“We are people too”: Consumer participation and the potential transformation of therapeutic relations within drug treatment

Rance, Jake; Treloar, Carla

doi:10.1016/j.drugpo.2014.05.002

Cited by 64 publications

(97 citation statements)

References 20 publications

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“…These findings are consistent with calls to increase patient participation in treatment decision making (Neale, 1998;Rance & Treloar, 2015;Trujols, 2012Trujols, , 2017 (Yarborough et al, 2016).…”

Section: Patient Views Of Opioid Pharmacotherapy Bio-delivery Systemssupporting

confidence: 79%

Patient views of opioid pharmacotherapy biodelivery systems: Qualitative study to assist treatment decision making.

Neale

Tompkins

Strang

2018

Experimental and Clinical Psychopharmacology

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The technology for delivering opioid pharmacotherapy (OPT) is expanding. It is important to know what OPT patients think of these developments, and to find ways of enabling patients and clinicians to make informed decisions about which bio-delivery system to choose. We explored the views of current and former OPT patients with a history of heroin use to identify factors influencing their preferences regarding routes of OPT administration. Data were generated via seven focus groups conducted in London, United Kingdom. Participants (n=44) considered standard bio-delivery systems (liquid/linctus, tablet, injectables), emergent systems (implants, depot injections), and a hypothetical system (nasal sprays). Groups were audio-recorded, transcribed verbatim, coded using qualitative software, and analyzed inductively via Iterative Categorization. Participants were cautious of, but willing to consider, new ways of receiving OPT and they welcomed having more choice. Their preferences and decision-making processes were influenced by nine interconnected factors: 1. personal dislike of particular bio-delivery systems; 2. desired feelings following OPT administration; 3.perceived effectiveness of OPT bio-delivery systems; 4. concerns about side effects; 5. ability to control the OPT; 6. impact on daily lives; 7. concerns about OPT-related stigma; 8. need for psychosocial support; and 9. personal treatment goals. This complexity may make it difficult for patients and clinicians to evaluate the pros and cons of the expanding array of OPT bio-delivery systems and to arrive at clear conclusions. We therefore use the findings to Article accepted by Experimental and Clinical Psychopharmacology 3 construct a checklist that may facilitate discussions with patients when decisions about OPT need to be made. KEYWORDS

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Section: Patient Views Of Opioid Pharmacotherapy Bio-delivery Systemssupporting

confidence: 79%

Patient views of opioid pharmacotherapy biodelivery systems: Qualitative study to assist treatment decision making.

Neale

Tompkins

Strang

2018

Experimental and Clinical Psychopharmacology

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“…Establishing a trusting and collaborative relationship between counsellor and patient early on in the treatment course may be a prerequisite for successful implementation of user involvement in substance abuse treatment (Rance & Treloar, 2015). Since 2004, persons with substance use disorders in Norway have legislated rights to specialised treatment equivalent to physical and mental health disorders.…”

mentioning

confidence: 99%

“…Our primary purpose was to identify aspects of inpatients' satisfaction most strongly associated with a positive outcome. Based on previous research (Brener et al, 2009;Morris & Gannon, 2008;Rance & Treloar, 2015), we assumed that patient satisfaction with opportunity to participate in treatment would be associated with a perceived positive treatment outcome.…”

mentioning

confidence: 99%

“…Patients' autonomy and opportunity to influence the course of their own treatment is crucial in substance abuse treatment (Brener, Resnick, Elard, Treloar, & Bryant, 2009;McCallum, Mikocka-Walus, Gaughwin, Andrews, & Turnbull, 2015;Rance & Treloar, 2015). Establishing a trusting and collaborative relationship between counsellor and patient early on in the treatment course may be a prerequisite for successful implementation of user involvement in substance abuse treatment (Rance & Treloar, 2015).…”

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confidence: 99%

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Patient satisfaction with treatments and outcomes in residential addiction institutions

