The cycle of relapse and recovery of substance misusing offenders on a community based rehabilitation programme: The impact of childhoods, family, relationships, significant life events and psychological wellbeing : an interpretative phenomenological analysis and approach.

Background and aims There is a paucity of research into the relapse and recovery of Class A drug misusing offenders who are part of the Drug Interventions Programme (DIP). The key aims of the DIP, a UK Government criminal justice strategy, are to reduce Class A drug misuse and the [perceived] associated offending behaviour. This group have entrenched and long lasting addictions, with many ‘failed’ attempts at recovery. There is no published research about DIP clients, using a qualitative methodology, which explores childhoods, relationships, psychological health and significant life events and how these might impact on drug use, relapse and recovery from their perspective. The aim of the research was to ask community based DIP clients what they considered to be important factors in their relapse and recovery and to explore how they understand and make sense of these. Theories within the developmental psychology field, some of which have not been extensively applied within the addiction field, have helped to inform the research. Method and participants To address a gap in the field, an Interpretative Phenomenological Analysis (IPA) was adapted for use with a focus group design (four Focus Groups, total N= 10), to explore the value and merit of the research question. These findings helped to inform semi-structured interviews (N= 17) using IPA. Participants were adult men and women who were either current or past DIP clients recruited through the DIP teams in England. Findings The following themes were developed from the semi-structured interview study: 1) Experiences of abusive childhoods – links to emotions that were experienced as damaging/harmful and problem behaviours; 2) The divergent and damaged selves – links to substance misuse; and 3) Drug use to cope and survive dangerous events and trauma/responses. Recovery was about managing these in a healthier way. A fourth theme showed how participants’ experiences changed during transitions into and out of recovery, for example the presence or absence of supportive networks. Conclusion The research has implications for theory, policy, practice and future research. This includes the provision of trauma based therapy and supporting clients to manage their emotions as well as their wider mental health problems. The importance of an integrated framework of theories from a developmental attachment, trauma and family systems approach to inform training and practice are highlighted from the findings