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UBC Theses and Dissertations

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UBC Theses and Dissertations

The processes of engaging in mandated addiction treatment : a grounded theory McCullough, Lucy


The aim of this research was to produce a grounded theory that describes and explains the experience of mandated addiction treatment (MAT) using a Straussian (Corbin & Strauss, 2008) qualitative grounded theory method. Overall, clients’ perspectives have been neglected in the creation and evaluation of MAT (Kras, 2013; Urbanoski, 2010). The main outcomes of interest in MAT research have been expressed as objective measures of abstinence, treatment retention, and recidivism. This study provides an in-depth look into the experiential processes of entering, attending, and exiting MAT. Without this fuller picture detailing the process of the MAT experience, MAT programs continue to run the risk of infringing on civil liberties; undermining the integrity of the treatment endeavour; and reproducing inconclusive outcomes on decontextualized variables. Forty adults (ages 25-64; 18 women and 22 men) were interviewed using a semi-structured interview guide. All participants had been institutionally referred through the criminal justice system, child protection services, or their employer. All interviews were subject to the constant comparative methods of open, axial, and theoretical coding to develop the model of MAT. The interview guide was modified three times over the course of the fieldwork in order to theoretically sample for the emerging concepts and categories and test for contradictory cases and opposing viewpoints. The process of what participants do as they go through MAT is explained as “engaging” in the Theory of Engaging in MAT (TEMAT). There are four processes and two contextual categories that constitute TEMAT. The processes are: Choosing Treatment, Readying to Participate in Treatment, Treating Addiction Experiences, and Evaluating Mandated Treatment. The personal contexts that frame the MAT experience are the contextual categories of Living Addiction and Living Sobriety. TEMAT illustrates the journey of MAT, describes the properties and characteristics of what participants do in each of the four process, and the relationship among the processes. This study uniquely adds to the literature on MAT by showing the ways participants are active in assessing, choosing, and evaluating consequences, despite the mandated nature of their treatment. Implications for future research and clinical practice are discussed.

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