Integrated treatment of dual disorders in The Netherlands: a qualitative study of client experiences

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Anneke van Wamel ◽  
Ankie Lempens ◽  
Arjen Neven
Keyword(s):  
Mental Health Problems ◽  
Recovery Process ◽  
Integrated Treatment ◽  
Dual Disorders ◽  
Content Type ◽  
Client Experiences ◽  
Organisation Of Care ◽  
Qualitative Thematic Analysis ◽  
Treatment Models ◽  
Dual Disorder

Purpose Many clients who suffer from severe mental health problems also struggle with alcohol and drug use. And although there seems to be a consensus in most European countries that integrated treatment models (especially the integrated treatment of dual disorder clients model) are best fitted to help these clients, none of these have strong evidence, mostly owing to methodological limitations in the studies. This study aims to contribute to the knowledge of why integrated treatment is helpful by conducting in-depth interviews with dual disorder clients who are currently receiving integrated treatment. Design/methodology/approach This study is a qualitative thematic analysis using a timeline tool to elicit participants’ responses. In the interviews, dual diagnosis clients with severe problems reflected on their situation at admission, the care they received in integrated treatment and their opinions on positive and negative elements. The interviews were coded and analysed with MAXQDA. Findings In the analyses of the interviews, this study found three clusters of elements that clients indicated were the most helpful during their treatment and recovery process: trusting and meaningful relationship with the team, components of integrated treatment and organisation of care. Originality/value The findings emphasized the importance of working relationship in the treatment of complex and long-term problems. This has implications for the evaluation of these integrated treatment models which so far mainly focuses on specific interventions.

scholarly journals Building trust and recovery capital: the professionals’ helpful practice

2018 ◽  
Vol 11 (2) ◽  
pp. 76-87 ◽  
Author(s):  
Alain Topor ◽  
Lisa Skogens ◽  
Ninive von Greiff
Keyword(s):  
Mental Health Problems ◽  
Specific Treatment ◽  
Recovery Process ◽  
Treatment Interventions ◽  
Content Type ◽  
Societal Factors ◽  
Recovery Processes ◽  
Personal Capital ◽  
Recovery Capital ◽  
Relationship Capital

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.

Counseling Clients with Dual Disorders: Information for Rehabilitation Counselors

1999 ◽  
Vol 30 (3) ◽  
pp. 3-10 ◽  
Author(s):  
Jhan D. Doughty ◽  
Brandon Hunt
Keyword(s):  
Substance Dependence ◽  
Psychotic Disorders ◽  
Rehabilitation Counseling ◽  
Chemical Dependency ◽  
Integrated Treatment ◽  
Future Research ◽  
Dual Disorders ◽  
Rehabilitation Programs ◽  
Dual Disorder ◽  
Counseling Clients

Persons with dual disorders of psychiatric illness and substance dependence represent a significant portion of clients in mental health, chemical dependency, and/or other rehabilitation programs. Several psychiatric disorders are commonly found in persons with coexisting substance dependence disorders, including anxiety and mood disorders, psychotic disorders, and personality disorders. In this paper, dual disorder classifications are discussed as well as information on the prevalence of each disorder. The differing views regarding dual disorders treatment are presented, as well as the models used in chemical dependency, psychiatric, and integrated treatment settings. Implications for rehabilitation counseling and future research needs are also addressed.

scholarly journals “It’s way more than just writing a prescription”: A qualitative study of preferences for integrated versus non-integrated treatment models among individuals with opioid use disorder

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Elizabeth C. Saunders ◽  
Sarah K. Moore ◽  
Olivia Walsh ◽  
Stephen A. Metcalf ◽  
Alan J. Budney ◽  
...  
Keyword(s):  
Qualitative Study ◽  
The United States ◽  
Opioid Use Disorder ◽  
Integrated Treatment ◽  
Medical Setting ◽  
Integrated Models ◽  
Opioid Use ◽  
Medical Settings ◽  
Psychosocial Services ◽  
Treatment Models

Abstract Background Increasingly, treatment for opioid use disorder (OUD) is offered in integrated treatment models addressing both substance use and other health conditions within the same system. This often includes offering medications for OUD in general medical settings. It remains uncertain whether integrated OUD treatment models are preferred to non-integrated models, where treatment is provided within a distinct treatment system. This study aimed to explore preferences for integrated versus non-integrated treatment models among people with OUD and examine what factors may influence preferences. Methods This qualitative study recruited participants (n = 40) through Craigslist advertisements and flyers posted in treatment programs across the United States. Participants were 18 years of age or older and scored a two or higher on the heroin or opioid pain reliever sections of the Tobacco, Alcohol, Prescription Medications, and Other Substances (TAPS) Tool. Each participant completed a demographic survey and a telephone interview. The interviews were coded and content analyzed. Results While some participants preferred receiving OUD treatment from an integrated model in a general medical setting, the majority preferred non-integrated models. Some participants preferred integrated models in theory but expressed concerns about stigma and a lack of psychosocial services. Tradeoffs between integrated and non-integrated models were centered around patient values (desire for anonymity and personalization, fear of consequences), the characteristics of the provider and setting (convenience, perceived treatment effectiveness, access to services), and the patient-provider relationship (disclosure, trust, comfort, stigma). Conclusions Among this sample of primarily White adults, preferences for non-integrated versus integrated OUD treatment were mixed. Perceived benefits of integrated models included convenience, potential for treatment personalization, and opportunity to extend established relationships with medical providers. Recommendations to make integrated treatment more patient-centered include facilitating access to psychosocial services, educating patients on privacy, individualizing treatment, and prioritizing the patient-provider relationship. This sample included very few minorities and thus findings may not be fully generalizable to the larger population of persons with OUD. Nonetheless, results suggest a need for expansion of both OUD treatment in specialty and general medical settings to ensure access to preferred treatment for all.

