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

Attitudes of psychiatric hospital staff towards mental illness The use of the social model of psychiatry as a form of treatment is increasingly accepted as a legitimate therapy. This is expressed in the continued growth of the 'therapeutic community* regimes. However, investigations into components of the social model, ie. attitudes of nursing staff in psychiatric hospitals, have not accompanied this growth. A cross-section of research over the past 25 years has shown an omission of behavioural correlations in attempting to measure staff attitudes. Research into attitudes expressed indicate a correlation between age, education, regime in hospital and occupation and the reponses to attitude questionnaires. Without behavioural correlations however, the value of this research is very questionable. A few studies have included behavioural correlations such as perception of staff, discharge rates and length of stay in the community. An example of an area in nursing that attitude studies with behavioural correlations could usefiiUy be employed is in examining the effectiveness of using staff from different cultures in therapeutic communities.

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- Nursing, Behavior, Advanced Nursing Practice, Mental Disorders

The purpose of the study was to determine whether a change in the treatment program at Akeela House Incorporated, a therapeutic community in Anchorage, Alaska, significantly increased the time in treatment for Alaska Native residents. The change in treatment involved implementation of culturally sensitive approaches that incorporated and reinforced Native lifestyles. Data were obtained from the Alaska Management Information System on all treatment admissions from January 1988 to January 1995. Prior to implementation, Alaska Native residents had significantly shorter times in treatment than Black or White residents. After implementation of the change in the treatment program, Alaska Native residents' times in treatment were no longer significantly different from those of Black or White residents, and all three ethnic groups had significantly longer times in treatment than before the intervention.

- by Dennis Fisher
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- Psychology, Treatment, Survival Analysis, Native American

Introduction and Aims. Drug treatment programs for adolescents are now more widespread with some evidence of success. However, there has been little in-depth exploration of factors that may encourage or hinder program completion. This ethnographic study of an adolescent therapeutic community aimed to provide insights into the experience of the adolescent residents. Design and Methods. Four months of participant observation at a program for drug-dependent adolescents in a metropolitan city in Australia. Twenty-one residents (15 boys and six girls) aged between 14 and 18 years participated, comprising all residents admitted during the study period. Results. Vocational Education and Art Therapy are activities that universally engaged residents whereas frustration was evident in Journaling—a core program activity. Group sessions were often used to set up or dismantle social cliques, although they were also useful to expose difficult inter-personal relationships. The risk of residents ‘taking off’ was heightened during breaks from program activities when strong emotions surfaced. Discussion and Conclusions. There needs to be a more central role for creative and vocational activities in adolescent programs and a variety of ways for them to document their journey. Group encounters need to be skilfully facilitated by staff to handle fluid inter-personal dynamics and residents need support outside of formal program time to minimise drop-out. The concept of a navigation-engagement continuum is discussed and the need to see treatment as a series of encounters that may be ‘successful’ despite ‘non-completion’. This study gives adolescents a voice in program evaluation which may help improve retention.[Foster M, Nathan S, Ferry M. The experience of drug-dependent adolescents in a therapeutic community. Drug Alcohol Rev 2010;29;531–539]

- by Sally Nathan
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- Program Evaluation, Australia, Treatment Outcome, Adolescent

Injection and other drug use and high-risk sexual behaviors put criminal offenders at increased risk for HIV infection. Studies in other populations, especially females, have found that a history of sexual or physical victimization increases engagement in HIV-risk behaviors, and drug-involved offenders have high rates of such prior victimization. However, there has been little research among male offenders. In a sample of 247 male felony drug offenders in New York City, prior sexual victimization was related to a higher number of sex partners and lower proportion of protected sex acts in the 30 days before arrest. Prior physical abuse was related to cocaine injection, but not heroin injection or high-risk sex behaviors. These results suggest a complex relationship between sexual and physical abuse and HIV risk among male offenders. Assessing for specific prior abuse histories of offenders and providing targeted interventions may be useful for developing more effective primary and secondary HIV prevention services for this high-risk population.

- by Hung-En Sung
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- Criminology, Criminal Justice, Offender Rehabilitation, Substance Abuse Treatment

This paper describes an intervention designed to address the special needs of youths with histories of maltreatment and exposure to family and community violence. The primary components of the model include an enhanced therapeutic community environment and a psychoeducation program that is aimed at changing non-adaptive cognitive and behavioral patterns which developed as means of coping with traumatic experiences. The implementation of the model and proximal effects on the therapeutic communities and youths are being examined in comparison to standard residential services. Initial perceptions of staff illustrate the challenges in applying an intervention that calls for changing the organizational culture.

