USER-INVOLVEMENT/ORIENTED MODELS OF CARE AND RESIDENTIAL SUBSTANCE USE DISORDER CARE

Objective: The purpose of this study was to examine the experiences of residential substance use disorder care participants with user-involvement/oriented models and processes of care, which are (1) person-centered, (2) shared decision-making, (3) recovery model, and (4) patient/person participation. Methods: Data collection was through semi-structured, open-ended, one-on-one interviews with a convenience sample of 12 persons over the age of 18—11 males and 1 female—who self-identified as having successfully completed at least one residential program for substance use disorder(s). All interviews were recorded and transcribed, and grounded theory methodology was used to analyze the results. Results: The experiences of the subjects in this study with residential substance use disorder care included some degree of experience with user-involvement models and processes of care. However, subjects also articulated experiences that represented the opposite of the models, and indicative of care delivery based in organizational stress and trauma, and a lack of trauma-informed care. Subjects perceived the care to be most beneficial in the presence of the models; however, good care was negated by spillage of organizational stress and trauma, and a lack of trauma-informed care. Conclusions: The current study finds organizational stress and trauma, and a lack of trauma-informed care not only serves as an impediment to the delivery of user-involvement/oriented care models and processes in residential substance use disorder care, but it becomes the overarching phenomena that informs clinical work.