Substance use and psychosis : an exploratory study
The needs of individuals who have a diagnosis of psychosis and use substances pose one of the greatest challenges faced by mental health services today (Department of Health, 2002). A large amount of research has been undertaken attempting to understand why apparently higher rates of substance use are observed in this population, yet the findings are equivocal at best. As such there is little understanding of the process by which substance use might be maintained in this population. This study aimed to address the research questions posed by investigating the experiences of the client group (individuals with a diagnosis of psychosis and substance use), a group whose experiences are notable by there absence from the research to date (Dixon et al, 1990). The objectives of the study were fulfilled, these being the exploration of individuals' experiences of use and the impact that this has upon their lives and the development of a model by which to understand the process by which substance use is maintained. Twelve qualitative interviews were analysed using Interpretative Phenomenological Analysis. Three super-ordinate themes were identified as emerging from the participants' transcripts; 'Increased control', 'Feeling out of control', and 'Ambivalence'. Ten composite themes contributed to the formation of these themes. The stages of change model and dialectical theory were used to understand the ambivalence that was seen to maintain participants' substance use. Further hypotheses were drawn from the literature regarding the process of change and a model of compiled. The implications for clinical practice and future research were discussed.