Therapeutic Communities最新文献

{"title":"Therapeutic community work with people who have sexually offended: responding to developments in research and practice","authors":"R. Shuker, Lawrence F. Jones","doi":"10.1108/tc-12-2020-0023","DOIUrl":"https://doi.org/10.1108/tc-12-2020-0023","url":null,"abstract":"\u0000Purpose\u0000This paper aims to review the clinical approach adopted in prison-based therapeutic communities (TCs) for working with residents who have committed sexual offences. It reviews recent research and practice developments and explores the implications for TCs.\u0000\u0000\u0000Design/methodology/approach\u0000This paper describes a “think tank” review process which explores and reviews practice. This paper discusses the current approach adopted by TCs when working with those who have sexually offended and explores changes in clinical approach which could be considered in the light of current developments.\u0000\u0000\u0000Findings\u0000This paper explores the implications for TCs of the recent research and wider practice developments in interventions for those who have sexually offended.\u0000\u0000\u0000Practical implications\u0000This paper presents clinical options for working with those who deny their offence and undertaking victim empathy and offence disclosure work. It makes recommendations regarding staff training and support. It also discusses the strengths of the TC approach and how these can be built upon.\u0000\u0000\u0000Social implications\u0000This paper makes recommendations concerning how practice could be improved which promotes safety and public protection and enhances resident well-being.\u0000\u0000\u0000Originality/value\u0000There has been no recent review of TC clinical practice for working with those who have sexually offended.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"45 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76470949","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":"What am I seen – who do I seem? Hidden discursive processes in the large group of a TC","authors":"Z. Zalka","doi":"10.1108/tc-01-2021-0001","DOIUrl":"https://doi.org/10.1108/tc-01-2021-0001","url":null,"abstract":"\u0000Purpose\u0000The purpose of the paper is to present a possible way of discourse analysis of the meaning giving processes in a therapeutic community (TC).\u0000\u0000\u0000Design/methodology/approach\u0000Presentation of a research project, which aim is to analyse the attitudes towards the large group within the TC, is based on analysing the conceptual metaphors in semi-structured interviews.\u0000\u0000\u0000Findings\u0000The findings delineate a possible discourse, namely, the TC’s hidden discourse of working through the mirror-transference at the community level.\u0000\u0000\u0000Practical implications\u0000The paper proposes a possible content analysis method for better understanding the deep processes of the TC by examining the large group.\u0000\u0000\u0000Social implications\u0000The paper emphasizes the matrix of a TC as a mentalizing scene.\u0000\u0000\u0000Originality/value\u0000The use of linguistic methods in understanding the hidden community level mentalizing processes.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"50 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88201871","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":"Taking the therapeutic community outside in the COVID-19 pandemic","authors":"Merryn Jones, A. Howe","doi":"10.1108/TC-12-2020-0022","DOIUrl":"https://doi.org/10.1108/TC-12-2020-0022","url":null,"abstract":"\u0000Purpose\u0000The COVID-19 pandemic has affected psychotherapy practice. A common change is a move to online sessions over video calls. In their therapeutic community (TC) for those with personality disorders, the authors have used video calls but not all clients could work in this way. The authors decided to meet patients outside and walked with them while adhering to government guidelines. This study aims to present the authors’ experience with one client who was interviewed afterwards about the experience.\u0000\u0000\u0000Design/methodology/approach\u0000A total of 10 walking therapy sessions of 60-min duration were conducted with the patient. After the sessions, both the patient and therapist were interviewed about their experience. The resulting interviews with both patient and therapist were thematically analysed independently by both authors.\u0000\u0000\u0000Findings\u0000There were common themes to both the client and therapist’s account following thematic analysis. These were: modelling and normalising in the real world, replacing what COVID-19 had taken away from the TC experience, changes at home, therapist disclosure, outcomes and good endings and being outside of the clinical environment.