Both employers and out-patient treatment centres are key role players in addressing workplace related substance abuse. On the one hand, employers are directly and indirectly affected by the huge problem of substance abuse. On the other hand, out-patient treatment centres provide, as their core goal, for the treatment of substance abuse and dependency. Due to the extent of the problem of substance abuse, collaborative intervention measures between employers and out-patient treatment centres are essential – especially the involvement of specialists in the treatment of substance abuse. Such a collaboration process requires specific, resolute measures, as well as a structured process in order to ensure sustainability and results. A networking programme that provides the opportunity to implement this collaborative process is proposed. Sound collaborations indeed provide the foundation to establish the networking programme for combating the problem of substance abuse in the workplace. A collaborative effort to address the problem of substance abuse in the workplace requires not only rallying the strengths and resources of both employers and out-patient treatment centres, but also developing a programme with well-defined processes beneficial to both. A qualitative research study by means of a grounded theory approach was conducted to explore how networking between employers and out-patient treatment centres might aid in addressing the problem of substance abuse in the workplace. Article 1 is a literature overview of substance abuse within the workplace and concerns the national directives, legislation requirements and measures of intervention aimed at dealing with the problem. The literature findings reveal clear national directives, legislation requirements and workplace policies, all aimed at providing a well-defined context for employers to manage substance abuse in the workplace. In addition, specialist treatment services are available to assist employers in addressing the problem in the workplace. Internal support structures in the workplace, however, often independently address the problem of substance abuse without involving the specialists. Literature findings indicate, though, that the personnel involved in the internal support structures are often not equipped to deal effectively with the problem. Research findings indicate positive treatment outcomes for employees with substance abuse problems. Statistics, however, indicate that the identification of employees with substance abuse problems is limited and that referrals of employees for treatment are infrequent. Underutilisation of out-patient treatment centres is therefore commonplace. Literature specifically indicates that the majority of employees are moderate drinkers and substance abusers, with only a small number being dependant. It is further indicated that the moderate drinkers and substance abusers account for almost half of the workforce. The critical factor, however, is that these categories of drinkers cause the majority of industrial accidents and are also responsible for the highest absenteeism rate. Prevention measures, sensitising the entire workforce to the early signs and dangers of substance abuse, facilitate the achievement of the best results in combating the problem. With an eye towards this, national directives advocate the following: intensified campaigns to educate people regarding the early signs and dangers of substance abuse, comprehensive prevention measures and increased rehabilitation efforts. Literature identified a limitation to effectively address substance abuse in the workplace, a problem catered for by specialist treatment centres. Article 2 reports the findings of a situation analysis regarding both the concerns and problems of employers and out-patient treatment centres, as well as resources needed to combat substance abuse in the workplace. Representatives from the employment sector, and out-patient treatment centres, participated in the situation analysis. Employees involved in substance abuse treatment programmes also participated in the study. A specific limitation, identified during the situation analysis, was the limited knowledge regarding the negative consequences of substance abuse in general. An unsupportive workplace environment, with regards especially to substance use and abuse, was also identified. Though empirical findings reported the existence of support structures in the workplace, these structures were found to be incapable of dealing with the problem. In the event of substance misconduct, employers are legally obligated to provide treatment and rehabilitation before considering dismissal; however, employers perceived these obligations as additional demands. Employers did not realise the possible benefits of treatment over dismissal. Misinformation and misinterpretation of the legal obligations were also identified during the research study. The stand against the problem of substance abuse in the workplace revealed a limited collaboration between employers and out-patient treatment centres. Employers were often not aware of specialist treatment centres and the available services. A lack of marketing and visibility – on the part of out-patient treatment centres – and an indifference and lack of support in the workplace were regarded as some of the causes for the limited collaboration between employers and out-patient treatment centres. Both ignorance in the workplace about the scope of substance abuse and a general lack of knowledge regarding the problem were identified as further limiting factors. A need for collaboration between employers and out-patient treatment centres was identified, especially if the problems of substance abuse in the workplace were to be successfully addressed. The development of a networking programme for employers and treatment centres was recommended and the core components to establish such a programme were identified. Article 3 discusses the components which were identified during the situation analysis and presents guidelines to develop a networking programme for employers and out-patient treatment centres. The components identified by the participants served as framework for the proposed networking programme. The programme comprises a specific purpose namely collaboration between employers and out-patient treatment centres, specific characteristics to sustain the programme, and the implementation of distinguishable procedures to establish and ensure sustainability of the programme. The purpose of the networking programme is to promote, between employers and out-patient treatment centres, a collaboration that will address the problem of substance abuse in the workplace. Involvement in the programme holds significant potential benefits for all relevant role players; the programme, in other words, advocates benefits for employers, employees and out-patient treatment centres. The proposed networking programme