The aim of this study is to demonstrate how the complementary concepts of stability and change could manifest during the therapeutic process, specifically with clients showing the symptom of dependency. The study is guided by a literature study on systems/cybernetic theory with a focus on the cybernetic complementarity of stability and change. A brief description is provided of the symptom of dependency from a more traditional lineal perspective as well as a non-lineal (systemic) perspective. A single case study is utilized to describe how both stability and change could manifest in the therapeutic process. From this description the relevance and usefulness of addressing both stability and change during the therapeutic process emerge and are outlined. / Social Work / M. A. (Social Science Mental Health)

Thesis (MSc)--Stellenbosch University, 2015 / Stellenbosch : Stellenbosch University / ENGLISH ABSTRACT : Substance abuse is a major problem globally with immeasurable consequences to the health of users. Rehabilitation is one of the strategies that can help to fight against substance abuse. It is divided into two forms: in-patient and out-patient rehabilitation. In this study, we consider a compartmental model of substance users in rehabilitation, where a periodic function is included to illustrate seasonal oscillations of drug users entering rehabilitation. In this thesis, we derive two basic reproduction numbers R0 and [R0], where R0 is the model with periodicity and [R0] the model without periodicity. We show that the model has a drug-free equilibrium when the basic reproduction number R0 is less than one and drug persistent equilibrium when R0 is greater than one. We fit the model to data and obtained sneak preview of the future of these forms of rehabilitation. Our results indicate that when R0 is less than one, the in- and out-patient populations decrease quickly and when R0 is greater than one drugs persists and after a long period of time, individuals in rehabilitation approaches w-periodic solution. Sensitivity analysis is performed and the results show that control measures should focus on the effective contact rate between susceptibles and drug users so as to control the epidemic. These results have significant implications on the management and planning of rehabilitation programs in South Africa. / AFRIKAANSE OPSOMMING : Dwelm misbruik is wêreldwyd ‘n ernstige problem met onmeetbare gevolge vir die gesondheid van gebruikers. Rehabilitasie is een van die strategieë wat dwelm misbruik kan help beveg. Dit word in twee vorms verdeel: binnepasiënt- en buitepasiëntrehabilitasie. In hierdie studie ondersoek ons ‘n kompartementele model van dwelmgebruikers in rehabilitasie, waar ‘n periodieke funksie ingesluit word om seisoenale skommelings aan te toon met betrekking tot dwelmgebruikers wat rehabilitasie aanpak. In hierdie tesis lei ons twee basiese reproduksienommers af, R0 en [R0], waar R0 die model met periodisiteit en [R0] die model sonder periodisiteit is. Ons toon aan dat die model ‘n dwelmvrye ekwilibrium het wanneer die basiese reproduksienommer R0 minder as een is en ‘n dwelm-voortsettingsekwilibrium het wanneer R0 meer as een is. Ons pas die model op die data toe en verkry ‘n vooruitskouende blik op die toekoms van hierdie vorms van rehabilitasie. Ons resultate dui aan dat wanneer R0 minder as een is, die binne- en buitepasiënt-bevolkings vinnig verminder en wanneer R0 meer as een is, die gebruik van dwelms voortduur en dat nà ‘n lang tydperk individue in rehabilitasie nader aan w-periodieke oplossing beweeg. Sensitiwiteitsontleding word uitgevoer en die resultate toon aan dat daar ‘n bewustheid moet bestaan dat die graad van effektiewe kontak tussen vatbare individue en dwelmgebruikers beperk moet word ten einde die epidemie onder beheer te bring. Hierdie resultate het betekenisvolle implikasies vir die bestuur en beplanning van rehabilitasieprogramme in Suid-Afrika. / rs201601

O estudo teve por objetivo avaliar os fatores sociais e de saúde associados à da gravidade da dependência de cocaína (fumada e inalada) entre usuários em tratamento ambulatorial. Trata- se de um estudo transversal de abordagem quantitativa, realizado com 160 indivíduos em tratamento para a dependência química no CAPS-ad de Ribeirão Preto, SP. Os participantes foram selecionados mediante critérios de elegibilidade e avaliação do estado mental por meio da Brief Psychiatric Rating Scale (BPRS-A). Para a coleta de dados um questionário foi elaborado contendo: Informações sociodemográficas, Addiction Severity Index (ASI-6); Short Alcohol Dependence Data (SADD); Alcohol Use Disorders Identification Test- Consumption (AUDIT-C); Severity of Dependence Scale (SDS) e Cocaine Craving Questionnaire - Brief (CCQ-B). Na análise estatística foram utilizados os testes: qui-quadrado, regressão logística, teste Mann Whitney e correlação de Spearman. A amostra foi composta por 78 (48,8%) de cocaína inalada e 82 (51,2%) de crack. Em relação aos aspectos sociais e de saúde, os usuários de crack foram mais velhos (p = 0,028), com menos anos de estudo (p = 0,042),desempregados (p = 0,05), maioria em situação de rua (p < 0,001), com antecedentes de tratamentos (p = 0,019), baixa renda mensal (p < 0.001), renda incompatível com despesas (p = 0,002), mais envolvidos em roubo (p = 0,009), sofreram agressão (por pessoa conhecida e desconhecida (p = 0,005 e p = 0,014), presenciaram agressão/homicídio (p = 0,030), dormiram em albergues (p = 0,011), apresentam