Coerced addiction treatment: Client perspectives and the implications of their neglect
Coerced addiction treatment: Client perspectives and the implications of their neglect
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强迫成瘾治疗：服务对象的观点及其忽视的影响
作者：
K. Urbanoski
近期的研究对社会控制和强制手段下成瘾治疗有效性的证据基础提出了批评，指出到目前为止所进行的研究存在诸多局限，阻碍了合理政策和治疗实践的发展。强制治疗有效的隐含假设在治疗、法律和社会服务系统的组织和演变以及相关立法实践中都很明显。本综述在以往研究的基础上，更详细地关注纳入服务对象对强制的看法的潜在价值，以及对解释和应用现有研究结果的影响。通过回顾现有的实证和理论文献，提出在研究中更准确地呈现强制经历和事件，以便使所衡量的概念与治疗准入和接纳的实际过程更好地契合。关注社会控制或压力下治疗有效性的研究、与强制和决策的联系，以及动机和行为改变的理论观点，特别是自我决定理论。对强制成瘾治疗现有研究的综合表明，在很大程度上仍不清楚许多常用的让人们接受治疗的方法在多大程度上可能对治疗过程和长期结果有害。到目前为止，成瘾研究人员尚未充分处理强制对个体服务对象、治疗系统和人群健康的影响。
Recent work has criticized the evidence base for the effectiveness of addiction treatment under social controls and coercion, suggesting that the development of sound policies and treatment practices has been hampered by numerous limitations of the research conducted to date. Implicit assumptions of the effectiveness of coerced treatment are evident in the organization and evolution of treatment, legal, and social service systems, as well as in related legislative practices. This review builds upon previous work by focusing in greater detail on the potential value of incorporating client perspectives on coercion and the implications for interpreting and applying existing research findings. Reviewing the existing empirical and theoretical literature, a case is made for greater accuracy in representing coercive experiences and events in research, so as to better align the measured concepts with actual processes of treatment entry and admission. Attention is given to studies of the effectiveness of treatment under social controls or pressures, the connections to coercion and decision-making, and theoretical perspectives on motivation and behaviour change, including Self-Determination Theory in particular. This synthesis of the available research on coerced addiction treatment suggests that it remains largely unclear to what extent many of the commonly employed methods for getting people into treatment may be detrimental to the treatment process and longer-term outcomes. The impact of coercion upon individual clients, treatment systems, and population health has not been adequately dealt with by addiction researchers to date.
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DOI：
10.1037/0278-6133.21.1.40
发表时间：
2002
期刊：
Health psychology : official journal of the Division of Health Psychology, American Psychological Association
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