Therapeutic Communities Research Papers - Academia.edu (original) (raw)

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- Crisis and Trauma Intervention, Therapeutic Communities

O uso de substâncias psicoativas (SPA) transcende a categoria de problema de saúde pública, gerando efeitos não apenas nos indivíduos, mas em toda a sociedade. As comunidades terapêuticas (CT) surgem como proposta complementar de cuidado em saúde mental que traz em sua lide uma fragilidade na cobertura assistencial do setor público de saúde. Algumas CT trazem a espiritualidade como recurso direcionador das intervenções por elas desenvolvidas. Neste sentido, o presente estudo objetivou elucidar o impacto da vivência da espiritualidade na terapêutica de usuários de substâncias psicoativas em CT do sudoeste baiano. Trata-se de um estudo qualitativo, descritivo e exploratório, com a participação de seis usuários de SPA. A coleta consistiu na aplicação entrevista semiestruturada. A análise ocorreu por meio da técnica do Discurso do Sujeito Coletivo. Observou-se a espiritualidade no CT é desenvolvida e direcionada pela vivência religiosa, intermediada pela organização e participação em cultos comunitários, estando a espiritualidade estimulada através de práticas de orações. / The use of psychoactive substances (SPA) transcends the category of public health problem, generating effects not only on individuals but also on society as a whole. Therapeutic communities (TCs) emerge as a complementary proposal of mental health care that brings in its dealings a fragility in the assistance coverage of the public health sector. Some TCs bring spirituality as a guiding resource for the interventions they develop. In this sense, this study aimed to elucidate the impact of the experience of spirituality in the therapeutics of users of psychoactive substances in Southwest Bahia. This is a qualitative, descriptive and exploratory study, with the participation of six SPA users. The collection consisted of the semi-structured interview application. The analysis occurred through the Collective Subject Speech technique. The spirituality at CT was developed and directed by religious experience, intermediated by the organization and participation in community services, with spirituality stimulated through prayer practices. / El uso de sustancias psicoactivas (SPA) trasciende la categoría de problema de salud pública, generando efectos no sólo en los individuos, sino en la sociedad en su conjunto. Las comunidades terapéuticas (CT) surgen como una propuesta complementaria de la atención de salud mental que trae en sus tratos una fragilidad en la cobertura asistencial del sector de la salud pública. Algunas CT traen la espiritualidad como un recurso de guía para las intervenciones que desarrollan. En este sentido, este estudio tenía por objeto dilucidar el impacto de la experiencia de la espiritualidad en la terapéutica de los usuarios de sustancias psicoactivas en el suroeste de Bahía. Se trata de un estudio cualitativo, descriptivo y exploratorio, con la participación de seis usuarios de SPA. La colección consistía en la solicitud de entrevista semiestructurada. El análisis se realizó mediante la técnica del discurso del sujeto colectivo. La espiritualidad en la TC fue desarrollada y dirigida por la experiencia religiosa, intermediada por la organización y la participación en servicios comunitarios, con la espiritualidad estimulada a través de prácticas de oración.

- by Cenas Educacionais and +2
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- Mental Health, Spirituality, Espiritualidad, Saúde Mental
- by Charalampos Poulopoulos
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- Drop Outs, Therapeutic Communities
- by Geraldine Akerman
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- Military Veterans, PTSD, Therapeutic Communities
- by Debora Upegui-Hernandez
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- Puerto Rico, Harm Reduction, Drug Treatment Court, Drug Courts

