Harm reduction in a Norwegian housing first project: a qualitative study of the treatment providers’ practice

2018 ◽  
Vol 11 (1) ◽  
pp. 4-15 ◽  
Author(s):  
Ellen Sofie Andvig ◽  
Knut Tore Sælør ◽  
Esther Ogundipe
Keyword(s):  
Substance Use ◽  
Qualitative Study ◽  
Harm Reduction ◽  
Local Community ◽  
Mental Health Problems ◽  
Housing First ◽  
Professional Judgment ◽  
Content Type ◽  
Treatment Providers ◽  
Reduction Approach

Purpose Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is 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 analyzed 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 approach. Practical implications To practice effective harm reduction, treatment providers must have open authorizations and the opportunity to exercise professional judgment. Harm reduction practice must also focus on social, political, and economic factors influencing users’ everyday lives. Originality/value The paper contributes to the knowledge base on harm reduction within HF practice that differs from a traditional model wherein clients are expected to abstain from substance use. It highlights important preconditions for challenges practitioners might encounter at both individual and service system levels.

Understanding addiction, relapse and recovery amongst substance using offenders – a qualitative study informed by developmental psychological theories

2020 ◽  
Vol 20 (4) ◽  
pp. 337-352
Author(s):  
Beverly Love ◽  
Arlene Vetere ◽  
Paul Davis
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Qualitative Study ◽  
Life Events ◽  
Mental Health Problems ◽  
Later Life ◽  
Social Experiences ◽  
Content Type ◽  
Significant Life ◽  
The Impact

Purpose Psychological developmental informed theories imply that addiction is not exclusively due to the addictive properties of the substance but that early psycho-social experiences are influential on later life. The purpose of this paper is to understand substance dependency, relapse and recovery amongst community-based substance using offenders in relation to their childhoods, relationships and significant life events, from their perspective. A key aim was to help better inform policy and practice. Design/methodology/approach A qualitative study (interpretative phenomenological analysis) was used to understand the impact of childhood, relationships and significant life events amongst (N = 17) adult ex/offenders with substance use dependency problems, (who were part of the UK Government rehabilitation programme), to understand their substance use and recovery from their own perspectives. Findings Four main superordinate themes were developed illustrating participants extremely adverse childhoods. Substance use was a means to cope with current and past trauma and crises and to help manage the emotions and mental health which could accompany these difficulties. Managing recovery was about learning to manage life itself, including emotions, mental health problems, trauma/responses, relationships and everyday life. Originality/value This group is under researched where qualitative methods have been used. The study focussed on early-psycho-social experiences and relationships and the influence of these throughout the life cycle, in relation to their substance use. The study was informed by theories often used in therapeutic settings but rarely in research, (Orford, 2008; Khantzian, 2012; Flores, 2012, Van Der Kolk, 2014).

Experience of family caregivers of community-dwelling stroke survivors and risk of elder abuse: a qualitative study

2014 ◽  
Vol 16 (5) ◽  
pp. 276-293 ◽  
Author(s):  
Celia Chow ◽  
Agnes Tiwari
Keyword(s):  
Qualitative Study ◽  
Family Caregivers ◽  
Local Community ◽  
Service Providers ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Content Type ◽  
The Disabled ◽  
Personal Resilience

Purpose – The purpose of this paper is to explore the following questions. First, what are the experiences of family caregivers in caring for community-dwelling stroke survivors? Second, what services help or do not help the caregivers in managing their caregiving role? Design/methodology/approach – A qualitative study was conducted with a total of six focus group interviews with 29 stroke caregivers selected using convenience sampling in a local community centre. All interviews were recorded and transcribed for content analysis. Findings – The results pointed to three main themes working together to facilitate desirable outcomes in caregiving and prevent elder abuse: factors contributing to caregiver stress and factors that have a buffering effect on caregiver stress and unmet needs identified from caregivers’ experiences. Research limitations/implications – The authors found that there were a number of factors contributing to caregiver stress. The findings matched with the concept that caregiver stress should not be considered as the primary cause of elder abuse. Findings provided information for further research to investigate positive coping and adjustment for stroke survivors, caregivers and their families. Practical implications – Policy makers and service providers may consider specific policies and tailor-made services to enhance the effectiveness of current practice. The themes emerging from the study could be further reviewed in a longitudinal way to explore the cost-effectiveness, the outcomes and trajectory of interventional programmes. Social implications – Education would be essential to let the public understand caregivers’ difficulties and needs. Prevention of elder abuse may be approached with a range of risk factors for both perpetrating and being elder abuse victim. Originality/value – From the findings of the study, the authors found that there were service gaps within policy and interventions. Concrete suggestions for improving the public's attitude and public facilities/transport for the disabled were captured in the study. In addition to personal resilience, caregivers had a strong wish for a supportive environment and services that would facilitate a better caregiving outcome.

