社會支持網絡之再建構：民間宗教型戒癮安置服務內涵的質性分析

Rebuilding Social Support Network of Substance Abusers: A Qualitative Inquiry into the Services in Faith-based Residential Treatment Centers

目標：當前的戒癮處遇工作由單純的監禁與醫療，轉向更多元、長期的服務，但關於安置處遇模式的文獻有限。本研究的目的是以社會網絡處遇的概念，分析民間戒癮安置服務如何進行中長期服務的內涵及其運作方式。方法：本研究以質性研究的焦點團體訪談法進行，針對三所成立已久的民間宗教型戒癮機構，邀請組織內八個不同安置處所之生輔人員及社工等（共計13位）進行焦點團體訪談，並將逐字稿內容運用質性研究軟體Nvivo 12加以分析。結果：在社會網絡處遇的服務模式內涵上，分析為建立內部新連結、重塑家庭舊連結、增進外部連結，以及連結同儕工作者與非過來人的經驗。結論：藉形塑內部規範、文化與信仰，戒癮社區協助戒癮者建立新的認同；藉減少或增加與家庭互動，戒癮安置服務協助形成正向的復元支持資源；藉向外擴展連結關係，穩定戒癮者社會適應的其他資源；藉同儕工作者與非過來人合作，增強戒癮復元的成效。建議戒癮安置服務應更著重發展同儕為基礎的各樣支持服務、應更為關注女性戒癮者及其家庭獨特的需求、應對內更深入文化與認同議題、對外更擴大與教會以外單位的連結。目前政策上戒癮同儕工作者缺乏明確的認定，相關方案補助辦法中皆具高中以上學歷之要求，使部分具正向戒癮經驗者不易留任成為同儕工作者。建議政府相關單位正視此問題，以增進戒癮處遇的多元性，鼓勵民間組織投入中長期戒癮安置服務。

"Objectives: Substance abuse treatments are gradually replacing incarceration with multiple, longitudinal treatment arrangements in Taiwan. Few studies have been conducted on how substance abusers are guided in rebuilding social support networks during recovery. The purpose of this study was to investigate social support network implications of services for recovery in nonprofit residential treatment centers. Methods: This study adopted a qualitative research design, and conducted three focus-group interviews with 13 living care assistants, social workers and directors from 8 residential centers. The interview data were converted into transcripts for analysis with Nvivo12. Results: The social support network implications of services for recovery include four dimensions: rebuilding new connections with people in the centers, reframing original connections with family members, extending outside connections with people outside the centers, and enhancing collaboration of peer workers and professional workers. Conclusions: It is recommended that residential treatment centers increase resources on services of social support network for abstinence. Peer support services are valuable in the service model. Specific services for female substance abusers and their families are needed in the treatment procedures. Policy should evaluate the subsidy requirements linked to education level to encourage people with recovery experiences to remain as peer workers."