Qualitative Study

The qualitative study of the Drug Treatment Outcomes Research Study (DTORS) was designed to explore treatment providers and treatment seekers perspectives on the factors influencing the effectiveness of drug misuse treatment in England. The main implications of the research are as follows. The findings highlight the complexity of drug treatment and are suggestive of the need for drug treatment to be sufficiently flexible to enable consideration of the range of pressures reinforcing an individuals dependency and thus their differing needs from drug treatment. A key challenge in meeting the multiple needs of treatment seekers within a multi-agency model of delivering services is developing effective working relationships among provider partners. It was suggested by some practitioners that more needs to be done in some areas to develop and strengthen the links between provider organisations. This may have particular relevance to the reintegration agenda, and is to some extent a focus for some of the areas involved in the Drug System Change Pilots. The additional challenges of responding comprehensively to clients needs against a backdrop of increasing numbers and longer retention in treatment were acknowledged. Service providers recognised a range of positive and negative impacts from the increase in referrals through criminal-justice-system routes. The benefits were felt to include increasing the numbers in treatment of people who would otherwise not have accessed drug treatment; the negative impacts were felt to include treatment services being under-resourced to cope with the additional high volume of clients. There was a widely held scepticism that treatment could be effective in the absence of a deep level of motivation on the part of the treatment seeker. Referral through the CJS did not seem to impact on levels of motivation. Thus both CJS and non-CJS pathways into treatment seem valid in this respect. Study participants reported that maintaining full and timely engagement with treatment seekers, particularly at key transition points such as leaving prison, was essential to successful drug treatment. (Author' s abstract)