Alcohol use disorders: patients' and professionals' perspectives

Background

There is a considerable amount of studies on alcohol related harm and promising interventions but little is known on how guidelines and policy recommendations are implemented. Also, the individual care pathways are poorly studied. Approaches that aim to understand how professionals work and how patients perceive treatments are lacking. The sociological research carried out by the OFDT has the following aims:

• Expand the knowledge of the professionals’ objectives and routine activities while helping users suffering from alcohol use disorders.
• Better understand the expectations and pathways of people seeking care
• Study the extent to which caregivers' goals match with patients' expectations

Methods

60 semi-structured interviews were conducted with practitioners from 7 treatment facilities (psychiatrists, psychologists, social workers, nurses, nurses’ assistants, general practitioners) as well as 9 focus groups with a total of around 100 professionals.

About seven weeks of observation were completed (consultations, team meetings.

Results

Preliminary results show that to tackle alcohol use disorders, abstinence from alcohol is seen as the only possible horizon. Patients are welcomed and supported, whatever their request and their ability to abstain from alcohol. But most caregivers and patients consider that reducing alcohol consumption is unrealistic or inappropriate. This seems to be specific to severe alcohol-related disorders. For other polydrug-users seen in treatment settings, the prevailing professional attitude is to support the person through the difficulties associated with his or her consumption, without necessarily aiming for abstinence.

Discharge from treatment is a key step, but not always perceived similarly by professionals and patients alike. On one hand, patients who have undergone a large number of cures sometimes feel that prolonging the duration of treatment is beneficial. On the other hand, some professionals believe that patients should be able to manage their alcohol consumption and dependance on their own. 

Conclusions

Comparing professionals' and patients' viewpoints on alcohol treatment sheds light on the need to encompass therapeutical objectives and patients’ motivations for treatment.