- by Sandra L . Bloom
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- Social Work, Organizational Culture, Proximity Effect, Special Needs
- by Daniel Santisteban
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- Program Evaluation, Psychology, Brief Psychotherapy, Family Therapy

This article describes a randomized study to determine the effectiveness of a reentry modified therapeutic community (RMTC) for offenders with co-occurring substance use and mental disorders (co-occurring disorders or COD). Men with COD, approved for community corrections placement postrelease, were recruited from nine Colorado prisons and stratified according to the type of treatment received while incarcerated (i.e., a prison modified therapeutic community [MTC] program or standard care). When released, each offender was randomly assigned either to the experimental RMTC (E-RMTC) condition (n = 71) or to the control parole supervision and case management (PSCM) condition (n = 56). An intent-to-treat analysis 12 months postprison release showed that the E-RMTC participants were significantly less likely to be reincarcerated (19% vs. 38%), with the greatest reduction in recidivism found for participants who received MTC treatment in both settings. These findings support the RMTC as a stand-alone intervention and provide initial evidence for integrated MTC programs in prison and in aftercare for offenders with COD.

- by Michael Chaple
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- Psychology, Mental Health, Randomization, Evolution

Health-related quality of life (HRQOL) in substance abusers remains an area of inquiry in need of investigation. The few studies on the topic have found substance abuser HRQOL less than that of the general population. The present research compared 303 substance abusers in long-term residential therapeutic community treatment in New York with a general non-institutionalized adult sample from New York (N=27,465) whose data were collected between 2002 and 2006 during the yearly administrations of the Behavioral Risk Factor Surveillance System (BRFSS), a state-based system of health surveys gathering data from upwards of 350,000 adults per year across all 50 states. One sample t-tests found that the in-treatment substance abusers reported significantly more physically and mentally unhealthy days over the past 30 days, as well as significantly more inactive days over the past 30 days due to illness. Keywords Substance abuse. Quality of life. Treatment. Health. Mental health Health-related quality of life (HRQOL) measures perceived mental and physical health over a period of time (Burgess et al. 2000) and is increasingly being used as an important construct in the evaluation of health and medical interventions. Although there is extensive literature on HRQOL in chronic diseases with high mortality rates, as well as with non-fatal medical conditions and mental disorders, comparatively few studies have examined HRQOL among chronic substance users (either in or out of treatment). This omission in the literature is interesting since, like other chronic diseases, alcohol and/or drug use have a powerful impact on the

- by k morgen
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- Sociology, Psychology, Mental Health, Quality of life

The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities. D

- by Manuel Trujillo
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- Psychology, Psychometrics, Spirituality, Substance Abuse Treatment

The authors of this paper have coined the term special needs community therapists to describe this unique group of special needs professionals involved in a participatory community-based trans-disciplinary treatment (involving intervention, rehabilitation and/or management) that caters to short-term (acute cases) and long-term (chronic cases) intellectual and developmental disabilities done within a residential context, where the clients (i.e., these individuals are treated as customers who need specialized therapy services) and the therapists live and work together. Community therapy for people with special needs can be provided via two main management systems – clinically based case management (institution-centered) and/or person-centered care management (client-centered) – and several different service models such as standard community treatment with high client-therapist ratios and intensive community treatment where the emphasis is on community involvement and lower client-therapist ratios.

This paper provides an existential analysis of male batterers' perceptions of the interventions they received. The data was collected from qualitative interviews with batterers in a series of studies, in a variety of settings in Israel. These include probation departments, community-based domestic violence units, a residential hostel for court-mandated batterers and a therapeutic community for batterers in the prison system. The analysis focused on the batterers' understanding of the intervention experienced, as reflecting their existential struggle around meaning and being in the world. The intervention forced batterers to examine their relationship towards self, others and their values, in a world that is perceived as hostile and lacking in significant meaning. It therefore focused on attempts to regain a sense of meaning and coherence. Batterers perceived their spouses as dangerous; as powerful agents that threaten their meaning system. In light of this, therapy is focused on the struggle between relinquishing or regaining control over meaning of self in the world. This process is associated with rediscovery of shame, loss and fear and thus involves much anxiety. The complexities and paradoxes emerging from the men's narratives of therapy are analyzed and discussed. Some principles of existential therapy with batterers are suggested.

