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This thesis aims to shed light on the role of religious, spiritual and secular beliefs in individuals’ recovery from problematic substance use in Scotland. The findings are based on semi-structured interviews with twenty individuals, living in Scotland, who had past experience of problematic substance use. The methodology was influenced by narrative theory and the analysis drew on a thematic narrative approach. It is suggested that individuals in recovery construct personal belief systems by drawing chiefly on established cultural belief systems. Personal belief systems are learned and reinforced through practice, notably, engaging with belief-orientated communities and practising personal rituals. Participants use their personal belief systems as frameworks to interpret and give meaning to fundamental experiences that were part of their recovery. Personal belief systems are also integral to the construction of identity in recovery, helping individuals to establish a new self or reclaim an idealised past self. While personal belief systems did not often fit within neat religious, spiritual or secular categories, those with religious and/or spiritual beliefs often stressed the importance of their beliefs and associated practices to their recovery. Secular existential beliefs were also important to some people. The implications of these findings are discussed in terms of research, policy and practice.

This research addresses the question ‘How does transformative change occur in rehabilitation programmes, and how is it facilitated or constrained by contextual factors?’ The study, carried out in three community-based intensive rehabilitation projects for alcohol and drug dependent people, is designed to specify and explain change mechanisms, understood as the processes through which programme resources influence the intentional actions of participants. A critical realist theoretical frame is used, drawing on the work of Margaret Archer and John Greenwood. The study consisted of two phases: in Phase 1, fourteen client interviews and eight counsellor interviews were carried out in two treatment programmes, and these were analysed abductively to produce a set of tentative contexts, mechanisms and outcomes. Phase 2 consisted of ten theory-driven interviews (Pawson 1996) with clients in a third programme, designed to elaborate the emerging theory. An explanatory model was produced, in contexts-mechanisms-outcomes form. This showed that the institutional context of active warmth and acceptance, combined with a clear, predictable and transparent structure, allowed participants to build trust, bond with the peer group and become ready to accept and process respectful challenges to their perspective or their interpersonal behaviour. This facilitated a change in the clients’ internal conversation (Archer 2000), permitting new emotional responses and the formation of new attachments, values and commitments. The programme was seen as a place which facilitated the development of a revised personal and social identity. The study contributes to the understanding of these programmes by clarifying how participants change or fail to change. It responds to recent calls for more useful forms of evidence, to complement the sparse and equivocal experimental evidence base. The study findings have the potential to improve counsellor training and programme development.

The subjects of ‘youth’, ‘substance use’ and ‘homelessness’ are interconnected, but only a relatively small number of studies have examined the relationships between all three components. Literature highlights how homeless substance users are constructed as ‘vulnerable’ – yet ‘deviant’. Furthermore, academics have examined how people manage the ascribed identities of ‘substance user’ and ‘homeless’ as well as that of ‘youth’. According to sociologists, people’s self-identities and actions develop as a consequence of interactions with their socio-spatial worlds. Therefore, it is useful to contextualise the act of substance use within these complex interactions. This thesis explores the meanings and contexts of young, homeless people’s substance use. Data were obtained through an ethnographic study conducted in a homeless hostel over a seven month period in 2013 in which twenty-two young people (aged 16-21) and twenty-seven staff members participated. The majority of data were derived from participant-observation encompassing 200-250 informal interactions with the young people and 100-120 interactions with staff along with observations of people’s actions and descriptions of events and appearances. The field-notes were supplemented by four semi-structured interviews and a focus group, involving a total of eleven young people. Drawing on theories underpinned by symbolic interactionist and phenomenological philosophies, three overarching dimensions of the young people’s experiences were identified as important to their substance use and wider lives. First, the young people engaged in ‘place-making’ actions (including substance use) to personalise spaces within the tightly controlled environment of the hostel. Secondly, substance use was interwoven with the relationships that the young people held with their families, friends and the staff. The ‘pro-drug’ voices of their friends and relatives were arguably stronger than the ‘anti-drug’ voices of the staff. Thirdly, the categories of ‘youth’ and ‘substance user’ were recognised by the participants as pertaining to them, whereas the ‘homeless’ label was relatively meaningless. The thesis concludes that to understand people’s substance use experiences, it is important to consider the socio-spatial contexts within which they are located, particularly when these are temporary.

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