How enough becomes enough: Processes of change prior to treatment for substance use disorder

Aim: Explore patient’s perceptions of change processes occurring prior to inpatient treatment for substance use disorder, forming the basis for treatment entry. Method: Four single focus-group interviews including a total of 14 patients (11 men and 3 women) were conducted in accordance with a brief interview guide. Interviews focused on patient’s perceptions of change processes prior to treatment entry, associated factors, decision-making and implications for their way forward. A content analysis was conducted to identify code and subcategorize meaning units. Results: Patients describe complex processes of change involving a new perception of life situation enabled by accumulation and escalation of negative consequences, especially related to loss and health, along with an external pressure or trigger. The transition to treatment entry is either based on a deliberate and active decision or a result of spontaneous action and less deliberate decision to initiate in treatment. Conclusions: Patient’s perceptions of treatment entry as a result of a more or less deliberate decision challenges patient’s readiness at treatment entry, constituting an important clinical challenge of relevance for clarifying treatment goals and interventions which in turn may affect the course of treatment applied to the patient.