problemas para dormir (p = 0,007), sintomas de alucinações (p > 0,001), agressividade (p = 0,031). Os usuários de cocaína inalada se diferenciaram apenas por apresentarem maior contato com amigo íntimo (p = 0,007). Em relação ao uso de drogas, os usuários de crack apresentaram maior tempo de uso na vida de tabaco (p = 0,032) e maconha (p = 0,047), maior frequência de uso do crack (p = 0,009). Nos resultados da análise multivariada, os indivíduos adultos (OR 3,1 95%CI 1,50;6,7) e em situação de rua (OR 4,5 95%CI 1,49;13,61) apresentaram chances aumentadas de utilizar crack. Quanto à avaliação final da ASI, constatou-se que os usuários de crack apresentaram elevados níveis de problemas nas áreas Emprego (p = 0,005) e Psiquiátrica (p = 0,003). Os níveis de problemas relacionados ao álcool, drogas e fissura (AUDIT, SDS, CCQ-B) não se diferenciaram entre os usuários de cocaína, resultando em severos níveis de gravidade independente a via de uso, com exceção da SADD. Das correlações entre as áreas da ASI e o dos instrumentos, destaca-se que a área Álcool foi correlacionada positivamente com os todos os instrumentos, a área Droga e os resultados do AUDIT, SDS e CCQ-B, a área Família com o CCQ-B, a área Psiquiátrica com SDS e CCQ-B, a área Problemas Sociais com a SDS e a CCQ-B. A área Médica foi correlacionada negativamente com a SDS. O uso de cocaína apresenta variações em relação aos níveis de gravidade da dependência da droga e problemas nas áreas emprego e sustento, uso de álcool e de drogas, situação legal social e saúde mental / The aim of this study was to evaluate the social and health factors associated with the severity of cocaine dependence (smoked and snuffed) among users on outpatient treatment. This is a cross-sectional quantitative study conducted with 160 individuals undergoing treatment for chemical dependence in the CAPS-ad in Ribeirão Preto, Sao Paulo. Participants were selected through eligibility criteria and mental status assessment using the Brief Psychiatric Rating Scale (BPRS-A). The data collection instruments were: Addiction Severity Index (ASI-6); Short Alcohol Dependence Data (SADD); Alcohol Use Disorders Identification Test- Consumption (AUDIT-C); Severity of Dependency Scale (SDS) and Cocaine Craving Questionnaire - Brief (CCQ-B). In the statistical analysis, the following tests were used: chi- square, logistic regression, Mann Whitney test and Spearman correlation. The sample consisted of 78 (48.8%) snorted cocaine and 82 (51.2%) of crack. In relation to social and health aspects, crack users were older (p = 0.028), with less years of study (p = 0.042), unemployed (p = 0.05), homeless (p < 0,001), history of previous treatments (p = 0.019), low monthly income (p <0.001), income incompatible with expenses (p = 0.002), more involved in robbery (p = 0.009), suffered aggression (per person known and unknown (p = 0.005 and p = 0.014), witnessed aggression / homicide (p = 0.030), slept in shelters (p = 0.011), trouble sleeping (p = 0.007), hallucinations (p> 0.001) and aggressiveness (p = 0.031). The snuffed cocaine users differed only because they had greater contact with close friends (p = 0.007). Regarding the drug use, crack users had a longer time of use in the life of tobacco (p = 0.032) and marijuana (p = 0.047), a higher frequency of crack use (p = 0.009). In the results of the multivariate analysis, the adult individuals (OR 3.1 95% CI 1.50, 6.7) and homeless (OR 4.5 95% CI 1.49, 13.61) presented increased odds of use crack. Regarding the final evaluation of ASI, It was found that crack users presented high levels of problems in the areas of Employment (p = 0.005) and Psychiatric (p = 0.003). The levels of alcohol, drug and fissure problems (AUDIT, SDS, CCQ-B) did not differ among cocaine users, resulting in increased levels of severity independent of the route of use, with the exception of SADD. From the correlations between the ASI and the instruments, the Alcohol use positively correlated with all the instruments, the Drug area and the results of the AUDIT, SDS and CCQ-B, the Family area with CCQ- B, the Psychiatric area with SDS and CCQ-B, the Social Problems area with SDS and CCQ-B. The Medical area was negatively correlated with SDS. The use of cocaine showed various severity levels of drug dependence and problems in the areas of employment and livelihood, alcohol and drug use, social legal status, and mental health

Many youth are able to be successful in the traditional school setting. Large numbers are not successful. Dropout rates are alarming. There is little research that examines the drop out problem from the perspective of the youth. Traditionally programs that are designed to help have been designed by adults. This qualitative study focused on the voices of youth. Participants in this study were male clients aged fifteen to seventeen who were adjudicated and court mandated to receive treatment in a drug treatment center. All of the participants had a history of delinquency and poor academic achievement. They had dropped out of school prior to entering the treatment program. This qualitative study addressed two questions: 1. What are the factors that prevent at-risk youth from being successful in school? 