"My Advice is to not let him in": How Support for Concerned Significant Others is Shaped by Professionals' Understandings of Alcohol and Other Drug Problems.

AIM: The study examines how Swedish welfare professionals linguistically construct and legitimize support for concerned significant others (CSOs) of individuals with alcohol and other drug (AOD) problems. This is studied through the professionals' understandings of AOD problems and how power relations embedded in their language shape the CSO role.

METHODS

Semi-structured interviews involving 10 AOD therapists and 10 family care consultants in Sweden were analyzed using Fairclough's critical discourse analysis.

RESULTS

The findings reveal three key logics, in which the CSOs are understood. First, professionals position themselves as educators, aiming to make CSOs understand AOD problems "correctly". Second, AOD problems are described as an evil force, making CSOs appear passive and reactive. Third, medical and resistance discourses dominate, portraying the AOD problem as an uncontrollable disease, legitimizing strategies such as boundary-setting and self-care. While use of these discourses is argued to reduce stigma and challenge traditional caregiving roles, it also pathologizes CSOs, reinforcing professional authority while limiting CSOs' perceived capacity for self-determined action and imposing an expectation of self-sufficiency.

CONCLUSIONS

The study highlights how medicalization influences CSO support by describing caregiving as dysfunctional, which legitimizes professional intervention while limiting CSOs' agency. The findings highlight the need for an integrated approach balancing medical and resistance discourses with relational perspectives that emphasize social support.