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Health Providers' Descriptions of the Significance of the Therapeutic Relationship in Treatment of Patients with Dual Diagnoses

Hoxmark, Ellen Margrethe1; Wynn, Rolf2

Journal of Addictions Nursing: 2010 - Volume 21 - Issue 4 - p 187–193
doi: 10.3109/10884602.2010.520170
Original Papers

Dual diagnosis of substance abuse and severe psychiatric illness is frequent, and the building of therapeutic relationships with this group of patients seems to be both important and difficult. An integrated treatment model has been claimed to be the preferred treatment for dual diagnosis patients. This study explores how providers in an integrated treatment model, and a substance abuse treatment model with less emphasis on psychiatric co‐morbidity, handle relationship building. Two focus groups included providers working in a Therapeutic Community (TC) and a Dual Diagnosis (DD) ward. Participants were given a short case history and asked to describe how they would approach the case. The analysis was based on a phenomenological method. All providers perceived a good relationship to be central to the treatment. Providers in the DD ward were more ready to build close relationships with the patients, and described their relationship with the patients as more crucial to treatment. The providers in the TC ascribed more importance to the role of peers and to the structure of the program itself. The providers agreed that a good therapeutic relationship is important to treatment. They differed in their opinion about how central this relationship was.

1Department of Substance Use and Specialized Psychiatric Services, University Hospital of Northern Norway, and Institute of Clinical Medicine (FT), Faculty of Health Sciences, University of Tromsø, Norway

2Department of Substance Use and Specialized Psychiatric Services, University Hospital of Northern Norway, and Institute of Clinical Medicine (FT), Faculty of Health Sciences, University of Tromsø, Norway

Address correspondence to Ellen Margrethe Hoxmark, University Hospital of North Norway, Department of Substance Use and Specialized Psychiatric Services, Boks 6124, Tromsø, 9013 Norway. E‐mail: ellen.hoxmark@unn.no

© 2010International Nurses Society on Addictions
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