COMMUNICATION
IS ANYONE LISTENING?
People enter treatment with a mixture of fear and hope. The first interactions are the building blocks for what happens next – so are we getting the conversations right, asks DDN
W hen someone plucks up the courage to come into a treatment service, they can feel at their most vulnerable. At this crucial point, the quality of communication – what’ s explained, how it’ s said, what’ s asked – can shape that vital next stage, and even the entire course of their treatment.
Conversations with people who’ ve accessed opioid substitution therapy( OST) give a mixed picture. Some of the experiences we’ re about to share are recent, some as long ago as two decades, but what we wanted to know was – did you have options? Were they explained clearly? Did you have time to ask questions? Were you involved in discussions about review and titration? And how did all of this affect you?
Two distinct scenarios began to form – while some described compassionate, collaborative care, others recalled feeling excluded from decisions, underinformed, or judged. So how much of this was down to the quality of the conversation?
For some, the first contact with treatment services was daunting but ultimately positive. Reagan, who accessed treatment at a clinic in Wales, recalls feeling frightened but supported.‘ The worker was good and helpful,’ she says.‘ I was always involved in decisions with my treatment.’ At the clinic she felt comfortable to ask questions and‘ always had them answered’, and if they didn’ t know the answer‘ they would find someone who did’. Later on, hospital staff and midwives were a different story –‘ I was treated so bad in hospital, I was even asked to find my own veins even though I never injected,’ she says.‘ They just assumed that I had, but I was on methadone.’
Julian, who first sought help in the mid-1990s, was fortunate to experience a positive and person-centred approach through his GP. Rather than defaulting to methadone, the doctor took time to assess his situation and discuss alternatives.‘ I was given more
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