The mechanisms of treatment – client and treatment staff perspectives on change during treatment for alcohol problems

Greiff, Ninive von; Skogens, Lisa

doi:10.1080/2156857x.2013.834840

Cited by 15 publications

(15 citation statements)

References 33 publications

(40 reference statements)

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“…Many of the present respondents described being in residential treatment in terms of establishing basic conventional or normative routines and rhythms of everyday life, which is consistent with other descriptions of the importance of the structure and regularities of the institution in creating positive changes (Orford et al, 2006;von Greiff & Skogens, 2013). Bill points out that it was important for him to learn the mundane everyday routines.…”

Section: Getting Involvedsupporting

confidence: 86%

Into the unknown: Treatment as a social arena for drug users’ transition into a non-using life

Robertson

Nesvåg

2018

Nordic Studies on Alcohol and Drugs

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Background and aims: For people trying to stop using alcohol or other drugs (AOD), the process is often characterised by periods of abstinence followed by relapse into their previous drug-related way of life and subsequent re-entry into the treatment system. There is a call for greater attention to the how of these transitions, with a special focus on the phase of leaving treatment. The aim of this article was to get a better understanding of the transformation of practice when moving from a drug-using to a non-using lifestyle by exploring the experience of (1) the involvement in treatment settings, (2) the process of leaving treatment, and finally, (3) the early phase of changing everyday practice into a drug-free way of living. Method: The article takes on a social practice approach, in particular Bourdieu's concepts of habitus, "doxa" and field to analyse 17 in-depth interviews with Norwegian men and women seeking treatment for problems resulting from the use of drugs and/or alcohol. Results: The study shows that the support of professionals operates as transitional relations that can bridge the transformation from a drug-using to a drugfree life, by providing a social web of relations, positions, settings and activities. However, leaving

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Section: Getting Involvedsupporting

confidence: 86%

Into the unknown: Treatment as a social arena for drug users’ transition into a non-using life

Robertson

Nesvåg

2018

Nordic Studies on Alcohol and Drugs

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“…The concept was initially used in the field of psychotherapy (Wampold 2001;Lambert and Barley 2001;Martin, Garske, and Davis 2000) but has emerged as an important common factor for treatment in several other fields, such as treatment for AOD problems (Babor and Del Boca 2003) and mental health (Goldsmith et al 2015). As pointed out earlier in the article, the creation of a therapeutic alliance cannot be described in a general way but may alter according to different groups (Herrestad et al 2014;von Greiff and Skogens 2014). How creation of a therapeutic alliance was described in the study could be related to the specific investigated group.…”

Section: Discussionmentioning

confidence: 99%

Supporting recovery in social work with persons having co-occurring problems – clients’ and professionals’ perceptions

Greiff

Skogens

Topor

2018

Nordic Social Work Research

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The study focus on how clients with co-occurring problems describe the importance of treatment factors for the recovery process and how these descriptions relates to professional descriptions. 40 client interviews and 15 interviews with professionals were conducted. Three major themes emerge in the results: medication, methods and the professionals.The amount of contact with psychiatry and social services that these clients often have through the years can lead to a 'learned passivity' towards their own recovery process. Thus, an important task for the professionals is to break through passivity and isolation. This can be done by treating the client like an 'ordinary fellow human'. Besides the actual professional tasks, small things seem to be important; greeting the person, paying respect when entering some one's home, etc.When a social network is missing, the professional can sometime fill this gap, but if this is to promote recovery, it seem important that the professional social network is used as a bridge to other social networks.The professionals as a group, including the environment, emerge as important. Accordingly, to be supportive as a group, and be able to act like 'social role models', the professionals need to have working alliances also between themselves. The environment can also offer tools that can be used for socialization that interfere with the 'learned passivity' and instead includes and respects the client. This, together with the results highlighting the importance of creating safe milieus, confident and secure professionals, puts focus on how the professional work is organized.

