Treatment Centre Interview Process (Clients & Counsellors)

April 13, 2007

The following is an outline of the ‘ideal’ treatment centre interview process. Some centres are more informal/laid back than others, so the researcher may have to
go with the flow at the centre they are at and make suitable modifications to the process.

STEP 1 – Scheduling the interviews

Sheila to set up dates for visiting the participating treatment centres.

(1) Cree Nations Treatment Haven (Canwood, SK) [Freda Ahenakew]

(2) Hey-way’-noqu’ Healing Centre for Addictions Society (Vancouver, BC) [Marie Anderson]

(3) Mi’kmaw Lodge Treatment Centre (Cape Breton, NS) [Clarence Gould] (Later)

(4) Native Addictions Council of Manitoba (Winnipeg, MB) [Bertha Fontaine]

(5) Native Horizons Treatment Centre (Hagersville, ON) [Claudette General]

(6) Nats’ejee K’eh (Hay River, NWT) [Melvin Larocque] (Later)

(7) Sakawatamo Lodge (Melfort, SK) [Joan Breland]

(8) Rising Sun Rehabilitation Centre (Eel Ground, NB) [Joyce Paul]

The researcher will spend 3-4 days per visit at a treatment centre. The length of stay will depend upon the number of women/counsellors to be interviewed. Multiple visits may be made to a treatment centre to coincide with different intakes. Regardless of the length of the researcher’s stay at the treatment centre, the first day will involve the researcher familiarizing themselves with the facility, its clients and staff (they will simply ‘hang out’ and participate in public activities). This will allow the researcher to get to know the treatment centre clients and staff, and for them to get to know the researcher.

We have experienced that some of the women get very excited about participating in the project and want to be interviewed ASAP. That is, they want to be interviewed on the first day when the interviewer is at the treatment centre to hang out. If this happens, it is OK to do the interview(s) on the first day.

At the end of each day, the researcher will take notes that reflect on the centre/program, the clients and counsellors. The purpose of the notes is for those who are not at the centre to get 'a feel'/context for it when reviewing the transcripts. This is also an opportunity for the researcher to record any thoughts and insights that they have in regard to the questions our study is addressing: What are the experiential paths of Aboriginal women in conflict with the law in the construction and re-construction of their self-identity, accounting for associated role expectations and stigma, prior to, during and following treatment for illicit drug use (defined as the healing journey)? And how do treatment program workers influence women’s construction and reconstruction of their self-identity and what is the relation to their healing? Doing interviews can be very draining, both emotionally and physically. So, if the notes are not taken at the end of each day, do fit them in and reflect whenever possible.

STEP 2 – Advertising the research project

Clients: The Executive Director of the treatment centre or a designated other will briefly introduce the project to the women (for whom illicit drug use is the primary reason for their attendance at the treatment centre) during their intake to the treatment facility, and in greater detail one week later. A poster will also be put up at the centre. Initially the women will be verbally introduced to the project during their intake. This is to only be a brief (2 minute) mention of the project, and to be on the lookout for it. They can also be provided with a copy of the poster. A week later the clients will be provided with an information letter from Colleen Dell formally introducing them to the project and inviting their participation. A copy of the interview guide will be attached to this. At all points when the research project is described to the clients, it will be conveyed that their decision to participate or not participate will in no way effect the treatment they receive at the treatment facility and that the information they share will be confidential. It will also be indicated to them that because the interview is about identity, they can bring anything to it that helps to show their identity (e.g., pictures), or that makes them comfortable during the interview (e.g., bead work). Be sure to stress the confidentiality of the interviews. Making the client comfortable enough to talk to the researcher is key.

If a woman is interested in participating, she will be able to sign up by speaking with the treatment centre Executive Director/designated other. This same individual will facilitate: (1) the organization and scheduling of the interviews, (2) an appropriate environment for the interviews to take place in (e.g., quiet space), and (3) inform the counsellors at their treatment centre that interviews with clients will be taking place in case they will be accessed. Also, as mentioned, the researcher will arrive at the treatment centre a day before the interviews are to take place to become familiar with the centre, its clients and staff. Additional women will likely sign up to participate in the project at this point (via the interviewer or the Executive Director/designated other).

Staff: The Executive Director of the treatment centre or a designated other will describe the project to the treatment counselors at a regular staff meeting. Similar to the clients, they will be provided with an information letter from Colleen Dell to formally introduce them to the project and invite their participation. A copy of the interview guide will be attached to this. When the research project is described to the counsellors, it will be conveyed that their decision to participate or not participate will in no way effect their employment at the treatment facility or jeopardize any of their relationships with the individuals/organizations involved in the project, and that the information they share will be confidential.

