The clients' perspective on change during treatment for an alcohol problem: qualitative analysis of follow-up interviews in the UK Alcohol Treatment Trial.

AIM: To develop a model of change during and following professional treatment for drinking problems, grounded in clients' accounts. PARTICIPANTS: Subsets of consecutively selected clients of the UK Alcohol Treatment Trial (UKATT), followed-up at 3 months (n = 211) and 12 months (n = 198) after rando...

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Published in:Addiction Vol. 101; no. 1; pp. 60 - 69
Main Authors: Orford J, Hodgson R, Copello A, John B, Smith M, Black R, Fryer K, Handforth L, Alwyn T, Kerr C, Thistlethwaite G, Slegg G
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Jan2006
Online Access:View this record in EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        106406351
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        2009111057
        10.1111/j.1360-0443.2005.01291.x
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        atl: The clients' perspective on change during treatment for an alcohol problem: qualitative analysis of follow-up interviews in the UK Alcohol Treatment Trial.
      aug:
        au:
          Orford J
          Hodgson R
          Copello A
          John B
          Smith M
          Black R
          Fryer K
          Handforth L
          Alwyn T
          Kerr C
          Thistlethwaite G
          Slegg G
        affil: Alcohol, Drugs, Gambling and Addiction Research Group, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; j.f.orford@bham.ac.uk
      sug:
        subj:
          Alcohol Abuse Therapy
          Behavioral Changes
          Causal Attribution
          Audiorecording
          England
          Funding Source
          Grounded Theory
          Interview Guides
          Interviews
          Models, Psychological
          Prospective Studies
          Support, Psychosocial
          Wales
          Human
      ab: AIM: To develop a model of change during and following professional treatment for drinking problems, grounded in clients' accounts. PARTICIPANTS: Subsets of consecutively selected clients of the UK Alcohol Treatment Trial (UKATT), followed-up at 3 months (n = 211) and 12 months (n = 198) after randomization. Location Five statutory and non-statutory alcohol problems treatment agencies in three areas of England and Wales. Data Open-ended interviews conducted according to a brief interview guide, leading to 400-800-word post-interview reports used for analysis (tape-recordings used for auditing purposes). ANALYSIS: Reports analysed by a team according to grounded theory principles, involving an iterative process with successive refinement of interviewing and analysis with each successive batch of data. FINDINGS: A model of change from the clients' perspective was developed. Treatment was seen by clients as facilitating various changes in ways of thinking and/or increased support of various kinds from family and friends, along with new ways of acting in relation to drinking or more generally. For many those changes had led to an appreciation of the benefits accruing to them. Treatment was seen as part of a broader treatment system which included pretreatment assessment, forms of help additional to the trial treatment, plus an element of self-directed change during and following treatment. Taken with awareness of worsening alcohol-related harms, triggering events and external influence to seek treatment (the catalyst system), to which clients continued to refer following treatment, the change process is depicted as a complex, ongoing set of systems in which a trial treatment is embedded. CONCLUSIONS: Models of change should be broadened so that treatment is seen as a complex system of parts, facilitating a nexus of cognitive, social and behavioural changes, embedded within a broader system of events and processes catalysing change. Such a model helps explain the relative absence of between-treatments outcome differences in UKATT and in the alcohol problems treatment and more general psychotherapy research literatures.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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