Despite the fact that a lot of information exist in the literature regarding factors leading to drug abuse, consequences of drug abuse for adolescents; little exists that focuses on family support for adolescents after rehabilitation. The purpose of this study was to explore family support for adolescents after rehabilitation for drug abuse. The study was based on semi-structured interview based qualitative research. Findings during interviews was that the families have no clear understanding or are not skilled as to how to continue supporting the adolescents after they are discharged from the rehabilitation centre. What was also interesting according to the participants was that even in the rehabilitation centres families are not made part of or involved during the rehabilitation process. There is a need to make the rehabilitation centres aware that families need to be involved during the rehabilitation process of the adolescent so that it becomes easy for the families to continue supporting the adolescents after they have completed the rehabilitation process. / Health Studies / M.A. (Health Studies)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Nesta pesquisa, a toxicomania não é sinônimo de dependência de uma substância psicoativa, e sim, é compreendida como uma relação intensa e exclusiva, em que o uso de drogas se estabelece também como uma função na vida psìquica. Este trabalho se propõe analisar os deslizamentos na demanda de tratamento por parte do toxicômano, ao longo do internamento voluntário. Tem como objetivos especìficos: identificar as especificidades da entrada do toxicômano em uma instituição de tratamento; investigar os destinos da demanda no percurso do internamento; situar o modo de manejo do lugar institucional na prática clìnica com toxicômanos; e articular os vieses do encontro - entre toxicômano e instituição - com o discurso em voga na pós-modernidade. O cerne da investigação é averiguar os efeitos singulares da escuta psicanalìtica no âmbito institucional, em favor da subversão do sujeito. Se para o toxicômano a droga participa como uma destituição do sujeito, ao apresentar-se colado, falando de si, somente a partir do uso que faz da droga, a via indicada consiste em ofertar palavras. A direção do tratamento, ao buscar ouvir a função tóxica da droga, ao invés de tão somente ocupar-se com o uso ou não uso de uma substância psicoativa, pode possibilitar que o sujeito que atua com sua toxicomania encontre espaço para um deslize significante, e que seja possìvel colocar em trabalho o seu modo de gozo. Portanto, uma instituição engajada na clìnica da toxicomania precisa estar duplamente advertida de sua função: primeiro, esquivar-se do modelo de instituição consonante com os princìpios pós-modernos, que exaltam o excesso de gozo e o apagamento do limite; e segundo, deve saber que é só ao preço de conseguir suportar o lugar do impossìvel que ela configura-se como um lugar possìvel de endereçamento. A pesquisa foi realizada no Instituto RAID, uma Organização Não Governamental, que segue a orientação psicanalìtica em seu manejo clìnico-institucional e trabalha na prevenção e tratamento de pessoas de ambos os sexos que, voluntariamente, optam por acompanhamento devido a problemas relacionados ao uso abusivo ou dependência de álcool e outras drogas. Participaram desta pesquisa, toxicômanos em tratamento, albergados integralmente na instituição. Por meio de entrevistas buscou-se percorrer os sentidos que a toxicomania evoca, e refletir as especificidades dessa Clìnica. Na articulação com os casos é possìvel reconhecer a singular significação e representação do uso de drogas na toxicomania, um dos modos de lidar com o mal-estar ao investir no tóxico como solução real para a subjetivação. Tais deslocamentos promovidos pelo sujeito que se nomeia toxicômano e traz como queixa seu uso de drogas pode no curso do internamento voluntário consentir em perceber a função que o tóxico ocupa em sua vida psìquica, e implicar-se nisso. A voluntariedade no tratamento é um componente ético fundamental, na medida em que, somente a partir da disponibilidade de cada sujeito será possìvel a construção de novos itinerários para o seu próprio desejo.

This study aimed to analyze statements made by professional practitioners and clients in verdicts related to compulsory drug treatment. The statements were examined in order to illustrate their contribution to the social construction of drug addicts. The study also aimed to address the power professionals have over individuals with drug problems. The data consisted of twelve verdicts obtained from administrative courts located in three different geographical areas in Sweden. Based on a qualitative approach we used a critical discourse analysis as a framework for the examination of vocabulary and sentence structures. The findings were further examined through a social constructivist approach and power theories. The results showed how all parties in the verdict can contribute to the social construction of drug addicts through substantial information that is given as well as the use of additional terms and discursive words. Themes and patterns identified within the statements showed how the clients’ life situation were described in terms of homelessness, unemployment, mental illness and crime. The results also showed that the clients were described as either responsible for or victimized by the drugs, a description that has a high impact on how the clients are subsequently perceived. It was also prominent that the professional statements, compared to the client’s, enjoyed higher degrees of credibility. The professional statements were also more often perceived as true due to the choice of words and structures of the sentences. Consequently, we could illustrate how professionals by the authority granted by their job title are given the power to depict and affect the social construction of drug addicts as a group.

