"If walls could talk": A photo-elicitation-based observation of service users' perceptions of the care setting and of its influence on the therapeutic alliance in addiction treatment. (November 2018)

• Record Type: Journal Article
• Authors: Bailly, Julie; Taïeb, Olivier; Moro, Marie Rose; Baubet, Thierry; Reyre, Aymeric
• Is Part Of: Health & place. Volume 54(2018:Nov.)
• Page Start: 69
• Page End: 78
• Publication Date: 2018-11
• Subjects: Therapeutic alliance -- substance use -- addiction -- photo-elicitation -- place of care -- care setting; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2018.09.007
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: A good quality therapeutic alliance is central to the support and treatment of people who use psychoactive substances. Although previous research has suggested that place has an important role in sustaining the therapeutic alliance, this issue has been insufficiently explored in the field of addiction treatment. We conducted a qualitative study using photo-elicitation and interviewing service users in an outpatient addiction treatment centre. They reported both strongly positive and negative perceptions of the place, alongside an unstable therapeutic alliance. Apprehending the place in which care is delivered as a dynamic relational network helps to understand the role of place in shaping the therapeutic alliance in addiction treatment. There is a need for careful design and layout, and thoughtful organisation of these places. Highlights: Place and its features are expected to affect the therapeutic alliance. Service users' perceptions of place were explored in an addiction care facility. Place appeared both protective and restrictive, acting as an avatar of self-image. These perceptions come with ambivalent commitment to the therapeutic alliance. Carefully designed addiction care premises could favour the therapeutic alliance.