People who use drugs, and particularly people experiencing addiction, are rarely afforded the opportunity to have their voices heard when it comes to drug treatment or drug policy or even when attempting to define themselves and their life experiences. Of course, there is much more to a person than one area of their behaviour. The current study seeks to capture and understand the lived experiences of people who use drugs, with a focus on their relationships and helping behaviour. We interviewed 32 participants in a harm reduction program seeking to provide understanding beyond stigmatizing and criminalizing drug narratives, by exploring their motivation and context for helping behaviours. Grounded theory methodology was used to understand the patterns of helping behaviour, along with the contexts in which help is or is not given. We particularly focus on participants' distribution of syringes and carrying medicine to reverse overdose (naloxone). Participants shared stories of altruism and mutual aid, along with barriers and disincentives to helping others. We situate these behaviours within contrasting environments of a free harm reduction program and the competitive market system of the U.S. society. Implications for practice and public policy are discussed.
Ayahuasca has gained the attention of researchers over the past decade as psychedelic-assisted therapy for MDMA and psilocybin have progressed through FDA approved clinical trials. In spite of the increase in research, there are relatively few clinical studies of ayahuasca and little qualitative research on the therapeutic or healing uses of psychedelics in general. The present study included 41 Western participants who were interviewed about their participation in facilitated group ayahuasca experiences (e.g., in shamanic, neoshamanic, spiritual, and religious settings). Participants were interviewed about their intentions for participating, along with the perceived impact of the experiences. In particular, we focused on impacts that participants perceived to be sustained and enduring. We identified an impressive range of beneficial impacts, including improvements in areas that are often a focus of psychotherapy, such as mental health and substance use, health behaviors, interpersonal relationships, sense of self, attitude. Extratherapeutic effects were also observed in areas such as changes in creativity, somatic sensations, physical health/pain, sense of connection to nature, spirituality, and concern for the greater good. Two participants also reported problematic experiences, apparently related to set and setting. Implications for research and practice, along with a humanistic framework for interpreting these findings is provided.
Much research has been conducted on multicultural competence (MCC) over the past four decades, though there is still a need to conduct further research into the role of MCC within actual counseling relationships and in relation to additional variables. The present survey study was designed to better elaborate on the relationship between MCC and several common factor therapy and outcome variables within counseling relationships. Findings indicated that MCC was more strongly correlated with all measured variables (except perceived change) within counseling relationships where client and/or counselor identified as BIPOC than in White–White client counselor dyads. MCC was associated with higher ratings on the other measured variables regardless of client–counselor race or ethnicity. Finally, path analysis supported a model where MCC (a therapist factor) influenced process factors, which in turn influenced therapeutic outcomes. The results provide support for the importance of MCC to the process and outcome of counseling, particularly for BIPOC clients.
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