Coparticipative Adherence: The Reconstruction of Discharge Categories in the Treatment of Substance Use Disorders. Issue 3 (3rd July 2017)

• Record Type: Journal Article
• Authors: Williams, Izaak L.; Mee-Lee, David
• Is Part Of: Alcoholism treatment quarterly. Volume 35:Issue 3(2017)
• Page Start: 279
• Page End: 297
• Publication Date: 2017-07-03
• Subjects: Discharge categories -- accreditation standards -- coparticipative adherence -- substance use disorders -- treatment regulations -- management information systems; Alcoholism -- Treatment -- Periodicals; 613.81
• DOI: 10.1080/07347324.2017.1322432
• Languages: English
• ISSNs: 0734-7324

Abstract

ABSTRACT: Management information systems and regulatory oversight in addiction treatment require classification of client discharge status and reports of relative percentages for commonly agreed categories, such as successfully completed or discharged for noncompliance. This article examines underlying assumptions and values for current addiction treatment discharge categories. It suggests that a "moral-choice compliance" model of addiction underpins current discharge categories despite the prevailing view of addiction as a disease, and recovery-oriented systems of care that values client empowerment. To contrast a compliance, program-driven philosophy implied in current discharge classification terminology, a "coparticipative adherence" model is suggested to drive discharge terminology. Such a model values client autonomy in the administrative and clinical program systems to participate and collaborate on goals and treatment plans, and self-fueled adherence and committed effort in treatment, which shapes discharge classification terminology. Contrasting and alternative discharge categories are offered and explained.