La Marihuana (Cannabis sativa) se ha vuelto en nuestros días un tema constante de debate y simboliza perfectamente la pugna entre los partidarios de la liberalización total del consumo de sustancias psicoactivas de una parte y por otra parte de los oponentes a toda tolerancia hacia ellas. Esas posiciones encontradas nos obligan casi automáticamente a escoger entre dos opciones “cerradas”: la primera que se envuelve púdicamente en el manto de la tolerancia, la libertad y un acercamiento seudo “angelical” a la “hierba”; la segunda que sataniza toda modificación inducida de los estados de conciencia y evoca horrorizada las cifras efectivamente escalofriantes de la drogadicción en el mundo. Al pronunciarse sobre este tema, uno se arriesga a parecer un verdugo mandado por el “establishment” para mantener el orden moral o un irresponsable rezago de la fantasía hippie incapaz de enfrentar los retos del mundo moderno. Queremos intentar abrir un tercer espacio ubicado a igual distancia de ambos grupos que se refuerzan mutuamente por presentar posturas que consideramos distorsionadas de la realidad y basadas en un cierto grado de auto-engaño sino de impostura.

La consolidación del uso de drogas como problema público, la relativa ausencia o falta de efectividad de las respuestas terapéuticas y la demanda social al Estado para que asuma su responsabilidad en este campo configuran el escenario contemporáneo en que se desarrollan y ganan legitimidad iniciativas religiosas de tratamiento para el consumo problemático de drogas. Desde las ciencias sociales no se han indagado en profundidad las perspectivas de trabajo de estas iniciativas, el alcance de su cobertura y el tipo de articulación con el Estado y otras instituciones. En este sentido, como equipo de investigación nos propusimos un estudio que permitiese relevar y sistematizar las organizaciones religiosas que orientan su labor a personas con consumos problemáticos de drogas en el Área Metropolitana de Buenos Aires; explorar los enfoques en este campo de parte de actores
religiosos, operadores socio-comunitarios y profesionales de la salud que trabajan en dichas organizaciones; y analizar las experiencias de personas que reciben atención en estas organizaciones, sus prácticas de cuidado, sus creencias y sus procesos de subjetivación.

- by Martín Güelman and +1
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- Religion, Drugs And Addiction, Alcohol Studies, Alcoholics Anonymous
- by Lea Campbell
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- Nursing, Adolescent, Humans, Nursing Education
- by Emmanuel Langlois and +1
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- Health Care, Sociology of Organizations, Informal Caregivers/Carers, Sociology of Health and Illness

We explore the problematic dynamics in the relationship between societal systems of care and the chronically excluded, with particular reference to severe personality disorder and the 'difficult-to-reach' patient. The individual who 'refuses' is often met with a violent response: yet his violence must be understood as related to an experience of being violently excluded. We reformulate personality disorder as a disturbance of 'groupishness' and suggest, as a paradigm for the problem of refusal, the story of Diogenes the Cynic, who 'holed himself up' in a barrel; and of his legendary encounter with Alexander the

- by John Adlam and +1
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- Social Exclusion, Cynicism (Ancient Greek Philosophy), Structural Violence, Group Analysis

'Reflective practice' is a term imprecisely understood and used to describe a wide range of different activities or interventions. In this paper I examine the Reflective Practice Group (RPG) as an intervention offered to multidisciplinary teams (MDTs) in mental health and social care settings. Drawing extensively upon the work of Wilfred Bion and on the 'Northfield I' experiment which he led in 1942, I formulate the existential, conceptual and functional challenges of the MDT in terms of the problematic interplay between the drive towards autonomy and the exigencies of interdependence. I take this interplay as the figure, with the ground being the baseline disarray of traumatised systems that both defines and contextualises the individual worker's predicament within the team. Analysing the nature of the MDT sheds new light on longstanding controversies about what ailment the RPG is there to address; what skill set is needed to facilitate it; and what methodology may be most appropriately used for its delivery.

