Provider views of harm reduction versus abstinence policies within homeless services for dually diagnosed adults.

Provider views of harm reduction versus abstinence policies within homeless services for dually diagnosed adults.
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DOI:
10.1007/s11414-013-9318-2
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发表时间:
2014-01
影响因子:
1.9
通讯作者:
Tiderington, Emmy
Tiderington, Emmy
中科院分区:
医学4区
文献类型:
--
作者:
Henwood, Benjamin F.;Padgett, Deborah K.;Tiderington, Emmy

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许多人认为减少伤害是双重诊断个人基于禁欲的服务的合法替代方案,但对于不同方法如何影响无家可归成年人支持性住房服务中的一线实践的了解有限。本文探讨了为无家可归者、严重精神疾病和成瘾者提供服务的一线服务提供者如何看待减少伤害与禁欲政策,两种截然不同的无家可归者服务方法:传统的或要求禁欲的“治疗优先”(TF)方法和最近包含减少伤害的住房优先(HF)方法。作为联邦政府资助的定性研究的一部分,对 41 家提供者进行的 129 次深度访谈进行了主题分析,以了解提供者如何看待减少伤害与禁欲方法。主题包括: (a) 减少伤害作为受欢迎的替代方案; (b) 工作含糊不清; (c) 允许禁欲。根据康复原则,我们考虑了研究结果对该人群行为健康护理的更广泛影响。
Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within supportive housing services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two distinctly different approaches to homeless services: the traditional or ‘treatment first’ (TF) approach that requires abstinence and the more recent Housing First (HF) approach that incorporates harm reduction. As part of a federally-funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view a harm reduction versus abstinence approach. Themes included: (a) harm reduction as a welcomed alternative; (b) working with ambiguity; and (c) accommodating abstinence. Drawing on recovery principles, we consider the broader implications of the findings for behavioral health care with this population.
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