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I had an interesting Blog Comment from Pavel Nepustil, a Czech republic NGO worker and PhD student, currently in Houston, USA, on a Fullbright Scholarship. Pavel came over to see us in Cardiff last year and we decided we would work together. He is one bright ‘cookie’ and very dedicated to this field. He got a big thumbs-up from the team.

Pavel responded to the Wired In ‘Way Forward’ in a very positive manner. Thanks, Pavel!

Here, I quote parts of his comment, for which I would welcome responses:

‘Hope, passion, talent, change – these are the words that were missing in the drug field! The “deficit discourse” brought by medicine made us think about drug users in terms of illness, disorder, chronic, irreversible disease… and these words created our expectations and these expectations created self-fulfilling prophecy…’

‘When I was asking one former methamphetamine user who recovered without formal treatment about his ideas for the services, he told me: “…it should be designed in such a way so that people will not be afraid to go there. They should offer help, not treatment. A lot of people are afraid of treatment…”’

I have to confess I have been worried about this term ‘treatment’ because what exactly does it mean? Clearly, it means different things to different people. It means something different in the Wired In vision to what it is in today’s system.

What does it mean to a potential client and to their family? Are they afraid to go there as suggested by Pavel’s associate? We certainly know many people who have substance use problems who are very cynical and untrusting of the treatment system and what it represents.

There are many people who are very concerned to hear a senior member of the treatment commissioning system say that the government provides money for people not because of their personal problems but, ‘Because you are seen as a threat, the government is prepared to spend money on drug treatment.’ (quote from DDN, Feb 25th issue). Would you trust such a system to help you with your own problems, or those of your child?

You might also like to think of something else. The term ‘treatment implies the existence of an entity (such as a drug) or a procedure (such as surgery) that is being applied to something else from without.’ (cf. ‘How Clients Make Therapy Work: The Process of Active Self-Healing’ by Arthur C. Bohart and Karen Tallman, pp13).

However, recovery comes from within the person. Addiction is not fixed like a broken leg. The work required to achieve recovery is ultimately done by the person, not by a treatment agency worker or doctor.

The practitioner may facilitate a process that enables the person to achieve more recovery capital (some money, a roof over their head, etc) so they are better able to concentrate on the substance use problem. They may provide methadone to help take chaos out of a person’s life, or their ‘talk’ may help the person alleviate some crisis in their life, or better understand where they are and where they need to go.

Ultimately, good practitioners are providing or enabling support, coaching, guidance, information and resources – or some combination of these.

Is this treatment? Or help? Or what? How we should term it? Any thoughts?
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source: davidclarkwired.blogspot.com/

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