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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.

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.

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.

Finally, implications for clinical practice, general limitations and some concrete recommendations for future research are presented in this paper.

The PhD summary study contributes to the existing literature on TC treatment.

This paper aims to provide a comparison of “old” democratic therapeutic communities, and “new” therapeutic communities for drug abuse.

The paper is a review of historical and cultural influences on therapeutic community development, with particular reference to leadership.

Free from bias, cultural, psychological or ideological, the next therapeutic communities should integrate elements of both old and new therapeutic communities, in a development strategy which assimilates, socializes and finally prepares the individual for full participation in the larger community. Within this strategy, a rational authority model is not inherently flawed but can provide a structured stage for corrective experience leading toward personal autonomy. Regardless of its particular form, however, the efficacy of the next therapeutic community will relate directly to the extent to which they incorporate the essential of its modern and ancient prototypes, that of community and healer and teacher.

The two main types of therapeutic community have tended to operate and develop separately. The author calls the rigid separation into question and identifies key shared elements.

This chapter summarizes findings and conclusions from recent studies exploring the role of motivation-readiness factors in drug abuse treatment. The research focuses on populations entering drug treatment, particularly therapeutic community programs in community- and prison-based settings. However, findings from studies in other modalities and from samples not entering treatment are also discussed. Issues addressed include (1) the nature of the motivational concept in recovery, (2) motivation as a variable affecting treatment retention and outcomes, (3) motivation in the treatment process, (4) differences in motivation across treatment populations and modalities, (5) client correlates of motivation, and (6) motivational enhancement. Conclusions highlight the critical role of motivation-readiness factors in understanding treatment-seeking, retention, and outcomes. Key implications are discussed for research, theory, treatment practice, and health care policy. These implications underscore issues relating to the interaction of motivation and treatment processes, the interaction of motivation and treatment demands, differences in motivation among special populations, client correlates of motivation, and self-selection and study designs.

For at least three decades, inter-organizational collaboration (IOC) has attracted scholarly attention and many studies have unveiled its inner dynamics. More recently, new phenomena have appeared in the changing landscape of IOC, affecting the way in which organizations are open to interact with, and rely upon, other actors that may be standalone entities as well as representatives of other organizations. These actors operate “betwixt and between” the organizational core and its external environment(s), populating a liminal space located at the organization’s boundary in which activities take place according to non-proprietary and non-employment logics. The authors focus on the forms of collaboration, which blur the lines between organizations, calling into question the fundamental label of crowd-focused IOCs. The authors consider two forms: crowd-open and crowd-based organizations. The authors show the organizational design impact of openness spans from the mere scalability associated with organizational growth to the phenomena of reshaping formalization and standardization of roles and processes, and self-organizing over time.

While recent years have seen a number of studies of social networks in therapeutic communities (TCs) and other residential settings, these have primarily focused on male residents. This paper aims to conduct a longitudinal social network analysis of interpersonal interactions in a TC for women.

The data consists of a longitudinal directed social network of instances of feedback between 56 residents of a 16 bed TC for women over a period of 611 days. Mean age of the participants was 33.1 years, mean length of stay was 133.9 days and 91% of the participants were female. Feedback consisted of written affirmations for prosocial behavior and written corrections for contravening TC norms. Data was analyzed using a latent factor longitudinal social network model.

Residents react to peer intervention in complex ways. Residents reciprocated affirmations (B = 0.14, 95% confidence interval = 0.10, 0.18) and corrections (B = 0.20, 95% CI = 0.13, 0.25). Controlling for reciprocity, participants who received affirmations were more likely to affirm and correct peers (B = 0.10, 95% CI = 0.06, 0.15; B = 0.17, 95% CI = 0.10, 0.23), suggesting that the encouragement offered by affirmations leads to increased activity. Homophily by admission time occurred in both affirmations and corrections (B = 0.23, 95% CI = 0.10, 0.37; B = 0.51, 95% CI = 0.29, 0.74).

While affirmations and corrections serve as vehicles for behavioral reinforcement and social learning, they also allow residents to interact in ways that strengthen social bonds.

The purpose of this paper is to examine personal and social network characteristics that predict staff ratings of therapeutic community (TC) resident role model status.

In all, 49 incarcerated female residents tracked interactions with peers, including verbal affirmations and corrections, during a 12-hour period. Two weeks later, staff members were surveyed about their view of participants as role models. Poisson regression was used to analyze resident interactions and demographics as predictors of role model status.

The number of corrections given to peers was positively related to staff ratings of role model status (B=0.234, SE=0.088, p=0.008). The number of affirmations given was negatively related to staff ratings (B=−0.112, SE=0.051, p=0.028). Resident phase was positively related to staff ratings (B=0.256, SE=0.102, p=0.012). These values did not significantly change when controlling for affirmations and corrections received from peers, non-programmatic interactions between residents, or resident demographics.

These results imply that TC staff judge role model status by resident actions in the community rather than demographics or peer reactions. External validity is limited by the single site, case study design, and the fact that only female TC residents were sampled.

This study is the first to track resident peer interactions over the course of a day and to link those interactions to role model status.

Innovation is a key driver of growth in the twenty-first century economy. Organisations of all types are increasingly relying on innovators to create and deliver this key driver in a constantly changing, globally competitive business environment. We need to understand innovation – what it is, how to harness it, why it is important and what frameworks and tools are useful for product, service, experience design and beyond.

The purpose of this chapter to introduce the principles of design thinking and its role in creativity and marketing as well as some of the organisations that are using it in order to spur innovation and how they are using it effectively. The chapter examines some of the results and best practices for how organisations, and their creative leaders, can use design thinking effectively. Last, the chapter provides some insight into the future trends of design thinking.