Keeping concerned significant others at a distance in compulsory treatment for people with substance use in Sweden

Abstract

While previous drug treatment research has focused on the importance of supportive social relationships for recovery from alcohol and drugs, less is known about how this theme relates to compulsory drug treatment. This study analyzes how staff at four compulsory treatment institutions for adult drug users in Sweden rationalize the importance of maintaining contact with concerned significant others (CSOs) during the client's treatment. Four focus groups (22 participants) were carried out and analyzed thematically. This study shows that staff perceives the client's initial isolation as a necessity, primarily making CSOs a problem or distraction in relation to the recovery process. Moreover, staff position CSOs in two broad categories, as either 'problematic' or 'resourceful' in relation to a client's recovery. The two categories are used to justify individual regulation between clients and their CSOs, which varies between strictness and leniency. In addition, staff position themselves as guides, finding it necessary to help clients regulate problematic CSOs themselves and strengthen the link to those who are seen as resources. These two forms of regulatory worksetting rules and providing guidanceare analyzed in terms of disciplinary and pastoral power.