Starting Where the Client Is: Harm Reduction Guidelines for Clinical Social Work Practice

Vakharia, Sheila P.; Little, Jeannie

doi:10.1007/s10615-016-0584-3

Cited by 40 publications

(34 citation statements)

References 36 publications

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“…Coded categories were not mutually exclusive such that a reference might have defined the principle of patient-centered care at more than one category. Bracketed numbers represent the number of unique references coded at each category b References coded at this category [45, 48, 51, 57, 59, 61–66, 71, 76, 77, 79, 83, 89, 91, 93, 94, 96, 99, 103, 104, 118–128] c References coded at this category [41, 43, 45, 48, 51, 57, 61, 63–66, 71, 74, 89–91, 96, 103, 118–121, 123, 125–132]…”

Section: Resultsmentioning

confidence: 99%

“…Coded categories were not mutually exclusive such that a reference might have defined the principle of patient-centered care at more than one category. Bracketed numbers represent the number of unique references coded at each category b References coded at this category [41, 42, 58, 133–135] c References coded at this category [44, 59, 79] d References coded at this category [79]…”

Section: Resultsmentioning

confidence: 99%

“…b References coded at this category [45, 48, 51, 57, 59, 61–66, 71, 76, 77, 79, 83, 89, 91, 93, 94, 96, 99, 103, 104, 118–128]…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

Marchand

Beaumont

Westfall³

et al. 2019

Subst Abuse Treat Prev Policy

142

110

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Background Despite ongoing efforts aimed to improve treatment engagement for people with substance-related disorders, evidence shows modest rates of utilization as well as client-perceived barriers to care. Patient-centered care (PCC) is one widely recognized approach that has been recommended as an evidence-based practice to improve the quality of substance use disorder treatment. PCC includes four core principles: a holistic and individualized focus to care, shared decision-making and enhanced therapeutic alliance. Aims This scoping review aimed to explore which PCC principles have been described and how they have defined and measured among people with substance-related disorders. Methods Following the iterative stages of the Arksey and O’Malley scoping review methodology, empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references were eligible if they focused on people accessing treatment for substance-related disorders and described PCC. Two reviewers independently screened the title/abstract and full-texts of references. Descriptive analyses and a directed content analysis were performed on extracted data. Findings One-hundred and forty-nine references met inclusion from the 2951 de-duplicated references screened. Therapeutic alliance was the most frequent principle of PCC described by references (72%); this was consistently defined by characteristics of empathy and non-judgment. Shared decision-making was identified in 36% of references and was primarily defined by client and provider strategies of negotiation in the treatment planning process. Individualized care was described by 30% of references and included individualized assessment and treatment delivery efforts. Holistic care was identified in 23% of references; it included an integrated delivery of substance use, health and psychosocial services via comprehensive care settings or coordination. Substance use and treatment engagement outcomes were most frequently described, regardless of PCC principle. Conclusions This review represents a necessary first step to explore how PCC has been defined and measured for people accessing substance use disorder treatment. The directed content analysis revealed population and context-specific evidence regarding the defining characteristics of PCC-principles that can be used to further support the implementation of PCC.

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Section: Resultsmentioning

confidence: 99%

“…Coded categories were not mutually exclusive such that a reference might have defined the principle of patient-centered care at more than one category. Bracketed numbers represent the number of unique references coded at each category b References coded at this category [41, 42, 58, 133–135] c References coded at this category [44, 59, 79] d References coded at this category [79]…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

