Counselling Utilization Experiences among Methadone Maintenance Treatment Clients in Rural and Small Urban Communities/Expériences De L'utilisation Du Counseling Parmi Les Clients Subissant Un Traitement De Maintien À la Méthadone Dans Les Communautés Rurales et Les Petites Communautés Urbaines
Notice bibliographique
Résumé
The association between opiate dependence and methadone maintenance treatment (MiMiT) has been extensively investigated, and research literature suggests it is an effective means of treatment (Ffealth Canada, 2002; New Brunswick Department of Ffealth, 2005; Ponizovsky & Grinshpoon, 2007). Methadone is a medical synthetic opioid agonist appropriate for maintenance therapy because it is an efficient and long-lasting method of relieving the intense cravings and withdrawal symptoms associated with opiate detoxification. Although the effec- tiveness of MMT is well documented, little research has been conducted on the utilization of counselling by MMT participants. Furthermore, the majority of existing research has been completed in large urban centres, potentially limiting the transferability of findings into smaller urban and rural settings. Taking into consideration the rising rates of opiate dependence experienced within Atlantic Canada in the past decade, the present study aimed to expand this research to examine the counselling experiences of MMT participants living in small urban and rural communities within Atlantic Canada.COUNSELLING AND METHADONE MAINTENANCE TREATMENTA small body of literature suggests there are additional benefits experienced by MMT clients who access counselling services as part of their opiate dependence treatment (Fischer, Chin, Kuo, Kirst, & Vlahov, 2002; Gossop, Stewart, & Marsden, 2003, 2006; New Brunswick Department of Health, 2005; Vigilant, 2008). Furthermore, many studies have found that better treatment outcomes occur when clients include some form of counselling as part of their recovery plan rather than relying solely on methadone to treat their opiate dependence (Gossop et al., 2003, 2006). Addiction and psychiatric focused counselling, including individual, group, couple, or family counselling, may contribute to providing important support, education, coping strategies, and skill development to the methadone maintained clients (Fals-Stewart, O'Farrell, & Birchler, 2001; Gossop et al., 2003; New Brunswick Department of Health, 2005). Furthermore, the behavioural and cognitive changes that occur when MMT is implemented have been found to be strongly associated with increased access to counselling services (Gossop et ah, 2006; Sigmon & Stitzer, 2005).Fischer et al. (2002) and Quigley (2003) found that MMT clients believed that counselling participation was an important element of their recovery efforts. However, attendance in counselling among the MMT population often remains very low. Sigmon and Stitzer (2005) reported only one third of the MMT population they surveyed accessed counselling services regularly. It has been suggested that low attendance may be the result of MMT participants wanting flexibility and active involvement in the decision-making process with regard to the counselling they receive (Fischer et al., 2002; Quigley, 2003). When given a choice in their counselling, opiate-dependent clients reported they felt the process was empowering. In addition, clients favoured counsellors who were flexible in their availability to schedule appointments. MMT participants stated they preferred a counsellor who could be available for them both physically and psychologically, with an understanding of the special needs of their population (Quigley, 2003). These participants felt that methadone gave them the ability to address their concerns therapeutically, examining their addictions in greater detail and offering a chance to rebuild important relationships hurt by their addictions (Vigilant, 2008).COUNSELLING SERVICES AND RURAL COMMUNITIESThe literature has repeatedly noted that individuals living in smaller urban and rural communities may face additional challenges to accessing counselling services for their substance abuse. Sexton, Carlson, Leukefeld, and Booth (2008) categorized these barriers into five areas: physical, financial, societal, organizational, and psychological. …
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,005 | 0,002 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».