“To every thing there is a season” — social time and clock time in addiction treatment

Abstract

Research on therapeutic interventions and the development or efficacy of treatment services consider ‘time’ only as a technical, ‘objective’ condition. Time series analysis and cohort studies describe changes in addiction careers over time, but fail to take into account the role of ‘subjective’ or ‘social time’, e.g. the functions of organisational and individual patterns of time use and time budgets. This paper reviews the notion of ‘time’ in addiction treatment systems. More specifically, the explicit or implicit role played by ‘the time factor’ in specific types of treatment such as ‘12-step programs’, in-patient, out-patient care and individual treatment plans differs considerably and implies a re-definition and interpretation of ‘Past’, ‘Present’ and ‘Future’. Temporal conceptions and time estimations of patients and therapists may influence the access to treatment and treatment outcomes. Societal values — lack of time in affluent societies — and a general acceleration in the fields of communication, consumption, work and leisure are mirrored in the treatment system. Recovery as a long-lasting learning process stands in sharp contrast to the ‘quick fix’. The question is raised whether a post-modern concept of time is gaining importance as a counter movement, promoting a more individualised and differentiated treatment response and not any longer based on assumingly objective, technical criteria such as cost-efficiency. More research is needed on group-specific time concepts in treatment programs and the acceleration hypothesis in treatment systems.