Marchand

Beaumont

Westfall³

et al. 2019

Subst Abuse Treat Prev Policy

142

110

View full text Add to dashboard Cite

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“…At its core, harm reduction is a pragmatic approach that aims to reduce the adverse consequences of substance use and related socio-cultural marginalization [18][19][20]. Within a harm reduction approach, specific interventions include opioid overdose response with naloxone, supervised consumption facilities, and managed alcohol programs [21]. Harm reduction approaches are particularly relevant for homeless populations given the extreme health inequities and stigma impacting both substance use and homelessness [1,22,23].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder

et al. 2020

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BackgroundSubstance use is disproportionately high among people who are homeless or vulnerably housed. We performed a systematic overview of reviews examining the effects of selected harm reduction and pharmacological interventions on the health and social well-being of people who use substances, with a focus on homeless populations. Methods and findingsWe searched MEDLINE, EMBASE, PsycINFO, Joanna Briggs Institute EBP, Cochrane Database of Systematic Reviews and DARE for systematic reviews from inception to August 2019. We conducted a grey literature search and hand searched reference lists. We selected reviews that synthesized evidence on supervised consumption facilities, managed alcohol programs and pharmacological interventions for opioid use disorders. We abstracted data specific to homeless or vulnerably housed populations. We assessed certainty of the evidence using the GRADE approach.

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“…For attendees, the fact that these programs are built on the social work principle of meeting people where they currently are in their addiction and keeping them safe that underlies the harm reduction approach, was central to facilitating attendance (Vakharia & Little, 2017…”

Section: Law Enforcementmentioning

confidence: 99%

Needle Exchange Programs to Prevent Hepatitis C Virus Infection in People Who Inject Drugs in Rural Appalachia

Davis¹

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The recent opioid epidemic in the rural Appalachian region of the United States has fueled an exponential increase in hepatitis C virus (HCV) infection among People Who Inject Drugs (PWID). Needle exchange programs (NEP), which provide clean needles in exchange for used needles, can reduce the incidence of HCV among PWIDs. However, the empirical evidence examining NEP effectiveness in the prevention of HCV in this population is mixed, only describes studies conducted in urban areas, and does not address the unique challenges associated with implementing NEPs in rural areas. Furthermore, no studies have examined barriers to using clean needles obtained from NEPs in rural settings. Therefore, there is a critical need to understand the unique context and programmatic challenges of rural NEPs to design and implement successful programs to reduce HCV transmission in this underserved population. The objective of this dissertation was to improve empirical evidence related to NEP efficacy, examine programmatic challenges encountered by rural NEPs, and identify clean needle use barriers unique to rural areas. The rationale underlying this research is that improved understanding of operational and clean needle use barriers will promote successful implementation of NEPs in rural areas. In the first study, a systematic review with meta-analysis was conducted to update the empirical evidence related to NEP prevention of HCV in PWIDs. Findings from this study revealed that the overall impact of NEPs on HCV prevention remains unclear and is complicated by significant heterogeneity between studies. Furthermore, no rural studies were identified in the review. Standardization of population characteristics, intervention components, empirical comparisons, and outcome assessments is suggested to reduce heterogeneity and clarify the empirical contribution of NEPs to HCV prevention. In the second study, a qualitative case study design was employed to examine barriers and facilitators to NEP implementation, ongoing operations, and future sustainability. Structured interviews with program directors, law enforcement leaders and personnel, and NEP attendees revealed common barriers and facilitators to program operations. Findings from this study indicated that despite broad community support, growing volumes, funding shortages, and the federal government's prohibition on the use of funds to purchase needles threatened program operations. Furthermore, paraphernalia laws created a legal conundrum in the form of criminal sanctions for the possession of needles, which may inadvertently promote needle sharing and disease transmission. In the third study, a mixed methods survey of PWIDs attending two rural, Appalachian programs regarding barriers to using clean needles obtained from the exchange for every injection was employed. Findings from this study revealed that fear of arrest and problems with obtaining clean needles from pharmacies were the most commonly endorsed barriers to clean needle use. The results of this dissertation suggest that ...

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Starting Where the Client Is: Harm Reduction Guidelines for Clinical Social Work Practice

Cited by 40 publications

References 36 publications

Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder

Needle Exchange Programs to Prevent Hepatitis C Virus Infection in People Who Inject Drugs in Rural Appalachia

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