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The dual burden of living with HIV and negotiating life stage changes has been identified as a contributing factor to lapsed adherence among adolescents with HIV in sub-Saharan Africa. While psychosocial support can promote medication adherence, most interventions in use with adolescents were originally developed for the general population creating a gap in appropriate support. Life-stage-appropriate, evidence-based psychosocial support interventions have been used with young people in high-income contexts, prompting interest in their use in low-income contexts. However, many interventions are less effective when implemented outside of their original settings, hence the need for modifications before implementation. We aimed to culturally adapt an evidence-based psychosocial support intervention designed to improve the mental health of young people for use among adolescents with HIV in a sub-Saharan African context and to explore the acceptability of the adapted intervention among adolescents. We engaged thirty stakeholders (n = 30) in Kampala, Uganda including psychologists, psychiatrists, social workers, HIV counselors, religious leaders and adolescent peers from December 2021 to April 2022 to modify an evidence-based intervention for adolescents. Key adaptations included simplifying the language, adding local practices, integrating locally relevant slang and stories into therapy, introducing racially-congruent visuals and cards representing emotions, and adjusting therapy materials for use in resource-constrained settings. We then tested the acceptability of the intervention in a small sample of service users using a qualitative approach. We recruited nine adolescents with HIV from a participating clinic in Kampala, delivered six 90-minute sessions of the adapted intervention across three weeks and conducted in-depth interviews to assess the acceptability of the intervention. We used thematic analysis to analyze the qualitative data. The adapted intervention was perceived as acceptable among adolescents with HIV, with many stating that it helped them overcome fears, increased their self-acceptance, and gave them the confidence to make careful health-enhancing decisions.

Issues: Self‐change from alcohol and drug use problems is increasingly acknowledged in research. Despite the growing number of published studies, the most recent broad review of this dispersed field dates back to 2010. The present review narratively synthesises key findings from empirical studies and critically identifies research gaps and directions for further research. Approach: Following the PRISMA guidelines for scoping reviews, a systematic search was conducted in multiple scientific databases, resulting in the identification of 56 relevant articles with explicit empirical results on self‐change. Key Findings: The scoping review presents findings related to: (i) methods and definitions used; (ii) the prevalence of self‐change; (iii) indicators of self‐change; (iv) the process of self‐change; and (v) population views on self‐change. Conclusion: The review highlights the significant growth in research on self‐change considering key themes as well as the need for a relational and time‐bound approach to self‐change in research and practice. [ABSTRACT FROM AUTHOR]

Introduction: Persons with substance use disorders (SUD) make up a considerable proportion of mental health care service users worldwide. Since 2010, Belgian mental health care has undergone a nationwide reform ('Title 107') aiming to realize a mental health care system that fosters more intensive collaboration, strengthens the cohesion and integration across and between different services, and is more responsive to the support needs of all service users. Although persons with SUD were named as a prioritized target group, how this reform impacted the lives and recovery journeys of persons with SUD remains understudied. This study aims to investigate how persons with SUD, regardless of whether they have co-occurring mental health issues, experience the accessibility of mental health care in light of the 'Title 107' reform. Methods: Data were collected by means of in-depth interviews with a heterogeneous sample of persons with SUD (n=52), recruited from five regional mental health networks in Belgium. In-depth interviews focused on experiences regarding (history of) substance use, accessibility of services and support needs, and were analyzed thematically. Results: Five dynamic themes came to the fore: fragmentation of care and support, the importance of "really listening", balancing between treatment-driven and person-centered support, the ambivalent role of peers, and the impact of stigma. Discussion: Despite the 'Title 107' reform, persons with SUD still experience mental health care services as 'islands in the stream', pointing to several pressing priorities for future policy and practice development: breaking the vicious cycles of waiting times, organizing relational case management, tackling stigma and centralizing lived experiences, and fostering recovery-promoting collaboration. [ABSTRACT FROM AUTHOR]

Background: Recovery is a widely accepted paradigm in mental health care, whilst the correctional and forensic-psychiatric field is still searching for foundations for its implementation. Knowledge regarding recovery of persons with intellectual disabilities in secure contexts is limited. This study assesses recovery needs and resources among persons with intellectual disabilities labelled not criminally responsible and investigates the impact of the judicial label on recovery processes. Methods: A sample of 26 individuals was composed purposively, and in-depth interviews were conducted. Recurrent themes were identified using thematic analysis. Results: Traditional recovery themes emerged from the narratives, next to aspects of recovery in a forensic or correctional context. However, the operationalization and proportional impact are specific for this sample. Conclusions: The social dimension overarches all other recovery dimensions. The integration of an explicit social rhetoric is imperative, including contextual, relational, interactional and societal dimensions. This offers pathways to reverse the traditional, paternalistic model of exclusion and classification.

Background: Recovery-supportive interventions and strategies for people with substance use disorders are a cornerstone of the emergent recovery paradigm. As compared to other services, such approaches have been shown to be holistically focused and improve outcomes (e.g. substance use, supportive relationships, social functioning, and well-being). Even so, a comprehensive overview of the nature, extent, and range of research on the topic is lacking. Methods: A scoping review of the literature was conducted to characterize the main topics on recovery-supportive interventions. A systematic search was conducted in three databases: Scopus, Web of Science, and PubMed from January 2000 to July 2023 using the PRISMA-ScR. Twenty-five studies published between 2005-2022 met the inclusion criteria. Results: Most studies emanated from the United States, and we found a peak in publication frequency between 2018-2022 (n = 13) relative to other years. The most prominent lines of inquiry appear to concern recovery-oriented policies; principles of recovery-oriented services (challenges encountered when implementing recovery-oriented practices, relationships with service providers characterized by trust, and service user-service provider collaboration), and recovery capital (particularly recovery-supportive networks, employment, and housing). Seventeen studies addressed co-occurring disorders, and eight addressed substance use recovery. Conclusion: To advance the field, more context-specific studies are required on supporting peer professionals, (including enabling cooperation with service users, and hiring experts by experience as staff), and training of professionals (e.g., nurses, psychologists, social workers, physicians) in the principles of recovery. [ABSTRACT FROM AUTHOR]

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