucestershire, Cheltenham, UK
| | - Paul Hazell
- School of the Arts, University of Worcester, Worcester, UK
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Railey AF, Roth AR, Krendl AC, Perry BL. Intergroup relationships with people who use drugs: A personal network approach. Soc Sci Med 2023; 317:115612. [PMID: 36542930 DOI: 10.1016/j.socscimed.2022.115612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Positive and meaningful intergroup contact between people who use drugs and those with the potential to provide positive social interactions has been identified as an important pathway to address the burden of drug use by reducing stigmatizing views and behaviors. Traditional approaches to intergroup contact typically rely on laboratory experiments or survey vignettes to examine the consequences of variation in contact conditions and relationships. Although seldom measured, contact occurs naturally through individuals' personal social networks. Here, we apply this latter approach to examine how the characteristics of drug use and social roles are associated with positive and meaningful intergroup contact in daily life. We leverage unique data from a state representative sample of Indiana residents aged 18 or older (n = 926) that completed a personal network interview and separately reported people they know who have a drug use problem. We first identified the respondents who nominated a person who uses drugs as a member of their core personal network and then evaluated the relationship, disease, and individual characteristics that were associated with that person's inclusion in the personal network. We find that primary relationships (e.g., having a spouse or child who uses drugs) are associated with meaningful contact with people who use drugs but that intense manifestations of disease characteristics (severe or problematic, danger to self) can limit the likelihood of contact. These findings demonstrate how the nature of intergroup contact can shape the types of relationships that have been shown to help reduce stigmatizing attitudes and the behavioral barriers to recovery, such as social isolation. Thus, core networks present a valuable approach to defining the factors that likely contribute to effective intergroup contact.
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Affiliation(s)
- Ashley F Railey
- Department of Sociology, Indiana University Bloomington, IN, USA; Department of Sociology, Oklahoma State University, Stillwater, OK, USA.
| | - Adam R Roth
- Department of Sociology, Indiana University Bloomington, IN, USA; Department of Sociology, Oklahoma State University, Stillwater, OK, USA; Network Science Institute, Indiana University Bloomington, IN, USA
| | - Anne C Krendl
- Department of Psychological and Brain Sciences, Indiana University Bloomington, IN, USA
| | - Brea L Perry
- Department of Sociology, Indiana University Bloomington, IN, USA; Network Science Institute, Indiana University Bloomington, IN, USA
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4
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Jurinsky J, Cowie K, Blyth S, Hennessy EA. "A lot better than it used to be": A qualitative study of adolescents' dynamic social recovery capital. ADDICTION RESEARCH & THEORY 2022; 31:77-83. [PMID: 37008756 PMCID: PMC10062693 DOI: 10.1080/16066359.2022.2114076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/05/2022] [Accepted: 08/14/2022] [Indexed: 06/10/2023]
Abstract
Background Substance use recovery is a dynamic process for youth, and social networks are tied to the recovery process. The Recovery Capital for Adolescents Model (RCAM) situates the resources accessible through social networks - social recovery capital (SRC) - in a larger framework of developmentally-informed recovery resources. This study aims to investigate the social network experiences among recovering youth enrolled in a recovery high school to understand how social influences help to build, or act as barriers to building, recovery capital. Methods To gain insight into these networks, Social Identity Maps and semi-structured interviews were conducted with ten youth ages 17-19 years (80% male; 50% non-Hispanic White). Study visits were conducted virtually, recorded, transcribed, and thematically analyzed using the RCAM as an organizing framework. Results Results supported that adolescent social networks play a unique and multifaceted role in the recovery journey. Three key nuances emerged: change permeates adolescent networks throughout the treatment and recovery process; shared substance use history and non-stigmatizing attitudes play a key role in connecting with others; and SRC is interconnected with human, financial, and community recovery capital. Conclusions With adolescent recovery receiving increased attention from policy makers, practitioners, and researchers, the RCAM may be a useful way to contextualize available resources. Findings suggest SRC as a crucial, yet complex component intertwined with all other forms of recovery capital.
