Homeless Men in Alcoholics Anonymous: Barriers to Achieving and Maintaining Sobriety

Rayburn, Rachel L; Wright, James

doi:10.1177/193672440900300106

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…Compassionate and non-judgemental support from staff and peers was the most consistently mentioned component of effective treatment services. It was reported in all but three studies [76,80,86], across both harm reduction and abstinence-based settings. Participants talked about the need to feel cared for and treated as individuals, by staff who would listen and be open and honest.…”

Section: (Ii) Compassionate and Non-judgemental Supportmentioning

confidence: 91%

“…Briefly, the 21 studies were conducted between 2002 and 2018 in the USA (n = 11), Canada (n = 7) and the UK (n = 3), involving 462 participants (one study did not report participant numbers) ranging from 18 to 62 years. Three studies focused entirely on women [84,86,87], and five involved men only [70,[80][81][82][83]. In the remaining studies, although women were involved, 50% to 84% of participants were male; only one study reported a majority of female participants [75].…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

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What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography

et al. 2020

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Background: People experiencing homelessness have higher rates of problematic substance use but difficulty engaging with treatment services. There is limited evidence regarding how problematic substance use treatment should be delivered for these individuals. Previous qualitative research has explored perceptions of effective treatment by people who are homeless, but these individual studies need to be synthesised to generate further practice-relevant insights from the perspective of this group. Methods: Meta-ethnography was conducted to synthesise research reporting views on substance use treatment by people experiencing homelessness. Studies were identified through systematic searching of electronic databases (CINAHL; Criminal Justice Abstracts; Health Source; MEDLINE; PsycINFO; SocINDEX; Scopus; and Web of Science) and websites and were quality appraised. Original participant quotes and author interpretations were extracted and coded thematically. Concepts identified were compared to determine similarities and differences between studies. Findings were translated (reciprocally and refutationally) across studies, enabling development of an original overarching line-of-argument and conceptual model. Results: Twenty-three papers published since 2002 in three countries, involving 462 participants, were synthesised. Findings broadly related, through personal descriptions of, and views on, the particular intervention components considered effective to people experiencing homelessness. Participants of all types of interventions had a preference for harm reduction-oriented services. Participants considered treatment effective when it provided a facilitative service environment; compassionate and non-judgemental support; time; choices; and opportunities to (re)learn how to live. Interventions that were of longer duration and offered stability to service users were valued, especially by women. From the line-of-argument synthesis, a new model was developed highlighting critical components of effective substance use treatment from the service user's perspective, including a service context of good relationships, with person-centred care and an understanding of the complexity of people's lives.

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Section: (Ii) Compassionate and Non-judgemental Supportmentioning

confidence: 91%

Section: Overview Of Included Studiesmentioning

confidence: 99%

What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography

et al. 2020

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“…However, research has also found that the sharing of "experience, strength, and hope" is critical to reducing substance abuse (Blondell, Behrens, Smith, Greene, & Servoss, 2008;Blondell et al, 2001, p. 7). Genuine and honest motivations are important in building trusting relationships between peer supporters and clients; participants report distrust for AA members visiting from the community, suggesting that they were motivated by needing to do their "service work" as outlined by the 12th step (Rayburn & Wright, 2009).…”

mentioning

confidence: 99%

Peer support critical elements and experiences in supporting the homeless: A qualitative study

Barker

Maguire

Bishop

et al. 2018

Community & Applied Soc Psy

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Peer supporters are individuals with lived experience and are an integral part of health care systems, providing support to those affected by various phenomena such as homelessness and addictions. However, little is known about the critical elements that underpin peer support interventions. This qualitative study sought to understand the critical elements of intentional peer support with a homeless population, voiced by those who provide and/or receive this support. Twenty‐nine participants from 4 different homeless charities in England were interviewed about their experiences of providing/receiving peer support and what they felt were critical factors to its success. Participants defined peer support as an experience‐based relationship, built upon mutual understanding, empathy, and support. Thematic analysis was utilised to in developing 6 themes. Results identified peers' persistence in developing unique experience‐based relationships, providing social support, role modelling recovery, and peers' motivations were perceived as important factors involved in peer support. It was also found that peers described benefitting from helping, such as, undergoing transformative identity developments that helped them to escape homelessness. Through the retelling of their stories, they create meaning and restructure their autobiography, attributing experiences of homelessness as a catalyst for positive changes in their lives. Limitations and future research are discussed.

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“…Thus, when an AA member experiences a “slip” the implication is that the member has allowed some other problem to assume a greater priority (Rayburn and Wright (2009). Certainly, focusing on a sustained effort not to drink or use is imperative; however, to achieve and maintain sobriety sometimes the “first” thing may not actually be putting down the drink or the drug.…”

Section: First Things First: What Is the First Thing?mentioning

confidence: 99%

“First Things First”: What is the First Thing?

Sussman

Forster

Grigsby

2015

Substance Use & Misuse

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This OP-ED piece comments on the down-side of an otherwise useful 12-step slogan, “First Things First,” which generally refers to staying sober (not drinking or using no matter what). While important, there are environmental, micro-social, psychiatric, and neurobiological considerations that may place other needs at an equal or higher priority than sobriety per se. That is, other changes may be needed to set the stage for, or enhance efforts at sobriety, prior to or concurrent with attempting to quit one's drug of choice. Perhaps slogans should be considered in a broader context and not be taken too literally.

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Homeless Men in Alcoholics Anonymous: Barriers to Achieving and Maintaining Sobriety

Cited by 11 publications

References 26 publications

What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography

What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography

Peer support critical elements and experiences in supporting the homeless: A qualitative study

“First Things First”: What is the First Thing?

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