includes specific procedures for establishing and sustaining the programme: Firstly, assessing the limitations, needs and strengths of both the employment sector and out-patient treatment centres; secondly, establishing a network agreement that defines the roles and responsibilities of the role players; thirdly, collectively planning the networking activities and implementation of these plans; and, finally, collaboratively evaluating the impact and effectiveness of the programme. The aforementioned procedures also apply to both the evaluation of the limitations and progress of the treatment programmes, as well as to the evaluation of service delivery of the treatment centres. As it enables the revision of plans that provide individualised services, the continuous reassessment of the limitations and strengths of the networking programme is important. Out-patient treatment centres are considered responsible for initiating the networking programme. Effective collaboration between employers and out-patient treatment centres, as well as quality service delivery by the treatment centres, is regarded as critically important. Ultimately, the networking programme – regarded as a collaborative process between employers, employees and out-patient treatment centres – promotes a partnership geared towards combating the problem of substance abuse in the workplace. The researcher concluded the study with the formulation of a theory regarding the development of a networking programme as its end goal. Also, it is hoped that both out-patient treatment centres and the employment sector (employers and employees) may benefit from it in practice. Eventually, the proposed networking programme was based on the data collected from the situation analysis in this study, the researcher’s experience as a counsellor in substance abuse treatment and her exposure to different networking programmes, as well as supportive theoretical knowledge. A guideline for application of the networking programme in practice is included in the study alongside examples of projects to apply the programme. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Both employers and out-patient treatment centres are key role players in addressing workplace related substance abuse. On the one hand, employers are directly and indirectly affected by the huge problem of substance abuse. On the other hand, out-patient treatment centres provide, as their core goal, for the treatment of substance abuse and dependency. Due to the extent of the problem of substance abuse, collaborative intervention measures between employers and out-patient treatment centres are essential – especially the involvement of specialists in the treatment of substance abuse. Such a collaboration process requires specific, resolute measures, as well as a structured process in order to ensure sustainability and results. A networking programme that provides the opportunity to implement this collaborative process is proposed. Sound collaborations indeed provide the foundation to establish the networking programme for combating the problem of substance abuse in the workplace. A collaborative effort to address the problem of substance abuse in the workplace requires not only rallying the strengths and resources of both employers and out-patient treatment centres, but also developing a programme with well-defined processes beneficial to both. A qualitative research study by means of a grounded theory approach was conducted to explore how networking between employers and out-patient treatment centres might aid in addressing the problem of substance abuse in the workplace. Article 1 is a literature overview of substance abuse within the workplace and concerns the national directives, legislation requirements and measures of intervention aimed at dealing with the problem. The literature findings reveal clear national directives, legislation requirements and workplace policies, all aimed at providing a well-defined context for employers to manage substance abuse in the workplace. In addition, specialist treatment services are available to assist employers in addressing the problem in the workplace. Internal support structures in the workplace, however, often independently address the problem of substance abuse without involving the specialists. Literature findings indicate, though, that the personnel involved in the internal support structures are often not equipped to deal effectively with the problem. Research findings indicate positive treatment outcomes for employees with substance abuse problems. Statistics, however, indicate that the identification of employees with substance abuse problems is limited and that referrals of employees for treatment are infrequent. Underutilisation of out-patient treatment centres is therefore commonplace. Literature specifically indicates that the majority of employees are moderate drinkers and substance abusers, with only a small number being dependant. It is further indicated that the moderate drinkers and substance abusers account for almost half of the workforce. The critical factor, however, is that these categories of drinkers cause the majority of industrial accidents and are also responsible for the highest absenteeism rate. Prevention measures, sensitising the entire workforce to the early signs and dangers of substance abuse, facilitate the achievement of the best results in combating the problem. With an eye towards this, national directives advocate the following: intensified campaigns to educate people regarding the early signs and dangers of substance abuse, comprehensive prevention measures and increased rehabilitation efforts. Literature identified a limitation to effectively address substance abuse in the workplace, a problem catered for by specialist treatment centres. Article 2 reports the findings of a situation analysis regarding both the concerns and problems of employers and out-patient treatment centres, as well as resources needed to combat substance abuse in the workplace. Representatives from the employment sector, and out-patient treatment centres, participated in the situation analysis. Employees involved in substance abuse treatment programmes also participated in the study. A specific limitation, identified during the situation analysis, was the limited knowledge regarding the negative consequences of substance abuse in general. An unsupportive workplace environment, with regards especially to substance use and abuse, was also identified. Though empirical findings reported the existence of support structures in the workplace, these structures were found to be incapable of dealing with the problem. In the event of substance misconduct, employers are legally obligated to provide treatment and rehabilitation before considering dismissal; however, employers perceived these obligations as additional demands. Employers did not realise the possible benefits of treatment over dismissal. Misinformation