Title

An occupational justice perspective of people’s experiences while on Methadone Maintenance Treatment

1

Location

Portland Room

Start Time

1-10-2016 1:30 PM

End Time

1-10-2016 2:30 PM

Session Type

Research Paper

Abstract

An occupational justice perspective of people’s experiences while on Methadone Maintenance Treatment

Purpose

A study was undertaken with people on Methadone Maintenance Treatment (MMT) in London, Ontario. Given that MMT is time intensive, the objectives were to better understand the experiences and daily routines of people on MMT through in-depth exploration of their everyday occupations and the ongoing challenges and barriers they face to accessing treatment.

Methods

We used a qualitative intrinsic case study methodology (Stake, 1995) informed by the framework for occupational justice (Stadnyk et al., 2010; Townsend, 2012).

Participants: Three females and two males between the ages of 27 and 42 who had been on MMT for at least one year.

Data collection: Two sessions were conducted with each participant. The first consisted of a semi-structured interview, the creation of an occupational map (Huot & Laliberte Rudman, 2015) and completion of a demographic questionnaire. The second entailed a follow-up interview.

Data analysis: Data analysis entailed whole text analysis and line-by-line coding of the ten transcripts. The analysis of the visual data generated through mapping also informed the findings.

Results

Four themes highlighting key aspects of the participants' experiences will be presented. First, findings outline a ‘descent into chaos’ as participants’ addictions began and worsened over time. Second, participants’ experiences of ‘MMT as a bridge’ to recovery from addiction are described. Third, a ‘new normal’ daily life that is characterized by liminality is shown to be linked to people’s experiences on MMT. Finally, participants’ hopes for ‘moving forward’ are outlined. These themes in the data suggest that participants do not follow a strictly linear route but generally shift from chaos to boredom with the ever present possibility of relapse.

Implications for occupational science

In relation to the framework for occupational justice, the findings illustrate how structural factors such as health and community supports, and income supports as well as contextual factors including income/wealth, employment status, homelessness, and family/friend support interact to create occupational outcomes contributed to the participants’ experiences of occupational imbalance and occupational marginalization. MMT is not strictly an 'individual' experience, rather it is shaped by broader factors, which leads people in treatment to experience particular occupational injustices. Thus, MMT practices and policies should consider the occupational implications to enhance clients’ experiences and further support their recovery.

Discussion questions

  • How might comparative research help further illuminate the challenges faced by MMT clients? (e.g. urban/rural)

  • How could MMT policies and practices be adapted to reflect the occupational implications discussed and to enhance clients' experiences?

  • How might other occupational science concepts be used to conduct additional research with people on MMT?

References

Huot, S., & Laliberte Rudman, D. (2015). Extending beyond qualitative interviewing to illuminate the tacit nature of everyday occupation: Occupational mapping and participatory occupation methods. OTJR: Occupation, Participation and Health, 35(3), 142-150.

Stadnyk, R. L., Townsend, E. A., & Wilcock, A. A. (2010). Chapter 13: Occupational justice. In C. H. Christiansen, & E. A. Townsend, Introduction to Occupation: The art and science of living (2nd ed., pp. 329-358).

Stake, R. E. (1995). The art of case study research. Thousand Oaks: Sage Publications.

Townsend, E. A. (2012, April). Boundaries and bridges to adult mental health: Critical occupational and capabilities perspectives of Justice. Journal of Occupational Science, 19(1), 8-24.

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Oct 1st, 1:30 PM Oct 1st, 2:30 PM

An occupational justice perspective of people’s experiences while on Methadone Maintenance Treatment

Portland Room

An occupational justice perspective of people’s experiences while on Methadone Maintenance Treatment

Purpose

A study was undertaken with people on Methadone Maintenance Treatment (MMT) in London, Ontario. Given that MMT is time intensive, the objectives were to better understand the experiences and daily routines of people on MMT through in-depth exploration of their everyday occupations and the ongoing challenges and barriers they face to accessing treatment.

Methods

We used a qualitative intrinsic case study methodology (Stake, 1995) informed by the framework for occupational justice (Stadnyk et al., 2010; Townsend, 2012).

Participants: Three females and two males between the ages of 27 and 42 who had been on MMT for at least one year.

Data collection: Two sessions were conducted with each participant. The first consisted of a semi-structured interview, the creation of an occupational map (Huot & Laliberte Rudman, 2015) and completion of a demographic questionnaire. The second entailed a follow-up interview.

Data analysis: Data analysis entailed whole text analysis and line-by-line coding of the ten transcripts. The analysis of the visual data generated through mapping also informed the findings.

Results

Four themes highlighting key aspects of the participants' experiences will be presented. First, findings outline a ‘descent into chaos’ as participants’ addictions began and worsened over time. Second, participants’ experiences of ‘MMT as a bridge’ to recovery from addiction are described. Third, a ‘new normal’ daily life that is characterized by liminality is shown to be linked to people’s experiences on MMT. Finally, participants’ hopes for ‘moving forward’ are outlined. These themes in the data suggest that participants do not follow a strictly linear route but generally shift from chaos to boredom with the ever present possibility of relapse.

Implications for occupational science

In relation to the framework for occupational justice, the findings illustrate how structural factors such as health and community supports, and income supports as well as contextual factors including income/wealth, employment status, homelessness, and family/friend support interact to create occupational outcomes contributed to the participants’ experiences of occupational imbalance and occupational marginalization. MMT is not strictly an 'individual' experience, rather it is shaped by broader factors, which leads people in treatment to experience particular occupational injustices. Thus, MMT practices and policies should consider the occupational implications to enhance clients’ experiences and further support their recovery.

Discussion questions

  • How might comparative research help further illuminate the challenges faced by MMT clients? (e.g. urban/rural)

  • How could MMT policies and practices be adapted to reflect the occupational implications discussed and to enhance clients' experiences?

  • How might other occupational science concepts be used to conduct additional research with people on MMT?