Presentation dianova cies iscte_iul_eftc prague 2013

Commitment| Solidarity| Tolerance| Internacionality… Inspiring Change! Dianova Portugal© 1
“Trajectories, from addiction to reintegration
3 Stages of Analysis Study of Drug Addicts Social Trajectories
After therapeutic Process” (PTDC/CS-SOC/099684/2008)
18th September, 14th EFTC Conference on Rehabilitation and Drug Policy, Prague, 2013
Rui Martins, Head of Communications at Dianova | Susana Henriques, Study Coordinator at CIES-ISCTE-IUL

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Commitment| Solidarity| Tolerance| Internacionality… Inspiring Change! Dianova Portugal© 6Compromisso| Solidariedade| Tolerância| Internacionalidade… Inspirando a Mudança! Dianova Portugal©
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50% Male
Age
Average 40,1
Qualifications
31% College
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School
The TeamTalent
Retention
94%41
Employees
90% Direct
Contracts
10% Indirects

Scientific Follow-up Study “Social
Trajectories” 2013 CIES | ISCTE-IUL
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Coordination Prof.ª Doutora Susana Henriques,
CIES-ISCTE-IUL
Main Goal
• To capture Social regularities and singularities present on social
reintegration of individuals associated with social, family and
individual patterns to acquired skills during the therapeutic
process on
individuals who have completed between 1999-2009 the
program at Dianova Therapeutic Community Quinta das
Lapas (Management Quality System ISO 9001:2008
implemented since 2005, with empirical control over quality
indicators).

• Main questions to be addressed:
– Which are the reinforcement and vulnerability factors
associated with the reintegration trajectories?
– Which changes occurred in the life style after the therapeutic
process (regarding relationship towards drugs, life project,
social networks, activities…)?
– Which were the agents of support to the reintegration
process (family, friends, therapeutic team, other social
support structures…)?
Coordination Prof.ª Doutora Susana Henriques,
CIES-ISCTE-IUL
Main Goal

Methodology
• 3 Main Phases (developed between 2010 and 2013)
1. Analysis of administrative processes (178) of the Therapeutic
Community users that have completed program between 1999-
2009, including individual records filled regarding life history, criminal
records and medical examinations, in order to characterize the
socioeconomic demographic and drug consumptions
2. Phone interviews (63) in order to follow-up and identify changes
on life trajectories of individuals such as the stop of drug use, to
know the social trajectories, identify obstacles and facilitators of family,
professional and social reintegration
3. In-depth interviews (17) – partial life stories through life grid,
ethnographic notes and auto-photographic studies – to a specific
group identified as relevant to the problem of the study according
to its reintegration trajectories’ characteristics
Note: All scientific Follow-up Studies demonstrate the difficulty in maintaining the individuals under participation along the years, s tudy limitation
due to the subject and the studied population

Phase 1 Sociodemographic: Origin

Phase 1 Sociodemographic: Sex & Age
12%
88%
Sex Ratio (%)
Age Structure

Phase 1 Sociodemographic: Education

Phase 1 Sociodemographic: Clinical Status
Health Problems

Phase 1 Treatment Internment
Main substance (%)

Main substance by
age group (%)

Age of beginning drug use

Time of drug use in years

Peridiocity in the drug use (%)

A. Work
1. Not being unemployed nor in treatment
2. Being a worker employed by others or hired without a term
B. Family
3. Autonomy regarding family of origin
C. Abstain from use
4. Not being using drugs | psichoactive substances
5. Haven’t had relapses
D. Social
6. Having created new friendships
7. Associativism
Note: Each factor counts one point in the Index, in a range between 0 (none reintegration) and 7
(full reintegration), mean=3,76, standard deviation=1,42
Phase 3 Final Results
The IRST | Ex-Drug Users Social Reintegration Index
(4 dimensions | 7 variables)

0
5
10
15
20
25
30
35
0 1 2 3 4 5 6 7
%Phase 3 Final Results
The IRST | Ex-Drug Users Social Reintegration Index
(4 dimensions | 7 variables)
IRST Graphic Representation

A. Sociodemographic factors
B. Judicial factors
C. Geographic factors
D. Treatment related factors
E. Drugs | Psichoactive Substance related factors
Factors related with the IRST |
Ex-Drug Users Social Reintegration Index
Note:
• for categorical variables = frequency and percentage and for quantitative variables = mean and
standard deviation
• Factors then crossed with IRST, for categorical variables = IRST mean and for quantitivative
variables = Pearson correlation coefficient

1. Age
2. Education level
B. Judicial factors
3. Criminal record situation when entering treatment
4. Having changed residence since treatment completed
5. Years after completed treatment
6. Treatment duration
7. Treatment evaluation
E. Drugs | Substances related factors
8. Main substance of use
9. Years of consumption of main substance

1. Age (being older, higher values on IRST | the better, successful the reintegration)
2. Education level (nonlinear relation, higher values in the extremes)
B. Judicial factors
3. With pending criminal record process when entering treatment (not relevant)
4. Having changed residence after completing treatment (higher values in those who have changed
residence)
5. Years after completing treatment (more years, higher values)
6. Duration of treatment (longer treatment in months, higher values)
7. Treatment evaluation (better treatment evaluation, higher values)
E. Substances related factors
8. Main substance (users with alcohol with main substance of use, higher values)
9. Years of consumption of main substance (more higher of use, higher values)

