從藥癮者到同儕支持員的歷程探究

Abstract

在社區戒癮單位中，進用同儕陪伴、同儕支持人力的服務已經是藥癮復元的趨勢。然而在身為同儕員角色之前，他們都曾經是藥癮者，以及戒癮機構當中的成員。本研究欲探索藥癮同儕員從藥癮者自身復元、進到機構中的處遇和復元模式、受到機構邀請擔任同儕員、經由機構方的培訓或訓練制度、轉化成為同儕員的過程，以及擔任同儕員後所工作的項目、角色定位，最後看到服務至今所面臨到的困境與調適。 為了更加深入探索同儕員的個人轉化經驗，因此本研究採用質性研究方法，透過立意取樣選取6位研究對象，使用深度訪談法蒐集同儕員們親身經歷轉化的寶貴歷程，最後以主題分析法進行分析。 研究結果發現，根據同儕員所處的機構文化不同，其所提供的服務項目、培訓歷程也會有所不同。目前在臺灣，藥癮同儕員的角色可能有團體領導或記錄者、使能與倡議者、支持與陪伴者、調節與轉介者，以及制度規劃與執行者。在同儕員目前遇到的困境方面，則有渴癮復發的困境、陪伴技巧與知能不足、不打烊的同儕員，以及在機構內和同儕員角色的身分認同。整體而言，本研究發現同儕員在從藥癮者轉化的過程中有許多議題需要探討，包括誰能成為同儕員？如何篩選與評估其條件？要進行哪些培訓？在擔任同儕員的過程中，也因為缺乏實質的同儕員樣貌能夠遵循，因此也對於同儕員角色缺乏想像，僅能依照助人工作者的模樣邊揣測、邊執行同儕員的工作。也期盼臺灣能逐漸開展屬於我們自己在地化、本土化的藥癮同儕員培力制度，完備機構、實務工作者與同儕員的工作環境，協助同儕員意識到提供服務過程中的風險，並能提供支持性的網絡環境，使同儕員在反思與整理自己生命的同時，在具備能力的情況下，能再以自己的生命經驗作為工具，協助和陪伴藥癮服務對象。In community rehabilitation units, the use of peer companionship and peer support services has become a trend in illict drug addiction recovery. However, before becoming peer workers, they were all illict drug users and members of addiction treatment agencies. The research intends to explore illict drug users’ own recovery journey, the training or frameworks of agencies, the process of transformation into peer workers, as well as the projects and roles they work on after serving as peer workers, and finally the difficulties and adjustments they have faced since serving. In order to explore more deeply the personal transformation experience of peer workers, this study adopted qualitative research methods, selected 6 peer workers through purposive sampling, used in-depth interviews to collect valuable experiences of peers’ personal transformation, and finally used thematic analysis to perform analysis. The research results found that the service items and training processes provided by peer workers will be different depending on the organizational culture in which they work. Currently in Taiwan, the roles of illict drug peer workers may include group leaders or recorders, enablers and advocates, supports and companions, adjusters and referrals, and system planners and implementers. In terms of the current difficulties encountered by peer workers, there are the difficulties of relapse of craving, insufficient companionship skills and knowledge, peer workers who works all the time, and identification with the role of peer workers within the institution. Overall, this study found that there are many issues that need to be discussed in the peer transition process from illict drug users, including who can be a peer worker? How to filter and evaluate its conditions? What training is required? In the process of serving as a peer worker, because there is no actual peer appearance to follow, there is also a lack of imagination about the role of a peer worker. They can only speculate and perform the work of a peer worker based on the appearance of a social worker. We also hope that Taiwan can gradually develop our own localized illict drug addiction peer training system, complete the working environment of institutions, practitioners and peers, and help peer workers to be aware of the risks in the process of providing services. It can also provide a supportive network environment so that peer workers can reflect on and sort out their own lives and, if they have the ability, use their own life experiences as tools to assist and accompany illict drug users.