Identical to the client process, if a treatment counsellor is interested in participating, s/he will be able to sign up via the treatment centre Executive Director/designated other. This same individual will facilitate organizing the scheduling of the interviews and ensure an appropriate environment for the interviews to take place in. Also, as mentioned, the researcher will arrive at the treatment centre a day before the interviews are to take place to become familiar with the centre, its clients and staff. Additional counsellors may sign up to participate in the project at this point (via the interviewer or the Executive Director/designated other).

STEP 3 – Conducting the interviews

Clients:At the start of each interview, participants will again be provided with the information letter on the project. The interviewer will review it orally or allow the treatment client time to read it themselves (client’s choice). The client will then be asked to sign a consent form (it too will be reviewed orally with them or they can choose to read it themselves. But either way, key information should be verbally relayed by the researcher, including confidentiality, the client can choose to stop the interview at any point, etc.). As part of the consent form, participants will be asked for permission to record the interview in order for them to be transcribed. If permission is granted, interviews will be recorded using a micro-cassette or digital recording system. If a participant does not consent to the recording, detailed notes will be taken during and after the interview. At the completion of the interview, the demographic questionnaire will be reviewed with the client in order to gather any information not covered in the interview. The clients are to be offered a blanket for relaxation/comfort (be sure to take thee blanket out of its wrapper before giving it to them). They can keep the blanket. Note that this is a long process, so being as familiar with it as you can to make it smooth and efficient is important.

Once a researcher completes an interview, it should be labelled (correspond a code/number on the tape to one on the consent form & demographic information questionnaire) and stored in a safe place (e.g., safe at the treatment centre, your locked suit case). If the interview is done with a digital voice recorder, if possible, it should be downloaded and burned onto a CD after each interview. If the researcher is not transcribing the interviews, the interview recording or notes should be returned immediately to Colleen Dell within one week of leaving the treatment centre.

Staff: Both full-time and part-time treatment counsellors can be interviewed. The rationale to interview only the treatment counselors is that the focus of the research is specific to the role of the treatment counselor, that is, the individual that has the closest awareness and relationship with the client (and thus more insight to offer surrounding issues of healing, stigma and self-harm), as well as the potential for the greatest impact (positive or negative) on a woman’s healing journey. All treatment counselors at each centre will be offered the opportunity to participate in an interview. Do note that some treatment centres identify some staff as counsellors that do not have the official 'councellor' title in their job description. Our primary interest is individuals whose employed position is as a counsellor, but the discretion of the Executive Director/designated other will be followed in determining who will be interviewed.

The process of conducting the interview for the counselors is identical to that with the clients (see above) except that a blanket will not be offered. They will be offered a CCSA pen.

Audio recording: Audio recording will be used in this project via digital voice or tape recorders. In cases where the participant does not agree to be recorded, the researcher will record the data by hand.

Photographs: Photographsof the researchers with no identifying characteristics of the treatment centres, clients, or counselors are to be taken for the presentation of the research findings (to give context to the research process). For example, a mock photo can be taken of an interviewer in an interview with a counselor, but the treatment counselor will not be shown. Be creative! Ask the women and counselors after the interview for ideas. Any of the researchers that have their picture taken for the project will need to sign a consent form for it to be used. No pictures of individuals (clients, counselors, others) are to be taken, except for members of our research team (including Executive Directors). If the researcher has a camera they are asked to bring it. If not, the project has one that can be borrowed.

Interviewing women not in treatmentAlthough not the central focus of this project, there may be past clients of a treatment centre, who upon the discretion of the Executive Director/designated other, will be asked if they are interested in participating in an interview. These will be women who are strongly travelling their healing journey (are 'stable', not in a vulnerable position). Ideally these women will not be using substances, however, they may be using some if their treatment is in the context of a harm reduction approach. They cannot, however, be intoxicated while being interviewed. All interviews are to take place on the treatment centre property. All protocols outlined here will remain in place, except that the $40 for the interview will be provided directly to her at the completion of the interview. Note that the women will be notified that should they need to debrief following their interview, they will have access to a treatment counsellor and/or other staff at the treatment centre.
STEP 4 – Post interview

It is important that the clients and counsellors get closure after their interview. Interviewer skills are important here. Closure will ideally take place as the oyster is opened and the pearl is revealed. Remember, the aim of this exercise is to relay hope for the future. Also remember that the pearl must be opened with you, and you are to discard of the solution (as it contains alcohol). To also assist with closure, the counsellors and clients will be offered a medicine bundle. The women will be provided with a contact number (poster) for Colleen Dell 1-800-559-4514, and should they want to get in contact with you after the interview, they can do so via this number. It is a toll free number for a FASD help line offered by the CCSA. A message will be taken and passed on to Colleen Dell.

