Evaluating Patient Satisfaction and Qualitative Outcomes during an Abstinence-Based Indigenous Residential Treatment Program in Northern Ontario

Abstract Background: Indigenous peoples with substance use disorders (SUD) and intergenerational trauma (IGT) have a variety of needs across the range of symptom severity and the challenging dual disorder (1). To address these needs, a continuum of holistic care that includes intensive treatment services and support must be in place (2–4). In collaboration with the North Shore Tribal Council and Benbowopka Treatment Center in Ontario, Canada, this study aimed to evaluate the effectiveness of the Abstinence-Based treatment model in place prior to implementing a novel treatment approach based on blending Indigenous healing practices and a mainstream treatment model, ‘Seeking Safety,’ for the treatment of Indigenous patients with a history of IGT and SUD in a four-week residential treatment program in Blind River, Northern Ontario. This paper is a retrospective qualitative analysis of an Indigenous community-run residential treatment program operating under an abstinence-based model prior to implementing a novel treatment paradigm based in Indigenous teachings and Seeking Safety. Methods: The historical data was collected from Benbowopka’s patient records; (n = 343) from January 2013 to March 2016 (end of the 2015 fiscal year). The data has been divided into the fiscal year and intake period at the request of Benbowopka. We evaluated the results of the abstinence-based model intervention against three distinct primary outcomes (1. The patient perspective, 2. The program perspective, and 3. The community perspective). The following variables were collected: name, health card number, date of birth, postal code, status card number, gender, date of admission to the program, date of discharge, program completion (Y/N), Indigenous (Y/N), status First Nation (Y/N), on reserve (Y/N), primary substance, and secondary substance(s). Any pertinent notes were also included in the data. All discussions and feedback from the Client Quality Assurance Survey tool was subjected to a qualitative thematic analysis. Results: Four core themes were identified: (1) Motivation to attend treatment; (2) Understanding Benbowopka’s treatment program and needs to be met; (3) Satisfaction with all interventions; and (4) Moving forward. We thus utilized a proposed conceptualized descriptive framework for the four core themes depicted in the medicine wheel. The center of the medicine wheel represented headings (self, family, children, worker, and community) or a lens, which participants used to frame their experiences. Conclusion: This research has identified that SUD Indigenous residential treatment programs need to include culture, healing practices, activities and relationships that are part of the treatment process. This study found that the cultural elements and healing practices of the program were highly valued by clients in the Blind River, Northern Ontario, Northern Indigenous residential treatment program.

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