- by Zvi Eisikovits
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- Social Work, Domestic Violence, Therapeutic Community

In this article two consumer leaders use their own experiences to explain the meaning and significance of recovery. They emphasize the importance of hope, personal responsibility, education, advocacy, and peer support. They also address controversial issues, such as the nature of the therapeutic relationship, the place of medications in symptom control, and the need for attitudinal changes in mental health professionals.

- by Shery Mead
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- Psychology, Mental Health, Social Support, Mental Disorders

López-Goni JJ, Fernández-Montalvo J, Menéndez JC, Yudego F, García AR, Esarte S. Employment integration after therapeutic community treatment: a case study from SpainInt J Soc Welfare 2011: 20: 292–297 © 2009 The Author(s), International Journal of Social Welfare © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.This article describes the employment evolution from pre- to post-treatment of 112 patients in two therapeutic communities of Proyecto Hombre (Spain). Moreover, an analysis was made using the composite scores of the EuropASI in order to evaluate the secondary outcomes in work status, beyond drug consumption. The results show that nearly half of the patients (46 per cent of the sample) changed their employment status after treatment. Specifically, 78.6 per cent of the men (N= 77) and 64.3 per cent of the women (N= 9) were working after treatment; there were no statistically significant differences between them. Although the unemployment figures after treatment remained high, the residents were satisfied with their work integration. No statistically significant differences were observed between those who completed the treatment and those who did not. Implications of these results for further research and clinical practice are discussed.

- by José J. López-Goñi and +1
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- Social Work, Political Science, Addictions, Social Welfare

An implementation and one-year follow-up of the Gambling Decisions program attempted to answer several important questions. First, is controlled gambling a viable treatment option for some gamblers? Can earlier stage problem gamblers be separated for treatment from those with more severe problems? Finally, would problem gamblers utilize a community health agency for treatment of their excessive gambling? A pretest/posttest design was chosen where the efficacy of the program was assessed using repeated measures ANOVA analysis. Results showed that an average loss of 608overa4−weekperiodwasreducedto608 over a 4-week period was reduced to 608overa4−weekperiodwasreducedto113 immediately after the 6-week program and to a loss of $73 at 12 months. The average number of hours spent gambling per 4 weeks was significantly reduced from 23.5 at pretest to 6.5 at the 12 month posttest. Significant decreases were also observed in the number of days per week that clients gambled, and clients reported significant reductions in everyday life problems related to gambling after completing the program.

- by Garry Smith
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- Sociology, Program Evaluation, Psychology, Early Intervention

The treatment of cocaine abusers is a newly emerging drsciplme, Many of the strategies that are bemg del eloped for this purpose hale been adapted from thc drug and alcoholism treatment S}sterns. These Include use of established programs that are only minimally modified for cocaine abusers, such as the 28-day mpauent hospital, therapeutic community, and 12-step programs Other approaches hale created specific techniques to meet particular clirucal needs of cocaine abusers, such as behavioral, pharmacologic, and nontraditional mtcrventions FInally, several attempts have been made to create Integrated outpatient approaches that address the multiple needs of the cocaine abusers. Man} of the clinical researchers conducting research on these modalities feel opnrmstic about the value of treatmcnt for cocaine abusers Many of the methods appear to have considerable promise However, only recently have well-controlled research efforts begun to provide the Information necessar} for empirically based decision-makmg. Dunng the next several years, outcome studies should provide an excellent set of data to guide treatment efforts. TIllS papcr reviews the treatment efforts that have been conducted, overviews the research data available, and describes some of the outcome research In progress.

