Using narratives to understand progress in youth alcohol and other drug treatment

Abstract

Purpose: This paper aims to illustrate how narrative research techniques can be employed to promote greater understanding of young people's experiences of progress in residential alcohol and other drug treatment. Design/methodology/approach: Narrative inquiry is used to explore client understandings of what characterises progress in treatment for young people attending a residential detoxification and a residential rehabilitation service in Perth, Western Australia. This article focuses on stories of progress collected through in-depth qualitative interviews, observation and participation with clients of the two services, over a five-month period. Findings: Analysis of data revealed that young people were able to vividly describe their progress through treatment, and their drug taking trajectories can be conceptualised along five stages. The authors prepared narrative accounts to illustrate the features characteristic of each stage as identified by the young people. These composite narratives, written from the perspectives of young people, are presented in this article. Practical implications: Clients' own perceptions of their journeys through drug treatment might enable staff of such services to collaborate with the young person, in shaping and positively reinforcing alternative life-stories; from those of exclusion and disconnection, to narratives of opportunity, inclusion and possibility. Originality/value: Harmful adolescent drug and alcohol use is on the rise in Australia and elsewhere. However, our knowledge of how young people experience progress through residential treatment for substance use is limited. This paper highlights how creating narratives from young people's own stories of progress can broaden our knowledge of "what works" in residential youth alcohol and other drug treatment services. 'Stories are like containers that hold us together; they give us a sense of coherence and continuity' (Mason-Schrock, 1996, p. 176). Recent publicity in Australia around binge drinking by young people refocuses the attention of governments and health professionals on issues arising from problematic substance use (Australian Government 2008). Some adolescent substance use is perceived as normative in Australian culture (Prior et al., 2000) and for most use will not become problematic (Gowing et al., 2001). However, despite reduced use of particular substances among the general population in Australia, this is not so among adolescents and other subpopulations, including Indigenous Australians and young women (Australia Bureau of Statistics, 2008; Australian Institute of Health and Welfare, 2008). In countries such as the United States and Australia, initiation to drug use is occurring at an increasingly young age (

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“…The findings show that many of the young people in the study have experienced significant external pressure to stop using drugs and undergo treatment, consistent with previous research (Battjes et al, 2003; Hugo et al, 2021; Wilson & Saggers, 2013). However, these interventions did not give the desired results due to a lack of autonomous motivation and a social environment that did not support this.…”

“…Young people often begin treatment due to pressure and demands from parents and professionals, and commonly lack intrinsic motivation to change their drug use, at least initially (Battjes et al, 2003; Hugo et al, 2021; Wilson & Saggers, 2013). In line with this, many of the participants in the study reported a high degree of external pressure to stop using drugs.…”

“…Furthermore, there are factors that differentiate young drug users from older drug users, including developmental aspects and shorter drug use history (Wilson & Saggers, 2013). It is known that young adults—those aged 18–25 years—use drugs to a greater extent than other age groups (Alley et al, 2014; Arnett, 2005; Rodriguez & Smith, 2014).…”

“…Several researchers claim that young people generally have less motivation to stop using drugs and undergo treatment, as they have not yet experienced as many negative consequences from their drug use (Battjes et al, 2003; Chan et al, 2004). They also often initiate treatment due to external pressure and demands from social services, parents, or the judiciary (Battjes et al, 2003; Hugo et al, 2021; Wilson & Saggers, 2013). Young people also have a higher rate of dropping out of treatment (Rodriguez & Smith, 2014).…”

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“…The client’s change experience progressed from a state of painful self-focus to a (eventual) positive other focus , exploring and forming new commitments instead of gambling. The reported change process bears resemblance to the narratives of people who recover from addiction, and whose stories change from that of exclusion and disconnection to that of opportunity, inclusion, and possibility (Wilson, Saggers, & Wildy, 2013). As seen in the phase-based results, the client’s experience of change was initially self-acceptance and relationship building, which took place through learning about trauma and feeling normalized.…”