Learning From the Experts, Part 1

Well, I’m back in the ‘office’ after my long overdue break. It was great to have a serious ‘time-out’ and also sit back and enjoy the Olympic Games. They were awesome and many performances stunning. What stood out most was the camaraderie between the athletes.

Anyway, here is today’s blog which focuses on a piece of research we conducted years ago, research of which I am particularly proud. Gemma Salter, who conducted the main analysis I describe, was one of my star undergraduate project students in the Department of Psychology, Swansea University. She had gained an outstanding First Class Honours Degree and won the prize for the best project of the year for an earlier piece of research she conducted on the impact of substance use problems on family members

In three earlier blog posts (starting here), I described the treatment service BAC O’Connor, or Burton Addiction Centre (BAC) as it was then. When I first visited BAC O’Connor, I was able to talk to clients and gain insights into the factors that they believed were helping them on their recovery journey. I later decided to send two of the Wired In team, Gemma Salter and Sarah Davies, to BAC in order to conduct a qualitative research project on the views and experiences of people who used this treatment service.

The research involved semi-structured interviews with 15 participants who were accessing BAC services. Seven of the participants were female, and eight were male. All were adults, although for most, their addiction had first developed during their teenage years. The duration of addiction varied, although it had generally lasted for a period of at least several years.

Seven of the participants described themselves as having an alcohol problem, and seven described themselves as having a drug problem, three of whom had a problem with heroin and four of whom had a poly-drug problem. The other participant had a problem with both alcohol and heroin.

The participants were at various stages of their addiction/recovery process. Most were currently on the Day Care rehabilitation programme—several had come back onto the programme after relapsing during their treatment episode—whilst others were using the Aftercare programme.

The interviews covered initial use of substances through to the participants’ current situation in treatment or aftercare. The interview transcripts were analysed by Gemma Salter using a qualitative analysis known as Grounded Theory. The results were integrated to form a model, which aimed to provide a picture of the processes involved in developing a substance use problem, the processes involved in behaviour change, the role treatment, as well as the potential path to recovery.

In this and the following post, I focus on client views of the treatment process, obtained from this research and my discussions with clients. Whilst these findings reflect the experiences and views of a population of clients undergoing one specific treatment programme, they provide important insights about addiction recovery and addiction treatment in general.

Gemma wrote a detailed report on her research which was posted on the Wired In websites. I later wrote an article, entitled Learning from the Experts, for the bi-weekly magazine Drink and Drugs News based on this work, which appeared on 21st March 2005. Parts of Gemma’s research findings were used in that article and this chapter.


The participants in our study had many unsuccessful attempts to change their substance use before joining the structured day care programme at the Burton Addiction Centre.

Participants reported numerous positive effects of treatment other than the effects on their substance use. One of the clearest improvements related to the participants’ understanding of themselves, their behaviour and their addiction.

‘What it’s done is to enlighten me on addiction. It’s given me more confidence. I’m learning about my addiction and myself and other people…it’s amazing how…things can change so much.’

Treatment helped participants to achieve a clearer perspective of their substance use problem, and the negative effects of it. After a period in treatment, participants were able to see what life without their substance use problem could be like. Physical health improved.

Treatment was thought to enhance confidence (as alluded to in the above quote), reduce feelings of guilt, shame and isolation, and lead to the use of better coping strategies.

‘It’s made me realise I’m not alone…when you’re in active addiction it seems like everyone around you have not got a clue what you are going through.’

‘Learning to deal with your emotions and feelings, that is the main thing, because as addicts you can play on your feelings to the extent that you will go out and use just to suppress them.’

Treatment produced clear changes in participants’ lifestyle, perspective and identity. During treatment, participants gained a new optimism for life and a desire to rebuild their life with better/new relationships, and college and job placements.

‘It gives you a chance to start again. You’ve got a new chance at life now to start again from scratch…I’m going back to college, getting my own place, get a job.’

Other less commonly reported improvements related to relationships, self-care, maturity and anger management.

Common experience was reported to be beneficial in providing a more empathic and understanding environment, where clients (and counsellors) could possibly relate to each other and provide useful support and advice as they could all draw upon their experiences. Common experience was also important since participants were less able to ‘blag’ treatment or conceal what was going on, as well as serving to reduce isolation.

‘It’s good to be with like-minded people because unless you’ve experienced it, it’s very, very difficult to understand where we’re coming from.’

‘There’s no way you can blag ‘cos they’ve been there themselves… If you are struggling at any point, there’s always somebody that’s weeks ahead of you and they can offer you the advice and support.’

Many participants described the benefits of being surrounded by people at different stages of their addiction and recovery, with new and relapsing addicts serving as a reminder of the negative effects of using, and successful recovering addicts (e.g. people in aftercare) providing hope and serving as potential role models and/or revealing goals to which one could aspire. This common experience was also important in reducing feelings of isolation

Another crucial component of treatment was having a welcoming, friendly and safe environment. Considering that one of the difficulties of treatment highlighted in our study was that participants often felt nervous, scared, lost and unsure of what to expect at the start of treatment, the presence of a welcoming and supportive environment was especially important in helping to ease some of the apprehension experienced.

Education also emerged as a crucial component of treatment, both in terms of the various aspects of addiction, and regarding the availability of treatment services. Some participants felt that earlier education may have been beneficial in engaging them or others earlier in the development of their substance use problems.

Participants also described how treatment provided them with the benefits of talking about problems and getting feedback and advice in both one-to-one counselling sessions and group therapy.

Much of the emphasis was placed on the positives of group therapy. The group environment seemed to provide a situation in which participants could get intimately involved, through the two-way process of feedback. Participants strongly advocated the process of both receiving and giving. Often this setting seemed to enhance confidence and self-esteem, as well as reduce feelings of isolation, e.g. through bonding with peers. Participants highlighted the value of being able to talk to others about the stresses and strains involved in trying to recover from their substance use problems.

‘I love feedback… it helps me to look at myself… I need that for me to be able to recover… and I think, “Yeah, that’s ok and that needs looking at.” I feedback to other people as well, and your confidence grows.’

Many participants reported having previously received substitute prescribing without any other form of help. They emphasised the need for some kind of therapy (one-to-one or group) alongside substitute prescriptions, along with education, advice on how to deal with the addiction in the long-term, and how to manage potential cravings.

The photograph used in this blog post is by Yousef Espanioly and has come from Unsplash, a great resource of free high resolution photographs.

> Learning From the Experts, Part 2