and misinterpretation of the legal obligations were also identified during the research study. The stand against the problem of substance abuse in the workplace revealed a limited collaboration between employers and out-patient treatment centres. Employers were often not aware of specialist treatment centres and the available services. A lack of marketing and visibility – on the part of out-patient treatment centres – and an indifference and lack of support in the workplace were regarded as some of the causes for the limited collaboration between employers and out-patient treatment centres. Both ignorance in the workplace about the scope of substance abuse and a general lack of knowledge regarding the problem were identified as further limiting factors. A need for collaboration between employers and out-patient treatment centres was identified, especially if the problems of substance abuse in the workplace were to be successfully addressed. The development of a networking programme for employers and treatment centres was recommended and the core components to establish such a programme were identified. Article 3 discusses the components which were identified during the situation analysis and presents guidelines to develop a networking programme for employers and out-patient treatment centres. The components identified by the participants served as framework for the proposed networking programme. The programme comprises a specific purpose namely collaboration between employers and out-patient treatment centres, specific characteristics to sustain the programme, and the implementation of distinguishable procedures to establish and ensure sustainability of the programme. The purpose of the networking programme is to promote, between employers and out-patient treatment centres, a collaboration that will address the problem of substance abuse in the workplace. Involvement in the programme holds significant potential benefits for all relevant role players; the programme, in other words, advocates benefits for employers, employees and out-patient treatment centres. The proposed networking programme includes specific procedures for establishing and sustaining the programme: Firstly, assessing the limitations, needs and strengths of both the employment sector and out-patient treatment centres; secondly, establishing a network agreement that defines the roles and responsibilities of the role players; thirdly, collectively planning the networking activities and implementation of these plans; and, finally, collaboratively evaluating the impact and effectiveness of the programme. The aforementioned procedures also apply to both the evaluation of the limitations and progress of the treatment programmes, as well as to the evaluation of service delivery of the treatment centres. As it enables the revision of plans that provide individualised services, the continuous reassessment of the limitations and strengths of the networking programme is important. Out-patient treatment centres are considered responsible for initiating the networking programme. Effective collaboration between employers and out-patient treatment centres, as well as quality service delivery by the treatment centres, is regarded as critically important. Ultimately, the networking programme – regarded as a collaborative process between employers, employees and out-patient treatment centres – promotes a partnership geared towards combating the problem of substance abuse in the workplace. The researcher concluded the study with the formulation of a theory regarding the development of a networking programme as its end goal. Also, it is hoped that both out-patient treatment centres and the employment sector (employers and employees) may benefit from it in practice. Eventually, the proposed networking programme was based on the data collected from the situation analysis in this study, the researcher’s experience as a counsellor in substance abuse treatment and her exposure to different networking programmes, as well as supportive theoretical knowledge. A guideline for application of the networking programme in practice is included in the study alongside examples of projects to apply the programme. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Magister Artium (Psychology) - MA(Psych) / Substance use is a worldwide health concern that has received significant attention as it is often related to deleterious outcomes. Various treatment programmes have been made available to assist people and their families who misuse substances, to aid rehabilitation and equip people with the necessary tools with the aim of preventing possible relapse. The Western Cape Province has been identified as experiencing the highest increase of substance use, with Cape Town being disproportionately affected. Substance use treatment and prevention programmes are therefore an increasingly important means of addressing substance use and related harms. This study aimed to explore the lived experiences of individuals in relation to the treatment they received at a treatment facility in the Cape Town area. As such, the researcher made use of the phenomenological approach as a theoretical framework as it aims to describe the lived experiences of individuals in relation to a particular phenomenon. Furthermore, a qualitative methodological framework was utilised to explore the experiences of individuals who received substance use treatment. Ten participants were purposively selected from an outpatient substance use treatment facility in Cape Town. Focus group discussions were used to collect data and the data were analysed using Interpretive Phenomenological Analysis (IPA). Findings suggest that there were various reasons participants sought treatment. This includes the challenges they experienced in both their personal and occupational lives as well as the realization of the negative effects substance use had on them physiologically. Findings also revealed that the environmental setting individuals were in fostered their treatment; the various aspects of the programme provided by the treatment facility had a significant contribution to their recovery and improved relationships with others; receiving support from family and friends were important in service providers treatment retention as well as individuals ability to identify the changes within themselves since receiving treatment. Overall, results indicate that the treatment programme helped participants in their recovery and enhanced personal relationships, self-perception as well as personal and occupational growth. Findings suggest that there are various reasons as to why people seek treatment and although this may differ, the treatment modality they were provided with contributed substantially to their recovery. Furthermore, this study will contribute to the literature and understanding the ways in which treatment fosters recovery, personal growth and relationships.