- by John Adlam
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- Reflective Practice, Organizational Culture, Multidisciplinary, Wilfred Bion
- by Dimitris Moschonas
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- Therapeutic Communities

Entre los primeros abordajes socio-terapéuticos para el consumo de drogas desarrollados por organizaciones de la sociedad civil en Argentina, los de orientación religiosa (fundamentalmente católicos y evangélicos) y espiritual (Alcohólicos Anónimos, Narcóticos Anónimos e instituciones que emplean el Modelo Minnesota) han ocupado un lugar preponderante. El objetivo de este artículo es describir las formas en que referentes de centros religiosos y espirituales de tratamiento para el consumo de drogas del Área Metropolitana de Buenos Aires (Argentina) conceptualizan las causas del consumo, y las vinculaciones de sus significaciones con las propuestas terapéuticas que desarrollan. La estrategia metodológica que adoptamos para responder a los objetivos de la investigación fue cualitativa. Para la construcción de los datos, entrevistamos a 21 referentes de estas instituciones, y realizamos registros de observación en dichos centros. Construimos una tipología conformada por tres maneras de concebir las causas de los consumos de drogas: como una problemática asociada a la pérdida del sentido de la vida; como una consecuencia de la exclusión social; y como una enfermedad crónica individual. Pese a las distintas formas de concebir la problemática, las instituciones ubicadas en los tres grupos siguen atribuyendo un rol preponderante a la familia de los usuarios en el desarrollo del tratamiento.

This presentation looks at how the gang culture affects groups and group therapy in a prison based therapeutic community

- by Ryan Kemp
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- Phenomenology, Group Theory, Group Analysis, Van den Berg's Metabletics

This article explores archival accounts of the experimental community, Kingsley Hall (1965-70), established by R. D. Laing, the radical Scottish psychiatrist. The paper contributes to renewed interest in Kingsley Hall, R. D. Laing's radical psychiatry and UK counterculture. Archival sources enable not only the further exploration of already known figures but also let us hear previously unheard voices. Following a discussion of archival materials, the Hall is analyzed thematically and historically as (i) an inner spaceship; (ii) an embattled middle-class countercultural plantation; (iii) a site of spiritual renewal and development; (iv) a single-building arts colony; and (v) a countercultural experiment. Finally, it is argued that with re-evaluation of 1960s and 1970s counterculture now underway on the Left, the Hall’s experiment in Laingian countercultural psychiatry—as we may fittingly call it—may yet inform future radical projects (in mental health and beyond).

- by Adrian Chapman
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- Mental Health, Countercultural Studies, Radical psychiatry, R D Laing

Esse estudo se trata de uma pesquisa em Psicologia Social Crítica, que toma como base teórica-metodológica autores das teorias críticas contemporâneas. Tem como objetivo compreender as experiências de sujeitos que passaram por tratamentos em comunidades terapêuticas e os efeitos destas nas metamorfoses identitárias. A pesquisa tem caráter qualitativo, e está ancorada no método de narrativas de história de vida, o qual possibilitou um amplo relato acerca do que foi vivenciado pelos participantes da pesquisa, reconhecendo-os como sujeitos ativos e implicados, e não simplesmente indivíduos assujeitados ao seu processo de produção de cuidado. Para essas entrevistas, não estabelecemos previamente um questionário estruturado, mas nos orientamos por duas perguntas disparadoras: “quem é você?” e “como você se tornou quem você é hoje?”. A partir disto, nossa pesquisa contou com dois participantes, que falaram das experiências
concernentes a este recorte de realidade. Para análise das narrativas que os sujeitos trouxeram, seguimos a proposta apresentada por Ciampa e Lima, organizando cada uma das personagens vividas pelos sujeitos, de modo a construir cada trajetória individual. Dividimos as narrativas dos participantes em momentos importantes de suas vidas,
destacando as primeiras experimentações das drogas e suas consequências, as internações e as experiências de tratamento, o uso de drogas e os impactos nas relações interpessoais, a religião e o uso de drogas, os efeitos destes usos e das internações e o posicionamento
atual frente ao uso de drogas e às comunidades terapêuticas. Como considerações finais deste estudo, destacamos os impactos que pudemos perceber dos tratamentos das
comunidades terapêuticas na vida destes sujeitos, discutindo sobre as formas de aprisionamentos, as políticas de cuidado impostas, os processos de estigmatização e hegemonia do saber técnico-psiquiátrico e a importância de se pensar formas do que chamamos de cuidados políticos, que promovam maior autonomia e emancipação nos processos vivenciados por estas pessoas.

