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  • 1.
    Bergmark, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    The pursuit of evidence-based practice - a comparison of three guidelines on psychosocial interventions for alcohol problems2014In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 31, no 3, p. 271-288Article in journal (Refereed)
    Abstract [en]

    Aims

    In this article we scrutinise three prominent guidelines on psychosocial interventions for alcohol problems. We pay special attention to how congruent the guidelines are in terms of the interventions recommended, and the processes used in order to identify and rank the “evidence” underpinning these recommendations.

    Data

    The analysed guidelines are: 1) Practice Guideline for the Treatment of Patients with Substance Use Disorders, American Psychiatric Association (2006); 2) Alcohol-Use Disorders. The NICE Guideline on Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (2011), National Collaborating Centre for Mental Health, UK; 3) Guidelines for the Treatment of Alcohol Problems, Australian Government, Department of Health and Ageing (2009). The purpose is not to review the three guidelines as such, but to study them as an example of the production of evidence. All report to be based on “best available evidence”, so the guidelines were compared both regarding the actual recommendations and the guideline production procedures and differences in these procedures with related consequences.

    Results & CONCLUSIONS

    Prestigious organisations in different national contexts have reached divergent conclusions about evidence-based practice and the quality of the scientific studies underpinning these conclusions. Differences in the guidelines regarding interpretations, limitations and grading illustrate the difficulties with the dilemmas of sensitivity (to include factors that are significant for how a psychological intervention is to be judged) and specificity (that irrelevant studies are cleared off) in the recommendations presented.

  • 2.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Approaching drinking problems in single male clients receiving social assistance2012In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 15, no 2, p. 257-274Article in journal (Refereed)
    Abstract [en]

    How are drinking problems in single male clients receiving social assistance approached?This subject has been investigated in two studies. In Study I, 103 social workersresponded to a questionnaire on how they would act towards a hypothetical client. Theresults suggest that there is no consensus among social workers as to how to act towardstheir clients’ drinking problems and that personal values more than anything else arewhat seem to influence the choice of action taken. Study II is based on focus groupinterviews with social workers. The social workers’ approach to the clients’ problems isdescribed as a mobile point within a two-dimensional system. One dimension concernsthe client’s right to equal treatment versus the right to have their application judgedindividually with special circumstances considered. The other dimension is related to theclient’s integrity versus the need for support and control. The results are contextualisedmainly from three aspects: the demands on ‘knowledge’ in social work, the specificframework of social work, and changes in the public discourse regarding sociallyacceptable drinking habits.

  • 3.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    ASI i retorik och praktik2012In: Socionomens forskningssupplement, ISSN 0283-1929, no 32, p. 34-42Article in journal (Refereed)
    Abstract [sv]

    Här diskuteras användningen av ASI i socialtjänstens arbete med missbruksvård och om instrumentet i sig kan ge kvalitetsförbättringar i arbetet, både i form av att möjliggöra gruppsammanställningar och som instrument i det direkta klientarbetet. Utgångspunkt för diskussionen är dels en studie där socialarbetare återger hur de värderar instrumentet och dels exempel på hur gruppsammanställnignar görs på kommunnivå. Slutsatsen dras att det är av stor vikt att ASI användare är utbildade i att använda verktyget och att de är professionella socialarbetare, att ökad transparens och rättsäkerhet med hjälp a ASIinstrumentet troligtvis är avhängigt en bred användning samt att sammanställnignar på gruppnivå riskerar att bli missvisande om ingen kontroll finns över vilka klienter som inte finns med i sammanställningen.

  • 4.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hantering av alkoholproblem inom arbetet med socialbidrag2009In: Alkohol och droger: Samhällsvetenskapliga perspektiv / [ed] Kajsa Billinger & Lena Hübner, Malmö: Gleerups Utbildning AB, 2009, 1, p. 191-207Chapter in book (Other academic)
  • 5.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Labour market status, requirements and social support—single male clientswith problematic alcohol consumption2011In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 14, no 4, p. 513-523Article in journal (Refereed)
    Abstract [en]

    The study presented in this article investigates relations between two phenomena that arewidely considered to be social problems*unemployment and alcohol abuse. Theinvestigated group is that of single male clients receiving social assistance in Sweden.Difficulty in supporting themselves is thus the main reason why these clients have contactwith the social welfare office, but to some extent the clients in focus do also have adrinking problem (defined as notes on drinking problems in their case files). Case files onmale, single clients in which alcohol-related notes were present are investigated(n297). The results indicate that social workers are more active in making demandson clients to change their alcohol habits if the clients are able to support themselvesthrough work than if they are not. This implies that resources for the treatment of alcoholand drug abuse may be allocated on the basis of which clients it is possible to removefrom the social service system*i.e. who are able to support themselves through work*and not on the basis of which clients are the most needy.

