Padgett Deborah K, Henwood Ben, Abrams Courtney, Drake Robert E
Silver School of Social Work, New York University, New York, NY 10003, USA.
Am J Orthopsychiatry. 2008 Jul;78(3):333-9. doi: 10.1037/a0014155.
The new paradigm of recovery has highlighted the importance of positive social relationships, but little is known about their role in recovery among homeless individuals with serious mental illness and comorbid substance abuse. This study used within- and across-case analyses of longitudinal data from qualitative interviews with 41 dually diagnosed individuals entering residential programs to exit homelessness and receive needed services. Thematic findings include (a) "loner talk" and the need for privacy; (b) family ties as "good news, bad news"; (c) when it comes to a partner, other things come first; and (d) in search of positive people. Analyses of change in individual trajectories revealed that stronger social relationships did not coincide exactly with positive outcomes. Although positive life changes were gradual, negative changes could be precipitous. Social relationships were threatened by concentrated disadvantage, that is, a lack of social and economic currency. Findings are discussed with implications for improving services for the most vulnerable individuals who stand to benefit from the era of recovery.
新的康复模式凸显了积极社会关系的重要性,但对于这些关系在患有严重精神疾病且并发药物滥用问题的无家可归者康复过程中的作用,我们却知之甚少。本研究对41名同时患有精神疾病和药物滥用问题、进入住宿项目以摆脱无家可归状态并获得所需服务的个体进行了定性访谈,采用纵向数据进行个案内和跨案例分析。主题研究结果包括:(a)“孤独者的交谈”与隐私需求;(b)家庭关系是“好消息,坏消息”;(c)说到伴侣,其他事情优先;(d)寻找积极向上的人。对个体轨迹变化的分析表明,更紧密的社会关系与积极结果并非完全一致。虽然积极的生活变化是渐进的,但消极变化可能很突然。社会关系受到集中劣势的威胁,即缺乏社会和经济资本。本文将对研究结果进行讨论,并探讨其对改善服务的意义,这些服务将惠及那些有望从康复时代中受益的最弱势群体。