scholarly journals Substance use Treatment and Harm Reduction Services for Migrants and Refugees in the COVID-19 Pandemic: Findings from a Global Survey

2020 ◽  
Author(s):  
Cornelis De Jong ◽  
Ali Farhoudian ◽  
Mehrnoosh Vahidi ◽  
Mohsen Ebrahimi ◽  
Hamed Ekhtiari ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Substance Use Disorders ◽  
Mental Health Problems ◽  
World Health ◽  
Substance Use Treatment ◽  
Second Phase ◽  
Addiction Medicine ◽  
Global Survey ◽  
The Impact

Abstract Migrants and refugees are considered vulnerable to mental health problems and substance use disorders; and may be particularly affected by service disruptions associated with the COVID-19 pandemic The International Society of Addiction Medicine (ISAM) ran a multi-phased global survey among clinicians and health professional that are actively working in the field of addiction medicine to investigate the impact of the COVID-19 pandemic on substance use and related services. In March 2020, the first month after the announcement of the pandemic by the World Health Organization, 177 informants from 77 countries took part in the global survey, and only 12.9% of them reported their countries’ substance use treatment and harm reduction services for the migrants and refugees with substance use disorders continued as usual. In May 2020, 11.7% of respondents of the second phase reported that the services for refugees and migrants improved in comparison to March 2020; 11.7% reported that these services in their country discontinued. Results suggest that refugee and migrants access to treatment and harm reduction services has been reduced as a result of COVID-19. It can be concluded that it is crucial to improve the visibility of migrants’ needs and exploit appropriate interventions for those with substance use disorders.

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

2021 ◽  
Vol 23 (1) ◽  
pp. 39-52
Author(s):  
Michele Schmitter ◽  
Jeroen Vermunt ◽  
Eric Blaauw ◽  
Stefan Bogaerts
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Latent Class ◽  
Mental Health Problems ◽  
Treatment Approach ◽  
Future Research ◽  
Content Type ◽  
Forensic Patients ◽  
Axis I ◽  
Forensic Psychiatric

Purpose Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.

What is the host community perception of slum tourism in Colombia?

2019 ◽  
Vol 11 (2) ◽  
pp. 140-146
Author(s):  
María Dolores Herrero Amo ◽  
Chandana (Chandi) Jayawardena ◽  
Salomé Laloum Gaultier
Keyword(s):  
Qualitative Study ◽  
Design Methodology ◽  
Local Community ◽  
Host Community ◽  
Community Perception ◽  
Positive Perception ◽  
Structured Interviews ◽  
Content Type ◽  
Slum Tourism ◽  
Research Questions

Purpose This paper aims to find answers to two research questions: What is the perception of the Moravia community on tourism in their neighbourhood? What are the conditions under which they can accept slum tourism? Design/methodology/approach The foundation of this paper was laid during a field trip to Medellin, Colombia, in March 2018. More than three weeks were spent in the neighbourhood of Moravia, one of Medellin’s “barrios” or slums, where a qualitative study was led. Semi-structured interviews with the local community were done around the neighbourhood. Findings The main finding of this research is the positive perception of slum tourism within the Moravia community. The researchers found that the locals are proud when outsiders visit to see their neighbourhood. The locals felt that, it breaks the prejudice surrounding their homes, and tourists are seen as spokespeople for the barrio. There are visible improvements made to the barrio owing to tourism. This research drew attention to the conditions under which this type of tourism can be accepted in the neighbourhood: community participation, interaction between hosts and tourists, education and respect of tourists and the visible improvements to the neighbourhood. Originality/value Slum tourism is an understudied topic in Colombia, especially in Medellin. By researching on the host perception on slum tourism, this paper contributes to literature on slum tourism from a new angle.

