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Article
Publication date: 11 September 2017

Steve Pearce and Rex Haigh

The purpose of this paper is to provide an overview of the application of therapeutic community (TC) method in non-TC environments.

Abstract

Purpose

The purpose of this paper is to provide an overview of the application of therapeutic community (TC) method in non-TC environments.

Design/methodology/approach

Milieu treatment is defined and differentiated from TC “proper”. Literature is reviewed covering attempts to use TC methods in inpatient wards, across hospitals, and more recently in the criminal justice system and more widely through the enabling environments initiative.

Findings

It is unclear whether TC milieu treatments proved helpful in acute ward environments in their heyday in the 1950s, 1960s and 1970s, in particular those involving people suffering from acute psychosis, and the changing landscape of psychiatric provision may make further investigation difficult. The reasons for this, and for the difficulties reaching a firm conclusion, are outlined. In contrast, TC milieu interventions appear to be demonstrating usefulness more recently in less mixed populations without the implementation of full TC “proper”.

Research limitations/implications

Much of the research is old and the methodology poor, which limits the conclusions that can be drawn.

Practical implications

Recent innovations pick up in a more accessible way principles of therapeutic communities that can inform and improve care in a variety of contexts. They are sufficiently well defined to lend themselves to research, which should now be a priority.

Originality/value

After a gap in developments in the field, recent innovations are reintroducing elements of TC functioning to new contexts including criminal justice settings, inpatient wards, homeless shelters and city communities.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 38 no. 3
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 8 February 2013

Clive G. Long

The purpose of this paper is to review issues of relevance to practitioners using group cognitive behavioural therapy (CBT) with women in secure settings.

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Abstract

Purpose

The purpose of this paper is to review issues of relevance to practitioners using group cognitive behavioural therapy (CBT) with women in secure settings.

Design/methodology/approach

The extant literature on CBT as applied to women in secure settings is reviewed to highlight best practice. Aspects of best practice are illustrated with examples from a women's medium secure service.

Findings

Obstacles include the characteristics of the patient group, treatment non compliance and an environment that accepts the primacy of security over treatment. Environmental and need factors amenable to intervention are highlighted in addition to CBT specific considerations that include the timing and intensiveness of treatment, content and delivery of therapy, treatment readiness and use of the group process. The use of a manualised CBT group treatment aid attempts to ensure treatment integrity is associated, and which is associated with treatment outcome. A focus on the social and environmental factors that attribute to the therapeutic milieu is vital to treatment generalisation, as is harnessing the therapeutic potential of the built environment. Finally, treatment evaluation imposes a structure that can facilitate progress in treatment.

Originality/value

There is comparatively little work on CBT group treatments for women in secure settings. Attempts to synthesise best practice initiatives in this area are helpful in guiding treatment developments.

Details

The Journal of Forensic Practice, vol. 15 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Book part
Publication date: 5 February 2010

Holly Ventura Miller, J. Mitchell Miller, Rob Tillyer and Kristina M. Lopez

Purpose – Treatment for alcohol and drug addiction in correctional settings has become commonplace throughout much of the United States. The delivery of treatment services in…

Abstract

Purpose – Treatment for alcohol and drug addiction in correctional settings has become commonplace throughout much of the United States. The delivery of treatment services in prisons is a promising approach and has certain advantages relative to outpatient and voluntary treatment, including (i) certainty of program enrollment and participation by individuals who would not likely seek treatment on their own (i.e., coerced participation/guaranteed delivery of treatment); (ii) program modalities specific to residential settings as treatment options – in effect, more intensive treatment; and (iii) the parole process ensures participation in post-release aftercare services. During this era wherein reentry is a pronounced theme throughout American corrections, substance abuse treatment is fundamental in terms of rehabilitating offenders, increasing public safety, and lowering recidivism rates and, ultimately, the overall prison population.

Methodology – Using data from a process evaluation of an in-prison alcohol treatment program in Texas, this study examines the environmental barriers to effective recovery present in correctional settings and considers the strengths and weaknesses of coercive treatment, generally.

Findings – Findings indicate that offenders can indeed become motivated to change through coerced treatment. However, study findings also suggested that a certain number of offenders will not become engaged in treatment and fail to develop any internal motivation, which can be problematic for a number of reasons.

Practical implications – The highly coercive and restrictive nature of correctional facilities may negate the overall rehabilitative intent of treatment programs.

Details

New Approaches to Social Problems Treatment
Type: Book
ISBN: 978-1-84950-737-0

Article
Publication date: 12 April 2022

Tam Chipawe Cane, Paul Newton and John Foster

It is well established that women face multiple barriers accessing treatment for problematic and unhealthy alcohol use, but less is known about how their interconnected problems…

Abstract

Purpose

It is well established that women face multiple barriers accessing treatment for problematic and unhealthy alcohol use, but less is known about how their interconnected problems affect how they seek help from, and access, alcohol-treatment services. This study aims to explore the dynamic nature of women’s help-seeking for problematic and unhealthy alcohol use and how this can be compounded by unsuitable treatment services, especially when women present with complex needs.

