Therapeutic Communities最新文献

{"title":"The Northfield Experiments and the therapeutic community task","authors":"Tom Harrison","doi":"10.1108/tc-10-2022-0016","DOIUrl":"https://doi.org/10.1108/tc-10-2022-0016","url":null,"abstract":"Purpose This study aims to raise awareness of the importance of the sociological aspects of therapeutic community work, including clarity about the nature of the task, the power of informal interactions between participants and the relevance of leadership. Design/methodology/approach Applying insights from historical research to present-day practice. Findings The Northfield experiments offer a number of insights into present-day practice of therapeutic communities and enabling environments. These include clarity about the task, the relevance of participant interactions outside of specifically therapeutic work and the importance of leadership. Social implications The therapeutic community/enabling environments approach has relevance to a wider sector of society than solely the therapeutic. More attention needs to be paid to leadership issues in the therapeutic community movement, as well as the therapeutic power of the mutual support networks amongst those receiving care. Originality/value Through the lens of the Northfield experiments, this paper offers a broadening of the sociological nature of therapeutic community practice, arguing that the purpose is to enable greater social adaptability, thereby enhancing relationships and deepening our awareness of ourselves. Implicit in this perspective is the recognition of the power of non-formal interrelationships in the service as well as the importance of leadership. It is also suggested that our experience in this way of working has a value in other organisations such as work places or schools. However, to achieve this, we need to adapt our language appropriately.","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"29 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical review of the antecedents of enabling communities","authors":"Tom Harrison","doi":"10.1108/tc-10-2023-0021","DOIUrl":"https://doi.org/10.1108/tc-10-2023-0021","url":null,"abstract":"Purpose Adopting a sense of critical enquiry when examining historical sources, it is possible to gain a richer and broader sense of present practice. The aim of this study is to emphasise the importance of historical research to present practice in teasing out the different elements at work and how they developed. A core assumption is that our consciousness depends on our interactions with others. Design/methodology/approach This study is part of ongoing research into the historical background of the practice of discerning compassion. The methods used include archival research and the reading of primary and secondary literature. Findings In particular, it becomes clear that this way of working is always going to be problematic for political authorities as it promotes the questioning of accepted beliefs. This study emphasises that the core concepts underlying enabling community practice reach deep into the past and involve events not usually associated with the traditional histories of the approach. In particular, exploring outside of the traditional mental hospital background reveals a greater involvement of women than previously demonstrated. There are processes that have deep historical roots, the culture of enquiry, the benefits of mutual support and the understanding that people flourish better interacting with each other in a supportive and trusting environment rather than through coercion and instruction. Research limitations/implications As with all historical research, this paper is limited by the resources available to examine particular events. Practical implications Recognition of the importance of historical enquiry as relevant to present-day practice. Social implications Historical enquiry helps to acknowledge the importance of social events in shaping our present understanding. As W.H. Rivers argues, we have to understand what happened in the past before comprehending why present sociological events occur. Originality/value This paper is a unique enquiry into the early historical antecedents of enabling community practice. It is intended to stimulate more research into the field and to stimulate debate about the relevance of particular aspects of practice. It refers to sources that are not usually part of such discussions and, by implication, suggests that there is more to be explored. It is not an exhaustive account and is to be supplemented by another paper on leadership.","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"3 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135161308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thematic group activities: accommodating the individual needs of clients undergoing therapeutic community approach in Indonesia","authors":"R. Sarasvita, Haryanto Haryanto, Siti Isfandari, Raharni Raharni, Yoseph Jody, Debby Hernawati, A. Baringbing, Fitri Isnaini, Linda Octarina","doi":"10.1108/tc-10-2022-0014","DOIUrl":"https://doi.org/10.1108/tc-10-2022-0014","url":null,"abstract":"\u0000Purpose\u0000Therapeutic community (TC) is a primary approach that has been used in all Indonesian National Narcotics Board residential treatment centers since 2012. In TC, all daily activities are strengthened into habits and routines without strong therapeutic or educational reasons. But recently, the TC members become more critical and have growing individual needs. Thus, the Indonesian National Narcotics Board (INNB) tried to combine the TC approach with thematic group activities (TGA) intervention using an integrated individual approach to improve the outcomes. This study aims to evaluate the client’s behavioral changes after undergoing a TC approach added with TGA intervention for two months.