El consumo de drogas es un fenómeno que, desde los orígenes de la humanidad, ha tenido vinculación con búsquedas de índole religiosa o espiritual. Solo en la modernidad, el uso de sustancias psicoactivas se conformó, en un proceso paulatino, como un problema público.
Para abordar el problema, tanto desde el Estado como desde la sociedad civil, han emergido iniciativas socioterapéuticas que han adoptado diversas modalidades, entre las que se cuentan los grupos de autoayuda, las comunidades terapéuticas, los centros de desintoxicación hospitalaria, los tratamientos ambulatorios, los hospitales de día, los centros comunitarios, las casas de medio camino y los programas de reducción de daños. Entre las iniciativas desarrolladas por organizaciones de la sociedad civil, han sido pioneras aquellas con orientación religiosa y espiritual. A su vez, dado el número de personas a las que brindan asistencia, estas detentan una gran importancia en un conjunto considerable de países.
El dossier temático de la Revista Cultura y Droga que aquí presentamos está dedicado a analizar las vinculaciones entre drogas y religión.

- by Martín Güelman
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- Religion, Sociology of Religion, Drugs And Addiction, Religious Conversion

Democratic therapeutic communities (TCs) are long-term group programs that address severely ingrained clinical populations. These psychodynamically informed social environments can facilitate improvement in people suffering from personality pathology. However, the TCs' working principle is not well documented, which threatens its continued existence. To gain further insight into how TCs work, this study explores former TC residents' perspectives on their treatment, its outcome, and the process of change they underwent. Four steps that might explain this process were identified through focus group interviews (using qualitative analyses) with 24 former residents of a Belgian democratic TC: (a) I encounter a safe, caring, and challenging Other, (b) I unfold my particular way of interacting with the Other, (c) I am confronted with the Otherness in me, and (d) I live an Other life. This fourth step refers to the reported treatment outcome that consists of 3 main changes: (a) residents became more resilient and capable of coping with their problems, (b) residents became more involved in pleasant social relations, and (c) residents developed the capacity to make choices in their own lives. We recommend a reappraisal of social psychiatry, emphasizing the social aspect of human life, psychopathology and its treatment. Limitations of the study and suggestions for further research are discussed.

- by Charalampos Poulopoulos
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- Therapeutic Communities

In 1989, the first drug-treatment court was established in Florida, inaugurating an era of state-supervised rehabilitation. Such courts have frequently been seen as a humane alternative to incarceration and the war on drugs. Enforcing Freedom offers an ethnographic account of drug courts and mandatory treatment centers as a system of coercion, demonstrating how the state uses notions of rehabilitation as a means of social regulation. Situating drug courts in a long line of state projects of race and class control, Kerwin Kaye details the ways in which the violence of the state is framed as beneficial for those subjected to it. He explores how courts decide whether to release or incarcerate participants using nominally colorblind criteria that draw on racialized imagery. Rehabilitation is defined as preparation for low-wage labor and the destruction of community ties with "bad influences," a process that turns participants against one another. At the same time, Kaye points toward the complex ways in which participants negotiate state control in relation to other forms of constraint in their lives, sometimes embracing the state's salutary violence as a means of countering their impoverishment. Simultaneously sensitive to ethnographic detail and theoretical implications, Enforcing Freedom offers a critical perspective on the punitive side of criminal-justice reform and points toward alternative paths forward.

- by Kerwin Kaye
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- Addiction, Drugs And Addiction, Race and Racism, Liberalism
- by David Scott
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- Critical Criminology, Abolitionism, Therapeutic Communities, Penal Abolitionism

Historically, a variety of spaces have been used to treat, produce, contain or engage with madness. These include physical places such as asylums and clinics, discursive places such as therapeutic communities, working groups or cartels, organised spaces such as archives or art collections and the space of literature, film, theatre and the written word. Up to now, although these spaces have been written about, this has largely been from their own terrains. This edited volume seeks to remedy this by surveying these spaces, exploring and critiquing the work that has been done on each of them, and by presenting new work which cuts across these spaces. Work is being sought from writers from many disciplinary practices including psychoanalysis, literature, geography, philosophy, cultural studies, psychotherapy, counselling, and history. Contributions from independent practitioners, researchers or creative writers would also be welcome.

