Exploring The Process of Change in Early Recovery following Alcohol Detoxification in a General Hospital Lucy Dorey PhD Student Supervisors: Professor Judith Lathlean, Dr Tracey Harding, Dr Greta Westwood, Professor Paul Roderick

Pathways Post Detoxification Hampshire Pathway (Fareham, Gosport & South Eastern Hampshire) Portsmouth Pathway (Portsmouth City) Twelve months Alcohol Specialist Nurse Service health & recovery focused outpatients appointments Referral to Community Alcohol & Drug Services RECOVERY GROUPS AND SERVICES

Combined Data Analysis Journeys of Recovery following a Hospital based Alcohol Detoxification Programme Mixed Methods Research Design RETROSPECTIVE ANALYSIS OF ROUTINE DATA QUALITATIVE LONGITUDINAL STUDY Statistical analysis Thematic analysis Combined Data Analysis

Qualitative Research Questions: What is the process of change in early recovery for this patient group? What treatment and non-treatment factors are seen as initiating, supporting and posing barriers to recovery? Four semi-structured interviews over a year: Changes made or noticed since detoxification What supports and hinders these changes Inductive Thematic Analysis using Nvivo software (Braun and Clarke 2006, 2013)

17 in Relationship 9 Employed, 24 Study Participants 11 Females, 13 Males 7 Single, 17 in Relationship 9 Employed, 13 Unemployed 2 Retired

People talked about change in terms of: Awareness People talked about change in terms of: Awareness New Thinking Doing Things Differently Feeling the benefits CRISIS POINT Sources of Support

Theme 1- Not drinking Just one would be ok? No, one will never be enough

Theme 2- Living “Even my food tasted wonderful you know just drinking soda and lime and having a lovely meal” “I love getting up and going to work, everything seems to be firing more quicker.”

Theme 3- Facing problems “it switches just as quick as it switched from food issue to using alcohol to block that out, its gone from stopping that to going straight to having the mental issues around food” OPENING UP

What supports Early Recovery? ONE DAY AT A TIME “You can open up to them and talk to them as if your talking to someone that you’ve known for years sort of thing …they make you feel that you can open up and talk to them”

Drawing on Previous Help “I'm aware of it and I can notice it and pause if you like and see it for what it is, not be going onto autopilot, hooked onto it and off, so that’s helped as well, that whole concept of just a pause before you act.”

What hinders early recovery? “ I stopped seeing the nurses last week and there is just this big big gap, this big hole of nothingness, you know….. the nurses said we have sent a referral through to the (name of service), so they will be in touch, haven't heard anything from them, but feel free to go to one of the drop in sessions, and I just remember the last experience which was so horrible”

Summary and what next? Patients perspective sheds light on the process of change. There is a high personal cost and the cost to the NHS My plans now are: Continue with the interviews over the next year. Reflect on the thematic analysis in relation to literature Possibly return to the data with a more deductive approach Use this understanding to compare the pathways