Design/methodology/approach

Thirteen semi-structured interviews with women who had accessed alcohol-support services were conducted, audio-recorded, transcribed and analysed thematically using the complexity theory.

Findings

For women with complex needs, the process of seeking help may trigger unpredictable behaviours, health or social problems and intermittent serial access to treatment. Current services do not always address women’s holistic needs. Unless services focus on addressing interconnected problems – including historic trauma – they may compound the complexity of women’s problems. Complexity theory offers novel insights into this process, a concept not applied to problematic and unhealthy alcohol use treatment previously.

Research limitations/implications

Services should adopt the complexity-focused perspective featured in this study. While the authors acknowledge the increase in gender-responsive provision, the limitations of this study include a small sample size, the self-selecting nature of the sample and retrospective reporting. Participants were recruited and selected by service staff resulting in gatekeeping and possible sampling bias.

Practical implications

Services should adopt non-linear approaches to treatment. Implementing complexity approaches to treating women’s problematic and unhealthy alcohol use should capture the dynamics, complexity and non-linear nature of women’s help-seeking journeys as well as their internal and external responses that may result in relapse. The authors recommend complexity-focused, multiple-component and integrated collaborative strategies to address not only addiction but also all components of women’s needs, including past trauma.

Originality/value

Applying complexity-thinking to help-seeking experiences for alcohol treatment and recovery services is novel and proved useful in understanding the variety of women’s experiences and how these interact with their help-seeking behaviours, including treatment environments.

Details

Advances in Dual Diagnosis, vol. 15 no. 2
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 9 April 2018

Christian Perrin, Andrew Frost and Jayson Barry Ware

In the quest to maximize treatment gains, recent research has shifted focus from treatment itself to the context in which treatment takes place. Such investigations have alluded…

Abstract

Purpose

In the quest to maximize treatment gains, recent research has shifted focus from treatment itself to the context in which treatment takes place. Such investigations have alluded to rehabilitative climate, therapeutic alliance, prison social climate, and the efficacy of group process. The purpose of this paper is to review peer-support as a mechanism via which these goals might be reached.

Design/methodology/approach

A review of the literature on peer-support in carceral settings was undertaken in February 2017.

Findings

While there is very little research exploring peer-support in the context of offender rehabilitation, there are some promising signs from many qualitative investigations that peer-led roles can bridge many gaps in support within the therapeutic context.

Research limitations/implications

More research on the potential negative impact of peer-support in carceral setting is needed.

Practical implications

This paper proposes that the implementation of peer-support programs that operate alongside treatment interventions represent an encouraging direction for the future. It is argued that prisoner-led peer-support initiatives that are characterized by shared problem solving and reciprocal emotional support can greatly reduce the anxiety prisoners face surrounding treatment. It is suggested that, through peer-support, treatment gains may be enhanced and better assimilated into program-completers’ lives.

Social implications

Peer-support may assist current treatment approaches with sexual offenders and could therefore potentially contribute to reductions in recidivism.

Originality/value

This paper is the first to review peer-support in the context of imprisonment and offender therapy. It therefore provides an important status update for future researchers wishing to investigate this topic, and outlines several priorities that such research might interrogate further.

Details

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

Keywords

Article
Publication date: 14 September 2015

Mieke Autrique, Steve Pearce and Wouter Vanderplasschen

– The purpose of this paper is to investigate the possible impact of a randomised controlled trial on the therapeutic environment of participating therapeutic communities (TCs).

Abstract

Purpose

The purpose of this paper is to investigate the possible impact of a randomised controlled trial on the therapeutic environment of participating therapeutic communities (TCs).

Design/methodology/approach

The authors compared the environment in four democratic day TCs involved in a randomised trial (experimental TCs) with a similar democratic day TC not involved in the trial (the control TC) by administering the Community Oriented Environment Scale (COPES) to 28 TC members.

Findings

TC members’ views of the real psychosocial environment at the experimental TC and control TC showed similar high levels for spontaneity, autonomy and personal problem orientation and similar intermediate levels for practical orientation and staff control. The TC members at the experimental TC rated significantly higher levels for order and organisation and clarity, while members at the control TC rated a significantly higher level for involvement.

