社会工作者介入美沙酮维持治疗综合服务模式的定性研究

Qualitative analysis of the social workers involved in intervention services for methadone maintenance treatment

目的探讨社会工作者介入美沙酮维持治疗综合服务模式,在实施和推广过程中遇到的机遇和挑战。方法运用定性研究方法,对美沙酮维持治疗中的利益相关者进行深入访谈。结果共访谈40人。调查发现,社工服务能够弥补美沙酮维持治疗中社会-心理服务这一缺口。然而,社工服务模式仍处于探索和发展阶段,在实施和推广过程中亦面临诸多困难和挑战,例如社工团队相对年轻、流动性较大;团队管理方面缺乏持续稳定的指导和良好的激励机制;社工社会资源有限,限制服务的开展;社工工作的社会认知度和社会支持力度不足。结论为了社工服务模式的可持续发展,一方面需要加强项目自身能力建设,另一方面需要外部环境的改变。

Objective To investigate the opportunities and challenges in the process of implementation and scaling up of comprehensive services provided by social workers in methadone maintenance treatment（MMT）.Methods In-depth interviews were conducted among the key stakeholders of MMT,followed by the qualitative analysis.Results The interviews of the 40 stakeholders showed that social workers had the advantages of providing psychosocial support services for the clients to MMT clinics.Social workers could adjust the emotion of the clients and promote them to stay on the MMT and help clients solve the problems.Social workers could also act as a bridge between clinical staff,family members of clients,harmonize their relationships,and build the adaptable environment for their behavior changes.However,the management system of social workers was not so mature.There were many difficulties and challenges in the process of promoting social workers involved in MMT.The social workers were relatively young,inexperienced and moving;the team management was short of continuous guidance and a good incentive mechanism;social resources were limited;and their work lacked social recognition and support.Conclusion For the sustainable development of the services provided by social workers,we should strengthen their capacity building and change the external environment.