ARTICLES: PDF OnlyLesbians Recovering from Alcohol Problems An Ethnographic Study of Health Care ExperiencesHALL, JOANNE M. Author Information JOANNE M. HAIL., PHD, RN, is a postdoctoral fellow, Department of Mental Health,Community, and Administrative Nursing, School of Nursing, University of California, San Francisco, CA. Nursing Research 43(4):p 238-244, July 1994. Buy Abstract The findings of this ethnographic study of 35 San Francisco lesbians in long-term alcohol recovery describe their identification of alcohol problems, help-seeking experiences, and barriers to recovery in health care interactions. Multiple addictions and “core difficulties,” such as childhood trauma, were common yet poorly addressed by health care providers. Lesbian clients mistrusted culturally ignorant providers who often inappropriately reversed therapeutic roles. Provider-client conceptual incongruence about alcohol problems often impeded recovery, while providers' persuasive styles (paternalistic, maternalistic, confrontational, and influential) were pivotal to recovery. The confrontational approach caused the most problems. It could precipitate crises, be interpreted by the women as social ostracism, and retraumatize those who had histories of childhood trauma. Consensus favored the influential style, characterized by flexibility, negotiation, support, and avoidance of ultimatums. Conclusions challenge the assumptions that alcoholics are manipulative, “in denial,” and require coercion to attain and maintain recovery. © Lippincott-Raven Publishers.
