Iudici Antonio, Berardelli Tobia, Fenini Davide, Subissi Emiliano, Neri Jessica
Department of Philosophy, Education, Sociology and Applied Psychology of Padua (FISPPA), University of Padua, 35139 Padua, Italy.
Institute of Psychology and Psychotherapy, Scuola Interazionista, 35100 Padua, Italy.
Behav Sci (Basel). 2024 Oct 15;14(10):951. doi: 10.3390/bs14100951.
Therapeutic communities face high drop-out rates and general distrust of their effectiveness among substance users. Actively involving users early in treatment promotes greater compliance with the treatment and is predictive of better outcomes. However, users often occupy a passive and subordinate role, exacerbated by the lack of research that explores their perspectives, beliefs, and experiences. This study examined the discourses of 57 consumers who were part of a community for less than 15 days, investigating the meanings attributed to service entry and treatment. A protocol of four written open-ended questions was employed and analysed through discourse analysis and positioning theory. The results indicate that participants configure the community as a place symbolically and spatially distinct from the rest of the world, where they isolate themselves to seek support during times of extreme difficulty. However, what they are seeking is a solution to acute distress caused by substance use, intertwined with social, economic, and relational issues. The concept of treatment is built on the image of the substance user as an individual making a weak request for help, attributing the problem solely to drugs and exhibiting reduced agency in addressing their issues. The collected texts provide a better understanding of the experiences of new users, highlighting the importance of co-constructing personalised projects that empower consumers to feel actively involved in their own change, exploring their theories and definitions of self to structure pathways based strictly on their needs.
治疗社区面临着高退出率以及药物使用者对其效果普遍不信任的问题。在治疗早期就让使用者积极参与,能促进他们更好地遵守治疗方案,并预示着更好的治疗效果。然而,使用者往往处于被动和从属地位,而对他们的观点、信念和经历缺乏研究则加剧了这一情况。本研究考察了57名在社区中停留不到15天的使用者的话语,探究了他们对进入服务机构和接受治疗的理解。研究采用了包含四个书面开放式问题的方案,并通过话语分析和定位理论进行分析。结果表明,参与者将社区视为一个在象征意义和空间上都与世界其他地方不同的场所,在极度困难时期他们会在这里隔离自己以寻求支持。然而,他们所寻求的是解决因药物使用引发的急性困扰的办法,这与社会、经济和人际关系问题交织在一起。治疗的概念建立在药物使用者是一个微弱求助个体的形象之上,将问题完全归咎于药物,且在解决自身问题时表现出能动性不足。所收集的文本能让我们更好地理解新使用者的经历,凸显了共同构建个性化方案的重要性,这些方案能让使用者积极参与自身的改变,探索他们对自我的理论和定义,从而严格依据自身需求构建路径。