  • 6.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Behandlingens mekanismer2015In: Socionomen, ISSN 0283-1929, no 3, p. 44-56Article in journal (Refereed)
  • 7.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Conditions for recovery from alcohol and drug abuse: comparisons between male and female clients of different social position2016In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 6, no 3, p. 211-221Article in journal (Refereed)
    Abstract [en]

    This study adduces an interactive perspective on treatment and relates to research describing change as a process. It focuses on differences in how the importance of internal and social factors for the change process is described among male and female clients of different social position. The concept of recovery capital is used as analytic tool. Female and male clients were interviewed and asked to talk about factors they perceived as important for initiating and maintaining change. The use of a relatively large amount of interviews strengthen the possibilities of drawing generalized conclusions on differences between the groups, making comparisons possible while still keeping the qualitative meaning of the investigated factors. The most important finding in the study is that the implications of different factors during the change process seem to relate to gender stereotypes and that the client’s social position (defined as marginalized or integrated) seems to be important for how gender stereotypes emerge. It is argued that gender stereotypes can serve both as a support and a hinder during recovery. This is discussed using the concept of recovery capital to illuminate qualitative differences regarding the importance of internal and social factors for the process of change for men and women of different social position.

  • 8.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Recovery capital in the process of change-differences and similarities between groups of clients treated for alcohol or drug problems2014In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 17, no 1, p. 58-73Article in journal (Refereed)
    Abstract [en]

    The study investigated clients' retrospective descriptions of the impact of treatment interventions as well as other contextual factors in the clients' process of recovery. The data set was divided into two groups based on the clients' social integration, one marginalized and one integrated group, and analyzed for qualitative group-related differences in common factors described by the clients. The results showed some group-related differences in the process of change. When a process of change was initiated, family-related problems were more often severe for clients in the marginalized group than for those in the integrated group. Important factors for maintaining positive change were to a greater extent present in the integrated group while the marginalized group recreated them during treatment, for example by creating new social networks and getting employment. With these differences in mind, both groups stressed the same type of factors as important for a process of change. This might suggest that although the clients in the marginalized group had restored their external social conditions during treatment, their actual recovery capital was in general more fragile than that of clients in the integrated group and hence these clients might be in need of extended support after treatment.

  • 9.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    A 30-year follow-up of substnace misusers in Sweden – differences and predictors of mortality between women and men2019In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 27, no 4, p. 328-336Article in journal (Refereed)
    Abstract [en]

    Background: Differing results on gender specific factors related to mortality risks among substance misusers highlights the need for further research. The present article is based on a 30-year follow-up study on substance misusers treated in residential care for drug problems in Sweden in 1982-1983 aiming to identify and compare gender differences in predictors of mortality.

    Method: Original data consists of personal interviews with 1163 substance misusers treated in inpatient units in Sweden during 1982-1983. The outcome variable is death retrieved from the National Cause of Death Register held by the National Board of Health and Welfare. Gender differences and similarities regarding predictors of mortality was estimated in univariate and multivariate models, using Cox proportional hazards models.

    Results: School failure, imprisonment and being a parent without custody of the child seem to constitute risk factors for mortality among women, but not among men. A social network of friends seemed to be more important for men. Treatment-dropout was a significant risk factor for premature death among men, but not among women. Both gender reporting alcohol as their self-reported most dominant substance misuse showed higher mortality risks compared with those with stimulants as dominant substance misuse.

    Conclusions: Imprisonment was highly predictive of mortality for the women, suggesting that this group is important to pay particular attention to. Suggested differences in the importance of social factors need to be investigated more thoroughly. The substantial hazard revealed for women with polydrug misuse including alcohol calls for attention to this in treatment for substance misuse.

