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Volume 27, Issue 1 (spring 2006)


Brief Encounters: The Development of European Drug Free Therapeutic Communities and The Origins of the European Federation of Therapeutic Communities

Rowdy Yates, Barbara Rawlings, Eric Broekaert and George De Leon

ABSTRACT: No abstract.

Some Reflections of a Decade of Experiences in British and American Concept House Therapeutic Communities, 1967 to 1977: A Personal Experience

David Warren-Holland

ABSTRACT: This brief paper recalls the author’s experiences of working in the early drug-free therapeutic community movement in the decade from 1967 to 1977. It describes the setting up of the first ‘concept-based’ community, the author’s experiences of learning placements in therapeutic communities in the USA and maps out the structure and methodology of the early UK therapeutic communities. The article also covers the author’s departure from the movement and the difficulties experienced in re-adjusting to a less intense working routine.

Therapeutic Communities for Addicts in the Czech Republic – Roots, Recent Development and Current Profiles

Kamil Kalina

ABSTRACT: Therapeutic communities in general have a long history in the Czech Republic (western part of former Czechoslovakia). In 1948, Prof Jaroslav Skala established, in Prague University Hospital, the first residential unit for alcohol treatment, close to TC principles. In the 1950s-1960s, the works of Jones and Main directly influenced both Skala´s unit and several newly established TCs for neurotic patients. During the 1970s, there emerged a unique system of training in group psychotherapy (called the SUR), based on TC principles. This stimulated another wave of TCs in the field of psychiatry and psychotherapy. After 1990, under new political conditions, autonomous TCs for drug addicts have been established as a next generation. These newer TCs are mostly ‘professionally staffed’ (although ex-users are valued members of therapeutic teams) and they can be seen as a mixture of the ‘hierarchic’ and ‘democratic’ models.

There are 15 TCs for addicts working on an independent basis and another 12 hospital-based residential units for alcohol and drug treatment, working on TC principles. An assessment of TC methodology in the Czech Republic has been undertaken by the author. The study utilised a checklist combining criteria of ‘hierarchic’ and ‘democratic’ models. Preliminary conclusions of this pilot study are presented at the end of the article suggesting an appropriate understanding to TC principles, and confirming mixed profiles of TCs for addicts in the Czech Republic.

Social Network Involvement During Therapeutic Community Treatment: Is There An Impact On Success?

Veerle Soyez, Eric Broekaert and Yves Rosseel

ABSTRACT: Success after substance abuse treatment is multi-factorially determined. Most of these factors have not been adequately studied yet. Specifically in therapeutic communities for substance abusers the impact on success of social network elements during and after treatment remains unclear. The goals of the current study were threefold: (1) to determine whether different factors predicted success after treatment; (2) to determine whether there was an improvement in the clients’ situation at follow-up compared to admission; (3) to determine whether a social network intervention added to standard family counselling in the beginning of treatment affected improvement.

A prospective, semi-controlled field study was set up. Consecutive admissions (N=124) to four long-term residential therapeutic communities were assessed at two measuring moments: immediately after admission (t=0) and between 12 and 18 months after leaving primary treatment (t=1). Network members of different cohorts of the baseline client sample were assigned to a social network intervention during the first three months of treatment.

Hierarchical regression analyses showed that women, clients that had remained longer in treatment, and clients that experienced more social support at the moment of the follow-up interview were more likely to be successful. Although the interaction effect between ‘full participation of social network members in the intervention’, treatment and ‘total number of days in treatment’ significantly contributed to success when measured as a separate domain, this interaction did not reach significance in the final model.