Syftet med denna studie var att svara på hur personer med ett icke aktivt spelberoende beskriver sin situation som spelberoende. Studien bygger på fem intervjuer som transkriberades och analyserades sedan med hjälp av en innehållsanalys. Analysen bygger på tidigare forskning och teorin the defining moment av Devine och Sparks (2014) samt Beckers (2006) avvikelseteori. Resultatet presenteras med hjälp av teman och kategorier. Studiens resultat visar att samtliga respondenter upplevde negativa konsekvenser till följd av spelandet. Konsekvenserna kunde visa sig ekonomiskt, hälsomässigt, socialt, arbetsmässigt samt påverkade även respondenternas närstående. Vidare framkom att samtliga respondenter ägnade en stor del av sin tid till att spela. Motivation var en stor faktor till att respondenterna till slut lyckades med sitt utträde ur spelberoendet. / The purpose of this study was to answer how people with a non-active gambling addiction described their situation as gambling addicts. The study is based on five interviews that were transcribed and then analyzed using a content analysis. The analysis is based on previous research and the theory the defining moment by Devine and Sparks (2014) aswell as Becker (2006) theory about outsiders. The result is presented with the help of themes and categories. The study results show that all respondents experienced negative consequences as a result of gambling. The consequences could prove economically, health, social, at the workplace and also affected the respondents relatives. Furthermore, it was found that all respondents spent a great deal of their time playing. Motivation was a major factor in the fact that the respondents eventually managed to withdraw from the game addiction.

Substance abuse and dependence causes many problems in our society. Attachment style may be useful in the etiology of this problem. Using archival data, this study hypothesizes men in a court-ordered facility will be more likely to have an insecure attachment style. The participants were 73 males ages 18-49. The Adult Attachment Scale (AAS) was used to measure adult romantic attachment style. Through cluster analysis and conversion of the subscales of the AAS, four attachment styles were measured. Men were more likely to have an insecure attachment style especially a Fearful style. The study concludes with limitations of the results and a discussion about possible interventions based on attachment style.

The purpose of this study was to determine what influence scheduled phone contacts would have on the extent of follow-through of continuing care recommednations by participants after treatment. Continuing care recommendations associated with ongoing sobriety include going to another level of care (individual therapy, group therapy, outpatient treatment), attending twelve-step meetings and communicating with a sponsor. Continuing care recommendations are typically written and referred to as a continuing care plan.

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child. While a preponderance of the drug dependence research is adult-centric, a significant body of research demonstrates the importance of not only addressing the immediate well being of the children of drug dependent caregivers but preventing the continuing cycle of drug dependence. The present commentary demonstrates through a brief review of the US history of drug dependence crises and research from the 1980s and 1990s, a range of “tried and true” family, school, and community interventions centered on children. We already know that these children are at high risk of maladjustment and early onset of drug dependence; early intervention is critical; multiple risk factors are likely to occur simultaneously; comprehensive strategies are optimal; and multiple risk-focused strategies are most protective. Where we need now to turn our efforts is on how to effectively implement and disseminate best practices, many of which we learned in the 1980s and 1990s. The greatest opportunity in both changing the nature of the opioid epidemic at scale and influencing rapid translation of existing research findings into policy and practice is not in asking what to do, but in asking how to do the right things well, and quickly.

