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How meaningful activities influence the recovery process 有意义的活动如何影响恢复过程
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-08-20 DOI: 10.1108/ADD-01-2018-0002
Ole Martin Nordaunet, Knut Tore Sælør
The purpose of this paper is to explore two research questions: how do people with concurrent substance abuse and mental health disorders (concurrent conditions) experience and describe meaningful activities? And how do meaningful activities influence the recovery process?,This qualitative study uses an explorative and interpretive design in a phenomenological-hermeneutic approach. Transcribed interviews are analysed using a phenomenological-hermeneutic method for researching lived experience. The study was submitted to the Norwegian Center for Research Data where it was approved (Case No. 54661).,Structural analysis resulted in three overarching themes: achieving a positive identity through actions and feeling worthwhile; physically outside but inside the norms of society, and idleness, isolation, and obstacles on the road to recovery. Meaningful activities, considered a cornerstone in the recovery process, vary widely and are primarily described in social contexts, thereby confirming the significance of social aspects of recovery in addition to recovery as an individual journey. The findings also show that experiencing meaningful activities contributes to recovery capital and the development of recovery-promotive identities.,The study consisted of a small sample size, recruited at one location which served as a primary research limitation.,This paper provides insights for health care practitioners and health care decision makers regarding the importance of meaningful activities viewed through a recovery perspective.,Few studies to date have used a comprehensive approach to describe the influence of experiencing meaningful activities on the recovery process.
本文的目的是探讨两个研究问题:同时滥用药物和精神健康障碍(并发条件)的人如何体验和描述有意义的活动?有意义的活动如何影响恢复过程?本定性研究采用现象学-解释学方法的探索性和解释性设计。转录采访分析使用现象学-解释学的方法来研究生活经验。该研究已提交给挪威研究数据中心,并获得批准(病例编号54661)。结构分析得出三个主要主题:通过行动和感觉有价值来获得积极的身份;身体在社会规范之外,但在社会规范之内,懒惰,孤立,在恢复的道路上障碍重重。有意义的活动被认为是康复过程的基石,它们差异很大,主要是在社会背景下描述的,因此,除了作为个人旅程的康复之外,还确认了康复的社会方面的重要性。研究结果还表明,经历有意义的活动有助于恢复资本和恢复促进身份的发展。这项研究的样本量很小,在一个地方招募,这是研究的主要局限性。本文为卫生保健从业者和卫生保健决策者提供了从康复角度看待有意义活动的重要性的见解。迄今为止,很少有研究使用全面的方法来描述经历有意义的活动对恢复过程的影响。
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引用次数: 18
Avatar and technology assisted platforms in the treatment of co-occurring addiction and IPV among male offenders 虚拟化身和技术辅助平台在治疗男性罪犯中同时发生的成瘾和IPV
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-08-08 DOI: 10.1108/ADD-03-2018-0003
C. Easton, Cassandra Berbary, Cory A. Crane
PurposeThe purpose of this paper is to review the research on the use of technology in mental health and addiction treatment, focusing on the use of technology-assisted treatment. Although initial research investigating technology-assisted treatment for substance use has demonstrated promising results, this paper highlights the need for treatment to address co-occurring substance use and intimate partner violence (IPV). This paper defines the benefits associated with the use of behavioral health avatar coaches in mental health treatment targeting substance use and IPV as well as providing preliminary research results regarding the use of avatar coaches in clinical settings.Design/methodology/approachA literature review of the research relating to the use of technology in mental health and addiction treatment is provided. Additionally, a preliminary study aimed to develop an interactive therapy platform that utilizes virtual avatars as therapy coaches to help clients with substance abuse and IPV is presented. In this preliminary study, male participants were shown videos of various technology-based coaches matched on length, gestures and content. Researchers investigated whether patients preferred a virtual reality health coach, a cartoon health coach or a human health coach; as well as patient satisfaction and preference between two versions of the avatar.FindingsA review of the relevant literature suggests that a majority of research has focused on using technology to replace face-to-face therapy with little research focusing on technology-assisted or augmented mental health and addiction treatment. Although initial research investigating avatar-assisted treatment for substance use has demonstrated promising results, research suggests a high prevalence of co-occurring substance use and IPV, suggesting the need for treatment to address co-occurring substance use and IPV. A preliminary research study was conducted to obtain patient feedback for personalizing avatar development into behavioral health interventions that target addiction and IPV.Research limitations/implicationsAlthough results of the preliminary study combined with previous research on avatar-assisted treatment for substance use has demonstrated promising results, theory-based research needs to be expanded to focus on randomized controlled trials of avatar-assisted treatment for co-occurring substance use and IPV.Practical implicationsThis paper provides an overview of the use of technology-assisted treatment for co-occurring substance use and IPV. The preliminary results regarding patient satisfaction led to the development of additional avatars for use in interactive therapy.Originality/valueThis paper is one of the first to explore the use of avatar-assisted treatment for male offenders with co-morbid substance use and IPV.
