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This paper aims to present the theoretical foundation and practical approach of “open-target addiction treatment” (OTAT). Traditional treatment programmes are usually-oriented towards fixed predefined goals (abstinence, reduced consumption and harm reduction) and often focus on one substance only (e.g. alcohol). However, as a rule, people who use drugs consume several substances and sometimes additionally exhibit behavioural addictions. For many of these addictions, there is more or less motivation for change, but commonly it is not abstinence as a consistent goal. The paradigm of OTAT systematically considers multi-substance use, expects high readiness to change and is aware that commonly clients lack the willingness to abstain permanently.

The theory and practice of OTAT involve three components, namely, first, to create a systematic inventory of all psychoactive substances consumed and addictive behaviours performed, second, to clarify, which substance-related change goals clients pursue and third, to choose adequate treatment options matching the substance-specific goals of the clients. Furthermore, OTAT includes didactic tools to support working along with these three steps (e.g. a set of cards to gain an overview over the psychoactive substances used and addictive behaviours performed).

The systematic implementation of OTAT requires fundamentally different concepts about addiction and its treatment, specific competencies of the staff and a corresponding portfolio of interventions within the treatment facilities.

Future research should focus more on patients’ goal preferences and their impact on their willingness to take up treatment and its outcomes.

To implement OTAT treatment, institutions have to undergo a systematic process of team and organizational development.

OTAT has the potential to reduce the treatment gap and to serve severely addicted individuals in a more comprehensive way.

The OTAT approach has not been described in the addiction treatment literature so far.

This paper aims to explore treatment implications of the self‐regulation model (SRM) for sexual offenders with an intellectual disability in an effort to provide practical applications that could be employed in treatment.

The SRM of sexual offending proposes that difficulties in self‐regulation may lead to an increased risk of sexual offending; describing four potential pathways to sexual offending that are based on self‐regulation style and offence‐related goals. Research has focussed on the application and implications of this theoretical model for mainstream sexual offenders. However, more recently, there has been an increasing interest into the application and treatment implications for the SRM for sexual offenders with an intellectual disability. This paper reviews literature on both the SRM and related work on offenders with intellectual disability.

The evidence reviewed supports the notion that the SRM is a valid theoretical model on which to base treatment programmes for people with intellectual disabilities and specific recommendations are made for the design of treatment programmes with this client group.

It is suggested that this model should be used when devising intervention programmes for people with intellectual disabilities in the future.

The purpose of this paper is to give an overview of the scientific evidence for reduced drinking in alcohol use disorders. While the aim of alcohol use disorders (AUD) treatment usually focuses on abstinence, only a minority of individuals with AUD enter treatment. Lack of alternative treatment goals, including reduced drinking instead of abstinence, have been identified as a potential barrier for treatment entry. Epidemiological and treatment outcome studies reveal that a large proportion of individuals with AUD are able to substantially reduce their alcohol intake for a prolonged duration of time.

A narrative review of the literature on prevalence rates and health effects as well as evidence-based approaches fostering reduced drinking in individuals with AUD is presented.

Reduced drinking is associated with improvements in both morbidity and mortality. Research has identified evidence-based psychosocial and pharmacological treatment approaches; however, implementation is still scarce.

Target groups for interventions fostering drinking reduction instead of abstinence are defined and desiderata for further research are outlined.

Mental health care in prisons involves many stakeholders. As a consequence, the goals involved are divergent but there is no sound theoretical framework that accounts for the complexity of care in prison. This paper considers a broad theory and its conceptual framework that differentiates between prisoners with emotional suffering and those without, the need for care from an objective point of view as opposed to a subjective one, and the need for care related to mental health problems versus care related to limiting recidivism.

The purpose of this paper is to: (1) better understand the structure (hierarchy) of customer goals providing conceptual clarity; and (2) propose a hierarchy of customer goals conceptual framework that explicates how healthcare customer goals are linked to drivers and outcomes, thus building theory and informing practice.

The research draws on 21 in-depth interviews of patients with a chronic disease. Drawing principally on construal-level theory and using manual thematic analysis and Leximancer, this article provides new insights into customer goals.

In a first, the authors identify a two-dimensional structure for each of the three main goal types, which previously had been viewed as unidimensional. The authors develop a conceptual framework linking drivers of goal setting (promotion/prevention focus world view and perceived role) with goal type (life goals, focal goals and action plan goals and their respective subgoals) and outcomes (four forms of subjective well-being). Visual concept maps illustrate the relative importance of certain health-related goals over others.

The usefulness of the authors’ conceptual framework is demonstrated through the application of their framework to goal setting among healthcare customers, showing links between the structure of goals (life goals, focal goals and action plan goals) to drivers (promotion/prevention focus world view and perceived role) and outcomes (subjective well-being) and the framework's potential application to other service settings.