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Affiliation(s)
- Jordan Jurinsky
- Vanderbilt University, Peabody College of Education and Human Development, Nashville, TN, USA 37203-5721
| | - Kiefer Cowie
- The Wright Institute Clinical Psychology Program, Berkeley, CA, USA 94704
| | | | - Emily A Hennessy
- Massachusetts General Hospital, Psychiatry, Recovery Research Institute, 151 Merrimac Road, Boston, MA, USA 02114-2696
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5
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The line of vulnerability in a recovery assemblage. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 107:103740. [DOI: 10.1016/j.drugpo.2022.103740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/22/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
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Gauthier GR, Markowski K, Smith JA, Harcy S, Johnston B. Co-use among confidants: An examination of polysubstance use and personal relationships in southeastern Nebraska. Addict Behav 2022; 124:107116. [PMID: 34562776 PMCID: PMC8542383 DOI: 10.1016/j.addbeh.2021.107116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
This study examines the relationship between personal networks and polysubstance use among people who use drugs (PWUD) in a medium sized city in the Midwest. A large body of work has demonstrated that personal relationships have an ambivalent association with substance use. On the one hand, a supportive network is associated with safer drug use practices and dramatically improves the outlook for recovery. However, individuals whose personal networks are composed of co-drug use partners are more likely to engage in risky practices. We argue that this notion of "supportive" social contacts and "risky" social contacts is ultimately incomplete: risky behaviors are introduced and further developed in a social context, often with the people who provide emotional support. We argue that personal networks with more multiplex relationships (where co-drug use and confiding fuse) are harmful because they combine norms of trust and reciprocity with drug use. We use data from the Rural Health Cohort (RHC) study to test this idea. The sample consists of 120 adult PWUD in a medium sized city located in southeastern Nebraska who were recruited using respondent-driven sampling. Participants listed up to nine confidants and nine co-drug use partners, indicating any overlap between the two networks. Our results demonstrate that multiplex ties are as strongly associated with polysubstance use as simple co-drug use relationships. As the drug crisis has increasingly shifted to underserved populations outside large urban centers, this paper represents an important advance in our understanding of the current drug crisis.
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Affiliation(s)
- G. Robin Gauthier
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA,Please address correspondence to Robin Gauthier, Research, Department of Sociology, 719 Oldfather Hall, University of Nebraska-Lincoln NE 68588-0623.
| | - Kelly Markowski
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| | - Jeffrey A. Smith
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| | - Sela Harcy
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| | - Bergen Johnston
- Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
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Alderson H, Spencer L, Scott S, Kaner E, Reeves A, Robson S, Ling J. Using Behavioural Insights to Improve the Uptake of Services for Drug and Alcohol Misuse. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136923. [PMID: 34203334 PMCID: PMC8297083 DOI: 10.3390/ijerph18136923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022]
Abstract
In the U.K., 270,705 adults were in contact with drug and alcohol treatment services between April 2019 and March 2020. Within the same time period, 118,995 individuals exited the treatment system, and just over a third (36%) left treatment without completing it. The latter includes individuals declining further treatment and unsuccessful transfers between services. The aim of this study was to explore the factors that affect drug and alcohol treatment uptake within a drug and alcohol service in North East England. A mixed-methods approach was adopted. The exploration of factors affecting treatment uptake was captured through a behavioural insights survey and 1:1 in-depth qualitative interviews with service users within one council area within the North East of England. There were 53 survey participants, and a further 15 participants took part in qualitative interviews. We triangulated data sources to report consistencies and discrepancies in the data. Findings show that treatment services aiming to reduce missed appointments and increase retention rates need to implement several strategies. Consistently distributing appointment cards, using text message reminders, displaying a timetable presenting all treatment options, and displaying information in a format to ensure it is accessible to individuals with lower health literacy and reducing wait times for appointments will all improve appointment attendance.