2. What can schools do to help these youth be successful at school? This study provided information about what schools could have done to help these youth be more successful. It also looked at their current academic success in the treatment program as a possible model to help other youth. Five youth volunteered to participate in the study. All interviews were confidential. Interviews were also conducted with a probation officer, program administrator, teacher, and a parent that had a youth in the program in order to triangulate results. The voices of students supported the literature with respect to the factors that contribute to students being at risk for delinquency and dropping out of school. Some of these factors include issues surrounding anger management, academic issues, nurturing at school, family situations, school at a treatment center, hiring teachers, childhood experiences, drug use, obtaining drugs, crime and drugs, treatment programs, dual diagnosis, communication and issues surrounding success and failure. The strength of this qualitative research project lies in the fact that the real voices of students did support the quantitative literature in this field. / Graduation date: 2004

The purpose of this study was to propose and evaluate a procedure for revising an existing self-administered survey that is in need of item revision and/or scale reduction while maximizing validity and reliability. The procedure was demonstrated using the Client Evaluation of Self and Treatment (CEST; Joe, Broome, Rowan-Szal, & Simpson, 2002), a self-administered survey used in drug and alcohol treatment agencies. The procedure included confirmatory and exploratory factor analyses of a large dataset of completed CEST surveys, a readability analysis, and cognitive interviewing of two different groups of respondents to determine what problems they might have with CEST items. The cognitive interviewing revealed a number of issues that led to confusion among respondents, including items with two distinct concepts embedded, items containing absolutes and vague qualifiers, misinterpreted items, and terms and phrases respondents had difficulty understanding. The CEST was also judged to be long and potentially burdensome to respondents. Based on the results of this evaluation, a new survey—the Brief Assessment of Self in Context (BASIC)—also intended for use by substance abuse treatment providers, was constructed. First, factor analyses of the CEST and advice from an expert panel were used to determine which scales to retain. Next, quantitative analyses and cognitive interviewing helped determine which CEST items to retain and which to revise. Readability, sound item writing principles, and response format and scale requirements were also used to determine which items to include in the initial draft of the BASIC and guided item construction when needed. After the panel of experts provided feedback on the first revision, a final draft was prepared. Another round of cognitive interviewing was followed by administration of the final draft of the survey to a representative sample. The results indicated that the BASIC’s items are clear, unambiguous, and easy to interact with and understand, and that the instrument is an improvement over the CEST. In brief, the procedure demonstrated in this study produced a psychometrically sound instrument composed of items that are easy for respondents to access. / text

This study was intended to determine the architectural characteristics of a built environment that makes a positive contribution to the effective treatment of addictions and associated mental illnesses. Buildings affect people both physically and psychologically: Architects and interior designers create retail spaces that increase sales, restaurants that stimulate appetite and offices that maximise productivity. But do they design mental health-care facilities that improve treatment and recovery? Surely, given the nature of its function, this building typology is the most deserving of attention with regard to the subject of ‘environmental psychology’. On the contrary however, mental health-care has a history of inadequacy when it comes to the buildings that have been constructed to facilitate it: During the middle of the twentieth century – particularly in Great Britain and the United States of America – state ‘mental asylums’ housed hundreds of people in oppressive, inhumane buildings, remote from their communities. Derelict asylums bear testimony to the ‘de-institutionalism’ movement that followed, favouring out-patient care in the community context. On the other hand however, homeless, destitute addicts and mentally ill individuals tell of the shortcomings of community-based care. Current medical insights have now led to a new concept of ‘balanced-care’, which calls for the integration of in-patient and out-patient treatment. This new approach provides an opportunity for architects to re-define the mental healthcare facility – to humanise the institution and create treatment environments that contribute positively to recovery. The purpose of this study was therefore to establish a sound understanding of the unique needs of this particular user group, to interpret the implications of these needs with regard to the design of the treatment environment, and to assess the appropriateness of existing facilities in terms of these findings. The research was carried out by way of consultation with local mental health-care professionals, a review of existing literature on the subject, and relevant precedent and case studies. The outcome was a set of principles and criteria to inform the design of a new addiction and mental health clinic in Durban. / Thesis (M.Arch.)-University of KwaZulu-Natal, Durban, 2011.

