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"What constitutes a 'problem'?" Producing 'alcohol problems' through online counselling encounters
Michael Savic1, Nyssa Ferguson1, Victoria Manning1
1Turning Point, Eastern Health, 54-62 Gertrude Street, Fitzroy, Victoria 3065, Australia; Eastern Health Clinical School, Monash University, Level 2, 5 Arnold Street, Box Hill, Victoria 3128, Australia.
The International Journal on Drug Policy
|July 3, 2017
Summary
Online alcohol and other drug (AOD) counselling actively shapes how AOD problems are understood, rather than just responding to pre-existing issues. This highlights the need for critical reflexivity in AOD treatment and policy.
Area of Science:
- Social Sciences
- Health Policy
- Addiction Studies
Background:
- Traditional health policy views alcohol and other drug (AOD) problems as objective issues for diagnosis and treatment.
- This perspective often overlooks how clinical practices and systems define AOD use as a problem.
- People may present with multiple concerns, but typically only one AOD-related problem is addressed in treatment.
Purpose of the Study:
- To critically analyze clinical practices of problem formulation in online AOD counselling for individuals aged 55 and over.
- To examine how 'problems' are produced within these online encounters using poststructural approaches.
- To understand the effects of these problem formulations on individuals and treatment responses.
Main Methods:
- Drawing on poststructural theories of problematisation.
- Analyzing online alcohol counselling encounters with individuals aged 55 and over.
- Examining three approaches to problem formulation: addiction discourses, moving between concerns and alcohol problems, and making problems complex and multiple.
Main Results:
- Online AOD counselling actively produces 'problems' through social and clinical formulation practices, not merely responding to pre-existing ones.
- The way problems are formulated influences treatment responses and how individuals are perceived (e.g., as 'addicted' or 'normal').
- Different circumstances and practices could lead to problems being defined differently, or not as problems at all.
Conclusions:
- Online AOD counselling is a site where alcohol and other drug problems are actively constructed.
- There is a need for critical reflexivity in AOD treatment and policy to acknowledge and address the complexity of individuals' needs.
- This reflexivity can open possibilities for more nuanced and effective engagement with people seeking AOD support.
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