Disertacijoje nagrinėjama depresija sergančių moterų gyvenimo kokybė ir jos kitimas trejų metų ambulatorinio depresijos gydymo laikotarpiu, kaip veiksniai, galintys padėti įvertinti psichikos sveikatos paslaugų vartotojų išteklius, svarbius sveikatai užtikrinti bei kuriant efektyvesnes sveikatos apsaugos ir gydymo strategijas. Empirinėje darbo dalyje pristatomas moterų gyvenimo kokybės kitimo trejų metų ambulatorinio depresijos gydymo laikotarpiu, tyrimas, atliktas Kauno m. Šančių Psichikos sveikatos centre. Trejuose tyrimo etapuose dalyvavo 62 moterys. Šio tyrimo rezultatai atskleidžia, kad depresija sergančių moterų susirgimo pradžios amžius, gretutinių somatinių ligų buvimas, amžius, mokamo darbo turėjimas ir šių rodiklių sąveikos, susiję su gyvenimo kokybės vertinimu. Išanalizavus rezultatus nustatyta, kad per pirmuosius ambulatorinio depresijos gydymo metus moterims vyksta teigiami gyvenimo kokybės pokyčiai, o per antrus- trečius gydymo metus moterų gyvenimo kokybė nesikeičia arba blogėja, tačiau po trejų gydymo metų yra geresnė nei gydymo pradžioje. Nustatyta, kad po vienerių metų gydymo pasiektas pasveikimas yra reikšmingiausias veiksnys, lemiantis didesnius teigiamus gyvenimo kokybės pokyčius, kiti svarbūs veiksniai - mažesnis depresijos klinikinių rodiklių kiekis ir/arba išreikštumas bei socialiniai ir demografiniai veiksniai (jaunesnis amžius, gyvenimas su partneriu, žemesnis išsilavinimas). Tyrimo rezultatai patvirtino, jog teigiami gyvenimo kokybės pokyčiai... [toliau žr. visą tekstą] / Depressive women’ quality of life and its changes during three years of the outpatient treatment is analyzed in this study. This study looks deeper into the factors which are helpful in assessment of recourses enhancing efficiency of mental health services and providing for better treatment and health protection strategies on behalf of the users of those services. The longitudinal panel survey of changes in women’ quality of life during three years of outpatient treatment of depression (in Kaunas city, Sanciu mental health center) is presented in the empirical part of the dissertation. 62 women participated in 3 screenings. The results of research show that more positive evaluation of the quality of life is related to the following factors: the older age of the beginning of the illness, absence of co morbid somatic illness, patient’s older age, having a paid job and interactions of these factors. Positive changes in quality of life occur during the first year of outpatient treatment of depression, while during the second-third year of treatment women’ quality of life remains stable or worsens, but after three years it becomes again better than in the initial screening. It is found that the recovery after one year of treatment is the most significant factor predicting more positive changes in the quality of life, while other important factors are: smaller number or less expressed clinical indicators of depression and social and demographic indicators (younger age, living with... [to full text]

Depressive women’ quality of life and its changes during three years of the outpatient treatment is analyzed in this study. This study looks deeper into the factors which are helpful in assessment of recourses enhancing efficiency of mental health services and providing for better treatment and health protection strategies on behalf of the users of those services. The longitudinal panel survey of changes in women’ quality of life during three years of outpatient treatment of depression (in Kaunas city, Sanciu mental health center) is presented in the empirical part of the dissertation. 62 women participated in 3 screenings. The results of research show that more positive evaluation of the quality of life is related to the following factors: the older age of the beginning of the illness, absence of co morbid somatic illness, patient’s older age, having a paid job and interactions of these factors. Positive changes in quality of life occur during the first year of outpatient treatment of depression, while during the second-third year of treatment women’ quality of life remains stable or worsens, but after three years it becomes again better than in the initial screening. It is found that the recovery after one year of treatment is the most significant factor predicting more positive changes in the quality of life, while other important factors are: smaller number or less expressed clinical indicators of depression and social and demographic indicators (younger age, living with... [to full text] / Disertacijoje nagrinėjama depresija sergančių moterų gyvenimo kokybė ir jos kitimas trejų metų ambulatorinio depresijos gydymo laikotarpiu, kaip veiksniai, galintys padėti įvertinti psichikos sveikatos paslaugų vartotojų išteklius, svarbius sveikatai užtikrinti bei kuriant efektyvesnes sveikatos apsaugos ir gydymo strategijas. Empirinėje