Harmen Beurmanjer

38 Chapter 3 order to understand and cope with health threats. Illness perceptions can be measured using questionnaires(Moss-Morris et al., 2002), assessing patients’ drawings (Klis et al., 2008), and interviews (Groleau, Young, & Kirmayer, 2006). A meta-analysis of 45 studies on mainly somatic diseases (Hagger & Orbell, 2003) shows that illness perceptions are linked to patients’ coping strategies, treatment seeking behaviour, adherence, and outcome (Hagger & Orbell, 2003; Jones, Smith, & Llewellyn, 2016). For instance, the more patients view their illness as controllable the more likely they are to use problem focused coping strategies (Hagger & Orbell, 2003). Patients who perceive their condition as highly symptomatic, chronic and serious, are more likely to use avoidant coping strategies in dealing with their condition. Importantly, in patients with SUD, perceived controllability is a predictor of recovery (Chan & Mak, 2016). No studies have been conducted in individuals with GUD. The current study aims to provide insight in 1) how dependent users perceive their GHB use and 2) what they need from treatment. Methods Design The proposed study is a qualitative cross-sectional observational study. A qualitative approach was used because personal interviews give a more in depth and detailed account of individuals´ perceptions than questionnaires. In accordance with the SRM we explored believes of participants concerning their GHB use and dependence, and how they coped with this during the interview (H Leventhal et al., 1980; Howard Leventhal et al., 2016). To do this we used the approach of the Explanatory Models of Arthur Kleinmann (Kleinman, 1978; KLEINMAN, 1978; Kleinman & Benson, 2006). An explanatory model consists of all opinions about the cause of a disease, the beginning of symptoms, the pathophysiology, the course, and treatment of the disease. The interview had three main topics: the development of GUD, the perception of GHB use and the treatment needs of the participants. A translated topic list can be found in appendix I. The study protocol was approved by the intern institute’s scientific committee. Participants participated in the study voluntarily and they were guaranteed anonymity. Participants Interviews were held between November 2015 and June 2016, with a total of 20 participants, each of which was interviewed once. Recruitment took place through three addiction care facilities in the Netherlands: Novadic-Kentron, Jellinek and IrisZorg, using snowball sampling. The inclusion criteria were: between 18 and 40 years old, having had treatment for GUD (according to DSM-IV criteria) in the past two years, and willing to provide informed consent. Exclusion criteria: currently in withdrawal, current acute severe psychiatric disorders such as major depression, bipolar disorders, psychotic disorders and/