Factors associated with relapse among persons discharged from rehabilitation centres in Kenya.
Olando, Yvonne A
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Background: People getting into rehabilitation programs have physical and psychological problems .Some are jobless (because of their inability to sustain their jobs because of intoxication or other alcohol related incidences). Some are separated, divorced or widowed. Some are suicidal or have attempted suicide and failed. Some are serving their probation or have a case in court. By the time these individuals leave rehabilitation centers’, they are seen to be healthy looking. They seem to have been embraced back by their families. They are seen to appear confident, self assured and to have their sense of self worth restored. They have been detoxified and their co-morbidities have been managed. After some time, a number of them may start using their substance again. They seem to forget all they had learnt-their lives loose meaning again and the previous lifestyle resumes; and one is left to wonder where things went wrong. Aim The aim is to establish the factors associated with the relapse of these individuals who have undergone residential drug rehabilitation programs. Study design The study design was a cross- sectional descriptive study. The respondents in this study were 206 individuals, both males and females who have undergone rehabilitation, completed the program and have relapsed and they have sought help in rehabilitation centres again. Settings The study was conducted in eight rehabilitation centers and four half way houses in Kenya.(Asumbi treatment Centres: Homa-Bay and Karen branches, Red Hill (The Raphaelites), Jorgs Ark and Jorgs Sober House, Eden village and Eden House, Masaa Home and Half way house, The Retreat and the Havilla (half way house) ,and Mathare Hospital (Rehabilitation Unit). xi Methods Two study instruments were used: The relapse analysis exercises (Self Assessment of treatment needs, Recovery program evaluation, the internal and external causes of relapse and Relapse episode analysis-developed by Gorski T. (1992) and the Socio -demographic Questionnaire. The study was conducted for 6 months. Data analysis was done by an analyst using the SPSS version 12 and the results presented using diagrams, graphs and figures. Results: The study participants had major problems with relationships with family, friends and colleagues/ employer before relapse. They also reported feeling angry, guilty, shame, self pity, frustrated and failures before their most recent relapse. Majority did not complete working on their twelve step program, and those who completed reported that steps 1, 2, 3 and 4 were the most important. Majority did not attend after care or any follow up programs. Most had physical pains like headaches and tremors before their relapse. Most did not have a sponsor, and those who did, did not communicate with their sponsors often. Most reported not being convinced or being partially convinced that they are dependent on substances. Conclusion: Intrapersonal, interpersonal and program/ treatment factors are important associated determinants of a sustained remission for persons with substance abuse disorders after rehabilitation.