Skip to main content

Advertisement

SpringerLink
Log in

Using a Film Intervention in Early Addiction Treatment: a Qualitative Analysis of Process

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Purpose

There is a need for knowledge about how self-help materials can be made useful in treatment for Substance Abuse Disorders (SUD), as a supplement to ongoing treatment, or as independent tools for change.

Objective

In this study, we explored the use of self-help films in early addiction treatment, taking into account both patient and therapist perspectives, as well as dyadic functions. We explored how active mechanisms might be related to intervention format and implementation context. A secondary aim was to examine the potential mechanisms related to the specific content of the intervention: mindfulness and acceptance psychoeducation.

Methods

A qualitative exploratory research design, including a general inductive analytic approach, constructivist grounded theory, and source triangulation features, was used to code and analyze interview material. Emerging themes were developed into concepts, and finally an operational model. Participants included 12 patients and 22 therapists, in in-/outpatient addiction clinics, all in urban areas of Norway. The purpose of the design was empirical grounding of developed concepts, to promote different potential user perspectives (patients’ and therapists’) and obtain process data.

Results

The core concept constructed, “Alliance as experiential process,” gives a description of the data where patients and therapists accept or reject the film as a result of an experience process conceptualized as alliance formation. The alliance process model reflects the observation that patients constructed alliances autonomously, while therapists built alliances indirectly through their patients’ experiences.

Conclusions

Use of a self-help film may be a helpful adjunct to face-to-face therapy for patients who create a personally meaningful attachment to the film. Mindfulness/acceptance may offer one basic framework for such connection to take place.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. By the time of the telephone interviews, one therapist had left her job. A simplified follow-up was conducted by e-mail.

References

  1. McLellan AT, Woody GE, Metzger D, McKay J, Alterman AI, O’Brien CP. Evaluating the effectiveness of treatments for substance use disorders: reasonable expectations, appropriate comparisons. Milbank Quarterly. 1996. http://www.jstor.org/stable/3350433.

  2. Najavits LM, Weiss RD. Variations in therapist effectiveness in the treatment of patients with substance use disorders: an empirical review. Addiction. 1994; doi:10.1111/j.1360-0443.1994.tb00954.x.

    PubMed  Google Scholar 

  3. McKay JR, Weiss RV. A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups: preliminary results and methodological issues. Eval Rev. 2001; doi:10.1177/0193841X0102500202.

    Google Scholar 

  4. McLellan AT, Lewis DC, O‘Brian CP, Kleber HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcome evaluation. J Am Med Assoc. 2000; doi:10.1001/jama.284.13.1689.

    Google Scholar 

  5. Walitzer KS, Dermen KH, Connors GJ. Strategies for preparing clients for treatment. Behav Modif. 1999; doi:10.1177/0145445599231006.

    PubMed  Google Scholar 

  6. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011; doi:10.1192/bjp.bp.110.083733.

    PubMed  Google Scholar 

  7. Cook JE, Doyle C. Working alliance in online therapy as compared to face-to- face therapy: preliminary results. Cyber Psychology & Behavior. 2002; doi:10.1089/109493102753770480.

    Google Scholar 

  8. Duckert F, Drozd F, Kraft P. Alkoholproblemer på arbeidsplassen – en arena for tidlig intervensjon via nye medier. Tidsskrift for Norsk Psykologforening. 2011. http://www.psykologtidsskriftet.no/index.php?seks_id=149371&a=2

  9. Miller W, Rollnick S. Motivational interviewing: preparing people for change. NewYork: Guilford Press; 2002. ISBN13: 9780898625660

    Google Scholar 

  10. Oldham M, Kellet S, Miles E, Sheeran P. Interventions to increase attendance at psychotherapy: a meta-analysis of randomized controlled trials. J Consult Clin Psychol. 2012; doi:10.1037/a0029630.

    PubMed  Google Scholar 

  11. Punch S. Interviewing strategies with young people; the ‘secret box’, stimulus material and task-based activities. Child Soc. 2002; doi:10.1002/chi.685.

    Google Scholar 

  12. Krouse HJ. Video modeling to educate patients. J Adv Nurs. 2001; doi:10.1046/j.1365-2648.2001.01716.x.

    PubMed  Google Scholar 

  13. Johansen AB, Lumley M, Cano A. Effects of video-based therapy preparation targeting experiential acceptance or the therapeutic alliance. Psychotherapy. 2011; doi:10.1037/a0022422.