Made available in DSpace on 2015-05-14T12:47:15Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1498803 bytes, checksum: bb0d1c69bf1b311944f8a9b85c3e2f48 (MD5) Previous issue date: 2013-08-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Adherence to treatment by drug users is an emerging issue, given the high dropout rates reflecting with low levels of successful treatment. To investigate the factors associated with noncompliance with treatment for drug addiction in the city of João Pessoa, in order to provide information to support managers in making decision in the thematic area of attention to drug use. The research used a descriptive exploratory methodological basis of quantitative approach of retrospective character and documentary source to analyze the period at February 2010 to June 2013. The datas were collected at the Center for Psychosocial Alcohol and Other Drugs (CAPSad) and the sample was of 706 records. The analysis was performed in R version 2.15.3 and we used the logistic regression and Pearson chi-square test. Most patients were male, mulatto, single, aged between 21 and 30 years, with low education level, unemployed, good family relationship, who they arrived in the service mainly through spontaneous demand, starting the accompaniment in the semi-intensive modality of treatment. The main drugs of abuse were alcohol, tobacco, marijuana and crack, ranging from 01 to up to 10 the number of drugs used by a single user. Based on the statistical significance of the tests, the results showed as predisposing factors to the treatment dropout the number the drugs of abuse equals 03, single marital status and crack and alcohol consumption. As favorable factors for treatment adherence were the psychiatric hospitalization, bad family relationships, social benefit, and age 41 to 50 years. The health teams must be qualified to deal with the diversity of user drugs, in order to promote health promotion and injury prevention, addressing other forms besides models of conventional treatments, according to the profile of the clientele. In this sense, the work of CAPSad in conjunction with other services is relevant. Given that the logistic regression model wasn't appropriate and on limiting the independence test, alert to the need for a deeper study about the theme. / A adesão ao tratamento por parte dos usuários de substâncias psicoativas constitui-se em uma problemática emergente, tendo em vista as altas taxas de abandono, refletindo em níveis baixos de sucesso no tratamento. Objetivo: averiguar os fatores associados ao abandono do tratamento para a dependência química no município de João Pessoa, de modo a fornecer informações que possam subsidiar os gestores no processo de tomada de decisão na área temática de atenção ao consumo de drogas. Metodologia: pesquisa descritivo-exploratória de abordagem quantitativa, de caráter retrospectivo e em fonte documental para analisar o período de Fevereiro de 2010 a Junho de 2013. Os dados foram coletados no Centro de Atenção Psicossocial Álcool e outras Drogas (CAPSad), obtendo-se uma amostra de 706 prontuários. A análise foi feita no R versão 2.15.3 e utilizou-se da Regressão Logística e do Teste Qui-quadrado de Pearson. Resultados: a maioria dos usuários era do sexo masculino, raça parda, solteiros, com idade entre 21 e 30 anos, com baixa escolaridade, desempregados, relação familiar boa, que adentraram ao serviço, principalmente por demanda espontânea, iniciando o tratamento na modalidade semi-intensiva. As principais drogas de abuso foram álcool, tabaco, crack e maconha, variando de 01 a até 10 tipos de drogas consumidas por um mesmo usuário. Com base na significância estatística dos testes realizados, os resultados evidenciaram como fatores predisponentes ao abandono número de drogas de abuso igual a 03, estado civil solteiro, consumo de crack e consumo de álcool. Como fatores favoráveis à adesão ao tratamento foram identificados a internação, relação familiar ruim, benefício social e idade dos 41 aos 50 anos. Conclusões: é importante que as equipes de saúde sejam qualificadas para lidar com a diversidade dos usuários de drogas, de modo a promover ações de promoção e prevenção e utilizar outras formas de tratamentos, conforme o perfil da clientela. O CAPSad deve trabalhar em articulação com os outros serviços. Dado que o modelo de regressão logística não foi adequado e diante da limitação do teste de independência, alerta-se para a necessidade de estudos mais profundos.