目的综述了技术在心理健康和成瘾治疗中的应用研究,重点介绍了技术辅助治疗的应用。尽管调查药物使用技术辅助治疗的初步研究已经显示出有希望的结果,但本文强调需要治疗以解决同时发生的药物使用和亲密伴侣暴力(IPV)。本文定义了在针对物质使用和IPV的心理健康治疗中使用行为健康化身教练的益处,并提供了关于在临床环境中使用化身教练的初步研究结果。设计/方法/方法对有关在心理健康和成瘾治疗中使用技术的研究进行了文献综述。此外,一项初步研究旨在开发一个互动治疗平台,利用虚拟化身作为治疗教练来帮助药物滥用和IPV的客户。在这项初步研究中,研究人员向男性参与者展示了各种技术教练的视频,这些视频的长度、手势和内容都是相匹配的。研究人员调查了患者是更喜欢虚拟现实健康教练、卡通健康教练还是真人健康教练;以及患者的满意度和偏好之间的两个版本的化身。对相关文献的回顾表明,大多数研究都集中在使用技术取代面对面治疗上,而很少有研究关注技术辅助或增强的心理健康和成瘾治疗。虽然初步研究调查了对药物使用的化身辅助治疗已经显示出有希望的结果,但研究表明,同时发生的药物使用和IPV的发生率很高,这表明需要治疗来解决同时发生的药物使用和IPV。我们进行了一项初步研究,以获得针对成瘾和IPV的行为健康干预中个性化虚拟形象发展的患者反馈。研究局限/启示虽然前期研究结果与前期关于虚拟现实辅助药物使用治疗的研究结果一致,但基于理论的研究需要扩大,以集中于虚拟现实辅助药物使用和IPV同时发生的随机对照试验。实际意义本文概述了技术辅助治疗共存物质使用和IPV的应用。关于患者满意度的初步结果导致了在互动治疗中使用的其他化身的发展。原创性/价值本文是第一个探讨使用虚拟化身辅助治疗男性罪犯与合并症的物质使用和IPV。
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引用次数: 5
Challenges in working with patients with dual diagnosis 与双重诊断患者合作的挑战
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-05-21 DOI: 10.1108/ADD-11-2017-0021
Pernille Pinderup
Studies have shown that mental health professionals find working with patients with dual diagnosis challenging, and the purpose of this paper is to examine some of these challenges.,In total, 85 mental health professionals from 8 different mental health centres in Denmark were interviewed. The data analysis was inspired by a grounded theory approach.,Different challenges in the dual diagnosis treatment were identified and they suggested that the focus of treatment was mainly on the mental illness rather than the substance use disorder. The single focus of the treatment made it challenging to treat patients with dual diagnosis sufficiently. While several studies explain the single focus by inadequate competencies among professionals, the present study suggests that the single focus is also explained by the way that the treatment is organised. For instance, standardized treatment packages and insufficient guidelines on substance abuse treatment make it challenging to treat patients with dual diagnosis.,This paper suggests that a more flexible, and a longer period of, treatment, together with more sufficient guidelines on dual diagnosis treatment and a more formalized collaboration with the substance abuse treatment centres, will make it a less challenging issue to treat patients with dual diagnosis.
