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Robinson LD, Degan TJ, Deane FP, Kelly PJ. Patterns of substance use recovery following residential treatment: A repeated measures latent profile analysis. Drug Alcohol Rev 2024. [PMID: 39044399 DOI: 10.1111/dar.13904] [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: 10/12/2023] [Revised: 04/30/2024] [Accepted: 06/23/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Ongoing improvement to residential treatment for substance use disorders is critical as it typically targets people with the highest need. Assessing multiple recovery indicators, such as cravings and mental health, at intake and following discharge is important in evaluating treatment effectiveness. To refine services, research should explore whether there are subgroups of individuals with different patterns of recovery following treatment. METHODS Participants (n = 554) were attending Australian Salvation Army residential treatment services for substance use issues. Data were collected by surveys at intake and 3-month post-discharge ('early recovery'). Recovery indicators were cravings, confidence to resist substance use and the Depression, Anxiety and Stress Scale. Subgroups of individuals based on these recovery indicators ('profiles') were identified using repeated measures latent profile analysis. RESULTS Five profiles were identified, three profiles improved over time (81.4%) and two (18.6%) deteriorated across all indicators. These two profiles had the poorest mental health and addiction scores at intake and reported shorter time in treatment compared to the three profiles showing improvement. There were no demographic or substance type differences between profiles. DISCUSSION AND CONCLUSIONS By considering initial severity and multiple recovery indicators at early recovery, this study suggests that individuals at-risk of poor early recovery can be identified at intake. This opens opportunities for tailored treatment approaches to address both mental health and substance use, thereby potentially improving treatment outcomes and reducing the risk of relapse.
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Affiliation(s)
- Laura D Robinson
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Centre for Health Psychology Practice and Research, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Tayla J Degan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Frank P Deane
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Centre for Health Psychology Practice and Research, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
- Centre for Health Psychology Practice and Research, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
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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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Zemore SE, Ziemer KL, Gilbert PA, Karno MP, Kaskutas LA. Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study. Subst Abuse 2023; 17:11782218231199372. [PMID: 37731748 PMCID: PMC10508054 DOI: 10.1177/11782218231199372] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
Background Substance use disorder (SUD) resolution typically involves a long-term, comprehensive process of change now widely referred to as "recovery." Yet, definitions of recovery vary substantially, producing significant confusion. To support formal recovery definitions, we aimed to systematically identify recovery elements that are central to those in recovery and shared regardless of subgroup/pathway. Methods Data were from the What is Recovery? Study, involving a diverse, national, online survey of people in recovery (N = 9341). Surveys included a 35-item recovery measure reflecting 4 domains; participants reported whether or not each element definitely belonged in their recovery definitions. Analyses examined item endorsements overall and among 30 subgroups defined a priori (by sociodemographics, substance use characteristics, and help-seeking history) to determine where items met study-specific centrality thresholds (ie, endorsement by ⩾80% and top-10 ranking, by endorsement level). We then classified items as "core" if meeting centrality thresholds both overall and for all 30 subgroups, and "prevalent" if meeting centrality thresholds overall and for 26 to 29 subgroups. Results Four "core" recovery elements emerged, including a process of growth or development; being honest with oneself; taking responsibility for the things one can change; and reacting in a more balanced way. Four "prevalent" recovery elements also emerged, referencing the ability to enjoy life and handle negative feelings without substance use; abstinence and/or nonproblematic substance use; and living a life that contributes. Subgroups differing most in their endorsements included those reporting mild/moderate SUD severity; non-abstinent recovery; and no specialty treatment or mutual-help group attendance. Conclusions Recovery elements identified here partially reflect some stakeholder definitions, but offer greater specificity and include novel elements (eg, personal integrity). Elements may point to areas of functioning that are damaged in the addiction process and can support an addiction-free life. Findings should inform institutional recovery definitions; SUD services and research; and communications about recovery.