darbo dalyje pristatomas moterų gyvenimo kokybės kitimo trejų metų ambulatorinio depresijos gydymo laikotarpiu, tyrimas, atliktas Kauno m. Šančių Psichikos sveikatos centre. Trejuose tyrimo etapuose dalyvavo 62 moterys. Šio tyrimo rezultatai atskleidžia, kad depresija sergančių moterų susirgimo pradžios amžius, gretutinių somatinių ligų buvimas, amžius, mokamo darbo turėjimas ir šių rodiklių sąveikos, susiję su gyvenimo kokybės vertinimu. Išanalizavus rezultatus nustatyta, kad per pirmuosius ambulatorinio depresijos gydymo metus moterims vyksta teigiami gyvenimo kokybės pokyčiai, o per antrus- trečius gydymo metus moterų gyvenimo kokybė nesikeičia arba blogėja, tačiau po trejų gydymo metų yra geresnė nei gydymo pradžioje. Nustatyta, kad po vienerių metų gydymo pasiektas pasveikimas yra reikšmingiausias veiksnys, lemiantis didesnius teigiamus gyvenimo kokybės pokyčius, kiti svarbūs veiksniai - mažesnis depresijos klinikinių rodiklių kiekis ir/arba išreikštumas bei socialiniai ir demografiniai veiksniai (jaunesnis amžius, gyvenimas su partneriu, žemesnis išsilavinimas). Tyrimo rezultatai patvirtino, jog teigiami gyvenimo kokybės pokyčiai... [toliau žr. visą tekstą]

ABSTRACT Background: Alcohol use disorders (AUD) affect health and wellbeing, and have broad societal costs (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011; Rehm et al., 2009; Sudhinaraset, Wigglesworth, Takeuchi, & Tsuker, 2016). While treatments have existed for decades, they are limited in success and expensive to administer. As such, understanding which factors best predict who will benefit most from treatment remains a laudable goal. Prior attempts to predict factors associated with positive treatment outcome are limited by methodology including statistical methods that lead to poor predictive power in new samples. This study aims to use a data-driven approach to clarify the predictors of AUD treatment success (Objective 1) accompanied by a theory-driven analysis assessing the mediation of treatment outcomes through psychological distress (Objective 2). Methods: One hundred forty-five patients seeking treatment for alcohol use problems at the Day One Intensive Outpatient Treatment Program (part of UVM Medical Center) between June 2011 and June 2012 were examined. Variables were extracted through chart review and were categorized using the Bronfenbrenner Ecological Model. First, 20% of the sample was set-aside for model testing, and the remaining 80% was used in an Elastic Net Regularized linear regression, with 10-fold cross validation. Models were tested on the set-aside sample to yield estimates of out-of-sample prediction and repeated models were compared to ensure generalizability. Next, a theoretical model was tested examining a model of psychological distress mediating the relationship between individual predictors and treatment outcome. Results: The models developed from the Elastic Net Regularization approach demonstrated consistency in model strength (mean=0.32, standard deviation=0.03) with models ranging from 14 to 31 included variables. Across the models, 15 variables occurred in >75% of the models, and an additional 7 variables were included in 25% - 75% of the models. Some of the strongest predictors included treatment non-compliance (β=-0.92), ASI Alcohol Composite (β=0.63), treatment dosage (β =-0.36), and readiness to change (β=-0.95). The results of the theory-driven mediation analysis demonstrated several strong direct predictors of outcome frequency of alcohol use, including readiness to change (β=-0.59), initial frequency of alcohol use (β=0.27), and access to a primary care physician (β=-2.20). The theoretical model found that none of the mediation pathways (testing psychological variables) were significantly different from the direct models. Conclusions: This study used both data-driven and theory-driven methods to examine factors affecting treatment of AUDs. The application of data-driven methods provided several predictors of outcome that can guide treatment efforts within Day One IOP treatment, as well as generalized to other abstinence-based treatment settings. For example, focusing on treatment attendance and using motivational interviewing to enhance readiness to change are methods supported by this study. Demographic variables that have been shown to predict treatment outcome in small studies, without cross-validation were not identified by the elastic net regression (e.g., age and gender). It is suspected that this is due to model overfitting in prior studies supporting the importance of using generalizable statistical methods to understand predictors of treatment outcome. This notion is supported by the results of the theory-driven model, which did not yield a strong model of treatment success. Taken together, the results support the use of strong analytic techniques which will guide theory in the future.