研究表明,心理健康专业人员发现与双重诊断的患者一起工作具有挑战性,本文的目的是研究其中的一些挑战。总共采访了来自丹麦8个不同心理健康中心的85名心理健康专业人员。数据分析受到扎根理论方法的启发。双重诊断治疗面临的不同挑战表明,治疗的重点主要放在精神疾病而不是物质使用障碍上。治疗的单一焦点使得对双重诊断患者的治疗具有挑战性。虽然有几项研究将单一焦点解释为专业人员能力不足,但本研究表明,单一焦点也可以解释为治疗的组织方式。例如,标准化的治疗方案和药物滥用治疗指南的不足,使得治疗双重诊断患者具有挑战性。本文建议,更灵活、更长的治疗周期,以及更充分的双重诊断治疗指南,以及与药物滥用治疗中心更正式的合作,将使治疗双重诊断患者成为一个不那么具有挑战性的问题。
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引用次数: 9
Expanding the use of the ASAM CriteriaTM to make mental health level of care placements 扩大对美国精神卫生协会标准的使用,以确定精神卫生护理水平
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-04-23 DOI: 10.1108/ADD-10-2017-0020
W. M. Drymalski
Purpose Despite the prevalence of co-occurring mental health and substance use disorders, the assessment and placement processes for each often remain separate. The purpose of this paper is to describe an expanded use of the American Society of Addiction Medicine (ASAM) CriteriaTM to make placements into substance use, co-occurring, and mental health treatment. Design/methodology/approach A rationale for the development of two new domains (Domain 7, substance use and Domain 8, independent living skills) and preliminary data supporting the use of the ASAM CriteriaTM as a placement process for all types of behavioral health issues will be provided. Findings Dimension 3 and Domains 7 and 8 were correlated with selected clinical indices in the expected direction (Dimension 3: depression (F (4, 4650)=202.092, p<0.001), medication usage (F (4, 4,637)=174.254, p<0.001), and psychotic symptoms (F (4, 4,561)=62.954, p<0.001); Domain 7: alcohol use (F (4, 4,458)=213.786, p<0.001) and drug use (F (4, 4,471)=611.491, p<0.001); and Domain 8: functional impairment (F (4, 3,927)=815.646, p<0.001) and number of “high needs” (F (4, 3,927)=737.568, p<0.001). Research limitations/implications The limitations of this research included a lack of inter-rater reliability data and less established intake assessments. Practical implications This single placement approach for clients seeking behavioral health services can create a more efficient, person-centered intake experience. Originality/value This paper suggests that it is possible to deploy a single assessment and placement approach for all types of behavioral health issues.
尽管同时发生的精神健康和药物使用障碍很普遍,但对两者的评估和安置过程往往是分开的。本文的目的是描述美国成瘾医学协会(ASAM)标准的扩展使用,以放置在物质使用,共同发生和心理健康治疗中。设计/方法/方法将提供开发两个新领域(领域7,物质使用和领域8,独立生活技能)的基本原理和支持使用ASAM标准作为所有类型行为健康问题的安置过程的初步数据。维度3和域7、域8与所选临床指标呈预期方向相关(维度3:抑郁(F (4,4650)=202.092, p<0.001)、用药(F (4,4,637)=174.254, p<0.001)、精神症状(F (4,4,561)=62.954, p<0.001);域7:酒精使用(F (4,4,458)=213.786, p<0.001)和药物使用(F (4,4,471)=611.491, p<0.001);领域8:功能障碍(F (4,3,927)=815.646, p<0.001)和“高需求”数量(F (4,3,927)=737.568, p<0.001)。研究局限性/启示本研究的局限性包括缺乏评分者之间的可靠性数据和较少建立的摄入评估。对于寻求行为健康服务的客户来说,这种单一的安置方法可以创造一个更有效的、以人为本的就诊体验。原创性/价值这篇论文表明,对所有类型的行为健康问题采用单一的评估和安置方法是可能的。
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引用次数: 0
Engagement in help-seeking of dual diagnosed mothers at a low-threshold service: grasping life through co-created opportunities 以低门槛服务参与双重诊断母亲的求助:通过共同创造的机会把握生活
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-04-23 DOI: 10.1108/ADD-11-2017-0025
M. Sorsa, I. Kiikkala, P. Åstedt‐Kurki
Purpose Mothers with a dual diagnosis (mental ill health and substance use) have delays in accessing services, or their care may be interrupted prior to therapeutic relationships being formed. The purpose of this paper is to explore and describe how engagement merges in the context of mothers with a dual diagnosis. Design/methodology/approach This is a qualitative, focused ethnographic study at a low-threshold service for substance abusing families. The data contain interviews, observations, field notes, and reflections. The analysis followed several systematic steps. Findings Engagement is the co-creation of possibilities between workplace staff and the client in different interfaces. It is not a single act, emotion, or verbal communication, but a complex intertwined system of events that can awaken or enable the client to get a grasp on life. The sensitivity of the worker is one tool for engaging the client in manifold ways in different interfaces: even the smallest events with connection are viewed as valuable. Engagement involves the intentional client in the process of interaction: the client needs to participate and become an acting and sensing part of the change, which occurs on an experiential level. The process is described with the metaphor of a seed. Originality/value Engagement as inner involvement challenges the current working methods, and requires sensitivity, because the mothers with a dual diagnosis may not have verbalisable goals when arriving to the services.
