What's in a rehab? Ethnographic evaluation research in Indigenous Australian residential alcohol and drug rehabilitation centres

Abstract

Residential rehabilitation centres are a popular form of treatment for Indigenous Australians suffering from alcohol and drug misuse; however, there has been very little substantive research and evaluation in this area. Based on long-term ethnographic research, this study examines the informal aspects of a treatment programme in an Indigenous residential alcohol and drug rehabilitation service. Evaluation of such services often focuses on treatment length and/or treatment level obtained as key indicators of success. This study suggests that ‘treatment’ may be more complex and layered with multiple levels of meaning, which may not necessarily be captured in some evaluation designs. For the residential rehabilitation centre discussed in this paper, oscillating periods of mutual support and discipline have an important therapeutic function. Standard measures of treatment length and level obtained are meaningless without incorporating understanding of this process. This paper presents some of the ethnographic findings, alongside some of the evaluation implications of doing this kind of research.

Keywords:

• evaluation research
• Indigenous alcohol and drug residential rehabilitation
• treatment process and outcome

Notes

Notes

1. I was invited by the organisation to conduct participant observation research in 1998/99. Any views or opinions presented here are solely those of the author and do not necessarily represent those of the ‘rehab’. Confidentiality of all participants was maintained by attributing numbers to residents in field notes, which were later changed to pseudonyms. Place names were also given pseudonyms. Data was kept in a locked cabinet and on a computer (password access only) within the organisation. Residents and staff were fully informed about the nature of the project and consent was sought for all who participated. I did not ask those residents who had newly arrived to the centre to be part of this project, recognising that individuals arrived with various health and emotional issues.

2. Ethics was granted by the Top End Human Research Ethics Committee in 2005 and by the University of Newcastle, New South Wales, Australia and the London School of Economics in 1998. Funding was received from the NHMRC (ID 323248), British Council's Overseas Research Student Award, London School of Economics (LSE) Studentship, LSE Australian Postgraduate Scholarship, the Radcliffe-Brown and Firth Trust Fund for Social Anthropological Research and the Queen's Trust Achiever Award.

3. The ‘rehab’ is a fictitious name.