- by Dr. Trudy Clutterbok and +1
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- Human Geography, Cultural Geography, World Literatures, Indigenous Studies
- by Clate J Korsant
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- Sociology, Criminal Justice, Anthropology, Ethnography

Casi 30 años de experiencia clínica nos indican que la interacción entre medicina tradicional amazónica, psicoterapia y espiritualidad, propuesta en el modelo terapéutico del Centro Takiwasi, resulta ser muy exitosa en el tratamiento de las adicciones y otros trastornos de salud mental. Consideramos que la articulación de esos diferentes enfoques terapéuticos beneficia enormemente el resultado del tratamiento y esto está mostrando un camino a seguir de manera más general en la búsqueda global del bienestar mental y del buen vivir. Es vocación inicial del Centro Takiwasi asociar la práctica clínica con la investigación. Desde el inicio de su funcionamiento, el Centro Takiwasi ha evaluado permanentemente sus actividades, su población de pacientes y los resultados de las intervenciones terapéuticas con el fin de ir mejorando constantemente su modelo. Sin embargo, para evitar el bias de la auto-evaluación y responder las exigencias económicas y técnicas de una investigación científica de alto nivel, se ha buscado convocar investigadores externos e independientes. En este artículo queremos resumir algunos de los más destacados resultados registrados en recientes publicaciones académicas y que resaltan la eficacia de nuestro modelo terapéutico. Los resultados presentados proporcionan claras indicaciones de la efectividad del uso de la medicina tradicional amazónica dentro del protocolo elaborado por Takiwasi para el tratamiento de las adicciones.

The difficult relationship between the forensic patient and the system of care is characterised by the giving and taking of offence. The capacity of the individual to act out violently an offended state of mind is what has resulted in his entry into the forensic system, rather than any more conscious motivation for treatment or recovery. In relation to the offender, the wider social systems in turn, for the most part, cannot help but be offended. Those who offend and those who are offended then enter into a reciprocal relationship in which violence and offence of different sorts are transacted in both directions (Scanlon and Adlam, 2009a). In this chapter we attempt to examine the quality of hostile dependency that lies at the heart of this relationship, most obviously in the case of recidivist offenders and chronically disturbed and excluded personality disordered individuals.
There is necessarily something very public about the way that each party to the long and fraught relationship prosecutes and defends the publication of their grievances with each other. The index offence, where there is one – the criminal record – can be understood as both a cryptic and a straightforward expression or publication of the patient’s distress, disturbance or disaffection. The sentence meted out is an equivalent public expression of the extent to which the judgement of the courts has taken offence on behalf of the wider community. In cases where the community has taken greatest offence, the offending individual is not only deprived of his ‘liberty’ or ‘freedom to act’, but is then often further punished through degrading and inhumane treatment under the cover of correction or rehabilitation. These are the outward, psycho-social manifestations of the difficulties which follow from the problematic relationship between the offender and the offended.

- by John Adlam and +1
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- Mental Health, Forensic Mental Health, Cynicism (Ancient Greek Philosophy), Forensic Psychotherapy