  • 10.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Esch-Ekström, Jasmine
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Positiva förändringsprocesser bland unga vuxna i öppenvård2017In: Socialvetenskaplig tidskrift, ISSN 1104-1420, Vol. 24, no 1, p. 39-57Article in journal (Refereed)
    Abstract [en]

    Positive processes of change among young adults in out-patient care

    In contemporary society, the transition phase from adolescence to adulthood  is often described as a period of moving back and forth between youthful dependency  and independent adulthood in what is called ‘yo-yo-transitions’. However, studies of young people in need of out-of-home care, or other child welfare, for psychosocial problems, points out that this vulnerable group have limited possibilities to do these transition movements. The present study investigates positive change processes during this particular part of life in out-patient care clients. The research questions are: 1) How do young adult clients describe important factors for a positive process of change and 2) How are important factors related to the treatment described by clients and by treatment staff. Data consists of seven personnel interviews and twenty interviews with young adults that have completed out-patient care. The results suggest that the relation between an individual treatment staff and the young adult is central for the positive change process. In the discussion it is suggested that the preconditions for this relation are: 1) A genuine engagement and dedication from the professional. 2) With this first point as a foundation, the mastering of a spectrum of professional methods and the ability to choose when to use them are necessary means for positive change processes to come about. 3) A supportive organisation and leadership are crucial for setting the frames that makes the first two points possible to establish.

  • 11.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Topor, Alain
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Initiating and maintaining a recovery process - experiences of persons with dual diagnosis2018In: Advances in Dual Diagnosis, ISSN 1757-0972, E-ISSN 2042-8324, Vol. 11, no 3, p. 101-113Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to investigate the internal and social factors that persons with experience from severe mental illness and alcohol and other drugs problems, and who have received treatment for these problems, describe as important for initiating and maintaining a recovery process.

    Design/methodology/approach - In total, 40 persons were interviewed and asked to describe factors they perceived as important for initiating and maintaining recovery. The software Nvivo was used to categorise data in internal and social factors with subcategories.

    Findings - There is significant variation in how recovery emerged but involved in general having a proper social situation and finding meaning in life. Initially, the majority had a marginalised situation with need of assistance with housing, employment, financial and social support.

    Research limitations/implications - The change process in the investigated group is interpreted as related to individual resources rather than belonging to a group defined as having double trouble.

    Practical implications - The study implies that in addition to professional help to handle diagnosed problems, the group in focus also need support and interventions that address individual complex needs.

    Social implications - Supporting activities/peer support seem to be important for those lacking support from family. At the same time, it is important to recognise the risk of being forced into a recovery identity which might lead to worsening the situation for those who do not fit into this.

    Originality/value - By using the same design as in previous studies, comparisons with other groups are possible while still keeping the qualitative meaning of the investigated factors.

  • 12.
    Topor, Alain
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Building trust and recovery capital: the professionals' helpful practice2018In: Advances in Dual Diagnosis, ISSN 1757-0972, E-ISSN 2042-8324, Vol. 11, no 2, p. 76-87Article in journal (Refereed)
    Abstract [en]

    Purpose - The possibility of recovery for persons with co-occurring addiction and mental health problems has been contested. Though, recent studies show that recovery might happen, but without connection to specific treatment interventions. The purpose of this paper is to analyse professionals' perceptions of their contribution to improvement.

    Design/methodology/approach - In all, 15 experienced professionals were interviewed. The interviews were analysed using thematic analysis.

    Findings - Recovery processes were dependent of the persons' access to different forms of recovery capital (RC). Lack of RC was often associated with lack of trust in one's self and others (identity and personal capital). Professionals had to be accepted as trustful agents through co-creating changes in the person's life. Trusting a professional might be a basis for trusting one's self as an agent in one's recovery process and develop a social network (identity and relationship capital). Other aspects stressed by the professionals were to manage their own fragmentized organisations and societal shortcomings (economic capital).

    Practical implications - Recovery has been described as a profoundly individual journey. However, it is also deeply social, involving other persons and contextual factors. Focusing on just one level might counteract the complex work behind double recovery.

    Originality/value - Improvement was described as dependent on the presence of personal, inter-personal, organisational and societal factors. The findings give a deep and concrete understanding of the process constituting the development of a working alliance and its dependence on factors outside the direct relation between the staff member and the person.