The aim of this study was to examine how social workers in outpatient programs fordrug and alcohol abuse explain the process of working with parenthood and theparental ability amongst clients with children. The study was conducted throughqualitative interviews with five different social workers, who worked within anoutpatient programs. The analysis was done through two different perspectives; onewith focus on the clients engagement in different social systems and one regarding theclients relationships and interaction with others. The main findings of this study arethat the outpatient programs work with parenthood is initiated through the client'sown wishes to work on certain aspects of the parent-child relationship, and indialogue with social workers and other members of the outpatient program. It wasalso discovered that children were involved in the therapeutic work to some extent,but that working with parenthood also revolved around the client being able toexpress feelings of shame and guilt, and how to overcome these feelings with the helpof the social workers and fellow outpatients.

Drivers under the influence of alcohol cause nearly one third of all fatal motor vehicle accidents. Ambulatory outpatient alcohol abuse treatment has been clinically shown to increase abstinence, which could decrease the chance of subsequent DWI offences. A barrier to successful completion is extended waiting periods prior to treatment engagement. The theory of patient waiting supports the longer a patient waits to begin treatment the lower the likelihood of successful completion. By exploring the impact of waiting times on DWI court mandated clients, referral courts and treatment facilities can work together to create a successful completion strategy for offenders. The research question focused on if days waiting can predict successful outpatient treatment completion in court mandated adults. The TEDS-D archival data set was used, consisting of data collected between 2006-€”2011 from federally funded substance abuse treatment centers throughout the USA. The variables time awaiting treatment, treatment level, gender, race, employment status, and age were used as controls. A logistic regression using a random sample of 4,947 participants determined days waiting was significant but weak in nature. The variables of employment status and age are stronger predictors of treatment completion. An interaction effect analysis of days waiting and age results in clients over 45 years old being significantly impacted by days waiting while younger clients are not. Court and treatment agencies can use this information to give priority intake appointments to older clients to increase chances of treatment completion.

BACKGROUND: Despite the high number of methamphetamine users in the Czech Republic, the treatment is still only abstinent. Pharmacotherapy in terms of substitution treatment is not yet in place. No study has yet been conducted to examine the views of workers working with methamphetamine users on the possibility of introducing substitution treatment for methamphetamine dependence in the Czech Republic. OBJECTIVE: The aim of the practical part was to map the opinions of outpatient staff on the possibility of introducing substitution treatment for methamphetamine dependence. The monitored area included the evaluation of the success of the treatment of methamphetamine dependence in outpatient settings, disparity in working with users by substance use, percentage of methamphetamine users in the facilities, the suitability of drug addiction to methamphetamine for clients of outpatient facilities and position of substitution treatment for methamphetamine, according to respondents. METHOD: The sample was elected on the basis of deliberate targeted selection through the institutions. Data capture was performed using a semi-structured interview method, which was recorded using audio recording and then transcribed. The data capture method was used to analyze the data. FILES: The research team consisted of...