Spirituality is currently considered to be an emerging theme in addiction research, and substantial research has been conducted on the spirituality of Alcoholics Anonymous. However, little spirituality research has been undertaken on self-help groups that have traditions based on beliefs other than Christian ones. This chapter aims to fill this knowledge gap by exploring the spirituality of one Japanese self-help group for alcoholics, Danshukai, which incorporates principles of Zen Buddhism. Since 2006, we have utilised an ethnographic approach and engaged in participant observation at Danshukai meetings, as well as conducting ethnographic interviews with leaders and members. We have also visited and researched a Danshukai therapeutic community, Danshu Dôjô. We also collected Danshukai newsletters and leaflets describing members' experiences with Zen Buddhist spirituality. Three kinds of activities or artefacts were identified as spiritual: vows and prayers; acts of spiritual training, called gyô; and Buddhist symbols. First, almost every Danshukai meeting starts or ends with members affirming vows. At every big meeting, prayers for the deceased are offered by all attendees. Second, difficult acts and acts of austerity in Danshukai activities are considered as spiritual training. Third, in Danshu Dôjô there are a number of Buddhist symbols on display, such as a picture, and spiritual 'framed words'. Because the membership of Danshukai is decreasing, leaders have begun approaching medical professionals with the aim of getting them to refer their patients to Danshukai. As a result, the leaders have introduced many medical terms and concepts into their activities, which has weakened the alternative nature of their existing self-help culture. The spiritual aspects of Danshukai and Danshu Dôjô have been downgraded and labelled obsolete or unscientific. However, if it remodels itself as a mere supplement to medical treatment for alcoholism, how will Danshukai manage to reverse the long-term trend of falling membership?

- by Tomofumi Oka
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- Japanese Studies, Zen Buddhism, Self Help Groups, Therapeutic Communities

Previous research has evidenced that in different institutional settings professionals are cautious when responding to clients’ indirect complaints and tend to avoid siding either with the clients/complainants or the complained-of absent parties.
In this article we use the method of Conversation Analysis to explore professional responses to clients’ indirect complaints in the context of a Therapeutic Community (TC) for people with diagnoses of mental illness in Italy. Although the TC staff members sometimes display a neutral orientation toward the clients’ complaints, as is the case in other institutional settings, in some instances they take a stance toward the clients’ complaints, either
by distancing themselves or by overtly disaffiliating from them. We argue that these practices reflect the particular challenges of an institutional setting in which professionals engage with clients on a daily basis, have an institutional mandate of watching
over them and are responsible for their safety. According to this interpretation, staff members’ nonneutrality toward clients’ complaints can be seen as a way of defending against the possibility, raised by the clients’ reports, that the staff members might be involved, albeit indirectly, in courses of action that
have harmed or might harm the clients.

- by Luigina Mortari and +1
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- Psychiatry, Mental Health, Conversation Analysis, Mental Illness

This article uses a historical case study of a day hospital therapeutic community (TC) to explore the emergence of particular spaces of psychiatric contention. Using ideas from critical social geography, it employs the notion of ‘convergent spaces’ to understand how particular sites become important in the development of innovative practice and new social movements. It argues that these spaces of convergence enabled innovation to occur through a collectivised social setting where commonalities were expressed, new resistant identities forged and charismatic figures such as ‘tricksters’ emerge to challenge and subvert psychiatric authority. In discussing some of the problems which beset the day hospital, it is proposed that the notion of ‘paradoxical spaces’ might also be helpful to understand how contested spaces can avoid imposing new forms of totalisation. It concludes by reflecting on the conditions of possibility for new spaces of contention.

- by Clate J Korsant
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- Sociology, Criminal Justice, Anthropology, Ethnography

In “Dwelling on the Direction of the Treatment for the Homeless Subject,” Chris Vanderwees explores the lack of psychoanalytic literature on poverty and the political implications of this lack while providing a reflection upon the praxis of institutional psychotherapy and therapeutic community. This chapter highlights the clinical importance of therapeutic labor and open-ended psychoanalytic treatment in a therapeutic community while also trying to express how a psychoanalyst cannot defensively withdraw one’s desire to listen in the face of people who are homeless and impoverished (which would only reveal the resistance of the analyst), but can deploy an ethics given some variations to the more “classical” psychoanalytic frame so that space can be facilitated for the homeless subject to be able to speak about their own suffering.

