Positive processes of change among male and female clients treated for alcohol and/or drug problems

Addiction Research & Theory

Berlin

et al. 2019

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Background: Differing results on gender specific factors related to mortality risks among substance misusers highlights the need for further research. The present article is based on a 30-year follow-up study on substance misusers treated in residential care for drug problems in Sweden in 1982-1983 aiming to identify and compare gender differences in predictors of mortality. Method: Original data consists of personal interviews with 1163 substance misusers treated in inpatient units in Sweden during 1982Sweden during -1983. The outcome variable is death retrieved from the National Cause of Death Register held by the National Board of Health and Welfare. Gender differences and similarities regarding predictors of mortality was estimated in univariate and multivariate models, using Cox proportional hazards models. Results: School failure, imprisonment and being a parent without custody of the child seem to constitute risk factors for mortality among women, but not among men. A social network of friends seemed to be more important for men. Treatment-dropout was a significant risk factor for premature death among men, but not among women. Both gender reporting alcohol as their self-reported most dominant substance misuse showed higher mortality risks compared with those with stimulants as dominant substance misuse. Conclusions: Imprisonment was highly predictive of mortality for the women, suggesting that this group is important to pay particular attention to. Suggested differences in the importance of social factors need to be investigated more thoroughly. The substantial hazard revealed for women with polydrug misuse including alcohol calls for attention to this in treatment for substance misuse. ARTICLE HISTORY

Section: Gender Differences and Similarities Regarding Predictors Of mentioning

confidence: 99%

A 30-year follow-up of substance misusers in Sweden – differences in predictors of mortality between women and men

Addiction Research & Theory

Berlin

et al. 2019

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“…These supportive parts may be included in the interventions, for example, work in various forms where the client experiences the sense of doing a job that is needed and noticed. This is noted in previous studies emphasising that interventions with a broader focus than the actual problem are more beneficial for marginalised groups (Morgenstern et al 2008;von Greiff and Skogens 2017).…”

Section: Discussionmentioning

confidence: 68%

“…Recovery from problems with alcohol and other drugs (AOD) is often described as a process influenced by internal, social, and treatment-related factors (Trulson and Hedin 2004;Ammon et al 2008;Laudet and White 2008;Hibbert and Best 2011). Previous research shows that the conditions for recovery differ between individuals and groups of individuals (Ammon et al 2008;Morgenstein et al 2008;von Greiff and Skogens 2017) and these conditions can be related to the concept of recovery capital 1 (RC) (Cloud and Grandfield 2001. This article presents results from a Swedish research project focusing on recovery in a group that is common in social work: persons with co-occurring problems with AOD and mental health.…”

Section: Introductionmentioning

confidence: 99%

Supporting recovery in social work with persons having co-occurring problems – clients’ and professionals’ perceptions

Nordic Social Work Research

Topor

2018

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The study focus on how clients with co-occurring problems describe the importance of treatment factors for the recovery process and how these descriptions relates to professional descriptions. 40 client interviews and 15 interviews with professionals were conducted. Three major themes emerge in the results: medication, methods and the professionals.The amount of contact with psychiatry and social services that these clients often have through the years can lead to a 'learned passivity' towards their own recovery process. Thus, an important task for the professionals is to break through passivity and isolation. This can be done by treating the client like an 'ordinary fellow human'. Besides the actual professional tasks, small things seem to be important; greeting the person, paying respect when entering some one's home, etc.When a social network is missing, the professional can sometime fill this gap, but if this is to promote recovery, it seem important that the professional social network is used as a bridge to other social networks.The professionals as a group, including the environment, emerge as important. Accordingly, to be supportive as a group, and be able to act like 'social role models', the professionals need to have working alliances also between themselves. The environment can also offer tools that can be used for socialization that interfere with the 'learned passivity' and instead includes and respects the client. This, together with the results highlighting the importance of creating safe milieus, confident and secure professionals, puts focus on how the professional work is organized.

“…In this extended project, client groups have been compared regarding gender (von Greiff & Skogens, 2017) and social position (Skogens & von Greiff, 2016). The present article investigates how the importance of central treatment factors is described by different client groups and by treatment staff, and how these descriptions relate to the concept of a therapeutic alliance.…”

Section: Introductionmentioning

confidence: 99%

“…The importance of relations and the social network for initiating and maintaining change finds strong support in research (cf. Best, Groshkova, Sadler, Day, & White, 2011;Orford et al, 2006;Schön, Denhov, & Topor, 2009;Skogens & von Greiff, 2016;von Greiff & Skogens, 2017), and also the importance of a network of both persons in recovery and those without such connection (van Melick, McCartney, & Best, 2013). Further, research shows that persons with a supportive social network also find it easier to develop positive alliances in treatment .…”

Section: Introductionmentioning

confidence: 99%

Understanding the concept of the therapeutic alliance in group treatment for alcohol and drug problems

European Journal of Social Work

2017

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This article investigates how treatment factors are described by different client groups and by treatment staff. The material consists of interviews with clients (n = 81) and treatment staff (n = 18). The analysis focuses on two central themes -the importance of the treatment group and of the treatment staff, along with how these descriptions relate to the concept of the therapeutic alliance. The descriptions differ in parts between the client groups and between clients and staff. Clients as well as staff highlight structural and qualitative aspects of cohesion, but general patterns of how these are expressed in the groups are hard to grasp. However, some exceptions appear; while the clients often relate recognition to own experience of substance abuse, the staff often refer to external aspects of recognition, such as gender and/or experience of parenting. The results indicate that the social preconditions of the group members can influence group cohesion. In the treatment, focus is initially on cohesion and later on making change possible. This might create a dilemma; the homogeneity that initially creates cohesion can also act as a restraint on change. This is described in the results in relation to gender homogeneous client groups in treatment.ABSTRAKT I den studie som presenteras har 81 intervjuer gjorts med klienter som beskrivit vad de själva ser som verksamt för sin egen positiva förändringsprocess i samband med att de varit i behandling för missbruksproblem. 18 intervjuer har gjorts med behandlingspersonal som beskrivit vad de bedömer vara de verksamma faktorerna inom behandling. Artikeln fokuserar på två centrala teman som framkommit i intervjuerna; dels behandlingsgruppens betydelse och dels behandlingspersonalens betydelse för en positiv förändringsprocess. Dessa teman relateras till begreppet terapeutisk allians. Både klienter och personal uppmärksammar betydelsen av gemenskap under behandlingen och lyfter fram såväl strukturella som kvalitativa aspekter på hur gemenskap skapas. Det är svårt att se generella mönster men en skillnad som framkommer i materialet är att när klienterna beskriver igenkänning som en central faktor för upplevelsen av gemenskap så betonar de ofta igenkänning relaterat till missbruket. Personalen relaterar igenkänning till att dela mer generella företeelser som till exempel att vara kvinna eller att vara förälder. Studiens resultat tyder på att en viss homogenitet i social situation bland behandlingsgruppens deltagare underlättar skapandet av en gemenskap inom behandlingsgruppen. Behandlingstidens tidigare faser fokuserar ofta på att skapa denna gemenskap och att skapa en trygg situation, senare i behandlingen övergår fokus till förändring. Genom att använda exemplet könshomogenitet belyser studiens resultat ett dilemma som är relaterat till detta; den homogenitet som tidigt under behandlingen underlättar trygghet och gemenskap kan senare under behandlingen verka begränsande för förändring.