目的患有双重诊断(精神疾病和药物滥用)的母亲在获得服务方面有延误,或者在形成治疗关系之前,她们的护理可能被中断。本文的目的是探讨和描述在双重诊断的母亲的背景下,参与是如何合并的。设计/方法/方法这是一项针对药物滥用家庭的低门槛服务的定性、重点人种学研究。这些数据包括采访、观察、实地记录和反思。分析遵循了几个系统的步骤。参与是工作场所员工和客户在不同界面上共同创造可能性的过程。它不是一个单一的行为、情感或语言交流,而是一个复杂的交织在一起的事件系统,可以唤醒或使客户掌握生活。工作人员的敏感性是在不同接口中以多种方式参与客户端的一种工具:即使是具有连接的最小事件也被视为有价值的。参与涉及到有意的客户在互动过程中:客户需要参与并成为变化的行动和感知部分,这发生在体验层面上。这个过程用种子的比喻来描述。独创性/价值参与作为内在参与挑战了当前的工作方法,并且需要敏感性,因为患有双重诊断的母亲在到达服务时可能没有可言语表达的目标。
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引用次数: 6
Building trust and recovery capital: the professionals’ helpful practice 建立信任和恢复资本:专业人士的有益实践
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2018-04-23 DOI: 10.1108/ADD-11-2017-0022
A. Topor, Lisa Skogens, Ninive von Greiff
Purpose The possibility of recovery for persons with co-occurring addiction and mental health problems has been contested. Though, recent studies show that recovery might happen, but without connection to specific treatment interventions. The purpose of this paper is to analyse professionals’ perceptions of their contribution to improvement. Design/methodology/approach In all, 15 experienced professionals were interviewed. The interviews were analysed using thematic analysis. Findings Recovery processes were dependent of the persons’ access to different forms of recovery capital (RC). Lack of RC was often associated with lack of trust in one’s self and others (identity and personal capital). Professionals had to be accepted as trustful agents through co-creating changes in the person’s life. Trusting a professional might be a basis for trusting one’s self as an agent in one’s recovery process and develop a social network (identity and relationship capital). Other aspects stressed by the professionals were to manage their own fragmentized organisations and societal shortcomings (economic capital). Practical implications Recovery has been described as a profoundly individual journey. However, it is also deeply social, involving other persons and contextual factors. Focusing on just one level might counteract the complex work behind double recovery. Originality/value Improvement was described as dependent on the presence of personal, inter-personal, organisational and societal factors. The findings give a deep and concrete understanding of the process constituting the development of a working alliance and its dependence on factors outside the direct relation between the staff member and the person.
