title: Counselors' Clinical Use of Definitive Drug Testing Results in Their Work with Substance-Use Clients: a Qualitative Study.
abstract: We conducted a psychotherapeutic examination of the use of definitive drug testing (liquid chromatography with tandem mass spectrometry) in the treatment of substance use disorders (SUD). Employing a generic qualitative method (Caelli et al. inInternational Journal of Qualitative Methods, 2(2), 2003; Merriam, 2009) we asked SUD counselors to provide narratives about cases where drug testing had revealed new or unexpected information about clients' drug-taking behaviors. Semi-structured interviews with 12 SUD counselors were conducted by phone and analyzed for themes derived from the literature. These counselors reported many new positive drug tests in clients previously believed to be adherent with treatment. Key themes assessed in counselors' narratives included initial client denial that was often followed by later acknowledgement of relapse and increased motivation, at times presenting new opportunities for clients to engage in treatment and enhance the therapeutic alliance. These results suggest that definitive drug testing can be used in a non-stigmatizing and therapeutic manner.
authors.affiliation: Millennium Health, 16980 Via Tazon, San Diego, CA 92127 USA ; Millennium Research Institute, San Diego, CA USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Rzetelny
authors.affiliation: Housing Enterprise for the Less Privileged/Project Samaritan Inc (HELP/PSI), New York, NY USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zeller
authors.affiliation: Millennium Health, 16980 Via Tazon, San Diego, CA 92127 USA ; Millennium Research Institute, San Diego, CA USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Miller
authors.affiliation: Millennium Health, 16980 Via Tazon, San Diego, CA 92127 USA ; Millennium Research Institute, San Diego, CA USA.
authors.forename: Kathy Egan
authors.initials: KE
authors.lastname: City
authors.affiliation: Millennium Health, 16980 Via Tazon, San Diego, CA 92127 USA ; Millennium Research Institute, San Diego, CA USA.
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Kirsh
authors.affiliation: Millennium Health, 16980 Via Tazon, San Diego, CA 92127 USA ; Millennium Research Institute, San Diego, CA USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Passik
keywords: Addiction; Counselors; Definitive drug testing; Substance-use; Therapy; Treatment