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Article
Publication date: 9 April 2018

Laura Aslan

Therapeutic communities (TC’s) are consciously designed, living-learning environments designed to evoke social, psychological and behavioural change. The success of the…

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Abstract

Purpose

Therapeutic communities (TC’s) are consciously designed, living-learning environments designed to evoke social, psychological and behavioural change. The success of the residential TC model saw these community-led, self-help environments for addicts move into custodial settings and early evidence suggests this transition was effective. The purpose of this paper is to examine the evidence relevant to the effectiveness of prison based, drug-free TCs.

Design/methodology/approach

In order to establish their true efficiency, particular focus has been placed on studies conducted over the last ten years (2007-2017).

Findings

To date, the TC remains superior to other forms of drug treatment in reducing recidivism and drug relapse amongst addicts who offend.

Originality/value

Outcomes of this review highlighted the importance of aftercare in providing transitional support; a fundamental aspect of treatment necessary for success and for maintaining long-term recovery post release.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 39 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

Abstract

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Article
Publication date: 8 June 2015

Laura Aslan

It is common for people to view dropping out of substance misuse treatment as an unsuccessful attempt at recovery. The existing literature emphasises that those who drop out of…

Abstract

Purpose

It is common for people to view dropping out of substance misuse treatment as an unsuccessful attempt at recovery. The existing literature emphasises that those who drop out of treatment do worse than those who complete their treatment programme. More recently, however, those who discharge early are faring better than ever before.

Design/methodology/approach

In total, 13 service users who discharged early from three residential therapeutic communities were interviewed over the phone to discuss life after treatment. Interview transcripts were analysed using thematic analysis and found four main themes evidencing that “unsuccessful” really can be successful.

Findings

The study unearthed significant findings in the area of motivation for continued recovery in that 85 per cent of the sample were actively accessing further substance misuse treatment after leaving the service early. Five participants who had entered treatment as opiate users were all abstaining from Class A drugs at the time of interview; indeed 100 per cent of the sample were opiate free. Furthermore, self-reported psychological health had improved following discharge by 78 per cent.

Practical implications

Recent changes in policy and treatment design within drug treatment services may explain such positive outcomes in that a more responsive programme allows people to gain skills and make changes in a shorter time frame.

Social implications

Indeed, improved early discharge procedures and increased links to aftercare and follow on treatment may have impacted on this finding.

Originality/value

This study therefore proposes the notion of “right dose of treatment” as opposed to “time in treatment” and highlights the importance of exit procedures and aftercare.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 June 2015

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.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 June 2015

Anita Helen Harris

Research has shown mindfulness-based therapies to be an effective therapeutic intervention for a wide range of illnesses and disorders. However, little is known about how it may…

Abstract

Purpose

Research has shown mindfulness-based therapies to be an effective therapeutic intervention for a wide range of illnesses and disorders. However, little is known about how it may be helpful to individuals with addiction problems. The purpose of this paper is to evaluate by qualitative approach the impact of the newly introduced mindfulness-based relapse prevention programme (MBRP) programme on the TC to which it was introduced and to explore clients perception of and attitude to the programme. More specifically it aimed to examine how it may be helpful for individuals with substance abuse problems.

Design/methodology/approach

A qualitative approach was drew upon using both focus group methods and individual semi-structured interviews with clients of the TC to which it was introduced. Thematic analysis was performed on data collected.

Findings

Notwithstanding implementation issues, findings suggest MBRP to be a valuable and worthwhile programme with real perceived benefits.

Research limitations/implications

Clients’ detoxing cited real perceived gains as a result of participating which has clear implications for a TC which offers methadone detoxification.

Originality/value

It is noted that MBRP research is in its infancy, and whilst a number of quantitative studies have been carried out, little qualitative research exists. If MBRP is to be considered an effective relapse prevention strategy, research must clarify the process underlying participant’s use of mindfulness in a drug-free setting.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 June 2015

Susana Henriques and Pedro Candeias

Therapeutic communities (TCs) are one of the existent social responses in helping drug users overcome addiction and pursue social reintegration. The purpose of this paper is to…

Abstract

Purpose

Therapeutic communities (TCs) are one of the existent social responses in helping drug users overcome addiction and pursue social reintegration. The purpose of this paper is to present and discuss the general characteristics of about 200 drug users and their addiction and those of addicts abroad treated in a TC and clinically discharged. The analysis now presented is the first empirical approach to capture social regularities and singularities that are present in these individuals’ reintegration strategies.

Design/methodology/approach

The data have a ten-year range – from 1999 to 2009 – and were statically analysed.

Findings

They show a group of individuals with low qualifications reflected in their professional occupation, from which family is an essential support. These data also show a significant prevalence of heroin, alcohol, cocaine and polydrug uses, highlighting the need to consider new use patterns and new synthetic substances.

