Patient Assessments of the Factors Facilitating and Impeding User Involvement During the First Phase of Substance Abuse Treatment

Abstract

User involvement in the first phase of treatment is essential for treatment satisfaction among patients with substance use disorders (SUDs). This study explores how patients perceive the first phase of specialized SUD treatment and identifies what promotes and inhibits user involvement. We used a qualitative approach, and semi-structured interviews were conducted with 14 informants admitted to a substance abuse treatment unit in central Norway. The analysis was inspired by a phenomenographical analysis approach, and 4 categories were identified as the core experiences of user involvement during the first phase of SUD treatment: (a) a new hold on life, (b) missing information, (c) the importance of a sense of community, and (d) ambivalence about the usefulness of the treatment. Overlapping elements with Aaron Antonovsky’s theoretical framework of salutogenesis were used to support the main findings. The study indicates that activating personal resources (eg, the ability to envision a different life), conveying information in a matter sensitive to patients’ current cognitive state, a sense of community, and therapeutic alliance are essential factors to promote user involvement in the first phase of specialized SUD treatment. Based on the findings, we suggest a salutogenesis approach to promote user involvement and provide several ways to employ this approach in the crucial first phase of specialized SUD treatment.

In what ways do emerging adults with substance use problems experience their communities as influencing their personal recovery processes?

“…However, there has been little investigation into these relationships. A few previous findings suggest that family and peers are important sources for motivating and initiating recovery from substance use (Wenaas et al, 2021), particularly in emerging adulthood (Goodman et al, 2011). Several participants described family members, partners, and friends as important sources of motivation for recovery, including when family was not directly involved in their recovery process:…”

“…Studies of processes of recovery from problematic substance use have shown the importance of citizenship, supportive relationships, and experiencing social bonding and a sense of community (Bathish et al, 2017; Jason et al, 2001; Kelly et al, 2014; Moore et al, 2018; Mudry et al, 2019; Stevens et al, 2012; Wenaas et al, 2021). These studies have generally defined recovery as both a personal process and a social transformation.…”

“…Emerging adulthood is a particularly vulnerable period of life, with changing social structures and relationships (e.g., family, residential community, school, and peers) (Arnett, 2000; Bahl et al, 2021b). Thus, during this life phase, central elements needed for recovery may be missing; namely, social integration and belonging to groups, communities, and society at large (Bathish et al, 2017; Jason et al, 2001; Kelly et al, 2014; Moore et al, 2018; Mudry et al, 2019; Stevens et al, 2012; Wenaas et al, 2021). Furthermore, in many countries this developmental period is also marked by the highest prevalence of risk‐related episodes of high alcohol consumption and substance use (Arnett, 2000; Baumer et al, 2018; Bergman et al, 2016; Norwegian Institute of Public Health, 2018).…”

“…Across our lifespans, humans need to be accepted by, connected with, and be of value to others (Bahl et al, 2021b; Cicognani et al, 2014; Moore et al, 2018; Myers, 2004; Sarason, 1974). For treatment of problematic substance use, it is highly relevant to know more about individuals' social contexts and types of social bonding, as social relationships and social bonding can ultimately contribute to prevent and reduce misuse behaviours and promote recovery (Bathish et al, 2017; Ferrari et al, 2002; Kelly et al, 2014; Lardier Jr et al, 2017; Mayberry et al, 2009; Moore et al, 2018; Mudry et al, 2019; Stevens et al, 2010, 2012; Wenaas et al, 2021).…”

Effects of Experienced Discrimination in Pediatric Sickle Cell Disease: Caregiver and Provider Perspectives

“…Increasing awareness and education regarding SCD may equip providers to more effectively care for children and adults with SCD and may help to expand funding for research to inform efforts to mitigate the presence and negative effects of discrimination within healthcare settings. Drawing upon findings from other stigmatized illnesses such as HIV/ AIDS and substance use disorder, promising approaches to mitigate discrimination include ensuring appropriate descriptive language and naming of stigmatized populations within healthcare settings, listening to patient stories, and including and encouraging familial and/or community support [53,54].…”