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Latinx individuals have high rates of substance use disorders (SUDs) and are at elevated risk for overdose, HIV, other mental health disorders, and poverty, yet experience disproportionately low access to relevant services (SAMHSA, 2011; BPHC, 2019). It is essential to investigate specific barriers to SUD recovery and supports for maintaining recovery in the Latinx community at multiple levels. Previous qualitative investigations with Latinx individuals found that family and other social support, mutual-help, personal motivation, readiness to change, and a drug-free environment were important to maintaining recovery (Alvarez et al., 2009; Pino et al., 2014). Photovoice studies investigating recovery for mental illness and substance use identified themes such as spirituality, social support, change of identity loss, and life achievements; these studies mainly included White and African American English-speakers (Cabassa et al., 2013; Mizock et al., 2014). This study uses photovoice methods to better understand the key factors that facilitate and impede recovery for Latinx Spanish-speakers with SUDs.
Methods: Thirteen Spanish-speaking Latinx adult clients with SUDs from a community bilingual/bicultural integrated behavioral health and primary care setting in Boston were recruited for a photovoice project from a larger study. Participants were on average 48 years old (range of 35-58), 54% were unemployed, and 69.2% considered themselves homeless. Participants were in recovery for 2 months to 3.25 years and had mean lifetime substance use of 16.6 years (range 1-30 years). Photovoice is a community-based participatory research (CBPR) qualitative method for exploring themes and narratives through photos. Participants met for three sessions over a six week time period. Participants analyzed the images using the SHOWED methodology (Wang, 1997) to reflect on and better understand the recovery process. Participants discussed each photo and decided on a list of words to describe how the photos made them feel and named their presentation “Nuestra Recuperación”. Each session was audio-recorded and transcribed.
Results:
The participants identified five photos indicative of their recovery journey. The photos explored themes of hope, motivation, strength and responsibility and the constant efforts and challenges to maintain sobriety. Participants reflected on their recovery and the skills and tools they gained during this process. They expressed gratitude and mutual aid for each other. Findings indicated a sense of purpose and meaning, security, faith and housing to be important elements of recovery. The results showed the importance of sources of connection in maintaining sobriety. This study showed that photovoice is highly acceptable and feasible among Latinx clients receiving SUD services.
Conclusions and Implications: Through this photovoice project, Latinx Spanish speaking participants highlight barriers and facilitators to their SUD recovery which span individual, community, and structural levels. Client photos and narratives may inform evidence-based practices, programs, and provider training to highlight linguistically and culturally relevant elements of recovery. Social workers should play key roles in ensuring that voices from the Latinx community drive discussions that advance policy, enhance providers’ understanding of Latinx Spanish-speakers SUD recovery, and inform culturally and linguistically appropriate services.