Mental health and stigma in Saudi Arabia: a scoping review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nada Alattar ◽  
Anne Felton ◽  
Theodore Stickley
Keyword(s):  
Mental Health ◽  
Saudi Arabia ◽  
Scoping Review ◽  
Mental Health Problems ◽  
Cultural Beliefs ◽  
Relevant Literature ◽  
Mental Health Stigma ◽  
Health Issues ◽  
Content Type ◽  
Mental Health Issues

Purpose Stigma associated with mental health problems is widespread in the Kingdom of Saudi Arabia (KSA). Consequently, this may prevent many Saudi people from accessing the mental health-care services and support they need. The purpose of this study is to consider how stigma affects people needing to access mental health services in the KSA. To achieve this aim, this study reviews the knowledge base concerning stigma and mental health in KSA and considers specific further research necessary to increase the knowledge and understanding in this important area. Design/methodology/approach This review examines the relevant literature concerning mental health stigma and related issues in KSA using the Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses frameworks. As a scoping review, it has used a systematic approach in literature searching. The results of the search were then thematically analysed and the themes were then discussed in light of the concepts of stigma and mental health. Findings Stigma around mental health impedes access to care, the nature of care and current clinical practice in the KSA. The voices of those with mental health issues in KSA are almost entirely unrepresented in the literature. Originality/value The review identifies that mental health stigma and cultural beliefs about mental health in KSA may act as barriers to accessing services. The voice of mental health service users in KSA remains largely unheard. If public discussion of mental health issues can increase, people’s experiences of accessing services may be improved.

scholarly journals Why service recovery fails

2009 ◽  
Vol 20 (3) ◽  
pp. 253-273 ◽  
Author(s):  
Stefan Michel ◽  
David Bowen ◽  
Robert Johnston
Keyword(s):  
Customer Satisfaction ◽  
Service Failure ◽  
Human Resources Management ◽  
Service Recovery ◽  
Recovery Process ◽  
Content Type ◽  
Information Recovery ◽  
Service Logic ◽  
Recovery Management ◽  
A Company

PurposeThe keys to effective service recovery are familiar to many throughout industry and academia. Nevertheless, overall customer satisfaction after a failure has not improved, and many managers claim their organizations cannot respond to and fix recurring problems quickly enough. Why does service recovery so often fail and what can managers do about it? This paper aims to address these issues.Design/methodology/approachThe objective is to produce an interdisciplinary summary of the growing literature on service recovery, bringing together what each of the author's domain – management, marketing, and human resources management – has to offer. By contrasting those three perspectives using 141 academic sources, nine tensions between customer, process, and employee recovery are discovered.FindingsIt is argued that service recovery often fails due to the unresolved tensions found between the conflicting perspectives of customer recovery, process recovery, and employee recovery. Therefore, successful service recovery requires the integration of these different perspectives. This is summarized in the following definition: “Service recovery are the integrative actions a company takes to re‐establish customer satisfaction and loyalty after a service failure (customer recovery), to ensure that failure incidents encourage learning and process improvement (process recovery) and to train and reward employees for this purpose (employee recovery).”Practical implicationsManagers are not advised to directly address and solve the nine tensions between customer recovery, process recovery, and employee recovery. Instead, concentrating on the underlying cause of these tensions is recommended. That is, managers should strive to integrate service recovery efforts based upon a “service logic”; a balance of functional subcultures; strategy‐driven resolution of functional differences; data‐based decision making from the seamless collection and sharing of information; recovery metrics and rewards; and development of “T‐shaped” employees with a service, not just functional, mindset.Originality/valueThis paper provides an interdisciplinary view of the difficulties to implement a successful service recovery management. The contribution is twofold. First, specific tensions between customer, process and employee recovery are identified. Second, managers are offered recommendations of how to integrate the diverging perspectives.

