Residential rehabilitation pathways: lived experience interviews

5. Appendices

5.1 Interview Topic Guide

Introduction

• We are trying to gather as much information as possible on residential rehabilitation for alcohol and drugs across Scotland. We have carried out surveys with rehab facilities, and with Alcohol and Drug Partnerships (the government funded organisations who coordinate alcohol and drug services locally).
• While these have been useful, we think it's particularly important to explore the experiences of people who have actually been through rehab in order to find out what the experience is like, so that these can inform ongoing improvements.
• This interview is designed to gather information on your experiences of your journey of going through residential rehabilitation from start to the present day. It has a few questions on your life and substance use before accessing rehab, questions asking how you came to be referred to, and accessed and funded your placement in rehab, on what the day-to-day process of attending rehab was like, and on the journey out of rehab towards aftercare and your life following your placement. It tries to focus on what worked well, and aspects of the journey which you would improve.
• You'll have seen this in the Participant Information sheet and Consent Form, but just to emphasise, if you do not feel comfortable answering any questions, you are under no obligation to answer them. You can ask us to skip particular questions, and are free to stop the interview at any time without giving us a reason. All of your responses will be made anonymous and made as confidential as possible (unless you inform us of risking harm to yourself or others).

Personal/Background

• Age
• Gender
• Ethnicity
• What rehab(s) did you go to and when?
• Which area did you live before accessing rehab? Where area do you live now?
• Employment status
• Housing status
• Any involvement with criminal justice history?

Experience of Alcohol/Drug Use

Substance use profile

• What substances were you using?
• What was the main substance for which you were seeking recovery?

Access

Previous experience of treatment/recovery services

• Did you have a history of accessing other treatment/recovery services before rehab?
• Why did you feel that these services had not worked for you?

Identification

• How long had you been using for, and attempting to recover before rehab was presented as an option?
• How did you come to hear about or consider rehab as an option?
• Who was the main person/agency who referred you in the end?
  • Did you think that people in these services were helpful in terms of helping you access rehab?
  • Why did you prefer the idea of residential rehabilitation in comparison with other treatment/recovery services?
  • What did you hope to get out of rehab?
  • Did you consider yourself to be in recovery before accessing rehab?

Assessment

• Can you tell us about the assessment?
  • Who was involved?
  • What kinds of questions did they ask?
  • How did you find the experience? How did it make you feel?

Funding

• Can you talk us through the process of accessing funding for your placement?
  • How easy was it to get funded?
  • Did the providers help you in the process of securing funding?
  • Had you approached anyone else for funding?
  • What would you have done if you hadn't accessed funding through that pathway?
  • Did you try and access statutory funding at all?

Selection of Facility

• How much of a say did you get in relation to choosing a facility?
  • Did you feel then that the choice was the best one for your needs at the time?

Pre-Rehab

Waiting Period

• After being accepted for a placement, did you have to wait to enter rehab?
  • How long did you have to wait?
  • What were things like for you during this waiting period? Did your motivation wane at all? Were you ever considering changing your mind?
  • IF P2R – What was the process of transfer like?
  • IF P2R – Did you go straight from prison or did you have a short stay outside of prison before going into rehab?
  • IF P2R – Did you feel the prison staff/rehab were working well together to organise

Preparatory Work

• What kind of preparatory work did you have to do before entering rehab?
  • Who was involved in this period of work?
  • Did you feel well-prepared for residential rehabilitation when you started your placement?
  • Did you feel you knew exactly what to expect from your placement, and the benefits and challenges?

Detox

• Did you have to undertake detox beforehand?
  • Where did this take place?
  • How long did you have to wait?
  • (If going to a facility) How was this funded?
  • Did you have to wait at all between detox and rehab?
  • Did you feel well supported?

Residential Phase

Engagement with external services

• How much engagement did you have with community-based services/ADP while in your rehab placement?
• Engagement with FAMILY and wider relationships during placement.

Success of programme

• What was your experience of being in rehab like?
• Was there anything that would have made your experience of rehab better or improved your likelihood of recovery?
  • [If having sustained recovery] What do you think it was about rehab that helped you towards success in recovery?
  • Why was rehab different to other kinds of treatment or recovery service?
  • [If not having sustained recovery] What do you think it was about rehab that was limited in helping you towards success in recovery? What did you feel disrupted their recovery or caused them to begin taking substances again?
• If you had mental health issues at the time, how were these addressed? Did you feel they were adequately dealt with? Who was involved in this?
• Did you feel that the staff at the rehab were competent? Informed? Sensitive in dealing with issues of trauma etc?
  • Were there any gaps in terms of staff that you would have liked to have been there?

Completion of Placement

• How long did your rehab placement last? Was this longer/ shorter than planned?
  • Did you ever leave and come back/ have multiple stays in rehab?
  • [If unplanned exit] What were the factors which led to you leaving rehab early?
  • (If having sustained recovery) What made the last stay a success?

Aftercare

Planning for Aftercare/Post-Rehab

• What kind of planning was undertaken for finishing rehab? In terms of housing? Employment/Training? Relationships?
  • Was planning for accessing aftercare undertaken during your placement? Can you tell us a bit about this?
  • Did you link in with other services/recovery communities etc?

Post-Rehab

• Can you talk a bit about the process of adjusting to life following your placement?
  • Did you feel ready for life after rehab? Life skills? Relationships?
  • How well supported did you feel at this time?
  • Who was involved in providing support to you throughout this process?

Aftercare Experiences

• If having accessed aftercare…
• Can you describe how you came to access aftercare following your placement?
• What aftercare services did you/have you been attending?
  • And for how long? how long do you think you will keep going?
• If not having accessed aftercare:
• Why did you feel you did not need to, or were not able to, access aftercare?

Readmission (if applicable)

• Can you tell us a bit about returning to residential rehabilitation?
  • Was the possibility of going back discussed at all with you and at what stage?
  • What was the process of gaining access again like?

General Questions

Suggestions for improvements

• What would have improved your journey into, through and out of residential rehabilitation?

General Comments

• Do you have anything you wish to add that was important about your experience of residential rehabilitation that we've not covered?

Findings from the ADP and Provider surveys

• Barriers for benzos
• Mental health comorbidities
• Workforce