- by Richard Rawson
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- Substance Abuse, Alcoholism, Behavior Therapy, Cocaine

Counselor turnover is a significant problem facing substance abuse treatment agencies. Understanding the role of organizational culture in predicting burnout and turnover intention may yield important information on how to address turnover in treatment organizations. Using data collected from 817 counselors employed in a national sample of 253 therapeutic communities (TCs), structural equation modeling was used to estimate the associations between emotional exhaustion, turnover intention, and three measures of organizational culture: centralized decision making, distributive justice, and procedural justice. The model controlled for counselor demographics, credentials, and earnings. Counselors' emotional exhaustion scores were higher in TCs with greater centralized decision making ( p b .01) but lower in TCs where greater distributive justice ( p b .05) and procedural justice ( p b .001) were reported. Likewise, turnover intention was positively associated with centralized decision making ( p b .05) and inversely associated with the workplace justice measures ( p b .001). These data suggest that management practices in TCs and perhaps in other types of substance abuse treatment facilities likely play a substantial role in counselors' well-being and in their decisions to leave their jobs. Because these practices are not structural features of organizations, they may be targeted for intervention and change. D

- by Paul Roman
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- Psychology, Demography, Decision Making, Organizational Culture

Psychopaths present serious problems for the criminal justice system because they are responsible for many serious crimes and appear to be very resistant to treatment. The present study was a retrospective evaluation of the efficacy of a maximum security therapeutic community program in reducing recidivism among mentally disordered offenders, some of whom were psychopaths. The study employed a matched group, quasiexperimental design. The results showed that, compared to no program (in most cases prison), treatment was associated with lower recidivism (especially violent recidivism) for nonpsychopaths and higher violent recidivism for psychopaths. The clinical and research utility of Hare's Psychopathy Checklist was strongly supported.

- by marni marny
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- Psychology, Cognitive Science, Law, Criminal Justice

Focus groups can be used to gather rich, detailed descriptions of shared individual experiences and beliefs. Group process enhances the richness of the data obtained via this method. Nurses are skilled in gathering detailed and often sensitive information and applying therapeutic communication and interviewing techniques within groups. They can take advantage of these skills by using focus groups to collect qualitative data. To maximize the collection of high-quality data, pay specific attention to the selection and training of the moderator, the development of the interview guide, and the analysis that addresses intragroup and intergroup processes.

- by Denise Cote-arsenault and +1
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- Nursing, Research Design, Focus Groups, Group Processes
- by Dwayne Simpson
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- Criminal Law, Jurisprudence, Adolescent, Motivation

This paper offers new theoretical and empirical insights into the emotional and spiritual geographies of religion in therapeutic landscapes designated for marginal and vulnerable populations. Drawing on original empirical work conducted in a Pentecostal Christian therapeutic community in the UK working in the area of addiction and rehabilitation, this paper investigates the spiritual landscapes of Pentecostal worship, and considers the emotional, spiritual and therapeutic sensibilities residents attach to, and experience during, practices of worship and prayer. By examining the complex intersections between belief, embodiment and performativity of religious practice, I illustrate how the distinct patterning of worship space can differently open out, and close down, capacities and affective atmospheres of the divine. Attention is given to the different ways in which the residents experienced this worship space, and the extent to which their presence therein created a range of therapeutic - and anti-therapeutic - experiences. Drawing on these narratives, this paper argues how the contingent configuration of care/control might be seen as both constraining and empowering for residents, underlining the importance for geographers of religion to ground conceptualisations of the staging and performance of spiritual landscapes in the divergent sensibilities and ethics of engagement individuals bring to these sites

This study aimed to determine the demographic profile of the inmates, their perception to the effectiveness of the program and the significant relationship between the profile of the inmates and their responses to the effectiveness of the program implemented in Batangas City Jail. Descriptive type of research was utilized in the study. Result showed that the majority of the inmates are male, 26-33 years old, single, high school undergraduate with the prison sentence of below 1 year and with involvement in drug related cases. Therapeutic Community modality Program was perceived by the inmates as effective specifically the Work and Educational Therapy Services, Livelihood Skill Training, Counseling and Religious Services and Medical Services. There are significant relationships between the profiles of the inmates in terms of age, civil status and length of prison sentence and their responses to the effectiveness of the program implemented in Batangas City jail.

