Follevåg Brit-Marie, Seim Sissel
Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, 6851 Sogndal, Norway.
Faculty of Social Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
Int J Environ Res Public Health. 2021 Oct 21;18(21):11060. doi: 10.3390/ijerph182111060.
This study explores patients' opportunities for collective participation in an institution for people with substance use disorder. Patients and staff from the treatment institution cooperated with researchers to make changes in the treatment practice, using a research circle as a model for the project. In the article, we discuss the following research questions: How and in what areas did patients have the opportunity to participate collectively in the treatment institution? How did the patients experience participation in the research circle? Data consist of minutes from meetings, seminars, and focus-group interviews. The participants analysed the material together, and the authors carried out a thematic analysis after the project. The participants chose to explore how milieu therapy could build a bridge from treatment in the institution to life after treatment, a "Bridge over troubled waters", to quote Simon and Garfunkel. Findings show that activities in the research circle led to changes at the institution, e.g., regular Sunday afternoon meetings, a weekly quiz, and less controlling procedures of substance use, and that the institutional culture in general became based more on participation and equality. Patients, staff, and researchers participated in a partnership; mutual recognition promoted cooperation and fellowship in the research circle. We conclude that the project provided the participants with opportunities for collective participation in the institution. In addition, the patients experienced partnership and empowerment in the research circle. Our attempts to change institutional practices yielded some improvements but also met with structural and cultural barriers. Thus, the project experienced challenges and obstacles mostly related to limitations in the institutional system and culture.
本研究探讨了物质使用障碍患者在一家机构中集体参与的机会。来自治疗机构的患者和工作人员与研究人员合作，以研究小组为项目模式对治疗实践进行变革。在本文中，我们讨论以下研究问题：患者如何以及在哪些领域有机会在治疗机构中进行集体参与？患者参与研究小组的体验如何？数据包括会议、研讨会和焦点小组访谈的记录。参与者共同分析材料，作者在项目结束后进行了主题分析。参与者选择探讨环境疗法如何能够搭建一座从机构内治疗通向治疗后生活的桥梁，借用西蒙和加芬克尔的话来说，就是“忧愁河上的金桥”。研究结果表明，研究小组中的活动导致了机构内的变化，例如定期的周日下午会议、每周一次的知识问答以及对物质使用管控程序的减少，而且总体而言机构文化变得更加基于参与和平等。患者、工作人员和研究人员参与了一种伙伴关系；相互认可促进了研究小组中的合作和情谊。我们得出结论，该项目为参与者提供了在机构中集体参与的机会。此外，患者在研究小组中体验到了伙伴关系和赋权。我们改变机构实践的尝试取得了一些改进，但也遇到了结构和文化障碍。因此，该项目遇到的挑战和障碍大多与机构系统和文化的局限性有关。