Managed alcohol programs in the context of Housing First

2019 ◽  
Vol 22 (4) ◽  
pp. 207-215 ◽  
Author(s):  
Rebecca Schiff ◽  
Bernie Pauly ◽  
Shana Hall ◽  
Kate Vallance ◽  
Andrew Ivsins ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Support Services ◽  
Housing First ◽  
Content Type ◽  
Treatment Models ◽  
Key Characteristics ◽  
Services And Supports ◽  
Alcohol Harm Reduction ◽  
Alcohol Programs

Purpose Recently, Managed Alcohol Programs (MAPs have emerged as an alcohol harm reduction model for those living with severe alcohol use disorder (AUD) and experiencing homelessness. There is still a lack of clarity about the role of these programs in relation to Housing First (HF) discourse. The authors examine the role of MAPs within a policy environment that has become dominated by a focus on HF approaches to addressing homelessness. This examination includes a focus on Canadian policy contexts where MAPs originated and are still predominately located. The purpose of this paper is to trace the development of MAPs as a novel response to homelessness among people experiencing severe AUD and to describe the place of MAPs within a HF context. Design/methodology/approach This conceptual paper outlines the development of discourses related to persons experiencing severe AUD and homelessness, with a focus on HF and MAPs as responses to these challenges. The authors compare the key characteristics of MAPs with “core principles” and values as outlined in various definitions of HF. Findings MAPs incorporate many of the core values or principles of HF as outlined in some definitions, although not all. MAPs (and other housing/treatment models) provide critical housing and support services for populations who might not fit well with or who might not prefer HF models. Originality/value The “silver bullet” discourse surrounding HF (and harm reduction) can obscure the importance of programs (such as MAPs) that do not fully align with all HF principles and program models. This is despite the fact that MAPs (and other models) provide critical housing and support services for populations who might fall between the cracks of HF models. There is the potential for MAPs to help fill a gap in the application of harm reduction in HF programs. The authors also suggest a need to move beyond HF discourse, to embrace complexity and move toward examining what mixture of different housing and harm reduction supports are needed to provide a complete or comprehensive array of services and supports for people who use substances and are experiencing homelessness.

The construction of audit partner’s judgment

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Alia MILEDI
Keyword(s):  
Qualitative Study ◽  
Social Practice ◽  
Design Methodology ◽  
Point Of View ◽  
Social Dimension ◽  
Professional Judgment ◽  
Auditor Judgment ◽  
Content Type ◽  
Audit Judgment ◽  
The Social

Purpose The purpose of this study is to explore the social and collective foundations of the auditor’s judgment and specifically highlights that the dialogical dimension of auditors’ judgment is founded on both their interactions with their auditees and their interactions with their colleagues. Design/methodology/approach This qualitative study is based on interviews with 22 audit partners, conducted between March 2013 and October 2016, in France. Findings The research points out the complexity of auditor judgment. Confronted with issues such as equivocal and ambiguous circumstances, auditors must question the relevance of the meanings elaborated to act according to the situation (self-criticism or doubt) and must be wise and not be overconfident toward the information provided by the manager (wisdom). Last but not least, the findings also suggest that contrary advice helps auditors to improve an alternative point of view and hence reach a consensus. Originality/value The research uses a K. Weick sensemaking approach and contributes theoretically to gaining deeper understanding of the social dimension in audit judgment, by showing that professional judgment is an interactive and social practice.

Exploring the impact of the recovery academy: a qualitative study of Recovery College experiences

2016 ◽  
Vol 11 (3) ◽  
pp. 162-171 ◽  
Author(s):  
Elisabeth Zabel ◽  
Grace Donegan ◽  
Kate Lawrence ◽  
Paul French
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Subjective Experience ◽  
Mental Health Problems ◽  
Positive Impact ◽  
Organisational Change ◽  
Evidence Base ◽  
Content Type ◽  
Using Data ◽  
The Impact

Purpose – Recovery Colleges strive to assist individuals in their journey of recovery and help organisations to become more recovery focused. The evidence base surrounding Recovery Colleges is still in its infancy and further research is required to investigate their effectiveness. The purpose of this paper is to explore the subjective experience of people involved with a Recovery College: “The Recovery Academy” based in Greater Manchester. Design/methodology/approach – A qualitative study using data collected from four focus groups of Recovery Academy students who have either lived experience of mental health problems, are health professionals or are family members or carers. The data were analysed using thematic analysis. Findings – Four main themes emerged from discussing experiences of the Recovery Academy and its courses: ethos of the Recovery Academy; personal and organisational impact; value of co-production; and barriers to engagement and impact. The Recovery Academy can have a positive impact on the lives of students who attend the courses and offer benefits to the organisation in which it is run. Originality/value – Recovery Colleges are gaining large interest nationally. However, to date there is a paucity of research on Recovery Colleges. This is the first paper to be presented for publication specifically on the Recovery Academy. The findings of this study suggest Recovery Colleges have the potential to positively impact students and facilitate recovery oriented organisational change. The findings can add valuable data to the emerging Recovery College evidence base.

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