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Introduction

Thank you for coming here today. It means a lot to us. The subject of this interview is perceptions and assessments of people who use alcohol or drugs, and how to decide how this should be handled. This is part of my PhD thesis, which focuses on differences between social services and regional healthcare. I am a PhD student at the Department of Social Work and SoRAD at Stockholm University. The study has been reviewed by an ethics committee and is financed by FAS.

The discussion will be recorded and transcribed. The audio files and the transcripts will be kept secure so that they cannot be accessed by unauthorised persons. Your participation is voluntary. You can terminate your participation at any time without giving a reason. You are anonymous. No information will be published that reveals who you are or where you work. The results will be presented in articles and you will be given information about them when they have been completed. Each of you will receive a cinema ticket when we are finished here today. I would also like to you sign this consent form. It is required in order to ensure that you have received this information. You can keep a copy. Do you have any ques- tions?

The plan is to first talk about practicalities and we will present ourselves briefly. We will discuss the subject in general, and thereafter on the basis of a couple of case descriptions. Then we will talk about some of the results from the vignette study that some of you participated in in 2011. Finally I will try to summarize briefly and you will have the opportunity to consider whether we have missed anything im- portant. We have a pretty tight schedule, a maximum of one and a half hours, so we might have to move on from interesting discussions to be able to cover all the topics. I will monitor the time. Does this sound ok to you?

About the interview. I would appreciate it if we could agree on not talking to others about what is said in this room, in order to make everyone feel comfortable to express their views. Can we agree on that? Also, there are no right or wrong answers. I would really like to have a discussion about difficult issues in your work. You do not have to agree on a subject, you may express different opinions, and I would really like you to discuss them among yourselves. This topic is really complex, and you possess valuable knowledge and experiences. I would like to shed light on these and to hear about different opinions and experiences.

Presentation

Name, age, occupation and work experience.

Introductory questions

What influences the first impression you get of a client/patient. How is the initial assessment made? What are the spontaneous thoughts about a person that arise when you first meet them?

If you were to imagine a person whom you would consider as not being in need of help from you – what would that person be like?

If you were to imagine a person whom you would consider to be definitely in need of help from you – what would that person be like?

Key questions 1. Discussion about vignettes

You are now about to read a short fictitious story about a person. The information given here is of course much more limited than when you meet people in reality. I would however like you to consider the con- crete situation and the limited information given.

What do you think about Johanna’s drinking? How severe is it? Does she need any help and if so, what kind of help?

What do you think about Hans’s drinking? How severe is it? Does he need any help and if so, what kind of help?

If you compare Johanna’s and Hans’s situations, what importance does their social situation have for the severity of their drinking situation and their treatment needs? What importance does their gender have?

Key questions 2. Discussion based on the results of the vignette study

Some of you participated in a vignette study in 2011, where you were presented with a number of ficti- tious cases and asked to assess the severity of the situation and how it should be handled. 480 people from 80 work units in different parts of the country participated. The ratings made in the study cannot be treated as evidence of the assessments that are made in practice – when one meets clients/patients in reality, the process is much more complicated. The vignette study may reveal assumptions that underlie perceptions of substance use. I would like to give you some examples of results from the study. The use of unemployed individuals was considered as being more severe, irrespective of the frequency or nature of the consequences, compared to the use of people who were working or studying.

Is it considered worse if a socially marginalised person uses alcohol or drugs? Are socially marginalised individuals less capable of dealing with their problems? Are socially marginalised individuals more eligible to receive help from society?

What importance does the social situation of the person coming to addiction care have for the help he or she is given and the response that he or she is met with?

One of the results of the study was that doctors saw women’s alcohol or drug use as being more severe than men’s. What are your thoughts about that?

Another result was that the drinking of young women was considered to be worse than the drinking of young men. What are your thoughts about that?

Do you think that men and women meet with a different response in their contacts with addiction care? In what way?

Female practitioners more often stressed the severity of a situation if there was a child present in the situation.

What difference does it make if a client is in contact with a male or female staff member in addiction care?

Different attitudes or approaches seem to be present in the social services versus regional healthcare. What effects might this have for patients/clients?

Concluding discussion

Is there something that we have forgotten or missed that is important in this context? Would you like to add anything?

How did you find this interview? How were the questions? Should anything be changed? Thank you so much for your participation.