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Affiliation(s)
| | - Kelly L Ziemer
- School of Social Welfare, University of California, Berkeley, CA, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Mitchell P Karno
- Department of Psychiatry and Biobehavioral Sciences, Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
- Independent clinician
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Neale J, Parkin S, Strang J. Patients' goals when initiating long-acting injectable buprenorphine treatment for opioid use disorder: findings from a longitudinal qualitative study. Subst Abuse Treat Prev Policy 2023; 18:37. [PMID: 37349776 PMCID: PMC10288705 DOI: 10.1186/s13011-023-00551-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Long-acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that has been introduced against an international policy backdrop of recovery and person-centred care. This paper explores the goals that people want to achieve from LAIB to identify potential implications for policy and practice. METHODS Data derive from longitudinal qualitative interviews conducted with 26 people (18 male; 8 female) initiating LAIB in England and Wales, UK (June 2021-March 2022). Participants were interviewed up to five times by telephone over six months (107 interviews in total). Transcribed interview data relating to each participant's treatment goals were coded, summarised in Excel, and then analysed via a process of Iterative Categorization. RESULTS Participants often articulated a desire to be abstinent without defining exactly what they meant by this. Most intended to reduce their dosage of LAIB but did not want to rush. Although participants seldom used the term 'recovery', almost all identified objectives consistent with current definitions of this concept. Participants articulated broadly consistent goals over time, although some extended the timeframes for achieving treatment-related goals at later interviews. At their last interview, most participants remained on LAIB, and there were reports that the medication was enabling positive outcomes. Despite this, participants were aware of the complex personal, service-level, and situational factors that hindered their treatment progress, understood the additional support they needed to achieve their goals, and voiced frustrations when services failed them. CONCLUSIONS There is a need for wider debate regarding the goals people initiating LAIB are seeking and the diverse range of positive treatment outcomes LAIB could potentially generate. Those providing LAIB should offer regular on-going contact and other forms of non-medical support so that patients have the best opportunity to succeed. Policies relating to recovery and person-centred care have previously been criticised for responsibilising patients and service users to take better care of themselves and to change their own lives. In contrast, our findings suggest that these policies may, in fact, be empowering people to expect a greater range of support as part of the package of care they receive from service providers.
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Affiliation(s)
- Joanne Neale
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8BB UK
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Stephen Parkin
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8BB UK
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE5 8BB UK
- South London & Maudsley (SLaM) NHS Foundation Trust, London, SE5 8AZ UK
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Rubio G, Esteban Rodríguez L, Sion A, Ramis Vidal L, Blanco MJ, Zamora-Bayon A, Caba-Moreno M, Macias-Molina AI, Pérez-Sánchez D, Rubio-Escobar E, Ruiz-Diez J, Marin M, Arias F, Lora D, Jurado-Barba R. How, when, and to what degree do people with alcohol dependence recover their psychological wellbeing and quality of life? The Madrid Recovery Project. Front Psychiatry 2023; 14:1130078. [PMID: 37398602 PMCID: PMC10313403 DOI: 10.3389/fpsyt.2023.1130078] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery. Method A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month-28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender. Results In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1-4 years: psychological health; (c) 4-10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables. Conclusion Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions.
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Affiliation(s)
- Gabriel Rubio
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
- Primary Care Research Network on Addictions (RIAPAd), Madrid, Spain
| | | | - Ana Sion
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
- Psychology Faculty, Complutense University of Madrid, Madrid, Spain
| | - Lilian Ramis Vidal
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | - María J. Blanco
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | | | - Marta Caba-Moreno
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | | | | | | | - Joaquín Ruiz-Diez
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | - Marta Marin
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
| | - Francisco Arias
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
| | - David Lora
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Faculty of Statistical Studies, Complutense University of Madrid, Madrid, Spain
| | - Rosa Jurado-Barba
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
- Department of Psychology, Education and Health Science Faculty, Camilo José Cela University, Madrid, Spain
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Neale J, Parkin S, Strang J. Qualitative study of patients’ decisions to initiate injectable depot buprenorphine for opioid use disorder: the role of information and other factors. DRUGS: EDUCATION, PREVENTION AND POLICY 2023. [DOI: 10.1080/09687637.2023.2165041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Joanne Neale
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Stephen Parkin
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- South London & Maudsley (SLaM), NHS Foundation Trust, London, UK
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Swan JE, Aldridge A, Joseph V, Tucker JA, Witkiewitz K. Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment. J Psychoactive Drugs 2021; 53:394-403. [PMID: 34727839 DOI: 10.1080/02791072.2021.1986243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants' study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants' alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery.
