Society For The Study Of Addiction

QMJC March 2022: Using narratives to understand progress in youth alcohol and other drug treatment

The Qualitative Methods Journal Club met in March 2022 to discuss a study about young people’s stories of their progress through treatment, from initially ‘feeling disconnected’, to later ‘imagining a future’.

About this month’s journal club

The article (available here) was discussed online (Zoom) at Simon Fraser University. Naomi Zakimi (School of Criminology, Simon Fraser University) presented and led the discussion alongside Alissa Greer (School of Criminology), Sheri Fabian, Amanda Butler (Health Sciences, Simon Fraser University), and Krista Glowacki (Faculty of Medicine, University of British Columbia). Journal club participants included research and teaching faculty, as well as postgraduate and graduate students from across institutions and organisations.

Summary of the article

This month’s article, written by Wilson, Saggers, and Wildy (2013), used ethnographic observation and in-depth interviews with young people in one detoxification service and one rehabilitation service in Australia to uncover their stories of progress through treatment. The study aimed not only to shed light on the stories of young people in treatment, but also to help service providers assess the effectiveness of such programmes.

The authors conducted in-depth qualitative interviews with eight young people and engaged in ethnographic observation and participation over five months. Data were coded for themes around the concept of “getting better”, and then used to develop a framework illustrating the different stages of progress. These stages were explained using composite narratives that drew from participants’ own stories, as well as the researchers’ analysis and interpretation.

The composite narratives served to illustrate the trajectory of young people in treatment who were initially “disconnected”, but, as time went on, a “’light-bulb’ moment” allowed them to “imagine a future.” The narratives were written in the first person and used participants’ language and way of speaking. Five stages of progress were presented, although the authors noted that recovery was not necessarily a linear process for all young people.

The researchers discussed implications for both service providers and young people in treatment. The narratives could be used by staff at treatment services to tailor interventions to each young person’s individual needs, as well as to help guide them through their own story of progress. For young people, reading or otherwise learning about the experiences of others in similar situations can help them reflect on their identities and allow them to imagine their futures.

Discussion of the article

This month’s article generated a lively discussion around the different ways that narrative inquiry can be used in drug-related research. Journal club members saw narratives as a great knowledge translation tool that could help make research findings available to participants, as well as policymakers.

Acknowledging our biases: Comparing narrative inquiry to other methods

As has happened in some of our previous journal club meetings, we reflected on our biases and the reason why some research decisions can make us ‘uncomfortable’. Narrative inquiry was quite new for most of our members, so we discussed the utility of this method to study treatment outcomes. As we reflected on our own research experiences, using both qualitative and quantitative methods, one member observed that narratives can help cohesively tell a story that “we would never get” with other methods, such as thematic or content analysis.

The importance of language

We were particularly interested in the way the authors used language. Some of our members found the narratives, which used informal, first-person language, and were written from the participants’ perspective, to be quite different from the research we usually read. This made the narratives enjoyable to read and allowed some of us to identify experiences working in similar settings in the past. As we read, we could feel the participants’ emotions; as one of our members put it: “you can’t read that and not feel something”.

Capturing a diversity of experiences

In this article, narrative inquiry helped highlight the experiences that participants had in common. However, some of our members wondered whether narratives could also be used to highlight the stories of people who did not follow the progressive stages uncovered in the study. While the authors acknowledged that not all participants experienced treatment as a linear process, we thought that it could also be useful for service providers and young people to read the stories of people who do not complete treatment or who are not able to “imagine a future” (the final stage) as they progress through the treatment programme.

Research as a tool for self-reflection

Our members also discussed the importance of research as a tool for self-reflection. The authors explained that the experience of telling stories can be useful and therapeutic for participants, especially young people. We enjoyed reading about the “light-bulb moment” in the composite narrative where participants embraced wanting to “get better,” and we wondered to what extent the research method had facilitated this turning point. While research is sometimes seen as a one-way relationship where researchers ‘collect data’ from participants, this study highlights how narrative inquiry can also be a positive experience for participants.

Knowledge translation

While discussing the practical implications of using narrative inquiry, we all agreed that this method has great potential for knowledge translation. Narratives can be used to share research findings with a wide variety of audiences, including participants, service providers, and people with similar experiences who might find value in participants’ stories. One of our members, for example, saw this study’s findings being used in an open public forum where the narratives could be read by actors to engage the community in discussions about policy implications.

Other comments and thoughts

  • Some of our journal club members wondered if the narrative approach used by the authors could also be used to highlight individual differences between participants or to tell more than one story of progress. We further discussed how narratives could be a useful method to do a case study on the story of a single person.
  • The authors pointed out that they interviewed an equal number of young women and men. Some of our members thought that it would have been interesting to read recovery narratives from the perspective of different genders.
  • We would have liked to read more about how the narratives were put together; specifically, we were curious about how the authors incorporated direct quotations from participants into the narratives.
  • Our members felt that narrative inquiry as used in this study helped “humanize” and empathise with participants. We all agreed that we would like to use this method in the future.
About the article

Wilson, M., Saggers, S., & Wildy, H. (2013). Using narratives to understand progress in youth alcohol and other drug treatment. Qualitative Research Journal, 13 (1), 114-131. https://doi.org/10.1108/14439881311314694

The article can be accessed here.


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