Bjelland Ingerid Elgesem, Johansen Ayna, Darnell Farnad, Brendryen Håvar
Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
Department of Substance Abuse and Addiction, Akershus University Hospital, P.o.box 1000, 1478, Lørenskog, Norway.
Int J Behav Med. 2017 Oct;24(5):740-748. doi: 10.1007/s12529-017-9654-3.
There is a need for knowledge about how self-help materials can be made useful in treatment for Substance Abuse Disorders (SUD), as a supplement to ongoing treatment, or as independent tools for change.
In this study, we explored the use of self-help films in early addiction treatment, taking into account both patient and therapist perspectives, as well as dyadic functions. We explored how active mechanisms might be related to intervention format and implementation context. A secondary aim was to examine the potential mechanisms related to the specific content of the intervention: mindfulness and acceptance psychoeducation.
A qualitative exploratory research design, including a general inductive analytic approach, constructivist grounded theory, and source triangulation features, was used to code and analyze interview material. Emerging themes were developed into concepts, and finally an operational model. Participants included 12 patients and 22 therapists, in in-/outpatient addiction clinics, all in urban areas of Norway. The purpose of the design was empirical grounding of developed concepts, to promote different potential user perspectives (patients' and therapists') and obtain process data.
The core concept constructed, "Alliance as experiential process," gives a description of the data where patients and therapists accept or reject the film as a result of an experience process conceptualized as alliance formation. The alliance process model reflects the observation that patients constructed alliances autonomously, while therapists built alliances indirectly through their patients' experiences.
Use of a self-help film may be a helpful adjunct to face-to-face therapy for patients who create a personally meaningful attachment to the film. Mindfulness/acceptance may offer one basic framework for such connection to take place.
需要了解如何使自助材料在物质使用障碍(SUD)治疗中发挥作用,作为正在进行的治疗的补充,或作为改变的独立工具。
在本研究中,我们探讨了自助影片在成瘾早期治疗中的使用情况,同时考虑了患者和治疗师的观点以及二元功能。我们探讨了积极机制可能如何与干预形式和实施背景相关。第二个目标是研究与干预具体内容相关的潜在机制:正念和接纳心理教育。
采用定性探索性研究设计,包括一般归纳分析方法、建构主义扎根理论和来源三角验证特征,对访谈材料进行编码和分析。将新出现的主题发展为概念,最后形成一个操作模型。参与者包括挪威城市地区门诊/住院成瘾诊所的12名患者和22名治疗师。该设计的目的是对所发展的概念进行实证基础研究,以促进不同潜在用户(患者和治疗师)的观点并获取过程数据。
构建的核心概念“作为体验过程的联盟”描述了这样的数据,即患者和治疗师由于被概念化为联盟形成的体验过程而接受或拒绝影片。联盟过程模型反映了这样的观察结果,即患者自主构建联盟,而治疗师则通过患者的体验间接构建联盟。
对于那些与影片建立了个人有意义联系的患者,使用自助影片可能是面对面治疗的有益辅助。正念/接纳可能为此类联系的发生提供一个基本框架。