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Affiliation(s)
- Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK; (H.A.); (S.S.); (E.K.)
| | - Liam Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK; (H.A.); (S.S.); (E.K.)
- Correspondence:
| | - Stephanie Scott
- Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK; (H.A.); (S.S.); (E.K.)
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK; (H.A.); (S.S.); (E.K.)
| | - Alison Reeves
- Hartlepool Borough Council, Civic Centre, Hartlepool TS24 8AY, UK; (A.R.); (S.R.)
| | - Sharon Robson
- Hartlepool Borough Council, Civic Centre, Hartlepool TS24 8AY, UK; (A.R.); (S.R.)
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK;
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Smith E, Carter M, Walklet E, Hazell P. Investigating the experiences of individuals in recovery from problem substance use and their perceptions of the COVID-19 pandemic. DRUGS AND ALCOHOL TODAY 2021. [DOI: 10.1108/dat-01-2021-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose
This paper aims to explore how enforced forms of social isolation arising from the first COVID-19 lockdown influenced experiences of problem substance use, relapse and coping strategies for recovery in individuals engaging with harm reduction recovery services.
Design/methodology/approach
A qualitative semi-structured interview design was adopted for this research. Seven participants were recruited from a harm reduction recovery organisation. During their initial interview, participants volunteered information regarding their experience of the first lockdown due to emerging concerns of the COVID-19 pandemic. Participants completed a second semi-structured interview at the end of the first lockdown regarding their experience of enforced isolation during this time.
Findings
Three themes identified from the analysis were isolation resulting in hindered human capabilities; adjusting to a new normal: an individual experience; and unexpected benefits to recovery resulting from isolation. While some participants reported boredom, loneliness and relapse events, others reported that the national response to the virus did not adversely affect them as they had already adjusted to living in a state of anxiety, isolation and uncertainty. These findings illuminate negative, neutral and positive aspects of substance use recovery throughout the COVID-19 lockdown as well as highlighting the complex and individualised role that social connectedness plays in relapse occurrence.
Originality/value
Participants reported differences in how they were affected by the pandemic, leading to theoretical implications for the effect of social isolation on recovery. For this reason, individuals with a history of dependency should be considered potentially vulnerable to the effects of enforced isolation and should be supported accordingly.
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Andersson C, Wincup E, Best D, Irving J. Gender and recovery pathways in the UK. DRUGS: EDUCATION, PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1852180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Catrin Andersson
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, UK
| | | | - David Best
- College of Business, Law and Social Science, University of Derby, One Friar Gate Square, Derby, UK
| | - Jamie Irving
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, UK
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Harrison R, Van Hout MC, Cochrane M, Eckley L, Noonan R, Timpson H, Sumnall H. Experiences of Sustainable Abstinence-Based Recovery: an Exploratory Study of Three Recovery Communities (RC) in England. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-018-9967-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Dekkers A, De Ruysscher C, Vanderplasschen W. Perspectives of cocaine users on addiction recovery: a qualitative study following a CRA + vouchers programme. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1687647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anne Dekkers
- Department of Special Needs Education, Ghent University, Ghent, Belgium
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Lloyd C, Page G, McKeganey N, Russell C. Capital depreciation: The lack of recovery capital and post-release support for prisoners leaving the Drug Recovery Wings in England and Wales. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 70:107-116. [PMID: 31238269 DOI: 10.1016/j.drugpo.2019.