The role of the admission phase in the Italian treatment setting: A research on individuating shared practices in psychotropic substance users’ communities

Abstract

There are various and diversified ways of admission of a substance user into a therapeutic community. When these ways result from actions that are inconsistent with the general objective of the service, they may lead to adverse outcomes that substantially impact both therapeutic interventions efficacy and services efficiency. Consequences are multiple, concerning the substance user, other users of the service, professionals working at the service, and the center’s relationships with the service network to which the center belongs. This study aims to define and share major interactive and organizational problems concerning the admission process at CEAL accredited structures and to define and standardize a protocol of procedures aimed at managing and supervising the admission process, through specific and commonly agreed indicators. The research was carried out according to the focus group methodology and involved sixty directors of various health communities offering residential services for substance use treatment. The research was guided by a focus group moderator. The research has made it possible to identify the biases and errors in the admission process and selected those practices shared by the therapeutic communities and conducive to generating positive outcomes. The findings in the definition of a procedure, complete with precise indicators that are applicable across the therapeutic communities and to the shared activities that constitute and are conducive to the success of the admission process.

Keywords:

• Admission process
• health care
• substance user
• therapeutic communities
• user drug service

Disclosure statement

The authors declare that they have no conflict of interest.

Notes

1 Researchers are well aware that the term “drug addicted” is to be considered obsolete and inappropriate as it may elicit negative stereotypes and stigmatization. Nevertheless, the Italian legislation, as well as the service provision system, still use this terminology.

2 Decree of the President of the Republic. No. 309 of October 9th 1990. Consolidation of the laws governing drugs and psychotropic substances, the prevention, treatment and rehabilitation of drug addicts.

3 Psychotropic substance users outpatient Service.