Narrative study of how non-qualified volunteers and ex-drug users make the transition to paid employment in the substance misuse field

Wilson, Sheila Marie (2014) Narrative study of how non-qualified volunteers and ex-drug users make the transition to paid employment in the substance misuse field. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

This thesis explores how non-qualified ex-user and carer drug workers have made the transition from alcohol and drug use to paid employment in the substance misuse field. The key aims of the research were to:  explore issues that affect the transition experiences of ex-users, carers, peer mentors, students, and paid workers;  examine influencing factors that determine ex-users’ and carers’ decisions to disclose or not their background to colleagues and service users at different stages of their transition;  explore how ex-users perceive their identity, or feel themselves to be perceived, within the context of the substance misuse field;  understand how non-qualified, ex-user or carer drug workers make the transition from service user to paid employee in the substance misuse field, in order to facilitate greater understanding of their experiences in becoming and developing as drug practitioners; and  make recommendations regarding training, employment, and staff development for my own organisation; to enhance my own practice; and to influence wider policy and practice principles. Most ex-user narratives already available ‘end’ at the point where treatment ends leaving much to be discovered regarding what happens next. Understanding the next stage of transition journeys will be valuable in enhancing recovery and treatment outcomes; and determining how best to recruit, induct, train, supervise and support ex-user drug workers in gaining paid employment within the substance misuse field. As a practitioner-researcher I adopted a narrative approach to gain insight into substance misuse practitioners’ experiences, perceptions and attitudes. Participants were recruited through a service user-designed questionnaire and 11 non-qualified ex-users/carers identified themselves as willing to participate in narrative interviews to share their journey of becoming practitioners (consent forms were used and identifying information anonymised through pseudonyms). I used process-mapping to develop participant-structured narratives, so that each participant ‘plotted’ key events along their journey (chronologically) while telling their story. I asked questions to clarify and gain insight into their self-identified significant events over two interviews, each lasting 1-2 hours. From these narratives and process-maps, I identified and analysed three orientations: transition, disclosure and professional identity. Key transition findings included the influence of key-workers in encouraging clients to become drug workers; difficulties, barriers, expectations and opportunities; and motivation to become drug workers (for example, ‘giving something back’, status and remuneration). The findings suggest that participants based disclosure decisions on previous experiences, that is, positive responses were more likely to result in future disclosures; there was limited (if any) guidance available to volunteers and staff; and disclosure was viewed as an individual, selective decision. In terms of professional identity, the findings highlighted different perceptions of what it meant to be a professional; the role boundaries, qualifications and status play in determining professional identity; and tensions between ‘textbook’ and ‘ex-user’ drug workers. A number of recommendations were identified, focusing on how ex-drug users can be better trained and supported in making the transition to substance misuse practitioner. The recommendations not only consider factors such as education and volunteering but, more specifically, how to utilise disclosure effectively and safely; inter-professional working; ex-user and carer motivation; and personal and professional boundaries.