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.

Background: People with substance use disorders (SUD) and concurrent mental health disorders often need prolonged, coordinated health and welfare services. Interprofessional team meetings are designed to tailor services to users’ needs and should be based on interprofessional collaboration involving the user. Aims: To investigate service users’ experiences with interprofessional team meetings and to identify potential barriers to successful user involvement. Methods: Semi-structured interviews with five male service users aged 27–36 years with concurrent substance use and psychiatric disorders, and observations of team meetings involving both users and relevant professionals. Users were interviewed shortly after commencing treatment and after the team meeting. A phenomenographical approach framed the data analysis. Results: Users described the interprofessional team meetings as less than useful, and perceived that lack of a targeted process and of information hindered their collaboration with professionals. Observations revealed that users were given a subordinate role in the meetings, which largely undermined their involvement. Three categories reflecting lack of information as a core obstacle to user involvement emerged from the data material: (i) unclear role responsibilities and unclear professional role functions, (ii) unclear practices regarding rules and routines, and (iii) absence of user knowledge. Conclusions: User involvement in team meetings may be improved by facilitating adequate information, clarifying role expectations, emphasising user knowledge, increasing professionals’ awareness of the importance of collaboration, and by teaching skills that enhance user involvement.

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