The aim of this study is to demonstrate how the complementary concepts of stability and change could manifest during the therapeutic process, specifically with clients showing the symptom of dependency. The study is guided by a literature study on systems/cybernetic theory with a focus on the cybernetic complementarity of stability and change. A brief description is provided of the symptom of dependency from a more traditional lineal perspective as well as a non-lineal (systemic) perspective. A single case study is utilized to describe how both stability and change could manifest in the therapeutic process. From this description the relevance and usefulness of addressing both stability and change during the therapeutic process emerge and are outlined. / Social Work / M. A. (Social Science Mental Health)

O estudo teve por objetivo avaliar os fatores sociais e de saúde associados à da gravidade da dependência de cocaína (fumada e inalada) entre usuários em tratamento ambulatorial. Trata- se de um estudo transversal de abordagem quantitativa, realizado com 160 indivíduos em tratamento para a dependência química no CAPS-ad de Ribeirão Preto, SP. Os participantes foram selecionados mediante critérios de elegibilidade e avaliação do estado mental por meio da Brief Psychiatric Rating Scale (BPRS-A). Para a coleta de dados um questionário foi elaborado contendo: Informações sociodemográficas, Addiction Severity Index (ASI-6); Short Alcohol Dependence Data (SADD); Alcohol Use Disorders Identification Test- Consumption (AUDIT-C); Severity of Dependence Scale (SDS) e Cocaine Craving Questionnaire - Brief (CCQ-B). Na análise estatística foram utilizados os testes: qui-quadrado, regressão logística, teste Mann Whitney e correlação de Spearman. A amostra foi composta por 78 (48,8%) de cocaína inalada e 82 (51,2%) de crack. Em relação aos aspectos sociais e de saúde, os usuários de crack foram mais velhos (p = 0,028), com menos anos de estudo (p = 0,042),desempregados (p = 0,05), maioria em situação de rua (p < 0,001), com antecedentes de tratamentos (p = 0,019), baixa renda mensal (p < 0.001), renda incompatível com despesas (p = 0,002), mais envolvidos em roubo (p = 0,009), sofreram agressão (por pessoa conhecida e desconhecida (p = 0,005 e p = 0,014), presenciaram agressão/homicídio (p = 0,030), dormiram em albergues (p = 0,011), apresentam problemas para dormir (p = 0,007), sintomas de alucinações (p > 0,001), agressividade (p = 0,031). Os usuários de cocaína inalada se diferenciaram apenas por apresentarem maior contato com amigo íntimo (p = 0,007). Em relação ao uso de drogas, os usuários de crack apresentaram maior tempo de uso na vida de tabaco (p = 0,032) e maconha (p = 0,047), maior frequência de uso do crack (p = 0,009). Nos resultados da análise multivariada, os indivíduos adultos (OR 3,1 95%CI 1,50;6,7) e em situação de rua (OR 4,5 95%CI 1,49;13,61) apresentaram chances aumentadas de utilizar crack. Quanto à avaliação final da ASI, constatou-se que os usuários de crack apresentaram elevados níveis de problemas nas áreas Emprego (p = 0,005) e Psiquiátrica (p = 0,003). Os níveis de problemas relacionados ao álcool, drogas e fissura (AUDIT, SDS, CCQ-B) não se diferenciaram entre os usuários de cocaína, resultando em severos níveis de gravidade independente a via de uso, com exceção da SADD. Das correlações entre as áreas da ASI e o dos instrumentos, destaca-se que a área Álcool foi correlacionada positivamente com os todos os instrumentos, a área Droga e os resultados do AUDIT, SDS e CCQ-B, a área Família com o CCQ-B, a área Psiquiátrica com SDS e CCQ-B, a área Problemas Sociais com a SDS e a CCQ-B. A área Médica foi correlacionada negativamente com a SDS. O uso de cocaína apresenta variações em relação aos níveis de gravidade da dependência da droga e problemas nas áreas emprego e sustento, uso de álcool e de drogas, situação legal social e saúde mental / The aim of this study was to evaluate the social and health factors associated with the severity of cocaine dependence (smoked and snuffed) among users on outpatient treatment. This is a cross-sectional quantitative study conducted with 160 individuals undergoing treatment for chemical dependence in the CAPS-ad in Ribeirão Preto, Sao Paulo. Participants were selected through eligibility criteria and mental status assessment using the Brief Psychiatric Rating Scale (BPRS-A). The data collection instruments were: Addiction Severity Index (ASI-6); Short