0 0,5 1 1,5 2 2,5 3 3,5 4 4,5
Heroína
Cocaína
Cannabinóides
Álcool
Substâncias:
Não mudou de residência
Mudou de residência
Geográficas:
Com antecedentes judiciais
Sem antecedentes judiciais
Jurídicas:
Universitário
Secundário
3º ciclo
2º ciclo
1º ciclo
Escolaridade:
mean
Education Level:
Primary education (4)
Primary education (6)
Lower secondary edu
Higher secondary edu
University
Judicial:
Without criminal record
With criminal record
Geographic:
Changed residence
Unchanged residence
Drugs | Substances:
Alcohol
Cannabis
Cocaine
Heroin

0 0,03 0,06 0,09 0,12 0,15
Anos de consumo da substância principal
Avaliação do tratamento
Duração do tratamento (meses)
Anos passados desde a alta terapêutica
Idade
Correlation coefficient
Age
Years after treatment completed
Durantion of treatment (months)
Treatment evaluation
Years of consumption of main
drug use

Family as supporting factor:
“Had psychological help from my family and that aspect was as important as
helping me in the matter of food, because I vented a lot with my father, I would
open up everything, anything I vented to speak with him, now I get along very
well with him, if I need to vent or need advice I have it on hand or my sisters.”
…and as complicating factor:
“One can change, but the family does not change or changes very little, is always
doubting on you, and now and then they remind it to you "eh that was fifteen
years ago, I've paid for it all!" It is not this way that they will help me to move
on.”
Understanding Reintegration on Individuals’ perspective
Reinforcement factors vs Limiting factors

The change of residence
1. support on work environment or among friends
2. autonomy:
“I am my own therapist ... and since 2007 that I'm out here, free of alcohol,
and drugs [...] Myself alone, therefore without my parents, without my brother
[...] There were times in which I was at home on the computer, playing a game,
and I felt like a beer, so I picked on me and went to the coffee bar, grabbed a
bottle of water, took a coffee and left.”

The return to the old residence place
1. contact with old use habits
2. residence in small towns or villages with high(er) social control:
“When I came they only talked about “ when will she relapse?” A guy
comes in to the coffe bar and listens: hein!... And one fakes it did not ear”
3. Return to a close environment in which the user was raised when
drug addict:
“[Do you believe if You would not be here it would be easier?] I do, because I
was in Alpiarça for 6 months (…), it was I to have to go to the pharmacy (…)
and people around knew that it belonged to Dianova and they always treated me
well… always with respect.”

1. Completing treatment without feeling fully ready
2. The shock of returning to the old residence place:
“I was dropped off, I had the feeling that my house was strange to me, I
was almost a year there, and because of fear they left me stay there a little
longer, only that there was a time when I was told “You have to go, have to go”
3. Take use to the new routines:
“And then it's into the routine, prepare my children to go to school, prepare
lunch and all those little things that I had forgotten there”
4. Economic difficulties and unemployment periods

Trajectories, from drug addiction to reintegration
Conclusions
• Five main social trajectories: Residencial, Marital status, Work,
Capabilities (Education or Training), Substance consumption
• Residencial trajectories emerge as most relevant (change
residence to get away from use environments)
• Capability is crucial to the reintegration process (rights of
access, social freedom and mobility, recognition of identities and
merit reward)
• Regarding the 3 factors related with the therapeutic process
the correlation is always positive: the more years have passed
since the clinical discharge, the longer the duration of the
treatment and the much better the treatment evaluation is, the
higher the values of the IRST (Ex-Drug Users Social
Reintegration Index)

Future Research
• Due to the reduced sample and lack of statistical
representativeness of the empirical basis of work,
as well as to the need of replication of the
proposed Index,
• More in-depth interviews (qualitative analysis) are
crucial to enrich the study,
• and future research should be developed in order to
validate its strength and to confirm whether a
successful reintegration depends more on the post-
treatment process than on the individuals’
characteristics (such as sex, age, education…)

Download Preliminary Reports EN
(I and II)
• The Full Scientific Study Reports can de downloaded from Dianova’s website:
http://dianova.pt/publicacoes/estudo-follow-up-trajectorias-sociais
• Report I (Phase 1)
http://dianova.pt/images/stories/publicacoes/estudos/trajectories_report_I
_en_2011.pdf
• Report II (Phase 2)
http://dianova.pt/images/stories/publicacoes/estudos/trajectories_report__
II_external_en_2012.pdf
• Report III (Phase 3 and Final) will be available from October | November
2013
• Prof.ª Doutora Susana Henriques
http://www.cies.iscte.pt/investigadores/ficha.jsp?pkid=67&a=1956703120
• CIES-ISCTE-IUL Project
http://www.cies.iscte.pt/projectos/ficha.jsp?pkid=428

Accept
Mistakes
Enjoy
In Conclusion
Simplicity in
Complexity
Guidance
for Learning Take risks.
Encourage
Inovate

Quinta das Lapas, 2565-517 Monte Redondo Torres Vedras Telf.: +351 261 312 300 Fax.: +351 261 312 322
E-mail: rui.martins@dianova.pt | susana_alexandre_henriques@iscte.pt
www.dianova.pt www.formacao.dianova.pt
http://aprendercrescerconcretizar.wordpress.com
dianovaportugal
dianova-portugal
www.apoiopsicossocial.dianova.pt

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