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It's Not Denial, It's Stigma: A Case Study.

Shari Harding1

  • 1Shari Harding, DNP, PMHNP-BC, CPRP, Graduate School of Nursing, University of Massachusetts Medical School, Worcester.

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|December 2, 2021
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Summary
This summary is machine-generated.

Addictions nurses can overcome client stigma and engagement barriers by using person-centered, recovery-oriented approaches. This strategy promotes positive problem-solving for individuals with alcohol use disorder and co-occurring depression.

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Area of Science:

  • Addiction Nursing
  • Psychiatry
  • Mental Health Care

Background:

  • Stigma remains a significant barrier in addiction treatment, particularly in non-specialty settings.
  • Client engagement is crucial for recovery, yet often hindered by past negative experiences and societal prejudice.
  • The COVID-19 pandemic and life transitions like retirement can exacerbate co-occurring mental health and substance use disorders.

Observation:

  • A 65-year-old woman with worsening alcohol use disorder and major depressive disorder, influenced by retirement and pandemic stressors, exhibited reluctance to discuss her substance use.
  • Her primary care provider perceived her as "in denial," highlighting a common misinterpretation of resistance stemming from stigma and prior confrontational treatment.
  • The case illustrates the impact of stigma, self-stigma, and the prevailing culture within addiction treatment on an individual's recovery journey.

Findings:

  • Past negative treatment experiences and pervasive stigma, including self-stigma, significantly impede client engagement in addiction recovery.
  • A person-centered and recovery-oriented approach is essential for fostering trust and facilitating open communication.
  • Understanding the interplay of social, psychological, and environmental factors is key to addressing complex addiction cases.

Implications:

  • Addictions nurses can effectively promote client engagement and recovery by adopting person-centered strategies.
  • Healthcare providers must recognize and address stigma within treatment settings to improve care for individuals with substance use disorders.
  • Interdisciplinary collaboration and tailored approaches are vital for supporting clients with co-occurring conditions and complex needs.