    PubMed  Google Scholar 

  14. Dundas I, Ravnanger K, Vøllestad J, Binder PE. Hvordan kan oppmerksomt nærvær hjelpe ved rusproblemer? Tidsskrift for Norsk Psykologforening 2013. http://www.psykologtidsskriftet.no/?seks_id=315402&a=2

  15. Hayes SC, Strosahl K, Wilson KG. Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press; 1999. ISBN10: 1572304812

    Google Scholar 

  16. Marlatt AG, Witkiewitz K, Dillworth TM, Bowen SW, Parks GA, Macpherson LM, Lonczak HS, Larimer ME, Simpson T, Blume AW, Crutcher R. Vipassana meditation as treatment for alcohol and drug use disorders. In: Hayes SC, Linehan MM, Follette VM, editors. Mindfulness and acceptance. Expanding the cognitive-behavioral tradition. London: Guilford Press; 2004. p. 261–87. ISBN10: 1609189892.

    Google Scholar 

  17. Zgierska A, Rabago D, Chawla N, Kushner D, Koehler R, Marlatt AG. Mindfulness meditation for substance use disorders: a systematic review. Subst Abus. 2009; doi:10.1080/08897070903250019.

    Google Scholar 

  18. Bateman A, Fonagy P. Mentalization-based treatment. Psychoanal Inq. 2013; doi:10.1080/07351690.2013.835170.

    PubMed  PubMed Central  Google Scholar 

  19. Hayes SC. Acceptance and commitment therapy and the new behavior therapies. In: Hayes SC, Linehan MM, Follette VM, editors. Mindfulness and acceptance: expanding the cognitive-behavioral tradition. London: Guilford Press; 2004. p. 1–29. ISBN10: 1428802843.

    Google Scholar 

  20. Holden B. Aksept- og forpliktelsesterapi: En atferdsanalytisk psykoterapi. Tidsskrift for Norsk Psykologforening. 2007; http://www.psykologtidsskriftet.no/index.php?seks_id=31146&a=2

  21. Kabat-Zinn J. Wherever you go there you are – mindfulness meditation in everyday life. New York: Hyperion; 2005. ISBN10: 1562827693

    Google Scholar 

  22. Luoma JB, Kohlenberg BS, Hayes SC, Fletcher L. Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. J Consult Clin Psychol. 2012; doi:10.1037/a0026070.

    PubMed  Google Scholar 

  23. Bowen S, Witkiewitz K, Dillworth TM, Marlatt GA. The role of thought suppression in the relationship between mindfulness mediation and alcohol use. Addict Behav. 2007; doi:10.1016/j.addbeh.2007.01.025.

    PubMed Central  Google Scholar 

  24. Murray E, Linke S, Harwood E, Conroy S, Stevenson F, Godfrey C. Widening access to treatment for alcohol misuse: description and formative evaluation of an innovative web-based Service in one Primary Care Trust. Alcohol Alcohol. 2012; doi:10.1093/alcalc/ags096.

    PubMed  Google Scholar 

  25. Johansen AB, Pettrem Y. Oppmerksomt nærvær – en kilde til et bedre liv. Intermedia: University of Oslo; 2010.

    Google Scholar 

  26. Charmaz K. Grounded Theory: objectivist and constructivist methods. In: Denzin NK, Lincoln YS, editors. Strategies of qualitative inquiry. 2.ed ed. London, Sage Publications; 2003. p. 249–91. ISBN10: 0585383405.

  27. Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006; doi:10.1177/1098214005283748.

    Google Scholar 

  28. Lynham SA. The general method of theory-building research in applied disciplines. Adv Dev Hum Resour. 2002; doi:10.1177/1523422302043002.

    Google Scholar 

  29. Charmaz K. Constructing grounded theory. A practical guide trough qualitative analysis. London: Sage Publications; 2006. ISBN10: 0857029134

    Google Scholar 

  30. Fassinger RE. Paradigms, praxis, problems, and promise: grounded theory in counseling Psychology research. J Couns Psychol. 2005; doi:10.1037/0022-0167.52.2.156.

    Google Scholar 

  31. McCreaddie M, Payne S. Evolving grounded theory methodology: towards a discursive approach. Int J Nurs Stud. 2010; doi:10.1016/j.ijnurstu.2009.11.006.

    PubMed  Google Scholar 

  32. Mills J, Bonner A, Francis K. The Development of Constructivist Grounded Theory. International Journal of Qualitative Methods. 2006. http://www.researchgate.net/publication/232272011_The_development_of_constructivist_grounded_theory/file/d912f50ea5f623bd98.pdf

  33. Patton MQ. Qualitative research and evaluation methods. Thousand Oaks: Sage Publications; 2002. ISBN10: 0803937792

    Google Scholar 

  34. Malterud K. Kvalitative metoder i medisinsk forskning. Oslo: Universitetsforlaget; 2003. ISBN 9788215018003

    Google Scholar 

  35. Babbie E. The basics of social research. Belmont: Wadsworth/Thomson Learning; 2002. ISBN10: 0495094684

    Google Scholar 

  36. Draucker CB, Martsolf DS, Ross R, Rusk TB. Theoretical sampling and category development in grounded theory. Qual Health Res. 2007; doi:10.1177/1049732307308450.

