Conflict and user involvement in drug misuse treatment decision-making: a qualitative study

Fischer, Jan; Neale, Joanne; Bloor, Michael; Jenkins, Nicholas

doi:10.1186/1747-597x-3-21

Cited by 13 publications

(15 citation statements)

References 12 publications

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“…Secondly, our analyses cause us to critically revisit the concept of user involvement in treatment decision‐making. User involvement has been advocated widely in many areas of health care, including alcohol and other drug treatment . The findings we present here reveal that some women may be adamant that they do not want a particular type of service, and then later come to recognize the benefits.…”

Section: Discussionmentioning

confidence: 68%

“…Also, we would probably have found some similar treatment experiences if we had conducted interviews in a mixed‐sex residential setting. Indeed, bonding, forming friendships, sharing personal stories but also tensions, arguments, conflict, mistrust, loneliness and social distancing have all been reported in the literature on mixed‐sex residential treatment . Lastly, we interviewed women cross‐sectionally, at different stages of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Do women with complex alcohol and other drug use histories want women‐only residential treatment?

et al. 2018

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BackgroundWomen‐only addiction services tend to be provided on a poorly evidenced assumption that women want single‐sex treatment. We draw upon women's expectations and experiences of women‐only residential rehabilitation to stimulate debate on this issue.MethodsSemi‐structured interviews were undertaken with 19 women aged 25–44 years [currently in treatment (n = 9), successfully completed treatment (n = 5), left treatment prematurely (n = 5)]. All had histories of physical or sexual abuse, and relapses linked to relationships with men. Interviews were audio‐recorded, transcribed verbatim, coded and analysed inductively following Iterative Categorization.FindingsWomen reported routinely that they had been concerned, anxious or scared about entering women‐only treatment. They attributed these feelings to previous poor relationships with women, being more accustomed to male company and negative experiences of other women‐only residential settings. Few women said that they had wanted women‐only treatment, although many became more positive after entering the women‐only service. Once in treatment, women often explained that they felt safe, supported, relaxed, understood and able to open up and develop relationships with other female residents. However, they also described tensions, conflicts, mistrust and social distancing that undermined their treatment experiences.ConclusionsWomen who have complex histories of alcohol and other drug use do not necessarily want or perceive benefit in women‐only residential treatment.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Do women with complex alcohol and other drug use histories want women‐only residential treatment?

et al. 2018

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“…Although chaotic drug users may not be wholly inconsiderate, the individuals with whom they interact (family members, professionals -including drug treatment providers -and the general public) often perceive them as dirty, undeserving, disagreeable and even frightening (Carroll, 1993;Murphy & Rosenbaum, 1999;Neale et al, 2008;Treloar & Holt, 2006). Despite this, research has indicated that individuals in recovery are concerned about how they present to other people (Biernacki, 1986;McIntosh & McKeganey, 2000, 2001a, 2001b and want to be cooperative and avoid conflict (Fischer, Neale, Bloor, & Jenkins, 2008;Matheson, 1998). Where this is so, it should be possible for them to participate in respectful, tactful and trusting relationships with others.…”

Section: Goffman Dramaturgy and Recoverymentioning

confidence: 90%

Recovery from problem drug use: What can we learn from the sociologist Erving Goffman?

Neale

Nettleton

Pickering

2010

Drugs: Education, Prevention and Policy

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In this commentary, we critically review the contribution of the sociologist Erving Goffman to understanding recovery from problem drug use. Previous research has indicated that drug users have a 'spoiled identity' and must restore a 'normal' or 'unspoiled' identity in order to recover. This argument has been linked to Goffman's classic work Stigma: Notes on the management of a spoiled identity [1963, Harmondsworth: Penguin]. Despite its evident appeal, linking recovery to repairing a spoiled identity has a number of problems. These include the derogatory connotations of 'spoiled', and the fact that the 'momentary' spoiled identity that Goffman likely intended is easily lost to a more 'totalizing' spoiled identity, from which it can be difficult for individuals to escape. Given such shortcomings, we consider how Goffman's broader dramaturgical work might contribute to our understanding of recovery processes. Dramaturgy, which focuses on the performative aspects of selfhood and the relational and situational nature of identity, suggests ways that individuals can work on their identity (and recovery) projects without over-prioritizing abstinence. We suggest that dramaturgy is more useful than the notion of repairing a spoiled identity for understanding and facilitating recovery. Nonetheless, it has limitations and other sociological perspectives provide fertile ground for future debate. BACKGROUND

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“…Lastly, interpersonal conflict within residential treatment is likely to be unavoidable, but rapid and sensitive mediation by peers and staff may help to prevent bickering and minor arguments from escalating into more serious disputes that impact negatively on the wider treatment community and undermine treatment and recovery goals (c.f. Fischer, Neale, Bloor, & Jenkins, ).…”

Section: Discussionmentioning

confidence: 99%

Qualitative exploration of relationships between peers in residential addiction treatment

Neale

Tompkins

Strang

2017

Health Soc Care Community

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Relationships between peers are often considered central to the therapeutic process, yet there is relatively little empirical research either on the nature of peer-to-peer relationships within residential treatment or on how those relationships generate positive behaviour change or facilitate recovery. In this paper, we explore relationships between peers in residential addiction treatment, drawing upon the concept of social capital to frame our analyses. Our study was undertaken during 2015 and 2016 in two English residential treatment services using the same therapeutic community-informed model of treatment. We conducted 22 in-depth interviews with 13 current and 9 former service residents. All interviews were audio-recorded, transcribed verbatim, coded in MAXQDA, and analysed using Iterative Categorisation. Residents reported difficult relationship histories and limited social networks on entry into treatment. Once in treatment, few residents described bonding with their peers on the basis of shared experiences and lifestyles. Instead, interpersonal differences polarised residents in ways that undermined their social capital further. Some senior peers who had been in residential treatment longer acted as positive role models, but many modelled negative behaviours that undermined others' commitment to treatment. Relationships between peers could generate feelings of comfort and connectedness, and friendships developed when residents found things in common with each other. However, residents more often reported isolation, loneliness, wariness, bullying, manipulation, intimidation, social distancing, tensions and conflict. Overall, relationships between peers within residential treatment seemed to generate some positive but more negative social capital; undermining the notion of the community as a method of positive behaviour change. With the caveat that our data have limitations and further research is needed, we suggest that residential treatment providers should more routinely open the "black box" of "community as method" to consider the complex and dynamic nature of the relationships and social capital inside.

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Conflict and user involvement in drug misuse treatment decision-making: a qualitative study

Abstract: Background: This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making.

Cited by 13 publications

References 12 publications

Do women with complex alcohol and other drug use histories want women‐only residential treatment?

Do women with complex alcohol and other drug use histories want women‐only residential treatment?

Recovery from problem drug use: What can we learn from the sociologist Erving Goffman?

Qualitative exploration of relationships between peers in residential addiction treatment

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