Participant Generated Outcomes of Two Harm Reduction Programs

171 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2006.Born of the desire to prevent the spread of HIV, harm reduction emerges as a new treatment model for drug and alcohol abuse. Of significance is its emphasis on treating users "where they are" and low-threshold requirements for treatment, contrasting with the abstinence requirement of the majority of treatment programs in the United States. This study investigates individual participant outcomes of two harm reduction programs: a center based on a private practice model and a drop-in center providing services to homeless, active users. Face-to-face, qualitative interviews were conducted with 18 staff members and 32 participants of both programs. Semi-structured interviews were designed to capture the perceived impact of programs on participants. Given the lack of literature on individual outcomes of harm reduction programs and the inherent challenge in measuring harm reduction outcomes, the study employed the principles of grounded theory to identify participant generated outcomes. Outcomes---which include process outcomes---emerged across sites in the areas of demarginalization, consistent engagement in the program, quality of life, social functioning, changes in use, and articulation of future goals and plans. These outcomes---differing from traditional measures of successful drug and alcohol treatment such as abstinence, completion, and recidivism---call for a reconceptualization of outcomes if harm reduction approaches are to be legitimated in the current context of substance abuse treatment. These findings are particularly significant in consideration of the low rates of completion in traditional substance abuse treatment programs which fail to engage clients in treatment.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD