Reyre Aymeric, Jeannin Raphaël, Largueche Myriam, Moro Marie Rose, Baubet Thierry, Taieb Olivier
APHP-Avicenne University Hospital, Department of Psychiatry and Addictology, Paris 13 SPC University, 125 rue de Stalingrad, 93000, Bobigny, France; CESP, INSERM U1178, 12 Avenue Paul Vaillant Couturier, 94800, Villejuif, France; Ile-de-France Regional Center for Bioethics, 1 rue Claude Vellefaux, 75010, Paris, France.
APHP-Avicenne University Hospital, Department of Psychiatry and Addictology, Paris 13 SPC University, 125 rue de Stalingrad, 93000, Bobigny, France.
Drug Alcohol Depend. 2017 May 1;174:30-38. doi: 10.1016/j.drugalcdep.2017.01.015. Epub 2017 Mar 1.
A good therapeutic alliance plays a major role in the healing process. Professionals working in addiction treatment report high levels of psychological distress related to work and this may challenge the establishment of a trustful therapeutic alliance, and lead to a loss of care quality provided to service users. The purpose of this study was to investigate the experience of specialized professionals, its effects on trust and the therapeutic alliance, and the means to restore them.
We conducted a qualitative study using a semi-structured questionnaire and a narrative tool. Discourse was extracted from focus groups and individual interviews and analyzed following the Interpretative Phenomenological Analysis method.
Twenty-six professionals from three addiction treatment centers in the Paris area were interviewed.
The difficulties weighing on the care alliance were described by the participants in terms of their nature, their effects and means to overcome them. Emotional drain leads to a climate of relational distrust and the temptation to desert or over-control patients. Teambuilding, specific training and self-care are viewed as means to restore a therapeutic alliance based on an appropriate type of trust.
Distrust deriving from professionals' challenging experiences may lead to worrying consequences. Promoting democratic organization of care structures, specific training, and also responsible self-care on the part of professionals could help to restore a type of trust that helps to establish a therapeutic alliance suited to service user individualities. This could ultimately be beneficial for user care, professional wellbeing and team functioning.
良好的治疗联盟在康复过程中起着重要作用。从事成瘾治疗工作的专业人员报告称，与工作相关的心理困扰程度较高，这可能会对建立信任的治疗联盟构成挑战，并导致向服务使用者提供的护理质量下降。本研究的目的是调查专业人员的经历、其对信任和治疗联盟的影响，以及恢复信任和治疗联盟的方法。
我们使用半结构化问卷和叙事工具进行了一项定性研究。从焦点小组和个人访谈中提取话语，并按照解释现象学分析方法进行分析。
对巴黎地区三个成瘾治疗中心的26名专业人员进行了访谈。
参与者从其性质、影响和克服方法等方面描述了影响护理联盟的困难。情感耗竭导致关系不信任的氛围，以及抛弃或过度控制患者的诱惑。团队建设、特定培训和自我护理被视为基于适当信任类型恢复治疗联盟的方法。
专业人员具有挑战性的经历所产生的不信任可能会导致令人担忧的后果。促进护理结构的民主组织、特定培训，以及专业人员进行负责任的自我护理，有助于恢复一种信任，这种信任有助于建立适合服务使用者个性的治疗联盟。这最终可能有利于使用者护理、专业人员的幸福感和团队运作。