Evaluation research documents a firm relationship between retention and treatment outcomes among substance abusers in therapeutic communities (TCs). However, most admissions leave treatment prematurely, particularly in the first months after admission. This paper reports findings from a controlled study that assessed the efficacy of an intervention to reduce early dropout in a residential TC. In the “Senior Professor” (SP) intervention, the most experienced clinical and managerial staff in a TC program were utilized to conduct program induction seminars during the first weeks of admissions, traditionally the period of the highest rate of dropout. Rates of short-term retention (30 days of treatment) were compared for the experimental cohort (N=362), who received the intervention, and a cohort of admissions (N=243), who received standard or non-enhanced treatment. Findings showed that the SP intervention significantly reduced the likelihood of early dropout compared with controls. The enhanced effects are most evident for the new inductees with the lowest levels of motivation. Some theoretical and clinical implications are discussed as to the utilization of experienced staff to increase retention among new inductees with relatively lower motivational levels, who are at greatest risk for early dropout.

- by George De Leon
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- Psychology, Treatment Outcome, Substance Abuse Treatment, Motivation

... Macon, GA: Mercer University. View all references; Shupe & Bromley, 198546. Shupe, A. and Bromley, D. 1985. ... Fallen angel. An introduction. In Therapeutic communities for the treatment of drug users , Edited by: Rawlings, B.... more

- by Rowdy Yates
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- Psychology, Mental Health, Qualitative Research, Substance Abuse
- by Sybille Hinze
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- Psychology, Political Economy, Urban Education, Governance

El objetivo de este trabajo es estimar la prevalencia de casos psiquiátricos en una muestra de pacientes con dependencia de opiáceos tratados con buprenorfina sublingual en régimen de comunidad terapéutica y describir su evolución durante el primer mes de tratamiento.Estudio observacional, longitudinal prospectivo. Se seleccionó a 119 pacientes con dependencia a opiáceos, de los que 46 aceptaron iniciar tratamiento con buprenorfina. Por motivos organizacionales, la evaluación psicopatológica se realizó a 36 de estos pacientes. Los instrumentos de medida empleados fueron la MINI, el GHQ-28, el IPDE y el TECVASP.La prevalencia observada de cualquier trastorno psiquiátrico fue del 78%. La prevalencia de diagnósticos en el Eje I es del 69,4%. La prevalencia de casos en el Eje II es del 58,3%. Un 50% de los pacientes presentaban simultáneamente trastornos en el Eje I y en el Eje II. Los pacientes con trastornos psiquiátricos del Eje I presentan una reducción significativa en las puntuaciones medias de la escala GHQ-28, y en las subescalas B (ansiedad/angustia), C (disfunción social) y D (depresión) del GHQ-28. Entre los pacientes sin trastornos psiquiátricos en el Eje I, las diferencias observadas al mes del tratamiento no son significativas. En ambos grupos de pacientes se observa una mejora de la calidad de vida, si bien estos cambios son de menor magnitud en el grupo con trastornos psiquiátricos.Los resultados de este estudio señalan una frecuencia muy elevada de trastornos psiquiátricos. Por ello, se hace necesario explorar activamente la psicopatología siempre que evaluemos a un paciente drogodependiente.The purpose of this work is to estimate the prevalence of psychiatric cases in a sample of opiate-dependent patients treated with sublingual buprenorphine in a therapeutic community regime, and to describe their progress during the first month of treatment.An observational, longitudinal, prospective study was conducted. Of the 119 opiate-dependent patients selected, 46 agreed to start treatment with buprenorphine. For organisational reasons, the psychopathological assessment was carried out on 36 of these patients. The measurement tools used were the MINI, GHQ-28, IPDE and Assessment of the Quality of Life in Psychoactive Substance Addicts (TEQLASP).The prevalence rate of any psychiatric disorder was 78%. The prevalence of Axis I diagnoses was 69.4%. The prevalence of cases in Axis II was 58.3%, and 50% of patients had concomitant Axis I and Axis II disorders. The patients with Axis I psychiatric disorders showed a significant reduction in the mean scores of the GHQ-28 scale, and in the B (anxiety/unease), C (social dysfunction), and D (depression) subscales of the GHQ-28. The differences observed between the patients with no psychiatric disorders after one month of treatment were not significant. An improvement in the quality of life wad observed in both groups, although these changes were of a lower magnitude in the group with psychiatric disorders.The results of this study show a very high frequency of psychiatric disorders. For this reason, psychiatric illness must be actively looked for whenever we assess a drug-dependent patient.

