Self-perception of program effects in a therapeutic community for substance users with dual diagnosis

Osebe z dvojno diagnozo imajo številne težave na različnih področjih življenja in delovanja, zato je ključno, da so vključene v celostno zdravljenje, kjer bodo lahko dosegale spremembe. Glede na to, da je področje raziskovanja doseganja sprememb tako v Sloveniji kot v tujini slabo raziskano, sem v magistrskem delu želela raziskati, kakšne spremembe pri sebi skozi terapijo zaznavajo uporabniki, odkar so vključeni v terapevtski program zdravljenja Terapevtske skupnosti Sostro za zasvojene s pridruženimi težavami v duševnem zdravju. V kvalitativnem delu sem preko polstrukturiranega intervjuja klientove spremembe želela ugotoviti, kako uporabniki skozi terapijo dojemajo svoj proces spremembe. Prav tako sem želela raziskati, kateri dejavniki tako zunaj kot znotraj terapije so tisti, ki so pri uporabnikih najbolj pripomogli k spremembi. Te ugotovitve sem nato primerjala z rezultati, pridobljenimi z vprašalnikom za evalvacijo terapevtske obravnave (CORE-OM). V raziskavo je bilo zajetih 7 uporabnikov. Rezultati so pokazali na trenutno zaznano psihično stanje uporabnikov, subjektivno izražene spremembe, ki so jih uporabniki dosegli tekom zdravljenja, ter dejavnike teh sprememb, ki delujejo znotraj terapevtskega procesa. Subjektivno izražene spremembe se nanašajo na dosežene spremembe na področju osebnosti, socialne kompetentnosti, čustev, vrednot, simptomatike in zunanjega izgleda. Dejavniki sprememb pa so: terapevtski program, socialna opora ter osebnost ter predelovanje notranjih težav. Ugotovila sem, da so dosežene spremembe pri uporabnikih stabilne skozi čas. Magistrsko delo je v pomoč terapevtom, ki izvajajo program zdravljenja dvojnih diagnoz, saj moje ugotovitve nudijo vpogled v spremembe, ki so jih uporabniki dosegli v času vključenosti v program, prav tako pa lahko ugotovitve magistrske naloge pripomorejo k uvajanju novosti in sprememb v načinu dela s trenutnimi uporabniki ter uporabniki, ki se bodo še srečali s programom zdravljenja v Terapevtski skupnosti Sostro. Poleg tega raziskava nakazuje potrebo po večjem raziskovanju pomena programa za zdravljenje dvojnih diagnoz.Individuals with dual diagnosis experience several difficulties in different parts of life and social functioning. This is why it is crucial that they are included in an integrated treatment program, where they will be able to achieve changes. Because this field is poorly researched in Slovenia, as well as abroad, I decided to research in my master thesis what kind of changes individuals go through when they are included in the therapeutic program in the Therapeutic Community Sostro for users with mental health problems. In the qualitative part of the thesis I used a client change interview to determine how users perceive their process of change through therapy. I also wanted to research which factors, external as well as internal ones, helped the users most to achieve change. I then compared these results with the results gained from the interview for clinical outcomes in routine evaluation – outcome measures (CORE-OM). The study consisted of 7 users who were included in the program for treating dual diagnoses. The results showed the current psychological state of the users, changes which the users achieved during the treatment and the internal factors which affected these changes. The detected changes refer to changes achieved in personal growth, social skills, emotions, values, symptoms and appearance. The factors that influenced these changes are: the therapeutic program, social support and personality and handling of internal difficulties. I concluded that the changes achieved by users are stable through time. My findings show an insight in the changes users achieve during the time they are included in the therapeutic programs, therefore my master degree is meant to help therapists who perform programs of treating dual diagnoses. My findings can at the same time be used to introduce novelties and changes in the ways of working with current users and users, who are yet to be included in the treatment program at the Therapeutic community Sostro. My study also indicates the need to research the field of treating dual diagnoses even more