‘<i>I</i>’<i>m getting the balls to say no</i>’: Trajectories in long-term recovery from problem substance use

Webb, Lucy; Clayson, Amanda; Duda‐Mikulin, Eva A.; Cox, Nigel

doi:10.1177/1359105320941248

Cited by 11 publications

(25 citation statements)

References 31 publications

(41 reference statements)

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“…However, this study's findings suggest that this mechanism is not limited to abstinence-focused environments and appears central to harm reduction approaches too. A sense of purpose was linked to positive changes in self-identify which has also previously been identified as important so people with PSU feel less characterised solely by their substance use [52].…”

Section: Meso-level Stakeholder Buy-inmentioning

confidence: 80%

Exploring how greenspace programmes might be effective in supporting people with problem substance use: a realist interview study

et al. 2022

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Background Greenspace programmes are health projects run outside in nature, typically with the aim of improving mental health. Research suggests that programmes may also be effective in supporting people with problem substance use (PSU), but there is limited understanding of the key components that make them successful for this client group. Previous work has claimed that a realist-informed intervention framework for greenspace programmes for mental health could be transferable to programmes that support people with PSU, and that this could provide insight into the causal processes within programmes. However, this claim is yet to be explored in depth. The aim of this study was to further test, refine, and consolidate the proposed framework to show how greenspace programmes could support people with PSU. Methods Using a realist approach, 17 participants (8 programme staff; 9 wider stakeholders) were interviewed about contexts, mechanisms, and outcomes (CMOs) relative to greenspace programmes for mental health and PSU. Semi-structured interviews were used since they facilitated exploration of the proposed framework but were flexible enough to allow identification of new CMOs for framework refinement. Interviews were audio-recorded, fully transcribed, and analysed inductively and deductively against the proposed framework. Results Findings supported the proposed framework and indicated that greenspace programmes support people with poor mental health and PSU due to: feelings of escape; space to reflect; physical activity; self-efficacy; feelings of purpose; relationships; and shared experiences. However, data showed that programmes must also consider: explicit intervention focus to ensure adequate support for clients; existing challenges with funding and stakeholder buy-in; and the impact of COVID-19. Findings allowed development of a refined framework that shows how greenspace programmes can support people with PSU. Conclusion The findings of this project are theoretically novel and have practical relevance for those designing greenspace programmes by providing recommendations on how to optimise, tailor, and implement future interventions. Findings could be particularly relevant for academic researchers, multidisciplinary health professionals, and for those working in the third sector, developing and delivering greenspace programmes for people to improve their mental health and to support them with PSU.

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Section: Meso-level Stakeholder Buy-inmentioning

confidence: 80%

Exploring how greenspace programmes might be effective in supporting people with problem substance use: a realist interview study

et al. 2022

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“…Practitioner skills in opening conversations about historical trauma in the lives of women with substance use histories has been found to be crucial ( 51 ). In this study, identifying experiences of parental substance use and/or their own substance use through the ACEs routine enquiry platform provided a basis for conversations and discussions about intergenerational patterns, positive change and resilience that may not have otherwise happened ( 51 , 52 ). Given the intersection of domestic violence and substance use can be very challenging for a single agency to address ( 53 ), the ACEs routine enquiry was found to be a constructive and useful mechanism to make links with women about their past traumas and current life trajectories, including any misuse of substances.…”

Section: Discussionmentioning

confidence: 99%

“…While the “simplicity” of the ACEs questionnaire was originally a concern for those implementing it, in practice, this became a strength. Once in use, the ACEs questionnaire was not viewed as an all-encompassing solution to address childhood legacies of trauma, but instead as a mechanism for opening a topic or aspect of a client's life patterns ( 21 , 52 ).…”

Section: Discussionmentioning

confidence: 99%

Adverse Childhood Experiences, Domestic Violence and Substance Misuse: An Action Research Study on Routine Enquiry and Practice Responses

Morton

Curran

O'Gorman³

2022

Front. Psychiatry

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The long-term impacts of Adverse Childhood Experiences (ACEs) are of increasing interest to researchers and practitioners, including the effectiveness of screening for ACEs to improve health and social outcomes. Despite a focus on implementing such practices, there has been little focus on ACEs experiences for women experiencing domestic violence and substance use, or consideration of practice responses around ACEs routine enquiry for domestic violence and related services. The Irish study discussed in this paper used an action research approach to implement ACEs routine enquiry within a domestic violence service for women accessing the service (n = 60), while also utilizing co-operative inquiry groups for practitioners both within the organization (n = 10) and with those working in associated fields of infant mental health, child protection, substance misuse and welfare and community support (n = 7). Of the 60 women who completed the ACEs routine enquiry in the study, over one-half (58 per cent) reported experiencing at least two ACEs in their childhood, including one-third of all respondents reporting experiencing four or more; service users reported significant levels of overlap between direct child maltreatment and adverse home environments. Reported parental substance misuse with the home environment was substantially higher than in general population studies. These findings offered early indications of both ACEs prevalence as well the types of ACEs that most define the experiences of the women presenting to a domestic violence service that supports women with substance misuse and other related issues. This paper discusses the ways in which the co-operative inquiry groups used this information and other processes to enhance practitioner, organizational, and inter-agency understanding and service responses. The practitioners felt that this form of ACEs routine enquiry, while not an end in itself, was a useful tool to engage women in conversations about trauma and intergenerational patterns and a basis for developing trauma-informed interventions. We conclude with discussion about: considerations of the risks of “individualizing” women's traumatic experiences; skills and supports for practitioners; and resource implications.

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“… 46 Although our participants were predominantly from urban settings, there are strong resonances with Krentzman and Glass's 46 study given tendency to the interweaving of lives in Assamese neighbourhoods. There is also potential to explore longer‐term recovery as Webb et al 47 did with a British sample to understand the transferability of their findings that gratitude and reliance on support groups transformed into greater self‐determination and independent decision‐making.…”

Section: Discussionmentioning

confidence: 99%

Pathways to recovery model of youth substance misuse in Assam, India

Madill

Duara

Goswami³

et al. 2022

Health Expectations

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Introduction There are global calls for better understanding of substance use disorder (SUD) to inform prevention, risk reduction and treatment of this relapse‐prone disorder. Our aim in this article is to understand the pathways to recovery of youth in Assam, India who have suffered SUD. Methods We recruited 15 participants (11 men and 4 women) via two rehabilitation facilities. All are addicts‐in‐recovery aged 19–24 years. Material was generated through photo‐led interviews, analysed using an inductive variant of thematic analysis and the resulting model refined through expert and participant checks. Results We present a multiroute, multidirectional pathway to recovery model. It has three phases, Recreational Use , Addiction ( Relaxed , Chaotic , Strategic ) and Supported Recovery , each phase consisting of cycling between, or transitioning through, a series of stages. Conclusions The model enhances psycho‐socio‐cultural insights into the experience of risk and recovery, and informs prevention and treatment for youth substance misuse in Assam. This is the first model of its kind and an important public health resource. We discuss the possible transferability of the model to a wider range of contexts. Patient or Public Contribution The model presented was generated through analysis of interviews with addicts‐in‐recovery. Four of these addicts‐in‐recovery, and two mental health and rehabilitation service providers, conducted participant and expert checks of the model leading to its improvement.

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‘I’m getting the balls to say no’: Trajectories in long-term recovery from problem substance use

Cited by 11 publications

References 31 publications

Exploring how greenspace programmes might be effective in supporting people with problem substance use: a realist interview study

Exploring how greenspace programmes might be effective in supporting people with problem substance use: a realist interview study

Adverse Childhood Experiences, Domestic Violence and Substance Misuse: An Action Research Study on Routine Enquiry and Practice Responses

Pathways to recovery model of youth substance misuse in Assam, India

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