- by Chris Vanderwees
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- Psychoanalysis, Poverty, Homelessness, Lacan

In this [Hungarian] paper we examine the very possibility
of integrating philosophical discussion
groups into the practice of community
psychiatry as a kind of therapeutic community.
We summarize the history of the caféphilo
movement, the conception, methods
and goals of the philosophical café. I present
a detailed report on the experiences
about the philosophical cafés going on at
the Awakenings Foundation on a weekly
basis for two years. I suggest group philosophy
discussion as a useful additional
form of activities usual in psychiatric rehabilitation.

There's an old joke about therapists, changing a light bulb, and the light bulb wanting to change. Clearly, one does have to want to change in order to change, which is why critics of prison-based therapeutic communities claim that if they are successful, it is because of a selection effect: only people who have already decided to change, go there and (much more importantly) stay there, so of course they change. And yet … prisons contain plenty of people who claim they sincerely want to change, but cannot even stay away from the temptations of mobile phones, drugs, hooch, and all manner of infractions of the Prison Rules while 'behind bars', let alone when unleashed on the unbounded temptations of life 'on the out'. (Perhaps one can sympathize: after all, every January millions of people say they want to change, by giving up smoking or losing weight, for example, but have given up on that resolution by February.) So if therapeutic communities (TCs) are able to exploit whatever willingness to change pre-exists, it must require more than exceptional willpower on the part of the prisoners who go there. What is it, then, that TCs do to nurture a desire for personal change? Can one, in fact, make claims for offenders' progress towards desistance from crime, while in prison? Even if prisoners are not committing any criminal offences or contravening institutional regulations, 'going straight' is clearly an imposed virtue while imprisoned within an environment which severely curtails opportunities for offending. In this article, based upon my research in three forensic TCs, I contend that it is possible to observe and evidence indicators of meaningful rehabilitation in the TC. Moreover, the theoretical similarities between these changes, between this desistance in process, and

- by Alisa Stevens
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- Rehabilitation, Prisons, Therapeutic Communities, Rehabilitating Offenders

Abstract
This chapter contributes to the understanding of therapeutic practices that take place in drug-free therapeutic communities as a particular model in the complex and pluralistic field of drug addiction treatment in Europe. Through a theoretical perspective which conceptualises recovery from addiction as “biographical work”, four life-stories of interviewed recovering addicts have been analysed. The interviews were conducted in a drug-free residential therapeutic community in Greece and for the purposes of this chapter one case will be presented, the life-story of Helen. The following typical components of the biographical work operating during the therapeutic procedure emerged: (a) the construction of a confessional and observant self; (b) excavation in the biographical stock of childhood to identify the causative factors of addiction; (c) the portrayal of the career in drug-use as a trajectory of suffering; (d) the identification of recovery as a process of restructuring the self which activates the latent potential of the biography; and (e) the production of a coherent life-story which integrates conflicting images of the self. The biographical work is mediated by the discourse and practices of the therapeutic community.

- by Zacharoula Kasseri and +1
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- Drugs And Addiction, Gender, Addiction and Recovery, Life Stories

Explicit generalisations are statements that attribute a characteristic to all members of a social category (e.g., drug users). This paper examines the tensions and negotiations that the use of generalisations prompts within support group interactions. Generalisations are practices for the cautious implementation of delicate actions. They can be used to convey perspectives on group members’ experiences by implication (without commenting on them directly), by virtue of those members belonging to the category to which a generalisation applies. At the same time, generalisations can misrepresent some individual cases within that category. Using conversation analysis, the paper investigates how generalisations are deployed, challenged, and then defended in support group interactions. These analyses identify a tension between utilising the sense-making resources that category memberships afford, and the protection of its members from unwelcome generalisations. Data consist of recorded support-group meetings for people recovering from drug addiction (in Italy) and for bereaved people (in the UK).