Alcohol Dependence Data (SADD); Alcohol Use Disorders Identification Test- Consumption (AUDIT-C); Severity of Dependency Scale (SDS) and Cocaine Craving Questionnaire - Brief (CCQ-B). In the statistical analysis, the following tests were used: chi- square, logistic regression, Mann Whitney test and Spearman correlation. The sample consisted of 78 (48.8%) snorted cocaine and 82 (51.2%) of crack. In relation to social and health aspects, crack users were older (p = 0.028), with less years of study (p = 0.042), unemployed (p = 0.05), homeless (p < 0,001), history of previous treatments (p = 0.019), low monthly income (p <0.001), income incompatible with expenses (p = 0.002), more involved in robbery (p = 0.009), suffered aggression (per person known and unknown (p = 0.005 and p = 0.014), witnessed aggression / homicide (p = 0.030), slept in shelters (p = 0.011), trouble sleeping (p = 0.007), hallucinations (p> 0.001) and aggressiveness (p = 0.031). The snuffed cocaine users differed only because they had greater contact with close friends (p = 0.007). Regarding the drug use, crack users had a longer time of use in the life of tobacco (p = 0.032) and marijuana (p = 0.047), a higher frequency of crack use (p = 0.009). In the results of the multivariate analysis, the adult individuals (OR 3.1 95% CI 1.50, 6.7) and homeless (OR 4.5 95% CI 1.49, 13.61) presented increased odds of use crack. Regarding the final evaluation of ASI, It was found that crack users presented high levels of problems in the areas of Employment (p = 0.005) and Psychiatric (p = 0.003). The levels of alcohol, drug and fissure problems (AUDIT, SDS, CCQ-B) did not differ among cocaine users, resulting in increased levels of severity independent of the route of use, with the exception of SADD. From the correlations between the ASI and the instruments, the Alcohol use positively correlated with all the instruments, the Drug area and the results of the AUDIT, SDS and CCQ-B, the Family area with CCQ- B, the Psychiatric area with SDS and CCQ-B, the Social Problems area with SDS and CCQ-B. The Medical area was negatively correlated with SDS. The use of cocaine showed various severity levels of drug dependence and problems in the areas of employment and livelihood, alcohol and drug use, social legal status, and mental health

This thesis focuses on the changed governance of the public sector and what it can entail for professional work in substance abuse treatment. The point of departure is one of these new forms of governing, namely ‘knowledge governance’, which refers to a policy-driven process for promoting the use of evidence-based practice.  The overall aim is to contribute to understanding and knowledge of the meaning and the conditions for knowledge governance in substance abuse treatment. The thesis studies how knowledge is interpreted by professionals and adapted to local practice in relation to organizational and professional conditions. The thesis also highlights the implications that   these conditions may have for knowledge development on a professional and organizational level. The empirical material comprises three studies. Study 1 included a document analysis and a literature review. The document analysis examines how knowledge governance is described in official documents, while the focus of the literature review is on the concept of knowledge management. In Studies 2 and 3 focus group interviews were conducted with professionals who participated in a specific project, and professionals who use structured interview methods in their work (Addiction Severity Index, ASI, or Documentation of clients, DOC). The theoretical perspectives used in the thesis are neo-institutional theory, professional theory and perspectives on workplace learning.   The results of Study 1 showed that knowledge governance embodies a steering of organizations, in comparison with knowledge management as a means for steering in organizations. The analyses from the focus group interviews demonstrate that knowledge governance becomes the subject of translations and edits to a local context. This process was affected by both organizational and professional conditions. The thesis is concluded with a discussion of the conditions that must be present if knowledge governance can lead to development of knowledge. The main result is that strategies must be tailored to each organization's specific condition and must be anchored throughout the organization.