\u0000\u0000\u0000Design/methodology/approach\u0000A mixed-methods study with the pre-post design was applied to 122 participants from six INNB rehabilitation centers. Pre-post behavioral changes were measured by using Client Evaluation of Self Treatment, University Rhode Island Change Assessment Scale, modified-Addiction Severity Index 3.0 and World Health Organization-Quality of Life instruments. Analysis was done by using univariate and bivariate on quantitative data, focus group discussion, and medical record review.\u0000\u0000\u0000Findings\u0000The participants’ mean age was 30.57 years, majority male, 50% graduated from senior high schools and were employed. Bivariate analysis resulted statistically significant (p-value < 0.05) in tendencies to seek treatment, participate more actively, maintain a good relationship with counselors during the program, and decrease the psychological problems of participants. The client’s social state, as well as adaptation to the program, were also amended.\u0000\u0000\u0000Originality/value\u0000TGA-added TC approach was proven to improve clients’ behavioral changes, particularly in social functioning, program involvement and psychological conditions, in people with substance use disorders.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"61 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84658418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking forward to 2023","authors":"G. Winship","doi":"10.1108/tc-04-2023-051","DOIUrl":"https://doi.org/10.1108/tc-04-2023-051","url":null,"abstract":"","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"8 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75841277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived effectiveness of therapeutic community model as a rehabilitation approach for Sri Lankan individuals with substance use disorder","authors":"Nishadi D. Dharmarathna, A. Jayamaha, Nadeeka Dimuthu Kumari Ranadeva, H. Rajapakse, C. Gunasekara, N. Fernando, L. Meegoda","doi":"10.1108/tc-06-2022-0007","DOIUrl":"https://doi.org/10.1108/tc-06-2022-0007","url":null,"abstract":"\u0000Purpose\u0000This study aims to evaluate the perceived effectiveness of residential treatment which follows the therapeutic community (TC) model for Sri Lankan individuals with substance use disorder (SUD).\u0000\u0000\u0000Design/methodology/approach\u0000A descriptive cross-sectional study was carried out in two selected residential treatment centers which follow the TC model as a rehabilitation approach. All the clients of the selected residential treatment centers were invited to take part in the study and data were collected from 75 consented male participants using an interviewer-administered questionnaire. The perceived effectiveness of the residential treatment was assessed using the Treatment Effectiveness Assessment instrument. Data were analyzed using descriptive statistics.\u0000\u0000\u0000Findings\u0000Most of the participants were Sinhalese (98.7%, n = 74) with a mean age of 27.0 ± 6.0 years. The average duration in which participants stayed at selected centers was 8.0 ± 4.0 months. Most of the participants reported that the encouragement during the program was sufficient (89.3%, n = 67), psychological support was satisfactory (89.3%, n = 67), freedom (69.5%, n = 52) and facilities were adequate (76.0%, n = 57) within the program. A higher proportion of participants said that the counselors and program guides were friendly (80.0%, n = 60), and participants were allowed to communicate with their family with restrictions (92.0%, n = 69). The mean perceived effectiveness score (score range 1–40) was 34.0 ± 7.0 and the four domain scores (score range 1–10) were substance use (9.0 ± 2.0), health (8.0 ± 2.0), lifestyle (9.0 ± 2.0) and community (9.0 ± 2.0). The majority (88.0%, n = 66) of the participants perceived a high level of treatment effectiveness.\u0000\u0000\u0000Originality/value\u0000There is a paucity of empirical evidence on effectiveness of TC model for individuals with SUD in South Asian countries including Sri Lanka. The findings of this study highlight that the participants perceived higher effectiveness of the residential treatment which follows the TC approach for Sri Lankan individuals with SUD.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89206420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the therapeutic factors of the social reintegration treatment stage in a residential treatment setting: a qualitative approach","authors":"K. Flora","doi":"10.1108/tc-07-2022-0008","DOIUrl":"https://doi.org/10.1108/tc-07-2022-0008","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to understand deeply the important elements of the reintegration phase of recovery.