- by Marco Pino
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- Addiction, Drugs And Addiction, Conversation Analysis, Bereavement

Drawing on the concept of liminality, we provide an alternative language for understanding how time, space, and power intersect to impact upon the relationship that individuals hold with themselves as “self.” A historical (re)contextualisation is presented that traces the genesis
of a notable development in British war-time psychiatry, the “Northfield experiments,” to its contemporary parallels in the democratic therapeutic community in prisons and Psychologically Informed Planned Environments. Links are made between the development of these “liminal events” and aspects of Foucault’s works on the technologies/techniques of objectification and subjectification/self, his critique of the object of painting and his critical analytics of “other” spaces. It is argued that the therapeutic community can be (re)contextualised as a highly functional liminal event that held/holds significant implications for how patients subjectively experience(d) “self” as certain forms of psychological power and knowledge were/are given (material) effect within this point in time and space.

- by Adrian Coyle
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- Self and Identity, Objectification Theory, The Self, Liminality

Atualmente, as Comunidades Terapêuticas (CTs), desempenham papel fundamental na gestão de usuários de crack e outras drogas no âmbito das políticas públicas vigentes. Considerando este cenário, esta pesquisa focaliza três comunidades terapêuticas (CTs) em regiões diferentes do país. Duas localizadas em cidades de médio porte do interior do estado de São Paulo e outra em uma cidade também de médio porte do interior do estado de Pernambuco. Esta dissertação apresenta o objetivo descritivo de demonstrar quais são as dinâmicas internas dessas comunidades terapêuticas. Desdobra-se disso dois objetivos: i) conhecer as práticas e os resultados das terapêuticas utilizadas; ii) conhecer o perfil dos internos, dos funcionários e operadores, sobretudo, conhecer a vida cotidiana no interior delas. O texto é amparado por trabalho etnográfico que compreende i) visitas intercaladas realizadas desde 2012; ii) imersão em campo realizando três períodos de quinze dias um em cada instituição.

- by Matheus Caracho Nunes
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- Drugs And Addiction, Drogas, Therapeutic Communities, Periferia
- by Wouter Vanderplasschen
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- Communication, Research, Humans, Substance Abuse

Drawing on the concept of liminality, we provide an alternative language for understanding how time, space, and power intersect to impact upon the relationship that individuals hold with themselves as “self.” A historical (re)contextualisation is presented that traces the genesis of a notable development in British war-time psychiatry, the “Northfield experiments,” to its contemporary parallels in the democratic therapeutic community in prisons and Psychologically Informed Planned Environments. Links are made between the development of these “liminal events” and aspects of Foucault’s works on the technologies/techniques of objectification and subjectification/self, his critique of the object of painting and his critical analytics of “other” spaces. It is argued that the therapeutic community can be (re)contextualised as a highly functional liminal event that held/holds significant implications for how patients subjectively experience(d) “self” as certain forms of psychological power...

- by Rory Slater
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- Psychology, Cognitive Science, Self and Identity, Objectification Theory

El aislamiento de los residentes ha sido una característica central de las comunidades terapéuticas para consumidores
de drogas desde sus orígenes. Desde este abordaje, se considera que la persona bajo tratamiento
debe ser separada de sus contextos de socialización y sociabilidad para evitar posibles recaídas, la exposición
a estímulos negativos y la convivencia con grupos perjudiciales para su recuperación. En este artículo presento
resultados de un estudio de casos múltiples sobre las vinculaciones entre rehabilitación y conversión en
dos comunidades terapéuticas de fuerte impronta religiosa que pertenecen a redes internacionales y cuentan
con sedes en el Área Metropolitana de Buenos Aires (Argentina). En el escrito analizo las particularidades que
asume la política de aislamiento de residentes en dichas instituciones. Para la construcción de los datos empíricos
entrevisté a residentes, exresidentes y directivos de ambas comunidades, realicé observaciones participantes
en distintas actividades institucionales y analicé documentos elaborados por los propios centros. La
“desconexión total” o “alejamiento de las cosas del mundo” es una dimensión fundamental del programa de
tratamiento de ambas instituciones. El diagnóstico institucional de la contemporaneidad como un período
caracterizado por la “proliferación del pecado” redunda en que esta política sea considerada un requisito indispensable
para el éxito del tratamiento.

- by Martín Güelman
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- Drugs And Addiction, Therapeutic Communities