title: Navigating the Alcohol Treatment Pathway: A Qualitative Study from the Service Users' Perspective.
abstract: OBJECTIVE
  Provision of effective treatment for dependent drinkers has been identified as a priority in England yet evidence suggests that access is problematic and there are low levels of retention. This qualitative study explores how the alcohol treatment system is experienced by service users, identifying barriers and facilitators that influence treatment outcomes.
  
  
  METHODS
  A total of 20 semi-structured face-to-face interviews were conducted with patients from community alcohol treatment services in three London boroughs in 2012. Interviews were undertaken one year after initially entering treatment. A thematic analysis was conducted, with the results further abstracted to relate them to specific aspects of the treatment journey.
  
  
  RESULTS
  Patients journeys were characterized by a perceived lack of control leading to help-seeking, with treatment outcomes influenced by an individuals' self-efficacy and the capabilities and skills of staff in actively engaging and supporting patients on the journey. A focus of services on the detoxification process and fragmented care pathways impacted negatively on engagement.
  
  
  CONCLUSIONS
  Current alcohol care pathways require significant levels of motivation and self-efficacy to navigate that few patients possess. Pathways need to better reflect the capacity and capabilities of patients to be successful in supporting recovery.
authors.affiliation: Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK helen.gilburt@kcl.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Gilburt
authors.affiliation: Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Drummond
authors.affiliation: University Department of Psychiatry, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Sinclair
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology* / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D020377:Self Efficacy; D055815:Young Adult
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