    PubMed  Google Scholar 

  37. Mays N, Pope C. Assessing quality in qualitative research. BMJ. 2000; doi:10.1136/bmj.320.7226.50.

    Google Scholar 

  38. Horvath AO, Luborsky L. The role of the therapeutic alliance in psychotherapy. Journal of Consultant and Clinical Psychology. 1993; doi:10.1037/0022-006X.61.4.561.

    Google Scholar 

  39. Horvath AO, Symonds BD. Relation between working alliance and outcome in psychotherapy: a meta-analysis. J Couns Psychol. 1991; doi:10.1037/0022-0167.38.2.139.

    Google Scholar 

  40. Rochlen AB, Zack JS, Speyer C. Online therapy: review of relevant definitions, debates, and current emipirical support. Journal of Clinical Psychology. 2004. http://www.acpor.ro/files/file/resurse_articole/ROCHLEN_2004_online_therapy.pdf

  41. Johansson R, Andersson G. Internet-based psychological treatments for depression. Expert Rev Neurother. 2012; doi:10.1586/ern.12.63.

    PubMed  Google Scholar 

  42. Rogers CR. The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol. 1957; doi:10.1037/h0045357.

    PubMed  Google Scholar 

  43. Watson JC, Steckley PL, McMullen EJ. The role of empathy in promoting change. Psychother Res. 2014; doi:10.1080/10503307.2013.802823.

    Google Scholar 

  44. Rucker DD, Petty RE, Briñol P. What’s a frame anyway? A meta-cognitive analysis of the impact of one versus two sided message framing on attitude certainty. J Consum Psychol. 2008; doi:10.1016/j.jcps.2008.01.008.

    Google Scholar 

  45. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977; doi:10.1016/0146-6402(78)90002-4.

    PubMed  Google Scholar 

  46. Markland D, Ryan RM, Tobin VJ, Rollnick S. Motivational interviewing and self-determination theory. J Soc Clin Psychol. 2005; doi:10.1521/jscp.2005.24.6.811.

    Google Scholar 

  47. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000; doi:10.1037/0003-066X.55.1.68.

    PubMed  Google Scholar 

  48. Johansen AB, Darnell FJ, Franzen E. Constructing a theory and evidence-based approach to promote and evaluate autonomy in addiction. Inquiry. 2013; doi:10.1080/0020174X.2013.806138.

    Google Scholar 

  49. Kvale S. Det kvalitative forskningsintervju. Gyldendal Akademisk: Oslo; 2006. ISBN 9788205463547

    Google Scholar 

Download references

Acknowledgements

This study was supported by the Norwegian Research Council through a Postdoctoral Fellowship awarded to the Norwegian Centre for Addiction Research, as well as a grant awarded to the Centre for Study of Mind in Nature for the project Personal Autonomy, Addiction and Mental Disorder. The production of the DVD “Mindfulness – a resource for life betterment” was supported by the Norwegian Directorate of Health and Stavanger University Hospital. We also thank Elisabeth Franzen for contributing to the data collection and analyses.

Author information

Authors and Affiliations

  1. Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway

    Ingerid Elgesem Bjelland, Ayna Johansen, Farnad Darnell & Håvar Brendryen

  2. Department of Substance Abuse and Addiction, Akershus University Hospital, P.o.box 1000, 1478, Lørenskog, Norway

    Ingerid Elgesem Bjelland

  3. Centre for Study of Mind in Nature, University of Oslo, Oslo, Norway

    Ayna Johansen

Authors
  1. Ingerid Elgesem Bjelland
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayna Johansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Farnad Darnell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Håvar Brendryen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ingerid Elgesem Bjelland.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Norwegian Ethics Committee. All informants were presented with written information and time to consider participating. No compensation was given. This article does not contain any studies with animals performed by any of the authors.

Conflict of Interest

Author Ingerid Elgesem Bjelland declares that she has no conflict of interest. Author Ayna Johansen declares that she has no conflict of interest. Author Farnad Darnell declares that he has no conflict of interest. Author Håvar Brendryen declares that she has no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bjelland, I.E., Johansen, A., Darnell, F. et al. Using a Film Intervention in Early Addiction Treatment: a Qualitative Analysis of Process. Int.J. Behav. Med. 24, 740–748 (2017). https://doi.org/10.1007/s12529-017-9654-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-017-9654-3

Keywords

Search

Navigation