A qualitative study exploring the benefits and challenges of implementing client centered care in a substance dependence rehabilitation service

Background Client centered care is strongly advocated as key to improving the quality of health care. However, there is a notable absence of research about the acceptability and feasibility of a client centered approach in substance dependence treatment settings. The aim of this study was to explore client and staff perspectives of a new client centered model of care implemented at Kedesh Rehabilitation Services, a residential substance dependence treatment service.Methods Participants were client and staff at Kedesh between April 2018 and April 2019. Clients were invited to take part in a focus group and staff in individual interviews. Questions elicited client and staff experience of client centered care at Kedesh, including advantages and disadvantages. Staff were also asked to describe how they would define the client centered model. Thematic analysis was conducted on transcriptions of audio recordings.Results Four focus groups were conducted amongst 18 clients and 8 individual interviews amongst staff. Staff identified the defining features of client centered care as that which is flexible, comprehensive, open-minded and inclusive. Clients and staff shared predominantly positive views on the client centered model, with an emphasis on the satisfaction in providing and receiving what felt like more authentic and comprehensive care. Shared themes emerged for clients and staff on the challenge of striking a balance between flexibility and structure, and managing comprehensive and individualized care within existing knowledge, skills and resources.Conclusions Client centered care encourages health care organisations and providers to strive for a more holistic and empowering standard of care. Results support the acceptability of client centered care in residential substance dependence treatment settings for both clients and staff. Future research is needed to develop knowledge in interpreting, implementing, and assessing client centered care in the treatment of substance dependence.

The Effect of Treatment Motivation Levels on Patients Sent to a Conditional Substance Abuse Treatment Program

The main purpose of this study is to examine the effect of treatment motivation levels on substance abuse behaviors of patients sent to a substance dependence treatment program based on the decision of Supervised Release made during a six-week psycho-educational group treatment program. The sample consisted of 112 participants who applied to the Ministry of Health Turkey, Sakarya University Training and Research Hospital, Psychiatry Clinic between the years 2012–2014, and were selected among patients who attended a six-week treatment program. The Treatment Motivation Questionnaire (TMQ), Demographic Information Questionnaire and interview methods were used in data collection. Patients with high treatment motivation levels were found to have a low substance abuse rate, and their adaptation to the treatment program was high. Patients who had high motivation levels at the beginning of the treatment, had low rates of substance abuse at the end of the treatment. This trend was confirmed for all of the measured four sub-types of motivation.