\u0000\u0000\u0000Research limitations/implications\u0000The authors have presented a single case of the patient and therapist experience of outdoor therapy sessions in a TC context response to the COVID-19 pandemic. The findings are not generalisable and can only provide a suggestion at the positive potential for working in this way. The authors hope that the positive effects of outdoor therapy noted here may inspire other clinicians to consider similar novel approaches in their work.\u0000\u0000\u0000Originality/value\u0000This study describes a novel way that a TC has adapted to the COVID-19 pandemic.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"38 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84403728","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":"The complexity of the therapeutic experience within the therapeutic community based on an ex-patient’s account","authors":"D. Ivanova, A. Howe, Patricia A. Burns, Merryn Jones","doi":"10.1108/TC-11-2020-0021","DOIUrl":"https://doi.org/10.1108/TC-11-2020-0021","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to explore the effectiveness of the therapeutic community and to look at the potential changes that some patients may experience following treatment at the therapeutic communities (TC).\u0000\u0000\u0000Design/methodology/approach\u0000A thematic analysis was conducted on an e-mail sent by an ex-patient of the TC. The text was reviewed multiple times and codes were generated. Based on the data found, three themes were identified. The e-mail was sent to the patient’s primary therapist, who was asked to provide an account of the e-mail. The therapist was sent six questions created by the authors of the paper; the responses were used to compare the two perspectives.\u0000\u0000\u0000Findings\u0000The main findings entailed the changes the patient went through after her treatment at the TC. The patient’s account described her inability to process the adversities she had been through at the time and therefore her inability to communicate them. However, the impact the service had on the patient, according to the e-mail was evident years later. The lack of a support network during treatment at the TC and evidence of one following treatment seemed to be the key factor in the patient’s improvement.\u0000\u0000\u0000Originality/value\u0000The authors confirm that the research presented in this paper is their original work. The authors hereby acknowledge that all material included in this piece of work, that has been published or written by another person has been referenced accordingly.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72762673","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":"How Brazilian therapeutic communities are facing COVID-19?","authors":"Pablo Kurlander, Antony Tomaz Diniz, G. Godoy, Katia Isicawa de Sousa Barreto, Lewis MacDonald-Winship","doi":"10.1108/TC-01-2021-0004","DOIUrl":"https://doi.org/10.1108/TC-01-2021-0004","url":null,"abstract":"Purpose: This paper aims to reflect upon the findings of a fast-track study carried out in April 2020, by the Brazilian Federation of Therapeutic Communities, focused on the impact of the first measures taken by the Brazilian therapeutic communities (TCs) in response to COVID-19 Design/methodology/approach: An electronic survey was disseminated to TCs in the different regions of Brazil through online platforms A total of 144 TCs responses were used in the final analysis The survey collected the following information: suspected and confirmed cases of COVID-19 (only one case of COVID-19 was confirmed), changes in treatment protocols, the impact in admissions and daily activities and the safety measures adopted to stop or reduce the transmission between residents, families and staff Findings: The survey successfully collected general data regarding interruptions (82 6% of TCs interrupted admissions, 100% of TCs interrupted volunteer’s activities, 94% of TCs interrupted family visits and 93% of TCs interrupted external activities) Research limitations/implications: The caveat of this study is the fact that there were tight deadlines for the TCs to generate their responses and the limited availability of staff to answer long surveys Because of this, the study could not explore other important qualitative data The results were shared in Brazil and Latin America with the staff of TCs, the national Federations of Therapeutic Communities and government agencies linked with them, in all Latin America Originality/value: This research aims to contribute to the adoption of developed prophylaxis and prevention protocols in response to COVID-19 © 2021, Emerald Publishing Limited","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"39 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80794590","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":"The therapist, the group and I: how therapeutic alliance moderates the effect of group cohesion on outcomes","authors":"Sofia Vicente, L. I. Ferreira, A. Jiménez-Ros, Cláudia Carmo, L. Janeiro","doi":"10.1108/TC-09-2020-0020","DOIUrl":"https://doi.org/10.1108/TC-09-2020-0020","url":null,"abstract":"\u0000Purpose\u0000This study aims to investigate whether the influence of group cohesion on the outcomes depended on the levels of the therapeutic alliance.