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Experiences of conducting a substance use disorder treatment, A-CRA, in compulsory institutional care for youth – The challenge of promoting openness in a closed, temporary setting

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  • Mälarstig, Ida
  • Tyrberg, Marten J
  • Lundgren, Tobias
  • Alfonsson, Sven

Abstract

Effective help for youths in compulsory institutional care in Sweden is of utter importance, but available substance use disorder treatments have been designed for outpatient care and are not readily implemented in the specific lockable setting. The main objective of this study was to explore the experiences of seven therapists who were trained and supervised in conducting the evidence-based method Adolescent Community Reinforcement Approach (A-CRA), with youth 16–21 years old. The youths suffered from substance use disorder and socially disruptive or criminal behaviour and were placed in compulsory institutional care run by the Swedish National Board of Institutional Care. Using content analysis with an inductive approach, results show that therapists perceive A-CRA as a helpful treatment but also describe challenges with the flexible and goal-oriented approach and the temporary context. For future studies, it would be valuable to further explore the youths’ experiences of psychological treatment in institutional care and how therapists can help youth identify and work towards desired change.

Suggested Citation

  • Mälarstig, Ida & Tyrberg, Marten J & Lundgren, Tobias & Alfonsson, Sven, 2023. "Experiences of conducting a substance use disorder treatment, A-CRA, in compulsory institutional care for youth – The challenge of promoting openness in a closed, temporary setting," Children and Youth Services Review, Elsevier, vol. 148(C).
    • Handle: RePEc:eee:cysrev:v:148:y:2023:i:c:s0190740923000452
    DOI: 10.1016/j.childyouth.2023.106850
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    References listed on IDEAS

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    1. Khoo, Evelyn & Skoog, Viktoria & Dalin, Rolf, 2012. "In and out of care. A profile and analysis of children in the out-of-home care system in Sweden," Children and Youth Services Review, Elsevier, vol. 34(5), pages 900-907.
    2. Brauers, Malou & Kroneman, Leoniek & Otten, René & Lindauer, Ramón & Popma, Arne, 2016. "Enhancing adolescents' motivation for treatment in compulsory residential care: A clinical review," Children and Youth Services Review, Elsevier, vol. 61(C), pages 117-125.
    3. Geir Smedslund & Rigmor C. Berg & Karianne T. Hammerstrøm & Asbjørn Steiro & Kari A. Leiknes & Helene M. Dahl & Kjetil Karlsen, 2011. "Motivational interviewing for substance abuse," Campbell Systematic Reviews, John Wiley & Sons, vol. 7(1), pages 1-126.
    4. Nijhof, Karin S. & Veerman, Jan W. & Engels, Rutger C.M.E. & Scholte, Ron H.J., 2011. "Compulsory residential care: An examination of treatment improvement of individual and family functioning," Children and Youth Services Review, Elsevier, vol. 33(10), pages 1779-1785, October.
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