How do users with comorbidity perceive participation in social services? A qualitative interview study

Abstract

Purpose: This study aims to construct a theoretical framework that explains how users with comorbidity of substance use and mental illness/neuropsychiatric disorders portray user participation in social work encounters. Methods: To construct this framework a constructivist grounded theory approach was used with semi-structured qualitative interviews with 12 users. Results: The main concern of the participants was the low trust in the social services and perceiving that this lack of trust is mutual. Establishing mutual trust is a social process that cuts through the whole framework. In the framework, prerequisites for participation are explained. The prerequisites are users being motivated and having the willingness to stop using drugs and receiving support, making use of user and staff knowledge and decisionmaking abilities and accessing help and support. Conclusion: Unlike previous frameworks, the model describes participation as a social process and does not explain participation at different levels of power. The results suggest that staff need to be aware of low trust perceptions and work on establishing mutual trust. In addition, the staff need to see each user as an individual and consider how the user would prefer to be involved in decision-making.

Social work, mental health and substance use: a scoping review

“…Of the 38 articles included in this study, 10 provided a clear focus on co-occurring mental health and substance disorders and the intersection with social work practice (Bahorik et al , 2015; Benda et al , 2002; Blix and Eek, 2005; Cheng and Robinson, 2013; DiNitto et al , 2016; Fisher et al , 2014; Jones et al , 2021; Mancini et al , 2008; Van Zyl and Geyer, 2019; Wiechelt et al , 2011).…”

“…Two studies focused on participants with co-occurring disorders and their experience of social work intervention (Jones et al , 2021; Van Zyl and Geyer, 2019) and another two studies were concerned with social work practitioners’ education and perspectives regarding co-occurring disorders and treatment approaches (Fisher et al , 2014; Mancini et al , 2008).…”

“…Another theme that emerged was the use of the harm reduction approach and its importance in the treatment of co-occurring disorders (Blix and Eek, 2005; DiNitto et al , 2016; Jones et al , 2021; Mancini et al , 2008). In two studies that focused on dual diagnosis-specific treatment programs, a harm reduction approach was outlined in their descriptions of social work practice (Blix and Eek, 2005; DiNitto et al , 2016).…”

“…In two studies that focused on dual diagnosis-specific treatment programs, a harm reduction approach was outlined in their descriptions of social work practice (Blix and Eek, 2005; DiNitto et al , 2016). In one study examining participant experiences (Jones et al , 2021), treatment programs requiring abstinence from substance use were highlighted as a barrier to recovery by participants. Furthermore, Mancini et al (2008) studied social work practitioners’ perspectives on the harm reduction approach and suggested the implementation of further training and education in this approach for future practice.…”

“…Of these ten studies, two examined the effectiveness of social work intervention in dual diagnosis-specific treatment settings (Blix and Eek, 2005;DiNitto et al, 2016). One of these studies outlined effective interventions for people experiencing co-occurring disorders Two studies focused on participants with co-occurring disorders and their experience of social work intervention (Jones et al, 2021;Van Zyl and Geyer, 2019) and another two studies were concerned with social work practitioners' education and perspectives regarding co-occurring disorders and treatment approaches (Fisher et al, 2014;Mancini et al, 2008).…”