\u0000\u0000\u0000Design/methodology/approach\u0000Sixteen individuals with a substance use disorder who were undergoing treatment in a therapeutic community responded to therapeutic alliance, group cohesion, craving and outcomes measures after every therapeutic small group session for a period of six weeks. Data analysis was performed using hierarchical linear modeling.\u0000\u0000\u0000Findings\u0000Results indicate that the effect of group cohesion is stronger when there is a high therapeutic alliance between resident and therapist.\u0000\u0000\u0000Originality/value\u0000Even on group interventions, to enhance group cohesion effects on outcomes, therapists must foster higher therapeutic alliance levels. The findings point out the importance of studying the effect of common factors on outcomes.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82246233","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":"Effective factors of addiction treatment communities in Peru, Nicaragua and Czechia","authors":"M. Horák, K. Somerlíková, R. Kočárová, N. Verter, Hector Santiago Aldama Gonzalez, Mariah Cruz de Souza Tronco","doi":"10.1108/TC-06-2020-0013","DOIUrl":"https://doi.org/10.1108/TC-06-2020-0013","url":null,"abstract":"\u0000Purpose\u0000This paper aims to explore the effective factors that influence the treatment of drug addiction in therapeutic communities (TCs) and to determine its essential elements in the Peruvian, Nicaraguan and Czech context.\u0000\u0000\u0000Design/methodology/approach\u0000The qualitative data were collected during semi-structured interviews with inpatients/clients of seven TCs based in Peru (Takiwasi), Nicaragua (Centro de Especialiades en Adicciones, Centro de Rehabilitación del Alcohólico y Adicto a Otras Drogas and Albergue de Miembros Adictos en Recuperación) and the Czech Republic (Renarkon, Sejrek and Kladno-Dubi). All 90 interviews were manually transcribed, and content analysis was performed. Codes were created using the grounded theory method.\u0000\u0000\u0000Findings\u0000The effective factors of TC, treatment in Peru, Nicaragua and Czechia are identical in conditions such as the presence of a personal therapist, the use of psychotherapy and the importance of group cohesion. In Peru, the administration of medicinal plants and diet was perceived as a principal part of the treatment. Nicaraguan TCs were specific for practicing 12 steps. In Czechia, an emphasis is put on the therapeutic program, workshops and leisure activities. Spirituality and religion play a main role in the Peruvian and Nicaraguan TCs only.\u0000\u0000\u0000Originality/value\u0000The current study presents a unique insight into the factors considered effective by inpatients/clients of TCs in different socio-cultural contexts.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"159 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73476517","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":"Correlates of motivation for treatment among alcohol service users in Uganda","authors":"David Kalema, L. V. Damme, Sofie Vindevogel, I. Derluyn, P. Baguma, W. Vanderplasschen","doi":"10.1108/TC-04-2020-0004","DOIUrl":"https://doi.org/10.1108/TC-04-2020-0004","url":null,"abstract":"\u0000Purpose\u0000Given the scarce literature on alcohol use disorders (AUD) and their treatment in developing countries, this paper aims to explore motivation levels and their correlates among alcohol service users in two residential treatment centres in Kampala, Uganda. This study how motivation levels of Ugandan alcohol service users compare with those from American studies; and the specific factors affecting internal and external motivation in the Ugandan context.\u0000\u0000\u0000Design/methodology/approach\u0000The motivation for treatment was measured among 100 individuals entering AUD treatment using the Texas Christian University (TCU) Treatment needs and Motivation scale. The WHOQoL–BREF, Addiction Severity Index–6 and Hopkins Symptoms Check List–37 were used to measure addiction severity, quality of life (QoL) and psychopathology, respectively. Correlates of motivation were identified using linear regression analyses.\u0000\u0000\u0000Findings\u0000Ugandan service users demonstrated low treatment motivation in the treatment needs a domain. While addiction severity (recent heavy alcohol use) and participating in private treatment were associated with higher internal and external motivation, deterioration in physical and environmental QoL, depressive symptoms and lower education were linked with higher internal motivation.\u0000\u0000\u0000Research limitations/implications\u0000Different elements affect domains of treatment motivation, requiring attention for clients’ unique needs as influenced by their background, addiction severity, QoL, psychological needs and contextual factors (e.g. treatment setting). Further studies are needed to explore additional correlates of motivation for treatment among alcohol service users in Uganda and to assess the longitudinal impact of motivation on treatment outcomes.