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND This article draws on the evaluation of the pilot Drug Recovery Wings (DRWs), which were introduced ten prisons in England and Wales, with the intention of delivering abstinence-focused drug recovery services. The DRW pilots can be seen as representing the extension of the recovery paradigm - so prevalent elsewhere in UK drug policy - to the prison system. This study aimed to provide a detailed account of DRW prisoners' expectations and experiences in the transition from prison to the community and explore the potential for 'doing recovery' in prison and on release. METHODS In-depth, qualitative interviews were conducted in prison with 61 prisoners across six of the DRWs. Follow-up interviews six months after release were conducted with 21 prisoners and 26 'recovery supports' (people identified as being close to the prisoners). Data from one, other or both sources was available for 36 prisoners. All interviews were fully transcribed and coded. RESULTS The majority of the 61 had long histories of alcohol and/or opiate dependence, childhood adversity, undiagnosed mental health problems and few educational qualifications. Nonetheless, many had long histories of employment - mostly in manual trades. The majority described themselves as being 'in recovery' at the time of the first interview in prison. While one of the main aims of the DRWs was to support prisoners' recovery journeys into the community, this aspect of their work did not materialize. Professional support at release was largely absent or, where present, ineffectual. Many were released street-homeless or to disordered and threatening hostels and night-shelters. Only three of the 36 were fully abstinent from drink and drugs at time of re-interview, although some had moderated their use. A substantial number had returned to pre-imprisonment levels of use, often with deeply damaging impacts on those around them. DISCUSSION AND CONCLUSIONS This research suggests a fundamental contradiction between recovery and imprisonment. In large part, imprisonment serves to erode recovery capital while, at the same time, making psychoactive substances readily available. Looking to the future, every effort should be made to divert substance users from imprisonment in the first place. Where that fails, the primary aim should be to reduce the erosion of recovery capital during imprisonment: through family support work, providing proper housing, training and education opportunities and ensuring a graduated reintroduction of prisoners into the community.
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Affiliation(s)
- Charlie Lloyd
- Social Policy and Social Work, University of York, Alcuin C, York, YO10 5DD, United Kingdom.
| | - Geoff Page
- Social Policy and Social Work, University of York, Alcuin C, York, YO10 5DD, United Kingdom
| | - Neil McKeganey
- Centre for Substance Use Research, Block 4/04, West of Scotland Science Park, 2317 Maryhill Road, Glasgow G20 0SP, United Kingdom
| | - Christopher Russell
- Centre for Substance Use Research, Block 4/04, West of Scotland Science Park, 2317 Maryhill Road, Glasgow G20 0SP, United Kingdom
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Morton S, O’Reilly L. Challenges, relationship and outcomes in low-threshold drug services. DRUGS AND ALCOHOL TODAY 2018. [DOI: 10.1108/dat-05-2018-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper reports on the findings of an action research study that sought to explore the development and provision of community-based low-threshold services within a socially disadvantaged area. In the context of debates, in regard to both the nature and efficacy of low-threshold drugs services and increasingly neo-liberal policy approaches to drug service provision that prioritise outcomes and drug treatment interventions, the purpose of this paper is to report on practitioners’ understandings of challenges, relationship building and outcomes within community-based low-threshold service provision in Dublin, Ireland.
Design/methodology/approach
An action research method of co-operative inquiry groups was utilised, with nine practitioners from one community-based drug agency participating in a series of four sessions over a three-month period.
Findings
Three key themes emerged in relation to building and sustaining client–practitioner relationships: the mechanisms by which the practitioners engaged with their clients and sought to develop relationships; how safe spaces were created and maintained in order to address client needs; and practitioners’ understanding of challenges and outcomes in low-threshold intervention work.
Originality/value
Drawing on a co-operative inquiry method, this paper concludes that practitioner attention to relational distance evidenced in community-based low-threshold service provision, may provide an alternative to episodic, outcome driven drug treatment and intervention.
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Graham S, Irving J, Cano I, Edwards M. Participation with online recovery specific groups - findings from the UK Life in Recovery survey 2015. ALCOHOLISM TREATMENT QUARTERLY 2018. [DOI: 10.1080/07347324.2018.1500873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Simon Graham
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
| | - Jamie Irving
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
| | - Ivan Cano
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
| | - Michael Edwards
- Helena Kennedy Centre for International Justice, Department of Law and Criminology, Development and Society, Sheffield Hallam University, Collegiate Crescent, Sheffield, United Kingdom
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