Therapeutic Community Meets Empowerment Evaluation: Combining Treatment and Internal Evaluation in a Therapeutic Community

Yrmy Ikonen

ABSTRACT: A model of combining treatment and internal treatment evaluation in a therapeutic community for drugaddicts is presented in this article. Basic concepts and elements of a participatory evaluation approach called empowerment evaluation are employed in making visible and modelling the treatment/evaluation process, which is carried out internally without an external moderator. Then, using ten empowerment evaluation principles as a reference point, the work done in the community is discussed. Finally, in order to articulate some changes involved in the process of adopting participatory evaluation elements, a few concrete examples are given. The author wishes to argue that using internal evaluation as a part of the treatment makes therapeutic sense.


Writings from the Edge

Rowdy Yates, Barbara Rawlings, Eric Broekaert and George De Leon

ABSTRACT: No abstract.

Managing the Transition from Treatment in a Therapeutic Community to Successful Integration Back into Society

Karen Diver and Neil Dickson

ABSTRACT: This paper outlines the crucial process by which positive change achieved through participation in an intensive residential drug and alcohol therapeutic community programme is sustained after residents complete and move on. The ongoing relationships between residents developed whilst in treatment, the experience of full time employment prior to leaving treatment, and the role of resettlement staff are all explored. A number of case studies are provided as illustration: none refers to any specific individual, but are rather a composite of issues that residents have presented in the past.

The Therapeutic Village of Care: An Alaska Native Alcohol Treatment Model

Valerie Naquin, Jodi Trojan, Gloria O’Neil and Spero M Manson

ABSTRACT: Little has been published regarding the treatment of substance abuse among Alaska Natives, particularly in residential settings. Notable exceptions, dating to nearly a decade ago, include reports on Akeela House and Dena A Coy, multi-faceted in-patient programmes that explicitly address cultural aspects of their Native clientele. This article describes the setting, establishment, structure, and process of the Therapeutic Village of Care within the Ernie Turner Center, a residential treatment programme operated by the Cook Inlet Council, Inc, an indigenously managed, non-profit human services organisation located in Anchorage, Alaska. The Therapeutic Village of Care borrows heavily from the core principles of the therapeutic community, but adapts them to the unique structural and functional aspects of Alaska Native culture. Qualitative and quantitative data assess resident engagement with treatment process, advancement through treatment levels, and subsequent social reintegration, as well as continued sobriety.

Women in European Therapeutic Communities: Conclusions of the BIOMED Project

Joke De Wilde and Karin Trulsson

ABSTRACT: The BIOMED II project aims to identify and address the needs of ‘emerging dependency groups’ in Europe. These new high-risk groups are a major challenge for the therapeutic community. Although a large database of their characteristics was set up in order to improve their treatment, the BIOMED II project failed to focus on genderspecific characteristics. A further development of the BIOMED II project succeeded in bringing the special needs of substance-abusing women to the forefront. The BIOMED for WOMEN reveals that women have different and more substance-related problems than men and that the connection between their substance abuse and other areas of functioning is much stronger. However, we must carefully consider how we look for differences between men and women. Women seem to manifest their problems in a different way, but they also are different in the way they develop and cope with their addiction. Therefore, women need a different treatment approach. Suggestions for a more women-sensitive treatment system will be discussed.

Music Therapy in the Tehran Therapeutic Community

Mohammad Reza Abdollahnejad

ABSTRACT: This article reports on research into music therapy activities in the Tehran TC for drug users. The research was in two parts. The first part looked at the effects of lyric analysis and song sharing. Clients were initially given a questionnaire about their previous use and choice of music. A total of 25 sessions were held and clients were asked focused questions at the end of each one to discover how they had reacted. The second part looked at the effects of relaxing music on sleep. A total of 30 sessions of relaxing music were held, before bedtime, and a questionnaire was used to learn how long it took residents to fall asleep, the frequency of nightmares experienced, and their mood on the following day. Conclusions showed the use of lyric analysis and song sharing was particularly useful for enabling residents to express their feelings and thoughts and that relaxing music shortened the time taken to fall asleep and improved mood on the following day. Finally it was found that the music which substance abusers had listened to during their addiction had positively affected their relapse and aggressive consuming.

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