Earnshaw Valerie A, Bogart Laura M, Menino David, Kelly John F, Chaudoir Stephenie R, Brousseau Natalie, Levy Sharon
University of Delaware, 111 Alison Hall West, Newark, DE 19716.
Harvard Medical School, 25 Shattuck Street, Boston, MA 02115.
Int J Ment Health Addict. 2019 Dec;17(6):1535-1549. doi: 10.1007/s11469-018-9930-8. Epub 2018 May 7.
Relational processes (i.e., disclosure, stigma, social support) experienced by youth with substance use disorders (SUDs) and their caregivers may act as barriers to, or facilitators of, recovery but are understudied. Single-session qualitative semi-structured interviews were conducted with 19 patients and 15 caregivers recruited by clinicians from a SUD program. There was variability in disclosure experiences, including how many people knew about patients' SUD diagnosis and treatment, whether patients or caregivers primarily disclosed to others, and feelings about others knowing about one's or one's child's SUD treatment. After disclosing, patients and caregivers experienced stigmatizing (e.g., social rejection) and supportive (e.g., understanding, advice) reactions from others. Disclosures may have important implications for relationship and recovery-related outcomes. Moreover, some child-caregiver pairs have significant disagreements regarding disclosure of SUD treatment. Addressing relational processes within treatment by encouraging patients and caregivers to share the disclosure decision-making process may support the recovery of youth with SUDs.
患有物质使用障碍(SUDs)的青少年及其照顾者所经历的关系过程(即披露、耻辱感、社会支持)可能成为康复的障碍或促进因素,但相关研究较少。对临床医生从一个SUD项目中招募的19名患者和15名照顾者进行了单场定性半结构化访谈。披露经历存在差异,包括有多少人知道患者的SUD诊断和治疗情况、主要是患者还是照顾者向他人披露,以及对他人知晓自己或自己孩子的SUD治疗的感受。披露后,患者和照顾者经历了他人的耻辱性反应(如社会排斥)和支持性反应(如理解、建议)。披露可能对关系和康复相关结果具有重要影响。此外,一些儿童-照顾者对在SUD治疗的披露问题上存在重大分歧。通过鼓励患者和照顾者分享披露决策过程来处理治疗中的关系过程,可能会支持患有SUDs的青少年康复。