\u0000\u0000\u0000Design/methodology/approach\u0000The participants were 14 people suffering from addiction to drugs, who met the criteria for substance use disorder according to the diagnostic and statistical manual of mental disorders, fifth edition. The data obtained by semi-structured interview were qualitatively analyzed by interpretive phenomenological analysis.\u0000\u0000\u0000Findings\u0000The results highlight the importance of relationships in therapy, identity reshaping, a deeper understanding of the causes of substance use, the importance of boundaries, the critical parameters of the transition to regularity and the important role of emotions.\u0000\u0000\u0000Originality/value\u0000The results are discussed on the basis of the enhancement of the therapeutic interventions that are followed at the reintegration stage, taking into account not only the peculiarities of this phase but also social factors such as stigmatization.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"4 4","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72398476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric attributes associated with attrition within a prison-based democratic therapeutic community","authors":"Victoria Jade Pointon, Rachel M. Roberts","doi":"10.1108/tc-10-2022-0017","DOIUrl":"https://doi.org/10.1108/tc-10-2022-0017","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to examine the psychometric characteristics of male offenders who joined a democratic therapeutic community and their relationship to attrition.\u0000\u0000\u0000Design/methodology/approach\u0000Residents who left therapy prematurely during the assessment phase (N = 46) and residents who left therapy prematurely during core therapy (N = 202) were compared to residents who completed therapy (N = 52) on two psychometric measures: Raven’s Standard Progressive Matrices and The Blame Attribution Inventory.\u0000\u0000\u0000Findings\u0000A multinomial logistic regression analysis showed higher levels of external blame can predict attrition during therapy; those with higher levels of external attribution are significantly more likely to leave therapy prematurely, including both during the assessment phase and during core therapy. Raven's Standard Progressive Matrices score did not significantly predict whether an individual left therapy prematurely.\u0000\u0000\u0000Originality/value\u0000Support was found for existing research within the academic evidence base. The findings have both empirical and clinical utility, suggesting during the assessment phase of therapy, practitioners can identify residents that may require additional support to maintain engagement, minimising the potential for premature departure. The implications of the findings are discussed, with suggestions made for future research.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"29 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84233879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Italian and British therapeutic communities: common threads from the 1960s to the 2010s","authors":"R. Haigh, J. Lees","doi":"10.1108/tc-10-2021-0021","DOIUrl":"https://doi.org/10.1108/tc-10-2021-0021","url":null,"abstract":"\u0000Purpose\u0000This study aims to describe Italian and UK therapeutic community developments during 1960–2021.\u0000\u0000\u0000Design/methodology/approach\u0000Historical review and personal experience.\u0000\u0000\u0000Findings\u0000After significant divergence in the nature of “therapeutic communities”, mostly based on the different sociopolitical contexts in the two countries, areas of formal rapprochement have been emerging in the past 20 years.\u0000\u0000\u0000Research limitations/implications\u0000The details of how therapeutic communities developed in Italy, particularly in the wake of Law 180, deserves investigation and comparison to the UK and other countries.\u0000\u0000\u0000Practical implications\u0000The recent collaborative work in quality, training and research could support the future use of therapeutic communities and enabling environments.\u0000\u0000\u0000Social implications\u0000The underlying principle of “relational practice”, which underlies the therapeutic community approach, could have wider implication in public services beyond mental health.\u0000\u0000\u0000Originality/value\u0000Much has been written about the progressive intentions of Italian mental health with Law 180, but not with a specific focus on therapeutic communities – which were an important initial impetus for Basaglia and his equipé.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"309 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78271451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview with RD Hinshelwood","authors":"R. Hinshelwood, G. Winship","doi":"10.1108/tc-07-2022-0010","DOIUrl":"https://doi.org/10.1108/tc-07-2022-0010","url":null,"abstract":"\u0000Purpose\u0000A one-day conference organised by the University of Essex and the Consortium of Therapeutic Communities, 10 December, 2021 with the theme, “The Unconscious and Organisations”. Presentations and discussions throughout the conference had the aim of generating ideas and sharing knowledge about the unconscious and how this can inform practitioners working in therapeutic communities and other organisations meeting the challenge of emotional distress.