目的对同时存在成瘾和精神健康问题的人康复的可能性一直存在争议。然而,最近的研究表明,康复可能会发生,但与特定的治疗干预没有联系。本文的目的是分析专业人士对他们对改进的贡献的看法。设计/方法/方法总共采访了15位经验丰富的专业人士。访谈采用专题分析进行分析。研究发现,恢复过程依赖于个人获得不同形式的恢复资本(RC)。缺乏RC通常与缺乏对自己和他人(身份和个人资本)的信任有关。专业人士必须通过共同创造个人生活中的变化而被接受为值得信赖的代理人。信任专业人士可能是信任自己在恢复过程中作为代理人并发展社会网络(身份和关系资本)的基础。专业人士强调的其他方面是管理他们自己分散的组织和社会缺陷(经济资本)。实际意义康复被描述为一个深刻的个人旅程。然而,它也有很深的社会性,涉及到其他人和环境因素。只关注一个层面可能会抵消双重恢复背后的复杂工作。原创性/价值改进被描述为依赖于个人、人际、组织和社会因素的存在。调查结果对工作联盟的发展过程及其对工作人员与个人之间直接关系之外的因素的依赖有了深刻和具体的了解。
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引用次数: 22
Joining the Dots: the combined burden of violence, abuse and poverty in the lives of women 串连:妇女生活中暴力、虐待和贫穷的综合负担
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2017-12-29 DOI: 10.1108/ADD-10-2017-0019
Katharine Sacks-Jones
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引用次数: 2
Harm reduction in a Norwegian housing first project: a qualitative study of the treatment providers’ practice 挪威住房优先项目中的减少危害:对治疗提供者实践的定性研究
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2017-12-29 DOI: 10.1108/ADD-08-2017-0015
Ellen Andvig, Knut Tore Sælør, E. Ogundipe
Purpose Little is known about how harm reduction is practiced in Norwegian Housing First (HF) projects. This study’s aim was to explore, describe, and interpret how providers apply a harm reduction approach within a housing project focused on individuals who are homeless with co-morbid substance use and mental health problems. Design/methodology/approach This qualitative study was part of a larger evaluation study of a three-year HF project in a Norwegian municipality. Data were collected using four multi-stage focus groups with five providers working in the HF-project. Focus group interviews were transcribed verbatim and analysed using thematic analysis. Findings Analysis resulted in three main themes: ‘Letting the service user sit in the driver's seat’, ‘We don’t follow service provision contracts, we do everything’, and ‘Collaborating with the local community’. Research limitations/implications There is a need to develop increased knowledge about service users’ experiences within the harm reduction app...
目的在挪威住房优先(HF)项目中,人们对减少伤害的做法知之甚少。本研究的目的是探索、描述和解释提供者如何在住房项目中应用减少伤害的方法,重点关注那些同时患有药物使用和精神健康问题的无家可归者。设计/方法/方法本定性研究是挪威市政当局为期三年的HF项目的大型评估研究的一部分。数据是通过四个多阶段焦点小组收集的,其中五个提供者参与了hf项目。焦点小组访谈逐字记录,并采用专题分析进行分析。调查结果分析得出了三个主要主题:“让服务用户坐在驾驶座上”,“我们不遵循服务提供合同,我们做任何事情”,以及“与当地社区合作”。有必要在减少危害应用程序中开发更多关于服务用户体验的知识……
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引用次数: 9
Psychiatric co-morbidity among women with substance use disorders 药物使用障碍妇女的精神疾病合并症
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2017-12-29 DOI: 10.1108/ADD-11-2017-0024
A. García-Guix, J. I. Mestre-Pintó, J. Tirado-Muñoz, A. Domingo-Salvany, M. Torrens
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引用次数: 3
Narratives of recovery in people with coexisting mental health and alcohol misuse difficulties 同时存在精神健康和酒精滥用困难的人的康复叙述
IF 0.9 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2017-12-29 DOI: 10.1108/ADD-08-2017-0012
A. Stott, H. Priest
Purpose Existing literature has examined what recovery means to people with co-occurring difficulties, but does little to examine experiences of recovery as a process. This paper uses a narrative approach to explore the process of recovery as an individual journey in a social context. It focusses on people who use alcohol in order to explore the impact of alcohol’s specific cultural meanings on the recovery journey. Design/methodology/approach Ten interviews with people with coexisting mental health and alcohol misuse difficulties were conducted, audio-recorded, and transcribed. The transcriptions were analysed using narrative analysis. Findings Most participants’ narratives shared a three-part structure, from a traumatic past, through an episode of change, to an ongoing recovery phase. Change and recovery were attributed to several factors including flexible and practical support from services, therapeutic relationships with key professionals, and peer support. Some participants redefined themselves and ...
现有文献已经研究了康复对同时出现困难的人意味着什么,但很少研究康复作为一个过程的经历。本文以叙事性的方式探讨社会背景下的个体康复过程。它关注的是那些酗酒的人,以探索酒精的特定文化含义对恢复之旅的影响。设计/方法/方法对同时存在精神健康和酒精滥用问题的人进行了10次访谈,录音并转录。使用叙事分析对转录进行分析。大多数参与者的叙述都有一个三部分结构,从创伤的过去,到一段改变,再到正在进行的恢复阶段。改变和恢复归因于几个因素,包括服务的灵活和实际支持,与关键专业人员的治疗关系,以及同伴支持。一些参与者重新定义了自己……
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引用次数: 12
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Advances in Dual Diagnosis
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