Originality/value

The study provided no evidence of a significant adverse impact on the culture of democratic day TCs due to participation in a randomised trial. This finding answers one of the most common arguments in the debate on the ethics of RCTs in TCs.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 3
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 1 November 2003

Louise Coughlin

The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously for a unit…

Abstract

The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously for a unit that has since closed, and second, to compare staff and patient perceptions of the new ward with their ideal ward environment. The results obtained from patients indicated that there were differences between perceptions of the new treatment unit and the former treatment unit. The results obtained from patients also indicated that there was a difference between perceptions of the new treatment unit and the ideal ward environment. Results obtained from staff could not be analysed because of a low response rate.

Details

The British Journal of Forensic Practice, vol. 5 no. 4
Type: Research Article
ISSN: 1463-6646

Article
Publication date: 24 January 2011

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…

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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.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 2 no. 1
Type: Research Article
ISSN: 2042-0927

Keywords

Article
Publication date: 2 March 2020

Huimin Li, Qing Xia, Lunyan Wang and Ying Ma

In recent years, with the increasingly serious urban water environmental pollution, the government has exerted considerable effort to promote the comprehensive improvement of the…

Abstract

Purpose

In recent years, with the increasingly serious urban water environmental pollution, the government has exerted considerable effort to promote the comprehensive improvement of the water environment and conducted numerous urban water environment treatment public–private partnership (PPP) projects (UWETP-PPP). The sustainability assessment of UWETP-PPP has important theoretical and practical significance for the public and private sectors to systematically evaluate the sustainability of projects and promote the sustainable development of projects. Therefore, the purpose of this paper is to advance a method to evaluate the sustainability of UWETP-PPP.

Design/methodology/approach

The paper adopted fuzzy logic method to evaluate the sustainability of UWETP-PPP. First, this paper constructed the sustainability assessment indicator system of UWETP-PPP. Second, this paper determined the appropriate linguistic scale for assessing the performance ratings and importance weights of UWETP-PPP sustainability indicators and collected experts’ evaluations of the project through questionnaires. Then, the linguistic variables were approximated as fuzzy numbers through the concept of fuzzy theory. Finally, the sustainability of the project was determined and the weak sustainability aspects of the project were identified by calculation.

Findings

The feasibility of this method was verified by a specific case. And, the results of the case study showed that the UWETP-PPP in Xuchang City, China, was sustainable, and the indicators of weak sustainability of the project were identified, namely, internal return ratio (IRR), sustainable cash flow, provision of employment opportunities, energy efficiency, comprehensive use of water resources, use of innovation materials, renewal of project facilities, adoption of advanced engineering technology, use of construction waste and waste recycling and reuse. This paper also proposed corresponding suggestions for further improving the sustainability of the UWETP-PPP in Xuchang City, China.

Originality/value

This paper makes two contributions: first, the fuzzy logic method is applied to provide new ideas for a sustainability assessment of UWETP-PPP, and the assessment results facilitate ways to monitor and estimate the degree of sustainability. Second, the identified indicators of weak sustainability provide useful references for the public and private sectors regarding implementing appropriate measures to improve the sustainability level of UWETP-PPP.

Details

Journal of Engineering, Design and Technology , vol. 18 no. 5
Type: Research Article
ISSN: 1726-0531

Keywords

Article
Publication date: 13 September 2018

Catherine Mullan, Darren Johnson and Jennifer Tomlinson

Although support exists for the effectiveness of treatment for personality disordered offenders there is limited knowledge about the processes underlying the therapeutic change…

Abstract

Purpose

Although support exists for the effectiveness of treatment for personality disordered offenders there is limited knowledge about the processes underlying the therapeutic change. The purpose of this paper is to explore the treatment experiences of six male psychopathic offenders who attended a social skills treatment component implemented within a high-secure personality disorder treatment service.

Design/methodology/approach

Interview transcripts were analysed by the lead researcher (first author) using interpretative phenomenological analysis (IPA) who compared and contrasted findings to develop superordinate themes across the group. External auditing analysis was conducted by the second author.

Findings

Several themes were identified that may indicate the unique ways this client group experienced treatment. These related to the importance of “group cohesion” with treatment progression and shared learning experiences, the significance of “therapeutic alliance” with treatment providers and perceived effectiveness of treatment, and the conflict participants experienced when acquiring and applying skills from their engagement in treatment. Participants identified aspects of the treatment component that facilitated the effectiveness of treatment and were effective in meeting their needs and some that would benefit from improvement.

Practical implications

Positive group dynamics are important. Operational staff inclusion within the facilitation team is beneficial. Attentiveness to participants’ specific responsivity needs is required. Supporting skill application post-treatment is important.

Originality/value

These findings add to the evidence base in relation to factors that support personality disordered offenders’ engagement within treatment. Areas that validate treatment delivery are highlighted, as are suggestions for change to maximise treatment gain for psychopathic and personality disordered offenders.

Details

Journal of Criminological Research, Policy and Practice, vol. 4 no. 3
Type: Research Article
ISSN: 2056-3841

Keywords

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