Hitting the right note for child and adolescent mental and emotional wellbeing: a formative qualitative evaluation of Sistema Scotland’s “Big Noise” orchestral programme

2016 ◽  
Vol 15 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Christopher Harkins ◽  
Lisa Garnham ◽  
Aileen Campbell ◽  
Carol Tannahill
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Early Stage ◽  
Qualitative Evaluation ◽  
Qualitative Assessment ◽  
Potential Contribution ◽  
Emotional Wellbeing ◽  
Structured Interviews ◽  
Content Type ◽  
Causal Pathways

Purpose – Previous research emphasises the need for preventative interventions to reduce mental health problems among disadvantaged children and adolescents. There is however little consensus concerning the delivery and impacts of such interventions particularly non-clinical, arts-based models delivered within community settings. The purpose of this paper is to begin to address this deficit through a qualitative assessment of the short- to medium-term impacts to participants’ mental and emotional wellbeing within Sistema Scotland’s Big Noise orchestral programme. Design/methodology/approach – Semi-structured interviews, observation, participant drawing exercise, participatory filmmaking, focus group and analysis of programme engagement were undertaken to examine the mental and emotional wellbeing impacts of the programme which are observable at this early stage of programme delivery and participants’ lives. Findings – The qualitative findings indicate that participation in the Big Noise programme enhances participant mental and emotional wellbeing in three ways; first, the happiness and enjoyment of taking part in the programme and orchestra, particularly from music making; second, the security, belonging and relationships fostered through participation; the quality of musician/participant relationship is important here as is programme design which enables support, routine and structure; and third, increased pride, confidence and self-esteem, as a result of acquiring difficult musical skills, receiving regular praise and having frequent opportunities to demonstrate these acquired skills through regular orchestral performances. Originality/value – There is little evidence or understanding of community-based, preventative, arts interventions like Big Noise: their delivery, their life-course impacts and their potential contribution to mental health and to addressing social and health inequalities. The causal pathways in the field are under-theorised. These early findings are important as they serve as an important basis from which to consider the programme’s wider and longer term impacts, which will be assessed through an on-going longitudinal, mixed method summative evaluation.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

Football teams for people with intellectual disabilities living in the community: “it helps your self-esteem and that, don’t it?”

2017 ◽  
Vol 8 (4) ◽  
pp. 201-211 ◽  
Author(s):  
Rose White ◽  
Katherine Lister ◽  
Kristian Northend ◽  
Stephen Moore ◽  
Kelly Rayner
Keyword(s):  
Intellectual Disabilities ◽  
Personal Growth ◽  
Interpretative Phenomenological Analysis ◽  
Mental Health Problems ◽  
Well Being ◽  
Training Programme ◽  
Social Emotional ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Football Training

Purpose People with intellectual disabilities (ID) can be vulnerable to developing mental health problems. It has been found that participating in regular exercise can help to improve emotional well-being, both in typically developing people and those with ID. The purpose of this paper is to investigate the experiences of community clients with ID who have engaged in a football training programme, and the perceived impacts on attitudes, mood and behaviour. Design/methodology/approach Interviews with seven patients from generic or forensic community ID services were conducted. The transcripts were analysed using interpretative phenomenological analysis. Findings Two master themes were identified from the interviews, “Striving” and “Togetherness”. Originality/value The most important factors related to taking part in the football programme were the social, emotional and personal growth associated with being part of a team and general enjoyment of being part of something. Although aspects of football knowledge and physical fitness were still evident, their impact seemed to be less significant. The experience of football was overwhelmingly positive.

scholarly journals An integrated social response to disasters: the case of the Indian Ocean tsunami in Sri Lanka

2016 ◽  
Vol 25 (5) ◽  
pp. 595-610 ◽  
Author(s):  
Siri Hettige ◽  
Richard Haigh
Keyword(s):  
Sri Lanka ◽  
Indian Ocean ◽  
Disaster Recovery ◽  
Mode Of Delivery ◽  
Recovery Process ◽  
Qualitative Assessment ◽  
Indian Ocean Tsunami ◽  
Content Type ◽  
The Indian Ocean ◽  
The Impact

Purpose The impact of disasters caused by natural hazards on people in affected communities is mediated by a whole range of circumstances such as the intensity of the disaster, type and nature of the community affected and the nature of loss and displacement. The purpose of this paper is to demonstrate the need to adopt a holistic or integrated approach to assessment of the process of disaster recovery, and to develop a multidimensional assessment framework. Design/methodology/approach The study is designed as a novel qualitative assessment of the recovery process using qualitative data collection techniques from a sample of communities affected by the Indian Ocean tsunami in Eastern and Southern Sri Lanka. Findings The outcomes of the interventions have varied widely depending on such factors as the nature of the community, the nature of the intervention and the mode of delivery for donor support. The surveyed communities are ranked in terms of the nature and extent of recovery. Practical implications The indices of recovery developed constitute a convenient tool of measurement of effectiveness and limitations of external interventions. The assessment used is multidimensional and socially inclusive. Originality/value The approach adopted is new to post-disaster recovery assessments and is useful for monitoring and evaluation of recovery processes. It also fits into the social accountability model as the assessment is based on community experience with the recovery process.

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