Quite a bit of interest has been expressed in purchasing pearls by both individuals and the treatment centres themselves. Refer to the handout on instructions of how this can be done.

When the researcher returns home, they are asked to send the women and counsellors they interview each a postcard thanking them for their time (CCSA North postcard for the women, CCSA Conference postcard for the staff).

STEP 5 – Safeguards

Potential harm is minimized to the clients by:

  • Conducting the interviews at the midpoint of their treatment episode. This may not always be the case for the continuous intake programs. The half-way point through treatment is typically the point in an individuals’ healing processes where they have already discussed in-depth issues with their counselors and established rapport and some sense of trust with them. This is an important safeguard for the interview process, because should the women require debriefing or follow-up from a treatment counselor, they will have access to their primary counselor (in addition to others) at the treatment facility.
  • Supplying a package of resources following the interview (and for women who request it, but do not want to be interviewed). The package will contain information on self-harm and illicit drug use resources, and access to the Elizabeth Fry Society of Manitoba 1-800 client number.

Potential harm is minimized to both the clients and counselors by:

  • The collaborative foundation of the study between NNAPF, CCSA and Carleton University, the establishment and workings of the Community Research Advisory Team, and the wisdom and experience of the Expert Mentors.
  • The First Nations cultural composition of the research partners in the study. This ensures that the research process is being carried out in a culturally sensitive and appropriate way. Further, the research methodology draws upon Aboriginal research protocols and ethics (e.g., NNADAP treatment client ethics, OCAP principles).
  • At some treatment centres, the Executive director to touch base with each client after they were interviewed. This is especially true for women who are interviewed and are not in treatment.

Potential harm is minimized to the researchers by:

  • Some researchers are travelling to the treatment centres in pairs (experienced researcher is mentoring a student/new researcher), while others will be travelling alone. For those travelling in pairs, they will be able to debrief with one another on the interview process and content. It is very important that a researcher work through any unsettling feelings they may have as a consequence of their interview(s). All interviewers will also have access to the treatment centre Executive Director, Colleen Dell (613) 823-8983 (home), Sheila Grantham (613) 565-2488, and Jennifer Kilty (613) 424-0818. You also have access to other members of our research team on the contact sheet provided. Keeping your own personal journal/diary is one way to work through some of the feelings after doing an interview. You will be provided one for your personal use (need not to be shared with the research team).

As stated, interviews can be draining – both emotionally and physically. It is important therefore not to do interviews back to back. After 1 or 2 interviews, take a walk outside or anything you find comfortable that allows you to take a break. Also, be sure to leave time for yourself in the evenings to de-stress (e.g., watching TV, discovering the city).

STEP 6 – Remuneration

Food (e.g., donuts, fruit) should be brought to the treatment centre daily by the researcher, if possible. Be sure to clear this with the Executive Director/designated other as some foods may be preferable over others. It was noticed that the men in the treatment centres sometimes felt ‘left out’ because they were not being interviewed. Be sure that they know that the food being offered is for them too.

Clients: The women will be remunerated in three forms.

  • $40: The money will be deposited into the treatment centre client accounts. This applies to both residential and out-patient treatment centres. Some centres prefer that the women receive a gift card (e.g., Walmart). A receipt will need to be filled out.
  • Oyster/pearl (value $10): An oyster/pearl, along with its inspirational story, will be distributed to the women at the completion of their interview. The oyster must be opened by the client at the completion of the interview, and the liquid it is stored in disposed of by the researcher (it contains alcohol).
  • Two women's personal stories of healing from illicit drug abuse. THESE STORIES ARE NOT TO BE ISSUED UNTIL ALL OF THE INTERVIEWS ARE CONDUCTED (WITH THE WOMEN AND STAFF). This is because if the stories are read by individuals (in particular treatment clients) before their interviews, it may very well influence their answers.
  • Similarly, THE SELF-HARM FACT SHEETS SHOULD BE ISSUED ONLY AFTER ALL THE INTERVIEWS ARE CONDUCTED.

The clients are to be remunerated in all three ways, even if they do not complete their interview.