Andersson

Otterholt

Gråwe

2017

Nordic Studies on Alcohol and Drugs

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Aim: The objective of the present study was to investigate associations between patients' satisfaction with different domains of inpatient substance use treatment and their perceived treatment outcome. The primary purpose was to identify domains of treatment satisfaction most strongly associated with a positive treatment outcome. Design: Data were based on a survey among 188 patients with alcohol and/or illicit substance use disorders completing a three-six-month inpatient stay at one of two public clinics in Central Norway. The survey was carried out shortly before discharge. The 15-item questionnaire covered ratings of staff and programme factors, and services received for medical and mental problems and ancillary services. The outcome score was based on items measuring perceived substance use improvements and benefit of treatment. Results: A significant proportion of patients were dissatisfied with the support provided for housing, financial issues and employment. Confidence in staff competence was the domain of treatment satisfaction most strongly associated with the outcome score. Furthermore, patients were more likely to report a positive outcome when they were actively involved in the treatment, as indicated by satisfaction with opportunities to affect treatment plans. Conclusion: Our results suggest that patient-experienced improvements are connected to confidence in staff competence and user

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“…Clients suggested that the measures identified required them to 'become superhuman', and did not capture sufficiently the complexity of their embodied experiences or circumstances. I suggest that this disjuncture between how clients and clinicians view 'recovery' not only re-emphasizes the value of including the voices of people who use drugs in policy processes and treatment systems [10][11][12], but also raises other questions which require critical consideration.First, it might be necessary to interrogate the assumptions and conceptual premises which lodge within the concept of 'recovery' [13]. The measures put forward by treatment providers in Neale's study [7] accord with McKay's [1] concerns and other definitions of 'recovery' developed by experts internationally [14,15], by focusing not only upon reduced drug use and improved health, but also upon notions of citizenship, roles and responsibilities.…”

mentioning

confidence: 99%

Rethinking recovery

Lancaster

2016

Addiction

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There has been renewed discussion about the notion of 'recovery' in drug policy and treatment service delivery. If we are to make 'recovery' more rewarding and appealing, we should consider the views of people who use drugs, and interrogate the underlying premises and constitutive effects of treatment policies and practices.The issues raised by McKay [1] resonate with an ongoing debate in the international drug policy field regarding 'recovery'. While the notion of 'recovery' is not new [2], in recent years there has been renewed discussion about 'recovery' as an organizing concept in drug policy and treatment delivery [3][4][5]. 'Recovery' is described frequently as a complex and contested concept [6] which eschews definition [3]. Despite the contentious debate, there has been increasing agreement that 'recovery' means more than abstinence or reduction in substance use, and should encompass improvements in other areas of clients' lives, including housing, relationships, employment, participation and wellbeing [6,7].However, as the work of Neale and colleagues [7][8][9] has shown, conceptualizing, defining and measuring the broad set of outcomes that might constitute 'recovery' is not without its challenges. Recognizing that clinicians and clients may differ in their understandings of 'recovery' and in their assessment of the relative importance of specific outcomes would appear to be essential. By examining how clients' views differed from those of treatment providers, Neale and colleagues [9] found that many of the measures of 'recovery' put forward by treatment providers were problematic. Clients suggested that the measures identified required them to 'become superhuman', and did not capture sufficiently the complexity of their embodied experiences or circumstances. I suggest that this disjuncture between how clients and clinicians view 'recovery' not only re-emphasizes the value of including the voices of people who use drugs in policy processes and treatment systems [10][11][12], but also raises other questions which require critical consideration.First, it might be necessary to interrogate the assumptions and conceptual premises which lodge within the concept of 'recovery' [13]. The measures put forward by treatment providers in Neale's study [7] accord with McKay's [1] concerns and other definitions of 'recovery' developed by experts internationally [14,15], by focusing not only upon reduced drug use and improved health, but also upon notions of citizenship, roles and responsibilities. As I have argued elsewhere [3], underpinning this idea is a set of neoliberal assumptions about work, productivity and what it means to live a 'contributing life' which fail to take into account the differences in the normative and social contexts of people's lives. Moreover, it implies that people who use drugs who are not 'in recovery' always already exist somehow outside of community and cannot live meaningful and fulfilled lives. Neale and colleagues [6] suggest that there are a range of alternative terms, such as 'dis...

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“We are people too”: Consumer participation and the potential transformation of therapeutic relations within drug treatment

Cited by 64 publications

References 20 publications

Patient views of opioid pharmacotherapy biodelivery systems: Qualitative study to assist treatment decision making.

Patient views of opioid pharmacotherapy biodelivery systems: Qualitative study to assist treatment decision making.

Patient satisfaction with treatments and outcomes in residential addiction institutions

Rethinking recovery

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