Overcoming professionals' challenging experiences to promote a trustful therapeutic alliance in addiction treatment: A qualitative study. (1st May 2017)

• Record Type: Journal Article
• Authors: Reyre, Aymeric; Jeannin, Raphaël; Largueche, Myriam; Moro, Marie Rose; Baubet, Thierry; Taieb, Olivier
• Is Part Of: Drug and alcohol dependence. Volume 174(2017)
• Page Start: 30
• Page End: 38
• Publication Date: 2017-05-01
• Subjects: Substance related disorders -- Professional-patient relations -- Qualitative research -- Compassion fatigue -- Delivery of health care -- Personnel management; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2017.01.015
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Professional challenges in addiction care lead to a poor therapeutic alliance. Distrust seeps in between professionals and service users with heavy consequences. Restoration of a trustful alliance requires institutional and individual efforts. Self-care, training and team organization promote a trustful alliance with clients. Abstract: Background and aims: A good therapeutic alliance plays a major role in the healing process. Professionals working in addiction treatment report high levels of psychological distress related to work and this may challenge the establishment of a trustful therapeutic alliance, and lead to a loss of care quality provided to service users. The purpose of this study was to investigate the experience of specialized professionals, its effects on trust and the therapeutic alliance, and the means to restore them. Design: We conducted a qualitative study using a semi-structured questionnaire and a narrative tool. Discourse was extracted from focus groups and individual interviews and analyzed following the Interpretative Phenomenological Analysis method. Participants: Twenty-six professionals from three addiction treatment centers in the Paris area were interviewed. Findings: The difficulties weighing on the care alliance were described by the participants in terms of their nature, their effects and means to overcome them. Emotional drain leads to a climate of relational distrust and the temptation to desert or over-control patients. Teambuilding, specific training and self-care are viewed as means to restore a therapeutic alliance based on an appropriate type of trust. Conclusions: Distrust deriving from professionals' challenging experiences may lead to worrying consequences. Promoting democratic organization of care structures, specific training, and also responsible self-care on the part of professionals could help to restore a type of trust that helps to establish a therapeutic alliance suited to service user individualities. This could ultimately be beneficial for user care, professional wellbeing and team functioning.