\u0000\u0000\u0000Originality/value\u0000Although motivation has been extensively studied, clinicians are challenged in understanding and explaining motivational dynamics given the multiplicity of factors influencing change-related decisions and behaviours and the diversity in substance-using populations. This need is even bigger in non-Western societies as cultural differences may require differential therapeutic management. This is one of the first studies measuring motivation for AUD treatment in a low-income country and offers insight for understanding motivation dynamics in similar settings.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"51 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86480400","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":"Transcultural transferability of transient therapeutic communities: the living-learning experience workshops","authors":"J. Lees, R. Haigh, S. Bruschetta, A. Chatterji, Veronica Dominguez-Bailey, Sandra Kelly, Aldo Lombardo, Shama Parkhe, J. Pereira, Y. Rahimi, B. Rawlings","doi":"10.1108/tc-06-2019-0006","DOIUrl":"https://doi.org/10.1108/tc-06-2019-0006","url":null,"abstract":"\u0000Purpose\u0000This paper aims to describe a method of training for practitioners in democratic Therapeutic Communities (TCs) which has been used in several settings across the world over the past 25 years: the “Living-Learning Experience” (LLE) workshop. It goes on to consider the cross-cultural implications of the work.\u0000\u0000\u0000Design/methodology/approach\u0000Drawing on the experience of running exactly the same programme in different countries and cultures, the paper examines the cross-cultural adaptability and describes necessary adaptations for local circumstances. It also contains original ethnographic research in UK and Italy; further study is planned for other countries.\u0000\u0000\u0000Findings\u0000The workshops are readily transferable to different cultures and are appreciated for their democratic and relational way of working.\u0000\u0000\u0000Research limitations/implications\u0000The ethnographic study examines the workshops in some depth, in UK and Italy, and could usefully be replicated in other countries. No quantitative, outcome or follow-up studies have yet been done, and this paper could contribute to the design of useful quantitative studies.\u0000\u0000\u0000Practical implications\u0000The paper demonstrates that the LLE is a useful experiential learning tool in widely different settings. It could be developed in different ways, such as for developing relational practice or establishing therapeutic environments in different settings.\u0000\u0000\u0000Social implications\u0000The workshops' acceptance in widely different cultures indicates that the open and non-didactic format addresses essential and fundamental qualities required for therapeutic engagement and human relatedness.\u0000\u0000\u0000Originality/value\u0000This is the first description of the principles of democratic TCs being applied across different international settings. Its value extends beyond the TC field, to the use of democratic and relational principles' applicability in therapeutic pedagogy and training.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"44 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75897030","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":"“Act-as-if you are infected and infectious”: what has the global therapeutic community movement learnt from COVID-19?","authors":"H. Gosling, Rowdy Yates","doi":"10.1108/tc-07-2020-0017","DOIUrl":"https://doi.org/10.1108/tc-07-2020-0017","url":null,"abstract":"Purpose - The purpose of this paper is twofold: to reflect upon what the global therapeutic community (TC) movement has learnt from coronavirus and to consider how TCs will continue to adapt and evolve in a post-pandemic climate Design/methodology/approach - This is a viewpoint paper based on the authors' participation in an international learning event whereby speakers from TCs from around the world spoke about how they adapted their services to overcome adversity Findings - The findings are usefully thought out as shelter, creativity, reintegration and employment, technology and roots Based on the material discussed in the learning event, it would seem that the global TC movement has engaged in a process of looking to the past to move forward by drawing upon founding principles and prescriptions of the TC tradition, rooted in humanistic and indeed humanitarian responses to staff, client and sociocultural needs Originality/value - According to the author, this paper is one of the first attempts to capture how TCs from across the globe have responded to the threat of coronavirus","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"32 1","pages":"129-135"},"PeriodicalIF":0.2,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79574798","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}