This study contributes to healthcare marketing and service management literature by providing new insights into goal setting and proposing a novel hierarchy of customer goals conceptual framework linking drivers, goal types and outcomes.

The therapeutic community (TC) is a widely used treatment approach for substance use disorders. Several psychological theories have been used to explain its processes but have put less emphasis on the specific contributions of the person’s cognitive resources. This paper aims to offer a theoretical conceptualization using the locus-of-hope theory which expounds on the person’s goal-directed thinking and how it bolsters the TC process.

This paper reviewed contemporary theoretical perspectives on TCs and studies on locus-of-hope theory to provide arguments for locus-of-hope’s utility in understanding TCs. From this review, this paper discusses a formal conceptualization of TCs using the locus-of-hope model.

In this conceptualization, the authors explained that the TC becomes a co-agent in the person’s goal-pursuit by strengthening the individual’s beliefs regarding one’s capability to develop goals together with the will and strategies to attain these important recovery goals. The person’s hopeful thinking boosts the TC protocols in a dynamic fashion.

This paper offers a locus-of-hope perspective that considers the person’s contributions in bolstering the TC process. Reflections on clinical and research implications were provided. This paper aids further in unboxing of the TC.

The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process.

Interviews with 40 clients were conducted shortly after them finishing treatment and five years later. All the interviewees had attended treatment programmes based on the 12-step philosophy, and they all described abstinence as crucial to their recovery process in an initial interview.

At follow-up, the majority remained abstinent. For many, attending AA meetings was still important – some described attending as a routine, whereas others stressed that the meetings were crucial for remaining abstinent. For those who reported controlled drinking (CD), this was described either as a natural step in their recovery process or as associated with worries and self-doubts.

The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.

There are heterogeneous views on the possibilities of CD after recovery from substance use disorder both in research and in treatment systems. This study on client views on abstinence versus CD after treatment advocating total abstinence can contribute with perspectives on this ongoing discussion.

The purpose of this paper is to study the US-based (American) physiotherapy customers’ goals to engage in value cocreation activities during their well-being experience.

The authors perform Smart PLS-SEM analysis of the primary data of physiotherapy service customers in the USA.

The findings show that the US well-being customer engages in physiotherapy for individualizing, empowering, development, concerted and ethical motives but not for relating motives. These findings are contrasted with previous research to show that the service-dominant logic is not sufficient to account for the contextual complexity of the well-being experience and to explain the identified differences across culturally different customer segments.

By integrating insights from health-care and cross-cultural literature, the authors highlight the importance of relationship dynamics, culture and institutional context in well-being sector and develop a more comprehensive understanding of the cocreation behaviors in this industry. This helps advance the value cocreation research in well-being sector and promote the well-being experiences such as physiotherapy.

The authors draw from a variety of disciplinary perspectives and challenge the service-dominant (S-D) logic as insufficient in explaining the value cocreation between the customer and expert in the well-being sector. The authors adapt physician–patient relationship model from health-care literature and cultural values of power distance from cross-cultural literature to complement the S-D logic to account for the complexity and nuanced context of the well-being cocreation experience.

This article aims to analyze and discuss the role of moral development in treatment of behavior problems and, further, to describe differences and similarities between two different methods – milieu therapy (MT) and cognitive behavioral therapy (CBT) – in terms of addressing criminogenic needs and promoting moral development.

By performing a literature review, the study shows that even though there are both pros and cons using MT and CBT in institutional care, relationships strong enough to restructure a young person's moral reasoning require time, and involves not only the young person's parents and social network members, but also a genuine therapeutic alliance with clinical staff at the institution.

These are central factors articulated in both CBT and MT, but are more explicitly expressed in MT. The results presented in this article highlight some important practical implications: in order to redevelop moral self and societal values, an overly narrow focus on criminogenic needs might exclude other components or processes of treatment and behavioral change. Together with a treatment program that views close staff‐resident interactions as of secondary importance, this could impair the possibility to obtain positive and long‐lasting treatment results.

In practice, moral development itself should be considered as an overall treatment goal, integrated into the daily life at the institution, 24 hours a day. Finally, the possibility to work with moral development in institutional settings is discussed.

This paper provides a clinical practice overview of the challenges that can arise when working with dangerous and severe personality‐disordered patients in a high secure hospital. Poor engagement and treatment readiness, mistrust, paranoia and dominant interpersonal styles are all clinical features that affect treatment delivery. The paper discusses the impact of these features, and suggests how clinicians can engage effectively with individuals who have personality disorders in regard to therapy in general.