  • 13.
    Topor, Alain
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work. University of Agder, Norway.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge2019In: International Journal of Mental Health and Addiction, ISSN 1557-1874, E-ISSN 1557-1882Article in journal (Refereed)
    Abstract [en]

    Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

  • 14.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Förändringsprocesser i samband med missbruksbehandling - vilka faktorer beskriver klienter som viktiga för att initiera och bibehålla positiva förändringar?2012In: Nordisk Alkohol- og narkotikatidsskrift (NAT), ISSN 1455-0725, E-ISSN 1458-6126, Vol. 29, no 2, p. 195-209Article in journal (Refereed)
    Abstract [en]

    ABSTRACTProcesses of change during and after drug treatment, What factors are described by clients asimportant to initiate and maintain positive changes?AIMS – The aim is to describe and analyze how clients recovered from alcohol or drug abuse perceivechange in connection with treatment interventions. The specific questions are: What factors aredescribed as important to 1) initiate a process of change? 2) avoid returning to abuse? DESIGN – 40clients were interviewed according to a brief interview guide. The analysis resulted in models withfactors that the clients considered important for initiating and maintaining positive changes. RESULTS– The result suggests that a pattern is emerging in the process of change. Although the clients oftendescribe common factors as important, the variation of timing and severity for different factors makesthe individual story unique. CONCLUSIONS – The variation of timing and severity for different factorsimplies that it is very difficult to predict when a factor is important or not. This underlines the importanceof treatment systems with a structure and a flexibility that enables supporting factors to be used whenthey are of importance for the individual client.

  • 15.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Positiva förändringsprocesser bland unga vuxna som haft Aleris Målet som insats2015Report (Other academic)
  • 16.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Positive processes of change among male and female clients treated for alcohol and/or drug problems2017In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296X, Vol. 17, no 2, p. 186-206Article in journal (Refereed)
    Abstract [en]

    Summary

    In social work practice, the role of substance use is often encountered in the context of other social problems such as child abuse and domestic violence. This article compares descriptions of important factors for initiating and maintaining positive changes among male and female clients treated for alcohol and/or drug problems. The results have a bearing both on substance use treatment and on other areas in social work practice where these problems are encountered. Studies highlighting gender perspective indicate differences regarding experience of alcohol and drug problems and treatment. An advantage of the study is the qualitative analysis of a rather comprehensive material (n = 90) enabling more general conclusions than in previous research with a limited number of clients.

    Findings

    Women more often than men stress poor mental health and their children as important for initiating change. When referring to partners, women report abusive rather than supportive partners while the opposite applies to men. For maintaining change, male clients more often stress changes in ways of thinking and feeling as important. Men also report becoming more sensitive while women get more active. This can be understood as transcending of gender with possibilities of a broader repertoire of how to act.

    Applications

    A challenge for practical treatment work is to create possibilities for clients to broaden their repertoire of ways of living and thinking about themselves, expressed by women as the importance of taking space and speaking up and by the men of showing emotion and listening more.

  • 17.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    The mechanisms of treatment – client and treatment staff perspectives on change during treatment for alcohol problems2013In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Article in journal (Refereed)
    Abstract [en]

    The overall aim of this study is to increase the understanding of operative factors in the treatment process by studying how clients and treatment unit staff perceive the relevance and value of the alcohol treatment intervention for a positive process of change. The specific research questions are: (1) How do clients describe the relevance and importance of treatment interventions in their own process of change? (2) How do treatment staffs describe experience and perceptions of how their work can contribute to a successful change process among treated clients? (3) How do client and the treatment staff descriptions relate to each other? Interviewees (40 clients and eight professionals) were recruited from four treatment units in the Stockholm area. In the results, the three treatment components most emphasised by clients are structure and regularity, friendship and support of the group and the personal conduct and professionalism of the staff. Both of the components referring to the client group and to the staff were also brought forward by the professionals interviewed. In treatment, the client group is used as an important tool for creating a sense of trust, confidence, acceptance and collaboration – all central components of the treatment alliance concept. With reference to the notion of rebuilding/extending recovery capital, it is suggested that in addition to the addiction problem intervention, a more extended system of support is vital for more marginalised clients.

  • 18.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Understanding the concept of the therapeutic alliance in group treatment for alcohol and drug problems2019In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 22, no 1, p. 69-81Article in journal (Refereed)
    Abstract [en]

    This article investigates how treatment factors are described by different client groups and by treatment staff. The material consists of interviews with clients (n = 81) and treatment staff (n = 18). The analysis focuses on two central themes – the importance of the treatment group and of the treatment staff, along with how these descriptions relate to the concept of the therapeutic alliance. The descriptions differ in parts between the client groups and between clients and staff. Clients as well as staff highlight structural and qualitative aspects of cohesion, but general patterns of how these are expressed in the groups are hard to grasp. However, some exceptions appear; while the clients often relate recognition to own experience of substance abuse, the staff often refer to external aspects of recognition, such as gender and/or experience of parenting. The results indicate that the social preconditions of the group members can influence group cohesion. In the treatment, focus is initially on cohesion and later on making change possible. This might create a dilemma; the homogeneity that initially creates cohesion can also act as a restraint on change. This is described in the results in relation to gender homogeneous client groups in treatment.

