Table 2 Clinical excerpts of clients’ chief concern depicting their motivation to use and stop drug use

Factors influencing drug use

Managing trauma and trauma triggers

When clients mention that they are using drugs as a means to cope with their past trauma and their triggers.

• “Client wants to hear from experiences of fellowship on how to handle triggers, cravings etc.”

• “He thinks issue comes from psychological aspect that could not articulate”

• “Family related, sex, triggers, trauma”

Managing feelings and emotions

When clients mention that they are using drugs to cope with feelings, such as anger, boredom, shame, etc.

• “Use drug to escape boredom, shame of christian gay”

• “Acting out angrily when using substance”

• “Deal with feelings of guilt”

Factors stopping drug use

Managing relationships

When clients mention that they are hoping to stop using drugs to improve the quality of relationships around them, such as with friends and family members.

Friends

• “Relationship - can cause triggering when fighting”

• “Repair rupture in the relationship.”

• “Problems making friends and having close friends”

Family

• “Find ways to build trust with mother (mum's anxiety with his using)”

• “Affected r/s with partner… …He hates the effect of using. Miss out a lot in loved ones' life... Does not want to lose family.”

• “Disclosing and coming to terms with family”