Use or Misuse?: Addiction Care Practitioners’ Perceptions of Substance Use and Treatment
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
The aim of this thesis has been to study boundary-making in addiction care practitioner’s perceptions of substance use and treatment. The four papers are based on three data collections in Swedish outpatient addiction care: a) a survey conducted in 2006 (n=655), b) a factorial survey using randomly constructed vignettes conducted in 2011 (n=474), and c) a focus group interview study from 2013 (n=30) with a sample of the respondents from the factorial survey.
The analyses show that practitioners tend to draw boundaries between various forms of substance use, with alcohol use being perceived as a less severe problem than narcotics use and requiring less extensive treatment measures. There are also partially varying perceptions in different parts of addiction care. By comparison with social services staff, regional healthcare staff generally see a greater need for treatment, recommend medical treatment to a greater extent, and display less confidence in the possibility of handling problematic use without professional treatment. Despite an ongoing medicalization at the policy level, psychosocial treatment interventions appear to have legitimacy in both regional healthcare and social services settings.
Boundary-making processes are also found in relation to the specific user’s age, family situation, socio-economic status and in some cases gender, with young women’s drinking being seen as more severe than young men’s drinking for example. The boundary-making between different substance users may be interpreted as a sign of an approach based on a professional consideration of the person’s socially exposed situation, which might require more comprehensive support. At the same time, it may be an expression of a stereotyped approach, involving a normative evaluation of women’s behaviour as being more deviant than men’s, thereby having a limiting effect on the conduct norms that regulate women’s behaviour and making the problems of men invisible. To avoid disparities in addiction care delivery, it is of major importance that practitioners are given room to reflect upon the assumptions and values that underlie the assessments they make in practice. Combining a factorial survey with focus group interviews is proposed as one means of facilitating this type of reflection.
Place, publisher, year, edition, pages
Stockholm: Department of Social Work, Stockholm University , 2015. , 121 p.
Stockholm studies in social work, ISSN 0281-2851 ; 30Dissertations at the Centre for Social Research on Alcohol and Drugs (SoRAD), ISSN 1650-819X ; 14
substance use, treatment, practitioners’ perceptions, social services, regional healthcare, factorial survey, multi-level analysis, focus group interviews, discourse analysis, Sweden
Research subject Social Work
IdentifiersURN: urn:nbn:se:su:diva-112132ISBN: 978-91-7649-060-0OAI: oai:DiVA.org:su-112132DiVA: diva2:778213
2015-02-13, Aula Svea, Socialhögskolan, Sveavägen 160, Stockholm, 10:00 (Swedish)
Sahlin, Ingrid, Professor
Blomqvist, Jan, ProfessorHübner, Lena, PhDWallander, Lisa, PhD
FunderForte, Swedish Research Council for Health, Working Life and Welfare, 2006-1523
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Submitted. Paper 4: Submitted.2015-01-222015-01-092015-01-14Bibliographically approved
List of papers