Originality/value

TC have been little studied, mainly in Portugal.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 June 2015

Stijn Vandevelde, Jessica De Maeyer, Clara De Ruysscher, Dirk Bryssinck, Dirk Meesen, Johan Vanderstraeten and Eric Broekaert

Influenced by evolutions in mental health, a meeting house, “Villa Voortman”, was recently developed. It is based on an integration of therapeutic community (TC) and…

Abstract

Purpose

Influenced by evolutions in mental health, a meeting house, “Villa Voortman”, was recently developed. It is based on an integration of therapeutic community (TC) and psychoanalytical Lacanian thinking. The purpose of this paper is to investigate the position of Villa Voortman in the treatment continuum for dually diagnosed clients. Two research questions are addressed: how does Villa Voortman operate ? and how do clients perceive the Villa?

Design/methodology/approach

The first question was tackled by a personal account of the founders of Villa Voortman. The second question was addressed by a qualitative study using video-material of 19 visitors’ personal accounts.

Findings

The visitors mentioned three themes: social inclusion, personal development and equality. These aspects are further refined into sub-themes including the provision of “asylum”; the instalment of a warm and welcoming atmosphere; the focus on real human encounter; a permissive, supportive and “waiting” environment; a minimal but “good enough” structure; the necessity of a place where persons can develop themselves; the striving for social inclusion and future perspectives; and the support in becoming inclusive citizens again.

Originality/value

The value of the paper lies in disclosing the visitors’ lived experience. This is an essential part of shedding light on the “active ingredients” of support, In reference to the title, visitors nor treatment staff have “carte blanche” with regard to how support develops, as this is driven by the dialectal course of everything that occurs during the support process.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 June 2015

Iain McPhee and Denice Fenton

There is limited research documenting recovery experiences of residential service users. The purpose of this paper is to explore the perceptions service users on methadone have…

Abstract

Purpose

There is limited research documenting recovery experiences of residential service users. The purpose of this paper is to explore the perceptions service users on methadone have about recovery. In depth, semi structured 1-1 interviews with seven poly drug using homeless males between the ages of 37 and 46 and analysed using NVivo software. Results are presented thematically. Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to former addict identities. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms that equate recovery with abstinence. Tensions were revealed in true motivations for active rather than passive participation in adopting group work norms.

Design/methodology/approach

A qualitative design utilises small numbers of participants to gather rich data. In depth, semi structured 1-1 interviews conducted with seven poly drug using homeless males who have completed between ten and 15 weeks of a minimum 26-week residential treatment programme. Participants were aged 37-46. Results were analysed thematically using NVivo software.

Findings

Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to a former stigmatised addict identity. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms regards recovery and abstinence. A significant process of recovery involved adopting the norms of 12-step groups and TC therapy to gain enough trust to leave the therapeutic community (TC) unsupervised. This created tension regards motivation, were these individuals in recovery, or merely “faking it”?

Research limitations/implications

A female perspective may have provided a more balanced discussion and yielded greater depth in results. Only one service was studied and the findings may be specific to that cohort. The duration of stay at the service of ten to 15 weeks is a relatively short time and excluded participants resident for six months or more. Longer term residents may have been more reflective and informative.

Practical implications

Encourage active options and increased debate on the variety of treatment options available to long term homeless opiate users who have failed to comply with previous treatments. While this is a small modest study, the rich data yields practical advice for policy makers and service providers.

Social implications

This research study adds to an informed perspective by encouraging debate on methadone as a challenge to definitions of recovery that infer abstinence as a key definition of success.

Originality/value

There is a paucity of research documenting a Scottish TC service user perspective using qualitative methods on experiences of addiction, treatment and recovery.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 June 2015

Eric Broekaert, Caroline Elizabeth Berg-Sørensen, Wouter Vanderplasschen and Stijn Vandevelde

Even though there is much information available with regard to the development of the therapeutic community (TC) for addictions in Europe, little is known about the particular…

Abstract

Purpose

Even though there is much information available with regard to the development of the therapeutic community (TC) for addictions in Europe, little is known about the particular situation in Denmark.The paper aims to discuss this issue.

Design/methodology/approach

In order to address this dearth, the methodology of the following historical account is largely based on an interview and personal contacts with Hanne Holm Hage-Ali, current director of TC Opbygningsgården and star witness of the development of TC in Denmark.

Findings

In 1971, the Freetown “Christiania”, Copenhagen, where TC Opbygningsgården started up, was based on communal, anarchic and hippie ideas and values. In the beginning, TC Opbygningsgården was not well accepted by TC pioneers promoting the classic hierarchical TC, as it was seen as a social experiment with anti-authoritarian roots. Later, in its turn, it became influenced by TCs Veksthuset and Phoenix House Haga, Norway, which were part of the common European TC movement. At this moment, TC Opbygningsgården functions as a well-accepted member of the European Federation of Therapeutic Communities.

Research limitations/implications

The interview revealed information that it is line with current trends in and challenges for TC throughout Europe, as outlined in a recent EMCDDA study: TC in Europe can be considered as “children of the late sixties”; TCs are embedded in the anti-psychiatric movement, existentialism and the promotion of alternative community living; European TC leaders had different origins and professional background; and the TC never belonged to one religion or ideology. The common human value system always transcended the different visions.

Originality/value

This paper aims at addressing the dearth in knowledge on the development of TCs in Denmark.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

Keywords

Content available
Article
Publication date: 9 April 2018

Richard Shuker and Jon Taylor

268

Abstract

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 39 no. 1
Type: Research Article
ISSN: 0964-1866

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