Syftet med studien var att utifrån behandlarnas erfarenhet på HVB-hem undersöka hur motiverande samtal som ett hälsofrämjande pedagogiskt verktyg är användbart inom missbruksvården för barn och ungdomar på individ- och gruppnivå. I studien speglas teoretiska utgångspunkter såsom hälsa som kontinuum och Illeris lärandemodell, detta bidrog till att kopplingar kunde dras mellan resultatet och teorierna. Fortsättningsvis genomfördes semistrukturerade intervjuer med fem olika behandlare som arbetar i olika kommuner på HVB-hem för barn och ungdomar med missbruksproblematik. Studiens resultat visade på att det kan bli svårigheter med motiverande samtal på gruppnivå eftersom det kan bidra till att passiva klienter blir desto mer passiva, vilket inte hjälper deras beteendeförändring. Resultatet visade även på att en ungdom lätt kan ta på sig ledarrollen vilket kan påverka utbyte av erfarenheter och därav hindrar lärandet. Däremot visade resultatet att motiverande samtal på individnivå kan bidra till motivation, självinsikt och individuellt lärande som således kan leda till hälsosamma livsstilsförändringar. Fortsättningsvis visade resultatet vikten av hur behandlaren stöttar individen under processen för att beteendeförändring ska bli lyckad. Slutsatsen som dras är att motiverande samtal som metod på individnivå är en fungerande metod på ungdomar som vill komma ifrån sitt missbruk och påbörja en livsstilsförändring. För att motiverande samtal på gruppnivå ska fungera som ett pedagogiskt verktyg krävs en tydlig struktur och en god relation till barn ungdomar. / The purpose of this study was to examine how therapist’s working at HVB homes in Sweden experience motivational conversations as a health-promoting pedagogical tool is useful in substance abuse care for children and young people at individual- and group level. The study reflects various theoretical starting points, such as health as a continuum and Illeri's learning model, which contributed to the fact that connections could be drawn between the results and the theories. Semi-structured interviews were conducted with five different therapists who works in different municipalities at HVB homes for children and young people with substance abuse problems. There may be difficulties with motivated conversations at group level because it can contribute to passive clients becoming all the more passive, which does not help their behavior change. The results also showed that a young person can easily take on the leadership role, which can affect the exchange of experiences and inhibit the learning. On the other hand, the results showed that motivational conversations at individual level can contribute to motivation, self-insight and individual learning, which can thus lead to healthy lifestyle changes. Furthermore, the results showed the importance of how the therapist supports the individual during the process for behavior change to be successful. The conclusion that is drawn is that motivational conversation as a method at the individual level is a working method for young people who want to be free from their addiction and start a lifestyle change. In order for motivational conversations at group level to function as a pedagogical tool, a clear structure and a good relationship with the children and young people is required.

The history of heroin use disorder intervention has been characterised by fads and fashions. Some of the treatments that have been used have been, at best ineffective, and at worst harmful, and occasionally even dangerous. It is a sad reflection upon the field that practices and procedures for the treatment of heroin use disorders can so easily be introduced and applied without (or even contrary to) evidence. In South Africa, the field of heroin use disorder intervention has been `in transition' since the outbreak of the heroin epidemic. Yet despite growing evidence of an association between heroin dependents use of supplementary intervention services (such as psychosocial and pharmacological/medical care) and intervention outcomes, and the fact that international emerging standards for substance use disorder intervention have called upon treatment intervention providers to enhance traditional substance use disorder services with services that address clients' psychological and social needs, heroin use disorder intervention programmes in South Africa generally fail to meet these research-based intervention standards. Much of what is currently delivered as intervention is based upon current best guesses of how to combine some science-based (for example, cognitive-behavioural therapy and pharmacotherapies) and self-help (12-step programmes) approaches into optimal intervention protocols. As progression is made in the twenty-first century, scientific information is now beginning to be used to guide the evolution and delivery of heroin use disorder care internationally. Regrettably, a scarcity of heroin use disorder intervention research is noted in South Africa. The present study delved into the insights of ten heroin use disorder specialists, and synthesised the findings with the results of a previous study undertaken by the author relating to forty long-term voluntarily abstinent heroin dependents. In terms of theory and practice, findings of the study suggest that the field is less in transition now than it was in 1995. It is an imperative that law-enforcement action be followed by an integrated programme of psychological, social and pharmacological outreach. These programmes will have to be expanded to address new demands and will need to include specialised skills training. Many interventions and procedures have begun to be integrated routinely into clinical practice. / Psychology / (D. Phil. (Psychology))

In South Africa, substance use, abuse and dependency is twice the world norm. To address this trend, the continuum of care guides legislative prescriptions for the treatment of a substance use disorder. This study aimed to address the lack of a description of the utilisation thereof in literature and recent research findings. A qualitative approach was followed and purposive sampling was employed to collect data from both service providers and users of services. Tesch’s framework for qualitative data analysis (Creswell, 2014:218) was used to identify themes, sub-themes and categories, while the data was compared with existing literature on the identified themes. The trustworthiness of the findings was enhanced by the verification of the data through aspects of credibility/authenticity, transformability, dependability and conformability (Schurink, Fouché and de Vos, 2011:397). Informed consent, confidentiality , non-compensation, debriefing of participants, and the management of information were considered to ensure ethical practice. / Social Work / M.A.(S.S.)