\u0000\u0000\u0000Design/methodology/approach\u0000Interview with Professor Robert (Bob) Hinshelwood (RH), now 83 years old, who has been involved in therapeutic communities (TCs) since 1969, part of the initial founding of the Association of Therapeutic Communities in 1974, is presented. He qualified as a psychoanalyst in 1976. In 1980 he instigated the founding of the International Journal of Therapeutic Communities along with Nick Manning, David Kennard, Jeff Roberts and Barry Shenkar. In 1984 he founded the British Journal of Psychotherapy, and edited it for 10 years. He was Director of the Cassel Hospital 1993–1997. In 1999 he founded the journal Psychoanalysis and History. He was part of the Free Associations Group (founded by Bob Young and others) which ran the journal Free Associations, and with Mike Rustin and the University of East London, the “Psychoanalysis and Public Sphere” conferences in the 1990s. He has written a great deal about the dynamics of organisational cultures in complex settings. He is Fellow of the British Psychoanalytical Society, Fellow of the Royal College of Psychiatrists and Professor Emeritus of the University of Essex. The interviewer was conducted by Dr Gary Winship (GW) is an associate professor at the University of Nottingham where he leads the MA in Trauma Informed Practice, visiting professor Moscow Institute of Psychoanalysis, and also visiting professor at the Russian State Humanities University, editor of the International Journal of Therapeutic Communities.\u0000\u0000\u0000Findings\u0000Hinshelwood reflects on the question of the unconscious and the impact of destructive tendencies on organisational process. He shares his personal experience being a young evacuee during the Second World War and considers the impact of trauma, losing his religion and his subsequent career choices in medicine, psychiatry and psychoanalysis. He discusses his experience of supervision with Isabel Menzies Lyth and reflects on the different groups in the Institute of Psychoanalysis. He turns to the question tribalism in TCs and regrets that there had not been more bridge building and collaboration. He talks about his own prolific writing and publishing career which he describes as obsessional rather than passionate, and finally candidly reflects on the prospect of facing death.\u0000\u0000\u0000Originality/value\u0000The interview was transcribed.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"115 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85360336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining influencers of treatment engagement by patients in an NHS medium-secure hospital treating high-risk offenders with personality disorder","authors":"John C Blake, Celia Taylor","doi":"10.1108/tc-07-2021-0017","DOIUrl":"https://doi.org/10.1108/tc-07-2021-0017","url":null,"abstract":"\u0000Purpose\u0000The Millfields unit is one of three medium secure hospital services on the Offender Personality Disorder (OPD) pathway, for the assessment and treatment of high-risk offenders who are likely to meet criteria for this diagnosis. This study has designed an audit to examine influencers of patient engagement within Millfields, whose treatment approach is that of an adapted therapeutic community (TC). The purpose of this study was to explore themes raised by patients in relation to engagement, drivers for and barriers to engagement and to make recommendations for improvement.\u0000\u0000\u0000Design/methodology/approach\u0000The first author engaged in ward and group observations, a review of each patient’s medical records, unstructured discussions with staff and semi-structured interviews with each patient exploring their experiences of therapy, relationships with staff, understanding of and engagement with the treatment model, attitudes towards peers and aspirations for the future. Themes were generated from the transcription of interviews and subsequent mind mapping.\u0000\u0000\u0000Findings\u0000In total, 12 of the 13 patients engaged in the semi-structured interviews. Six main themes were identified as being important influencers of engagement: the ward atmosphere, authenticity of engagement, perception of staff investment in the treatment, preferential treatment of senior residents, responses to boundary crosses and violations and the level of understanding a patient had of his treatment.\u0000\u0000\u0000Originality/value\u0000Research into engagement with psychosocial therapies in patients who have personality disorders has recently been published by Tetley et al. (2012) and Jinks et al. (2012). This study specifically focusses on TC engagement and male offenders with personality disorders.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"15 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73777842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}