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1 – 10 of over 48000The Philippines’ nationwide campaign on drugs has been under the limelight due to its controversial approaches in dealing with the problem of addiction. Despite the government’s…
Abstract
Purpose
The Philippines’ nationwide campaign on drugs has been under the limelight due to its controversial approaches in dealing with the problem of addiction. Despite the government’s current efforts, substance use disorders continue to persist within the population. The purpose of this paper is to provide recommendations for addressing the issue of substance use disorder treatment through a modification of the therapeutic community (TC) in the Philippine context.
Design/methodology/approach
This conceptual paper reviews the existing facts about the Philippines’ campaign against drugs, the approaches implemented by the government, current state and research developments of TCs, and its resulting impact on contemporary evidence-based treatment for addiction in the country.
Findings
A treatment framework outlining a recovery-oriented therapeutic community (ROTC) is presented. The ROTC aims to address addiction as a chronic, relapsing disease. This alternative approach for addiction treatment in the Philippines is based on the concept of recovery, principles of effective substance use disorder treatment, and recent developments in TC best practices from the international community.
Originality/value
This paper discusses different recommendations for policy development, interventions and research, aimed at improving the odds of securing recovery for people suffering from addiction.
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Dave Hingsburger, Eileen Flavelle, Julian Yates, Kelly King‐Muir, Manuela Nora and Shassha Loftman
This article sets out to explore three differing approaches from three agencies to supporting and treating people with a learning/intellectual disability who have sexually…
Abstract
This article sets out to explore three differing approaches from three agencies to supporting and treating people with a learning/intellectual disability who have sexually offended. The three agencies are: Waymarks in the United Kingdom, York Central Hospital Behaviour Management Services and Vita Community Living Services both in Ontario, Canada. Each agency provides services to a similar population of offenders with disabilities. Though each client engaged in vastly different behaviour, all clients have been identified as having sex offending history and as having a high likelihood of offending again in the future. As the organisations evolved, differing approaches to the provision of service developed. For the three agencies, it can be argued that there was a very limited range of theoretical models available when each organisation developed. Consequently each agency developed their service according to the needs and ‘best fit’ of the people they were supporting with the available resources at that time. This meant that services developed as a direct response to the need and were designed to best fit the need with the resources to hand at the time. As a result, three different models of service arose, all of which have had real success with meeting the needs of people with learning/intellectual disabilities who have sexually offended, while providing support and treatment in differing ways. This article will examine some of those differences.
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Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co‐epidemic of HIV, tuberculosis has already…
Abstract
Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co‐epidemic of HIV, tuberculosis has already started to make a comeback in wealthier countries. The WHO’s solution to this global tuberculosis epidemic is the DOTS strategy, the implementation of which presents many problems. The two issues most common to the majority of locations are delay in presentation for treatment and non‐completion of treatment. This review looks at the reasons for these problems in the less developed world, and addresses some solutions. The main reasons for delayed presentation are: a lack of understanding about TB; the stigma associated with the disease; the inaccessibility of treatment; and a preference for private practitioners. The main reasons for non‐completion of treatment are: the stigma of the disease; a lack of information; dissatisfaction with the treatment and its delivery; and inaccessibility of treatment. Successful implementations of the DOTS strategy need to address all these issues. There is little evidence that DOT enhances treatment completion unless combined with other strategies. Community‐based, patient‐orientated DOTS appears to be an appropriate way of addressing many of these issues. The involvement of volunteers in community‐based strategies is common, but needs more research in order for this strategy to realise its full potential.
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Brandie Stevenson, Luke Lynn, Katelyn Miller and Dave Hingsburger
Community‐based treatment programmes serving people with learning/intellectual disabilities face the problem of deciding how and when and under what conditions those in treatment…
Abstract
Purpose
Community‐based treatment programmes serving people with learning/intellectual disabilities face the problem of deciding how and when and under what conditions those in treatment will be able to independently access the community. Given the fact that people with disabilities have difficulties in generalization, knowing that they can practice skills in therapeutic sessions does not mean that they will be able to use these skills in real life situations. A Community Trust programme was first described theoretically in 1996 and this paper aims to present how that programme will work in practice.
Design/methodology/approach
From the moment treatment begins, data is collected with an eye to the future wherein individuals will be able to access the community and wherein agencies and therapists will be able to make decisions on that access, based on data not opinion. Two case examples demonstrate the principles of the trust programme.
Findings
Community trust for individuals who have engaged in serious, dangerous, or criminal behaviours is a serious issue and therefore must be a well thought out process. It also needs to be data based and decisions must be made not on “opinion” but on objective measures.
Originality/value
The paper demonstrates how community‐based treatment programmes, such as the example considered, give individuals “real life” opportunities to practice skills and thus transfer what is learned in therapeutic sessions to practical application.
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Tracy J. Pinkard and Leonard Bickman
Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement…
Abstract
Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement toward evidence-based practice. Results from several studies indicate that youth served in traditional residential or inpatient care may experience difficulty re-entering their natural environments, or were released into physically and emotionally unsafe homes (Bruns & Burchard, 2000; President's Commission on Mental Health, 1978; Stortz, 2000; Stroul & Friedman, 1986; U.S. Department of Health and Human Services, 1999). The cost of hospitalizing youth also became a policy concern (Henggeler et al., 1999b; Kielser, 1993; U.S. Department of Health and Human Services, 1999). For example, it is estimated that from the late 1980s through 1990 inpatient treatment consumed nearly half of all expenditures for child and adolescent mental health care although the services were found not to be very effective (Burns, 1991; Burns & Friedman, 1990). More recent analyses indicate that at least 1/3 of all mental health expenditures for youth are associated with inpatient hospitalization (Ringel & Sturm, 2001).
Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse…
Abstract
Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse treatment provision among individuals of varying socioeconomic and racial/ethnic backgrounds. This study investigates that achievement by analyzing the relationship between community socioeconomic and racial/ethnic disadvantage and organizational provision of substance abuse treatment, treatment need and utilization across United States counties, 2000, 2002 and 2003. Results confirm equity in service provision in poorer communities and those with higher concentrations of African Americans. Significant disparities remain, however, in communities with higher concentrations of Hispanics, youth and female-headed households. Limitations and implications for future studies of health care provision are discussed.
Travis K. Huang, Yi-Ting Wang and Kuan-Yu Lin
This study aims to examine members’ perceptions of interactivity in brand communities on social networking sites in the Super Basketball League (SBL) context in Taiwan.
Abstract
Purpose
This study aims to examine members’ perceptions of interactivity in brand communities on social networking sites in the Super Basketball League (SBL) context in Taiwan.
Design/methodology/approach
The proposed model was empirically evaluated using survey data collected from 332 followers of the SBL teams’ Facebook pages on their perceptions of brand communities. Structural equation modeling was used to examine the relationships in the research model.
Findings
The results suggest significant relationships between perceived interactivity and community benefits, including special treatment, social influence, sense of membership and the notion that community satisfaction has a strong and positive effect on brand loyalty. Both social influence and a sense of membership positively affect community satisfaction. However, special treatment negatively affects community satisfaction. Perceived interactivity positively affects a sense of membership and social influence, which, in turn, positively affect community satisfaction.
Originality/value
This study examines the effects of members’ perceived interactivity and community benefits. The results significantly advance the understanding of the antecedents of members’ loyalty to specific brands. The study offers insights into practical ways of improving community satisfaction and brand loyalty by running brand communities on social networking sites. The findings also augment the theory of brand management.
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Ilse Goethals, Wouter Vanderplasschen, Stijn Vandevelde and Eric Broekaert
– The purpose of this paper is to summarize the main findings and conclusions of four separate studies on treatment in therapeutic communities (TCs) for addictions.
Abstract
Purpose
The purpose of this paper is to summarize the main findings and conclusions of four separate studies on treatment in therapeutic communities (TCs) for addictions.
Design/methodology/approach
The first two studies address the core characteristics of the TC approach: a study on the workable and destructive elements of the Synanon model; and a comparative study on the essential elements of TCs for addictions in Europe and in the USA. The final two studies highlight clients’ perceptions of the TC treatment process in relation to retention: a study on clients’ first month perceptions of the TC treatment process and the influence of fixed and dynamic client factors; and a longitudinal study on changes in clients’ perception of the TC treatment process and the impact of motivation, psychological distress and cluster B personality traits.
Findings
The first study showed that Synanon’s therapeutic and pedagogical methods are still highly valued despite its negative reputation. The results of the second study suggest that while traditional TCs operate as concept-based TCs in Europe, modified TCs might differ in the extent to which they apply the core principles and elements of the TC approach. The third study provides evidence that suitability for treatment is a very important predictor for clients’ first month perceptions of the community environment. The fourth study shows that with time in treatment clients develop more profound perceptions regarding the essence of TC treatment.
Research limitations/implications
Finally, implications for clinical practice, general limitations and some concrete recommendations for future research are presented in this paper.
Originality/value
The PhD summary study contributes to the existing literature on TC treatment.
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John M Majer, Hannah M Chapman and Leonard A Jason
– The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.
Abstract
Purpose
The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.
Design/methodology/approach
A randomized clinical trial examined treatment conditions among justice involved persons with substance use disorders who reported high baseline levels of psychiatric severity indicative of diagnosable psychiatric comorbidity. Participants (n=39) were randomly assigned to one of three treatment conditions upon discharge from inpatient treatment for substance use disorders: a professionally staffed, integrated residential treatment setting (therapeutic community), a self-run residential setting (Oxford House), or a treatment-specific aftercare referral (usual care). Levels of psychiatric severity, a global estimate of current psychopathological problem severity, were measured at two years as the outcome.
Findings
Participants randomly assigned to residential conditions reported significant reductions in psychiatric severity whereas those assigned to the usual care condition reported significant increases. There were no significant differences in psychiatric severity levels between residential conditions.
Research limitations/implications
Findings suggest that cost-effective, self-run residential settings such as Oxford Houses provide benefits comparable to professionally run residential integrated treatments for justice involved persons who have dual diagnoses.
Social implications
Results support the utilization of low-cost, community-based treatments for a highly marginalized population.
Originality/value
Little is known about residential treatments that reduce psychiatric severity for this population. Results extend the body of knowledge regarding the effects of community-based, residential integrated treatment and the Oxford House model.
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Colin Hemmings and Titi Akinsola
We describe how Supervised Discharge (Section 25) of the Mental Health Act 1983 was used to promote mental health care in the community for a man with mild learning disabilities…
Abstract
We describe how Supervised Discharge (Section 25) of the Mental Health Act 1983 was used to promote mental health care in the community for a man with mild learning disabilities and paranoid schizophrenia who has had repeated relapses and hospital admissions. The new compulsory Community Treatment Order in England and Wales introduced by the Mental Health Act 2007 is explored in comparison with Section 25 Supervised Discharge, which it has now replaced, and compared with similar legislation already introduced in Scotland. The practice implications of the new supervised community treatment orders are discussed.
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