Care Experiences in Alcohol and Other Drug Treatment: a Thematic Synthesis of Qualitative Evidence from Australian Services

Abstract

This review synthesises qualitative evidence on care experiences within alcohol and other drug (AOD) treatment services in Australia, with a focus on factors influencing engagement, retention, and recovery across diverse populations and service settings. Across 25 qualitative studies, five interconnected themes were identified: relational practice, peer support and mixed staffing models, stigma and privacy, integrated and holistic care, and continuity and safety of treatment environments. Participants described the importance of respectful and consistent relationships with staff, the credibility of peer workers with lived experience, and the impact of stigma on disclosure and engagement. Holistic care, including housing and social supports, was described as closely connected to recovery, while gaps in aftercare and fragmented systems were highlighted as ongoing challenges. The synthesis indicates that AOD treatment experiences are shaped by the interaction of relational, structural, and cultural factors. Care was described as most effective when it extended beyond clinical intervention to include trust, cultural responsiveness, continuity, and practical support. Findings suggest that improving engagement and recovery may require integrated service models, strengthened peer workforce support, and attention to stigma reduction and continuity of care. These insights may inform the design of more responsive, person-centred AOD services aligned with the needs of diverse populations.