  • 19.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Sociology. The National Board of Health and Welfare, Sweden.
    Social inclusion of clients treated for substance abuse in Sweden in the 1980s: A 27-year follow-up2019In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 36, no 4, p. 314-329Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate social inclusion/exclusion in terms of criminality, substance abuse and participation in the labour market in clients treated for substance abuse in Sweden in the 1980s during a follow-up period of 27 years.

    Method: SWEDATE data are used for background information on the clients. The data were collected through interviews with clients registered for treatment in 31 in-patient treatment units in 1982 and 1983. Data on labour market status, education and medication related to drugs were collected from public registers. The study population consisted of 1132 individuals, who were followed from the year after exiting from treatment (Year 1) until the end of the follow-up (December 2013).

    Results: Among those who survived, the women seem to have succeeded better in terms of social inclusion both at an aggregated level and when the individual pathways were followed during the follow-up period. When comparing pathways between adverse and non-adverse groups during the follow-up period the results show movements from being adverse to non-adverse but also the opposite. In the last follow-up in 2013, the majority of the clients defined as non-adverse for the last nine years were in some way established in the labour market (including studies). In total, about two fifths of the group were in some way established in the labour market.

    Conclusions: The fairly high proportion of clients moving between being adverse and non-adverse during the follow-up might support the perspective suggesting that dependence should not be considered as chronic.

  • 20.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Berlin, Marie
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Mortality and Cause of DeathA 30-Year Follow-Up of Substance Misusers in Sweden2018In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 53, no 12, p. 2043-2051Article in journal (Refereed)
    Abstract [en]

    Background: This article presents a 30-year follow-up study of a cohort of 1163 substance misusers who were in inpatient treatment in the early 1980s. Data was originally collected in the Swedish Drug Addict Treatment Evaluation (SWEDATE). Objectives: The aim is to examine the overall mortality and identify causes of death in different groups based on self-reported most dominant substance misuse among those who have died during January 1984-December 2013. Methods: SWEDATE-data was linked to the National Cause of Death Register. Five mutually exclusive study groups were created based on self-reported most dominant substance misuse for the last 12 months before intake to treatment: Alcohol, Cannabis, Stimulants, Opiates, and Other. The Standardized Mortality Ratio (SMR) was calculated. Results: During the follow-up, 40% died. SMR is 10.3 for women and 11.7 for men. The study groups differed regarding SMR; 13.1 in the Alcohol group, 9.2 in the Cannabis group, 9.6 in the Stimulants group, 16.7 in the Opiates group and 10.8 in the Other group. Drug related death was the most common cause of death (28% only underlying, 19% both underlying and contributing) followed by alcohol related reasons (17% vs. 9%). Conclusions: Alcohol misuse among substance abusers might have a negative impact on mortality rates. Methodological changes in how drug related deaths is registered affects the interpretation of the statistics of cause of death. Further analysis on the relation between drug related cause of death and drug misuse related death is needed.

  • 21.
    von Greiff, Ninive
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Skogens, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Topor, Alain
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Supporting recovery in social work with persons having co-occurring problems – clients’ and professionals’ perceptions2018In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Article in journal (Refereed)
    Abstract [en]

    The study focus on how clients with co-occurring problems describe the importance of treatment factors for the recovery process and how these descriptions relates to professional descriptions. 40 client interviews and 15 interviews with professionals were conducted. Three major themes emerge in the results: medication, methods and the professionals.

    The amount of contact with psychiatry and social services that these clients often have through the years can lead to a ‘learned passivity’ towards their own recovery process. Thus, an important task for the professionals is to break through passivity and isolation. This can be done by treating the client like an ‘ordinary fellow human’. Besides the actual professional tasks, small things seem to be important; greeting the person, paying respect when entering some one’s home, etc.

    When a social network is missing, the professional can sometime fill this gap, but if this is to promote recovery, it seem important that the professional social network is used as a bridge to other social networks.

    The professionals as a group, including the environment, emerge as important. Accordingly, to be supportive as a group, and be able to act like ‘social role models’, the professionals need to have working alliances also between themselves. The environment can also offer tools that can be used for socialization that interfere with the ‘learned passivity’ and instead includes and respects the client. This, together with the results highlighting the importance of creating safe milieus, confident and secure professionals, puts focus on how the professional work is organized.

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