- by Oscar Rojas
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- Multiphase Flow, Therapeutic Community

Therapeutic Communities (TC's) have become increasingly popular in the treatment of substance abusing psychotherapy clients. Their popularity appears to have stemmed from the failures of traditional and more individual treatment modalities. Approaches focusing on immeasurable constructs and often irrelevant past events are argued to contribute to symptom maintenance and resistance in this client population. It is argued that a more direct, responsibility-oriented approach be implemented in a systematic and consistent fashion in order to facilitate treatment. The systematic application of Rational-Emotive Therapy in a self-contained therapeutic system is discussed.

- by Raymond DiGiuseppe
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- Psychology, Substance Abuse, Therapeutic Community

Background: schizophrenia patient with hardness behavior at patient schizophrenia at psychopath hospital of the make-up of its amount, and get ordered execute which is kinds of-kinds of with medication, column insulation, cordage, and form critical team. From here human aspect by comprehensive likely less is getting of attention in its execution. Therapeutic communications try to become bridge which can lay open cause and give solution of is way of constructive marang without destroy others and environment. Target of: This research aim to know therapeutic communications influence to behavioral degradation hardness behavior at schizophrenia patient at home Psychopath Area Surakarta. Method research use design experiment true, with pretest type control design group. Intake of Sample by using non sampling purposive type sampling probabiility matching with inklusi. Result criteria: result of research, indicating that: with value test Paired t test there are behavioral degradation of hardness at schizophrenia patient at treatment group and group control by significant. And percentage only there is difference equal to mean value 6 % among two groups. and Value difference between group control and this treatment group in test by using is Independent of t Test discovered by value 0,324, this value is compared to smaller of p significant value 0,05 meaning the result have a meaning of or significant. This matter answer hypothesizing early, meaning there is influence applying of therapeutic communications to behavioral degradation of hardness.

- by arif widodo
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- Control Design, Therapeutic Community

| Animazione Sociale agosto/settembre | 2013 inserto 42

- by Marco Pino
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- Drugs And Addiction, Conversation Analysis, Therapeutic Community

Therapeutic communities (TCs) are emerging as one of the primary approaches for the treatment of substance abuse for criminal offenders. However, the achievement of positive TC outcomes is predicated on their successful implementation. This study examines the effect of two situational influences on the implementation of a TC program in a state prison-the enactment of a smoking ban and a change in treatment providers. Results suggest that the smoking ban led to a loss of inmates'focus on treatment goals and strained inmate-custody staff relationships, whereas the change in treatment providers resulted in an immediate turnover of one third of the counselors and a disruption of relationships between custody and treatment staff.

- by Donald M Linhorst
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- Criminology, Prison, Therapeutic Community

RIASSUNTO. Introduzione. Nella nostra società l'abuso e la dipendenza da sostanze rappresentano un serio problema ed il fenomeno della tossicodipendenza desta un forte interesse sia per le problematiche sociali che comporta che per gli aspetti clinico-psicopatologici manifestati dai tossicodipendenti. Materiale e metodo. Lo scopo dello studio, è stato quello di valutare gli aspetti psicopatologici di un campione di 85 tossicodipendenti ospiti in comunità terapeutiche raffrontati ad un gruppo di 85 soggetti di controllo bilanciati per variabili sociodemografiche. Gli strumenti utilizzati sono stati: il TPQ di Cloninger, l'al. Risultati. Sessantuno soggetti (71,76%) del gruppo tossicodipendenti sono risultati avere uno o più disturbi di personalità rispetto ai 6 soggetti (7.06%) del gruppo di controllo. I soggetti tossicodipendenti inoltre sono risultati essere significativamente più ansiosi, depressi, con maggiore disagio sociale e più inibiti nelle loro manifestazioni emotive, nonché più impulsivi, con maggiore sensibilità all'ansia e con tratti alexitimici più marcati (25 sogg. sono inoltre risultati essere alexitimici). Le femmine rispetto i maschi sono risultate più ansiose, più impulsive, con maggiore tendenza a rispondere a stimoli gratificanti e con minori inibizioni verbali. Conclusioni. I risultati dello studio oltre che confermare ricerche precedenti hanno permesso di circoscrivere in maniera accurata la dimensione clinica del tossicodipendente evidenziando come la tossicodipendenza sia strettamente associata ad una psicopatologia radicata nella personalità dell'individuo.

