Effective places research
selected articles
Does the organisation benefit all of its stakeholders?
The culture of an organisation is all important: are service users welcomed and treated as individuals? is there an ethos that promotes the sense that everyone can be helped? is there a problem-solving environment, is there competent leadership, are the staff valued and involved? are dissent and whistleblowing encouraged or surreptitiously punished? The first study describes a tool for measuring organisational health…
Important study :: How do you check out organisational health?
Lehman WEK, Greener JM and Simpson DD (2002) Assessing organizational readiness for change. Journal of Substance Abuse Treatment 22: 197-209
The Organisational Readiness for Change tool is a useful way to check on organisational health. It is based on previous research by the Texas Christian University (measures are available free of charge for not-for-profit educational and research purposes).
There is a significant impact on treatment satisfaction and rapport where services ❶ ensure staff have an influence, ❷ the organisational climate allows higher levels of staff autonomy, ❸ there is openness of communication, and ❹ a willingness to change.
Healthy organisations value their staff
Addiction treatment agencies often report high staff turnover rates. How damaging this might be to services is uncertain, however, turnover undoubtedly has costs, for example financial costs of recruitment and staff training, loss of skills, knowledge and experience, difficulty carrying the history and culture…
Important study :: What factors predict staff turnover?
Garner BR and Hunter BD (2014) Predictors of Staff turnover and turnover Intentions within addiction treatment Settings: change over time matters. Substance Abuse: Research and Treatment 8: 63–71 doi: 10.4137/SaRt.S17133
What rate of staff turnover should be judged too much or too little is a moot point; however, it is important to understand why staff leave an organisation. If someone is unhappy with their workplace in some way, then they may start to contemplate leaving; this study suggests it is systematic and sustained changes that are perceived as being for the worse that most strongly tip the balance and result in someone actually leaving.
A set of work measures and psychological climate measures were created from existing scales and these were used as the predictors of staff turnover. The chart shows those things that were protective, that is, made turnover less likely, and those that likely to cause turnover. As might be expected, change, especially if seen as a downward spiral, was associated with turnover.
Service users want their problems sorted out in as straightforward way as possible
When someone is seeking help, for whatever problem, they want to go somewhere that they feel comfortable and believe that they are getting the best treatment possible. It follows that services need to understand what their service users want and how best to address their needs. This next study is about what service users want from an addiction service. While involving service users in treatment decision making is routine, service users will not always be happy with the plan that emerges, which raises a question of how to deal with this?
Important study :: Service user satisfaction
Congia P, Tarantini F, Pani FP, Loi A (2012) Exploring components and correlates of satisfaction in an outpatient drug addiction service. Italian Journal on Addiction 2: 6-12 PDF available from ResearchGate
This study explores the organisational factors that have an influence on treatment outcomes. There is an association between service users’ satisfaction with treatment and effectiveness of treatment. Both satisfaction and effectiveness of treatment are influenced by organisational factors including the choice of intervention paradigm. The study was undertaken across three Italian community drug clinics. Findings are expressed as correlates of service user satisfaction.
If applied, this strategy should constitute an excellent means of minimising limitations to patients’ quality of life and maximising the benefits of specific therapeutic interventions.
Service users both like and do better in integrated services
Mental health problems are very common in addiction services, and it is important to sort out people who need the expertise of mental health specialists from those whose symptoms are related to their substance use and likely to resolve alongside the addiction problem. Whereas multiagency working is ideal for many problems, for comorbidity it is not. This next study is a review of best practice for comorbidity…
Review article :: Integrated services for people with addiction and mental health problems
Drake RE and Mueser KT (2000) Psychosocial Approaches to dual diagnosis Schizophrenia Bulletin 26, 105-118
This study briefly reviewed research on the epidemiology, adverse consequences, and phenomenology of ‘dual diagnosis’, followed by a more extensive review of approaches to services, assessment, and treatment. Comorbidity, that is co-occurring addiction and mental health problems, are quite common and these individuals suffer serious adverse consequences as a result. The evidence for specific treatments for comorbidity is sparse and generally weak. However, the way services are delivered is considered to be very important and best practice is simple enough to implement.