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Affiliation(s)
- Julia E Swan
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Arnie Aldridge
- Behavioral Health Financing, Economics and Evaluation Department, RTI International, Research Triangle Park, NC, USA
| | - Verlin Joseph
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Jalie A Tucker
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
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Anderson M, Devlin AM, Pickering L, McCann M, Wight D. 'It's not 9 to 5 recovery': the role of a recovery community in producing social bonds that support recovery. DRUGS (ABINGDON, ENGLAND) 2021; 28:475-485. [PMID: 34675456 PMCID: PMC8522802 DOI: 10.1080/09687637.2021.1933911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022]
Abstract
AIM To understand how the social networks of a new recovery community can help sustain recovery, focusing on processes of social identity change, in the context of the wider UK recovery movement. METHODS A cross-sectional, mixed-methods social network analysis (SNA) of ego-network sociograms to map network transitions, using retrospective measures. Ten men were recruited from a peer-worker programme, in the South Ayrshire Alcohol and Drug Partnership (ADP), West of Scotland. Network measures were compared between two timepoints, just prior to current recovery and the present time. Measures included size and density, closeness of members, and their positive or negative influence, proportion of alcohol and other drug (AOD) using and recovery peers, and extent of separate subgroups. These were complemented with qualitative interview data. FINDINGS There was a significant transition in network composition, with the replacing of AOD-using peers with recovery peers and a broader transformation from relationships being framed as negative to positive. However, there was no significant transition in network structure, with AOD-using and recovery networks both consisting of strong ties and a similar density of connections between people in the networks. CONCLUSIONS The transition in network composition between pre-recovery and the present indicates a different set of social influences, while the similarities in network structure indicate that the recovery network replaced the role of the using network in providing close bonds. This helped reduce social isolation experienced in early-recovery and provided a pathway into more structured opportunities for volunteering and employment.
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Affiliation(s)
- Martin Anderson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alison M. Devlin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Lucy Pickering
- College of Social Sciences, Institute of Health and Wellbeing Social Sciences University of Glasgow, Glasgow, UK
| | - Mark McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Abstract
Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.
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Dilemmas in recovery-oriented practice to support people with co-occurring mental health and substance use disorders: a qualitative study of staff experiences in Norway. Int J Ment Health Syst 2018; 12:30. [PMID: 29930698 PMCID: PMC5992690 DOI: 10.1186/s13033-018-0211-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Recovery-oriented practice is recommended in services for people with co-occurring mental health and substance use disorders. Understanding practitioners’ perceptions of recovery-oriented services may be a key component of implementing recovery principles in day-to-day practice. This study explores and describes staff experiences with dilemmas in recovery-oriented practice to support people with co-occurring disorders. Methods Three focus group interviews were carried out over the course of 2 years with practitioners in a Norwegian community mental health and addictions team that was committed to developing recovery-oriented services. Thematic analysis was applied to yield descriptions of staff experiences with dilemmas in recovery-oriented practice. Results Three dilemmas were described: (1) balancing mastery and helplessness, (2) balancing directiveness and a non-judgmental attitude, and (3) balancing total abstinence and the acceptance of substance use. Conclusions Innovative approaches to practice development that address the inherent dilemmas in recovery-oriented practice to support people with co-occurring disorders are called for. Electronic supplementary material The online version of this article (10.1186/s13033-018-0211-5) contains supplementary material, which is available to authorized users.
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Pickering D, Keen B, Entwistle G, Blaszczynski A. Measuring treatment outcomes in gambling disorders: a systematic review. Addiction 2018; 113:411-426. [PMID: 28891116 PMCID: PMC5836978 DOI: 10.1111/add.13968] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/29/2017] [Accepted: 08/02/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. METHODS A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. RESULTS Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. CONCLUSIONS In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices across the field.
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Affiliation(s)
| | - Brittany Keen
- School of PsychologyUniversity of SydneySydneyAustralia
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12
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Kerrison EM. Exploring how prison-based drug rehabilitation programming shapes racial disparities in substance use disorder recovery. Soc Sci Med 2018; 199:140-147. [DOI: 10.1016/j.socscimed.2017.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 07/19/2017] [Accepted: 08/04/2017] [Indexed: 01/23/2023]
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Brekke E, Lien L, Biong S. Experiences of Professional Helping Relations by Persons with Co-occurring Mental Health and Substance Use Disorders. Int J Ment Health Addict 2017; 16:53-65. [PMID: 29491766 PMCID: PMC5814541 DOI: 10.1007/s11469-017-9780-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Recovery in co-occurring mental health and substance use disorders often involves relationships with professional helpers, yet little is known about how these are experienced by service users. The aim of this study was to explore and describe behaviour and attributes of professional helpers that support recovery, as experienced by persons with co-occurring disorders. Within a collaborative approach, in-depth individual interviews with eight persons with lived experience of co-occurring disorders were analysed using systematic text condensation. The analysis yielded four categories of recovery-supporting behaviour and attributes of professional helpers and the ability to build trust cuts across all of them: Building trust through (a) hopefulness and loving concern, (b) commitment, (c) direct honesty and expectation and (d) action and courage. Services should allow for flexibility and continuity, and training should recognise the importance of establishing trust in order to reach out to this group.
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Affiliation(s)
- E Brekke
- 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway.,2Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway.,NROP, Postal box 104, 2318 Brumunddal, Norway
| | - L Lien
- 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway.,Faculty of Public Health, Hedmark University of applied sciences, Elverum, Norway
| | - S Biong
- 2Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway
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Affiliation(s)
- Kari Lancaster
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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