- by Gianni Savron
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- Drug Addiction, Therapeutic Community
- by Rebecca Woodhouse and +3
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- Adolescent, Law Enforcement, Motivational Interviewing, Crime
- by Stephanie Mullins-sweatt
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- Psychology, Assessment, Psychometrics, Bipolar Disorder

This article is part of a discussion about the polices of care and assistance of drug users. The focus is to understand how a therapeutic community is structured, how is the work dynamic and which interactions take place in this particular space. This study is a result of an ethnographic research conducted in 2013, The concepts of Agency (ORTNER, 2006) and Power (FOUCAULT) were the main concepts chosen to conduct this reflection as
they appear, in my understanding, as strategic concepts to the problem related in the present study. The therapeutics communities is one of the alternatives in the network
of care for drug users in Brazil that adopts a psychosocial perspective and which it’s possible to observe a complex network of interactions. There are constant tensions and negotiations between the work of professionals and the way the hospitalized
individuals perceive this therapeutic project.

- by Sara Godoy Brito
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- Power relations, Drug Policy, Therapeutic Community

This paper examines the interplay of commercial imperatives and health care legislation in the survival of a privately owned psychiatric hospital in Guelph, Ontario, Canada. Using documentary and archival evidence, we show how the Homewood Retreat (later Sanitarium, and eventually Health Centre) was able to respond to and anticipate legislative developments through the agency of successive medical superintendents and the structural positioning of the institution as an inextricably integrated element in local and provincial mental health provision. Our case study is used to draw out wider lessons concerning agency, legislative context and treatment modality in the determination of organizational histories. We conclude by noting the important role of the private sector in ensuring the continued provision of an asylum form of mental health care. r

- by Graham Moon
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- Sociology, Anthropology, Mental Health, Health Care

'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

This study reports on the extent to which Therapeutic Community (TC) agencies share a common set of beliefs about the essential elements of TC treatment. The Survey of Essential Elements Questionnaire (SEEQ), a TC theory-based instrument, was used in a field survey of 59 directors of agencies identified as TCs through their membership in Therapeutic Communities of America (TCA). Results showed a high degree of concordance in the perceived importance of a common set of treatment elements identified as essential to the TC modality. Two clusters of TC-oriented agencies, identified as Traditional and Modified, were determined based on beliefs in the importance of the elements. Results were seen as validating the TC formulation from which the SEEQ items were drawn. Implications on the potential use of the SEEQ as a means of codifying TC treatment for research, training, and quality assurance are discussed.

- by Gerald Melnick
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- Psychology, Substance Abuse Treatment, Quality Assurance, Health Services

The treatment literature on offender rehabilitation is reviewed with the purpose of deriving further direction for researchers and clinicians in the field of correctional psychology. After addressing the measurement of recidivism and other indicators of effectiveness, this empirically guided article reviews individual studies and meta-analyses on effectiveness of psychosocial correctional treatment for adult offenders and specialized treatment for substance abuse offenders and sexual offenders. A foundation in the general principles of offender intervention is established; principles such as risk, need, and responsivity are upheld; and common themes including the use of cognitive-behavioral interventions and the importance of treatment integrity emerge. However, questions move beyond "what works" to detailed queries about the nuances of effective service delivery, including client motivation. Well-controlled clinical studies and detailed process evaluations are still required. Other new directions include the application of positive psychology to offender treatment and the improvement of conditions under which community reentry is more likely to succeed. Directions for further research on correctional treatment are suggested.

- by R. Althouse and +1
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- Criminology, Psychology, Positive Psychology, Law

Drug abusers' self-reports are vital to clinical and research endeavors, yet few studies have explicitly examined the test-retest reliability of drug abusers' reports of their pretreatment drug use. The present study evaluated the test-retest reliability of drug abusers' reports of (a) lifetime drug use using a drug history questionnaire (DHQ), and (b) demographic and drug-related events. Intraclass and Pearson correlation coefficients revealed reasonably good reliability for most reports of drug use and related events. Further research needs in this area are discussed.

- by Mark Sobell
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- Psychology, Psychometrics, Personality Assessment, Adolescent

We studied a modified therapeutic community designed for the treatment of patients with combined substance abuse and psychiatric disorders. This model has been ap117117plied on a limited basis in clinical practice, and little is known about the characteristics of patients who are likely to complete the prescribed stay in such a program. In this report, we present characteristics of 189 homeless dually diagnosed men who entered a shelter-based, modified therapeutic community with a prescribed 6-month stay. Thirty-four percent of admissions completed the prescribed stay. These patients were more likely to have fewer inpatient psychiatric admissions and more job experience than those who did not complete their stay. Findings are discussed in terms of their similarities and differences to findings from traditional therapeutic communities for the singly diagnosed.

