A two-way process: the client–keyworker relationship and its dynamics in coercive drug treatment¹

¹The research was conducted at University of Gothenburg, Department of Social Work.

Abstract

Relationships between client and professional have proved to be an important factor for treatment outcome and for how clients perceive and estimate the help. In this article, we aimed to explore the character and emotional quality of the relationship between client and keyworker, and the conditions for treatment collaboration, in coercive drug treatment. The data was obtained from a larger research project, conducted in Sweden 2005–2009 at four residential treatment centres for coercive care. The article is based on pairwise analyses of qualitative interviews with 16 clients and their keyworkers. By comparing both parties’ perspectives on their on-going relationship we identified three patterns that capture the studied relationships’ character and emotional quality: the ‘friendly and trustful relationship’, the ‘polite and neutral relationship’ and the ‘ambivalent and conflicted relationship’. The findings show that the key dimensions of interaction were (1) the clients and keyworkers expectations, (2) the meaning they ascribe to each other, the actions exchanged and the situation they are in, (3) contextual factors as they appear in everyday life at the centre and (4) how the clients and the keyworkers, individually and together, deal with the tensions and role conflicts embedded in the situation.

Keywords:

• Addiction
• coercive drug treatment
• treatment alliance

Notes

¹ The research was conducted at University of Gothenburg, Department of Social Work.

1. A more detailed description of the method in the project as a whole is outlined in the research report (Billquist and Skårner 2009a).

2. The study has been ethically examined and is approved by the Regional Ethical Review Board in Gothenburg (reg. 007-05; 2005-02-14).