Abstract The purpose of this study was to investigate treatment adherence among adolescents receiving mental health care, with a special focus on psychiatric inpatient treatment. Key goals were to derive a general definition of adherence suitable for this purpose and to assess adolescents’ adherence to medication and non-pharmacological treatments. This study had two phases; phase one involved conducting systematic literature reviews, and phase two was based on empirical research in which data were collected by analyzing notes on hospital patients. The aim of the reviews were to review current research evidence into treatment adherence in adolescents and factors relating adherence among adolescents receiving mental health care (original publication n=15 and original publication n=17). Phase two was part of a clinical follow-up project called STUDY-70 conducted at the Department of Psychiatry at Oulu University Hospital in Finland. This phase yielded two further original publications – papers III and IV. Paper III examined adherence among adolescents receiving psychiatric inpatient care (n=72), focusing on both medication and non-pharmacological treatments. Paper IV examined factors affecting treatment adherence among these 72 inpatient adolescents, including family- and clinic-related variables. The systematic reviews demonstrated that many different definitions of adherence have been used in the literature. A concept synthesis was applied to these definitions to establish a basis for empirical research. The main factors that were found to correlate positively with treatment adherence among adolescents were the patients’ own will to be treated and positive sentiments, but family also played an important role. Factors that correlated negatively with adherence included negative feelings, a lack of cooperation with treatment, and adverse mental symptoms. Adolescent who has received special support at school was found to favor treatment adherence, whereas involuntary treatment, self-mutilative behavior and a close maternal relationship were all linked to non-adherence. Treatment adherence is an ongoing process, and achieving high levels of adherence should be an important goal in all treatment processes. It is important for clinical staff to be aware of factors influencing adherence in order to support the provision of effective and high-quality care for adolescents. / Tiivistelmä Tutkimuksen tarkoituksena oli selvittää mielenterveyspalveluita käyttävien nuorien hoitoon sitoutumista ja erityisesti psykiatrisessa osastohoidossa olevan nuoren sitoutumista hoitoon. Keskeisinä tavoitteina oli kuvata hoitoon sitoutumisen määrittelyä ja arvioida nuoren sitoutumista lääke- ja ei-lääkinnälliseen hoitoon. Tutkimus sisälsi kaksi vaihetta: vaihe yksi systemaattiset kirjallisuuskatsaukset sekä vaihe kaksi empiirisen tutkimuksen, jossa tieto kerättiin analysoimalla potilasasiakirjoja. Systemaattisen kirjallisuuskatsauksen tarkoituksena oli selvittää nuoren hoitoon sitoutumista ja siihen yhteydessä olevia tekijöitä (alkuperäisjulkaisu I n=15, alkuperäisjulkaisu II n=17). Vaihe kaksi oli osa Oulun yliopistollisen sairaalan psykiatrian klinikan projektia, STUDY-70, joka tuotti kaksi osajulkaisua. Alkuperäisjulkaisun III tarkoituksena oli tutkia osastohoidossa olevan nuoren sitoutumista lääke- sekä ei lääkinnälliseen hoitoon (n=72). Alkuperäisjulkaisussa IV selvitettiin näiden nuoren sitoutumista hoitoon ja erityinen mielenkiinto tässä tutkimuksessa oli perhe- ja kliinisillä tekijöillä sitoutuminen (n=72). Systemaattisen kirjallisuuskatsauksen perusteella sitoutumisen määrittelyt vaihtelivat. Tästä huolimatta käsitteen määrittelyjen synteesi oli mahdollinen ja se loi pohjan empiiriselle tutkimukselle. Tämän tutkimuksen perusteella nuoren oma tahto ja positiivinen asenne olivat positiivisesti yhteydessä hoitoon sitoutumiseen. Myös perheen toiminta vaikutti hoitoon sitoutumiseen. Nuoren negatiiviset tunteet, yhteistyökyvyttömyys ja mielenterveysoireet vaikuttivat negatiivisesti sitoutumiseen. Lisäksi nuoren saamat erityispalvelut koulussa tukivat osastohoidossa olevan nuoren hoitoon sitoutumista. Vastentahtoinen hoito, viiltely sekä läheinen ja kestävä äitisuhde olivat yhteydessä sitoutumattomuuteen. Hoitoon sitoutuminen on kokonaisvaltainen prosessi ja yksi hoidon tavoitteista, joka voidaan saavuttaa. Hoitoon sitoutumisen edistämiseksi henkilökunnan tulee tiedostaa ne tekijät, jotka vaikuttavat hoitoon sitoutumiseen. Näin voidaan suunnitella ja toteuttaa laadukasta ja vaikuttavaa hoitoa.