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“…The analysis focuses on two central themes -the importance of the staff and of the treatment group. These themes were chosen on the basis of results from a previous study on parts of the material (von Greiff & Skogens, 2014) where an extended interpretation of the concept of the therapeutic alliance was suggested, i.e. that alliances are created not only between client and professional but also between group members.…”

Section: Discussionmentioning

confidence: 99%

“…This external homogeneity may thus be more of a factor in treatment interventions and less so in aftercare or in self-help groups (such as AA or NA) where the cohesion and safety lie in the shared problems that the self-help group focus on (Pooler et al, 2014;von Greiff & Skogens, 2014).…”

Section: The Staff As An Important Factormentioning

confidence: 99%

“…This broader meaning of the therapeutic alliance is discussed in relation to the results of a Swedish research project 1 investigating positive change processes among clients treated for alcohol and other drug (AOD) problems (von Greiff & Skogens, 2014). When the essential factors for initiating and maintaining a positive change process in relation to the actual treatment were studied, two important themes that emerged were the treatment group and the treatment staff.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the concept of the therapeutic alliance in group treatment for alcohol and drug problems

Greiff

Skogens

2017

European Journal of Social Work

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This article investigates how treatment factors are described by different client groups and by treatment staff. The material consists of interviews with clients (n = 81) and treatment staff (n = 18). The analysis focuses on two central themes -the importance of the treatment group and of the treatment staff, along with how these descriptions relate to the concept of the therapeutic alliance. The descriptions differ in parts between the client groups and between clients and staff. Clients as well as staff highlight structural and qualitative aspects of cohesion, but general patterns of how these are expressed in the groups are hard to grasp. However, some exceptions appear; while the clients often relate recognition to own experience of substance abuse, the staff often refer to external aspects of recognition, such as gender and/or experience of parenting. The results indicate that the social preconditions of the group members can influence group cohesion. In the treatment, focus is initially on cohesion and later on making change possible. This might create a dilemma; the homogeneity that initially creates cohesion can also act as a restraint on change. This is described in the results in relation to gender homogeneous client groups in treatment.ABSTRAKT I den studie som presenteras har 81 intervjuer gjorts med klienter som beskrivit vad de själva ser som verksamt för sin egen positiva förändringsprocess i samband med att de varit i behandling för missbruksproblem. 18 intervjuer har gjorts med behandlingspersonal som beskrivit vad de bedömer vara de verksamma faktorerna inom behandling. Artikeln fokuserar på två centrala teman som framkommit i intervjuerna; dels behandlingsgruppens betydelse och dels behandlingspersonalens betydelse för en positiv förändringsprocess. Dessa teman relateras till begreppet terapeutisk allians. Både klienter och personal uppmärksammar betydelsen av gemenskap under behandlingen och lyfter fram såväl strukturella som kvalitativa aspekter på hur gemenskap skapas. Det är svårt att se generella mönster men en skillnad som framkommer i materialet är att när klienterna beskriver igenkänning som en central faktor för upplevelsen av gemenskap så betonar de ofta igenkänning relaterat till missbruket. Personalen relaterar igenkänning till att dela mer generella företeelser som till exempel att vara kvinna eller att vara förälder. Studiens resultat tyder på att en viss homogenitet i social situation bland behandlingsgruppens deltagare underlättar skapandet av en gemenskap inom behandlingsgruppen. Behandlingstidens tidigare faser fokuserar ofta på att skapa denna gemenskap och att skapa en trygg situation, senare i behandlingen övergår fokus till förändring. Genom att använda exemplet könshomogenitet belyser studiens resultat ett dilemma som är relaterat till detta; den homogenitet som tidigt under behandlingen underlättar trygghet och gemenskap kan senare under behandlingen verka begränsande för förändring.

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The mechanisms of treatment – client and treatment staff perspectives on change during treatment for alcohol problems

Cited by 15 publications

References 33 publications

Into the unknown: Treatment as a social arena for drug users’ transition into a non-using life

Into the unknown: Treatment as a social arena for drug users’ transition into a non-using life

Supporting recovery in social work with persons having co-occurring problems – clients’ and professionals’ perceptions

Understanding the concept of the therapeutic alliance in group treatment for alcohol and drug problems

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