施用影響精神藥物者之以全人為導向的復元與社會復歸架構：社區服務機構之文本分析

A Whole Person-Oriented Recovery and Social Recovery Framework for Individuals Who Use Psychoactive Drugs: A Content Analysis of Community Recovery Service Providers

研究目的：本文目的是以美國物質成癮與心理健康服務部（SAMHSA, 2011）針對施用毒品者「復元」（recovery）所提出的定義、四大復元面向與十個指導原則為基礎，建構出以全人為導向的復元/社會復歸架構（whole person-oriented recovery and social recovery framework），來整合復元/社會復歸概念的實質內涵，並以其檢視台灣社會復歸服務機構對於施用影響精神藥物者復元/社會復歸的理念、目標與工作現況，做為未來政府與民間機構在建置施用影響精神藥物者的多元化復元與社區復歸服務網絡之參考。研究方法：針對2020年度18家接受衛生福利部「藥癮者社區復健方案布建及服務品質提升計畫」補助之民間機構的申請計劃書、結案報告書與實地訪談內容進行文本分析。研究結果：SAMHSA對於復元的工作定義與各項指導原則可以在18家機構中找到相對應的服務與工作內容，但對於復元的定義、機構本身在個案復元過程中的角色定位與提供服務策略，缺乏前後邏輯連結與品質確認，使得服務內涵與社會復歸的目的連結不明確、導致難有合適的效果評估。研究結論：本研究也針對建構施用影響精神藥物者復元政策與社會復歸服務機構提出相關建議。

Purpose: In 2011, the Substance Abuse and Mental Health Services Administration (SAMHSA) proposed a definition, dimensions, and guiding principles of recovery. We applied their concepts to construct the whole person-oriented recovery and social recovery framework, and used this framework to examine the contents of recovery service providers in Taiwan. Methods: We used thematic analysis to analyze annual reports from 18 service providers participating in a recovery project funded by the Taiwan Ministry of Health and Welfare in 2020. Results: Overall, the services and resources provided by the18 providers fell under SAMHSA’s working definition of recovery. However, there exists a lack of clear insight into the definition of recovery, roles of providers, and service strategies among the majority of the 18 providers. A blurred understanding may create dissonance between targeted services and goals for social recovery, and add to the difficulty in assessing the outcomes of a service program. Conclusions: Implications and future recommendations for recovery service providers and government regulations are discussed.