Transformation in the Psyche in the Congress 60: A Qualitative Study of Changes in Treatment Outcomes in Substance Use Disorders

Document Type : Original Article

Authors

1 Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

3 Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

4 QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany

5 Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

6 Department of Psychiatry, Faculty of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

10.34172/ahj.1574

Abstract

Background: Congress 60, as an NGO, provides services to people with substance use disorders (SUDs). Despite offering services and evaluating their effectiveness in several studies, the underlying theory of interventions and the impact process of these interventions have not been investigated within this organization. The purpose of this study is to obtain the underlying theory of changes in treatment outcomes in this organization.
Methods: To achieve this theory, the grounded theory methodology was used. The data for this study consisted of the results of in-depth individual interviews with 26 individuals treated at Congress 60 branches, as well as documents. The analysis of these data was conducted using continuous comparison analysis to extract concepts, involving open, axial, and selective coding. Trustworthiness was evaluated according to the grounded theory principles.
Findings: The core concept derived from this study was the “Theory of Transformations in the Psyche” as presented in Congress 60. Subcategories of the core concept included the psyche, the addictive psyche, and the healthy psyche.
Conclusion: In Congress 60, psyche is defined as the expression that a person shows, which is the interaction of physical structures and worldview. A person with SUD has an addictive psyche that is demonstrated in daily behavior and, therefore, experiences adverse outcomes. The person treated at Congress 60 achieves a healthy psyche, as shown in daily behavior, and thus experiences positive outcomes. The theory obtained in this study can explain the process of change in the outcomes in Congress 60.

Keywords


  1. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). APA; 2013.
  2. Dutra L, Stathopoulou G, Basden SL, Leyro TM, Powers MB, Otto MW. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry. 2008;165(2):179-87. doi: 10.1176/appi.ajp.2007.06111851.
  3. West R, Brown J. Theory of Addiction. John Wiley & Sons; 2013.
  4. Sadock BJ, Sadock VA, Ruiz P. Comprehensive Textbook of Psychiatry. Philadelphia: Lippincott Williams & Wilkins; 2017.
  5. Merikangas KR, McClair VL. Epidemiology of substance use disorders. Hum Genet. 2012;131(6):779-89. doi: 10.1007/ s00439-012-1168-0.
  6. Noorbala AA, Saljoughian A, Bagheri Yazdi SA, Faghihzadeh E, Farahzadi MH, Kamali K, et al. Evaluation of drug and alcohol abuse in people aged 15 years and older in Iran. Iran J Public Health. 2020;49(10):1940-6. doi: 10.18502/ijph. v49i10.4697.
  7. Dezhakam H, White WL. Innovations in Addiction Treatment and Recovery: The Story of Congress 60. Congress 60; 2021.
  8. White WL. Congress 60: an addiction recovery community within the Islamic Republic of Iran. Alcohol Treat Q. 2015;33(3):328-47. doi: 10.1080/07347324.2015.1050929.
  9. Rashidian A, Karbalaei Nouri A, Khankeh H, Rezaei O. “Transformation in the body structures in Congress 60”: application of grounded theory in addiction treatment. Addict Health. 2024;16(4):269-78. doi: 10.34172/ahj.1505.
  10. Rashidian A, Khankeh H, Karbalaei Nouri A, Rezaei O. “The worldview in the Congress 60”: a theory for psychological treatment of substance use disorders. Arch Rehabil. 2025;26(1):44-65. doi: 10.32598/rj.26.1.2691.4.
  11. Omidvar Tehrani S, Rezaei Ardani A, Akhlaghi S, Shayesteh Zarrin M, Talaei A. Long-term detoxification of opioid use disorder with opium tincture assisted treatment. Front Psychiatry. 2023;14:1273587. doi: 10.3389/fpsyt.2023.1273587.
  12. Zahedi Asl M, Pilevari A. A study of the cognitive processes of ex-addicts and their families (case study: Congress 60). Soc Sci. 2018;24(79):33-73. doi: 10.22054/qjss.2017.23549.1595.
  13. Tavakoli M, Sahaf R, Ghaffari S, Farhoudian A, Hayatbakhsh R. Cost benefit analysis of detoxification in addicts over 40 in human recovery population (Congress 60). Arch Rehabil. 2012;12:52-7.
  14. Tavakoli M, Sahaf R, Farhoudian A, Bakhtavar Y. The influence of detoxification on the quality of life in substance addicts lives with 40-65 years of age referring to the charity “Congress 60”. Iran J Ageing. 2012;6:34-40. [Persian].
  15. Pilevari A, Zahedi Asl M. The effects of drug addiction treatment methods on families’ behaviors: the Congress 60 treatment method. J Subst Abuse Treat. 2021;131:108564. doi: 10.1016/j.jsat.2021.108564.
  16. Dezhakam A, Dezhakam H, Haghighatfard A. Taper off treatment can improve executive functions and regulate expression of BDNF and 5HTTPLR genes in opium abusers after six months period. J Psychol Sci Res. 2022;2(2):1-8. doi: 10.53902/jpssr.2022.02.000530.
  17. Zahedi Asl M, Nemat Saatloo F. Support programs and quality of life of addicts: comparing rehabilitated drug addicts in the Congress 60 and other private rehabilitation clinics. J Soc Work Res. 2015;2(3):188-211. doi: 10.22054/rjsw.2015.4753.
  18. Dezhakam H, Dezhakam A, Dezhakam S, Haghighatfard A. A new taper off treatment of opium dependents can lead to cure the addiction as well as improvement of cognitive functions. Res Sq [Preprint]. January 3, 2023. Available from: https:// www.researchsquare.com/article/rs-2410457/v1.
  19. Dezhakam H, Dezhakam A, Dezhakam S, Dezhakam A, Haghighatfard A. A new protocol of methamphetamine dependence treatment with taper-up-off treatment of opium tincture, a new hope to cure the methamphetamine addiction. Int J Psychiatry. 2023;8(3):40-4.
  20. Corbin J, Strauss A. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. SAGE Publications; 2014.
  21. Khankeh H. Applied Qualitative Research in Health Science. 1st ed. Tehran: Jame Negar Publishing; 2024.
  22. Hoddy ET. Critical realism in empirical research: employing techniques from grounded theory methodology. Int J Soc Res Methodol. 2019;22(1):111-24. doi: 10.1080/13645579.2018.1503400.
  23. Oliver C. Critical realist grounded theory: a new approach for social work research. Br J Soc Work. 2012;42(2):371-87. Doi: 10.1093/bjsw/bcr064.
  24. Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Routledge; 2017.
  25. Boland R, Verdiun M, Ruiz P. Kaplan & Sadock’s Synopsis of Psychiatry. Lippincott Williams & Wilkins; 2021.