- by Joann Sacks
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- Criminology, Psychology, Criminal Justice, Mental Health
- by Jan Klimas
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- Psychology, Psychotherapy, Drugs And Addiction, Drug Addiction

This article aims to examine specific substance use profiles among former Soviet Union (FSU) immigrant and native-born women in Israeli therapeutic treatment facilities. Individuals were sampled at drug treatment facilities and assessed using the Addiction Severity Index. ASI scores suggest differences between the two groups. Among the findings are native born females have been using heroin and amphetamines longer than FSU immigrants; however, immigrant women have more years of alcohol use. FSU women are more inclined to be injection drug users, prefer shorter forms of treatment, and to use alcohol when receiving treatment for heroin addiction. FSU women have higher levels of chronic medical problems, HCV, and HIV/AIDS. The study results tend to support the position that treatment of special populations may be enhanced if their particular needs associated with personal attributes and background characteristcs are considered and met in a treatment environment.

- by Veerle Soyez
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- Psychology, Epidemiology, Mental Health, Statistical Analysis

Social relationships and communities provide the context and impetus for a range of psychological developments, from genetic expression to the development of core self-identities. This suggests a need to think about the therapeutic changes and processes that occur within a community context and how communities can enable therapeutic change. However, the ‘therapeutic communities’ that have developed since the Second World War have been under-researched. We suggest that the concept of community, as a change process, should be revisited within mainstream scientific research. This paper briefly reviews the historical development of therapeutic communities and critically evaluate their current theory, practice and outcomes in a systematic review. Attention is drawn to recent research on the nature of evolved emotion regulation systems, the way these are entrained by social relationships, the importance of affiliative emotions in the regulation of threat, and the role of fear of affiliative emotions in psychopathology. We draw on concepts from Compassion Focused Therapy, Social Learning Theory, and Functional Analytical Psychotherapy to consider how members of therapeutic community can be aware of each other’s acts of courage and respond using compassion. Living in structured and affiliative orientated communities, that are guided by scientific models of affect and self-regulation, offers potential therapeutic advantages over individual outpatient therapy for certain client groups. This conclusion should be investigated further.

Dr. Stevens has received numerous large-scale federal grants to administer and research innovative drug treatment programs that serve pregnant women and women with children. She has also developed and implemented women-centered interventions that assist drug using women to reduce their risk of becoming infected with HIV. Dr. Stevens is widely published in the area of women's health, particularly health issues that encompass concerns of underserved, disenfranchised drug-involved women.

- by Mary Cuadrado
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- Psychology, Treatment Outcome, Substance Abuse Treatment, Substance Abuse

where Dr Genevieve Dingle is a Lecturer.

- by Genevieve Dingle
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- Clinical Psychology, Social Psychology, Addiction, Therapeutic Community

- by Robert Abramovitz and +2
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- Social Work, Organizational Culture, Proximity Effect, Special Needs

Background The corrections-based therapeutic community (TC) is one of the most described treatment modalities for (substance abusing) incarcerated offenders. The origins and development of the therapeutic community have been traced back to two independent traditions: the American hierarchical concept-based TC and the British "democratic" Maxwell Jones-type TC. Both branches have developed independently, targeting different people and tackling diverse problems.

- by Eric Broekaert and +1
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- Psychology, Forensic psychiatry, Civil Rights, Social learning

Der Beitrag beschreibt die Grundlagen der Arbeit von The Sanctuary, einem für die besonderen Zwecke modifizierten therapeutischen Kurzzeitprogramm in den USA. Ziel des Programms ist die spezialisierte Behandlung traumatisierter Erwachsener. Weiterhin wird in das Behandlungsmodell SAGE eingeführt (abgekürzt für "Sicherheit -Affektmanagement -Trauer -Emanzipation"). -The paper describes the philosophical basis of The Sanctuary, a short-term modified therapeutic milieu program in the United States, designed to specialise in the treatment of traumatized adults. It also gives an introduction to the treatment model "SAGE", an acronym for Safety, Affect Management, Grieving, and Emancipation.