Purpose As Clinical Psychologists working in a tertiary Intellectual Disability (ID) service in the UK, this paper aims to address the impact of Covid-19 – and the subsequent transition out of Covid-19 restrictions – on individuals with an ID, and the clinicians working alongside them. Additionally, the paper reflects upon how Covid-19 has shaped and manipulated therapeutic communities and environments. Design/methodology/approach This paper is reflective in nature and reviews current evidence associated with how people with an ID experienced the impact of Covid-19. Clinicians reflect upon their shared experience in line with this evidence. Findings This paper highlights perpetuating inequalities and injustices on people with an ID as a result of Covid-19. Further, it is indicated that that there should be consideration of how people with an intellectual disability experience transitions back to their day-to-day environments and encourages clinicians to widely consider how to shape therapeutic communities and environments. Originality/value Multiple themes have been addressed in this paper, and the reflections add to an understanding of how those individuals specifically working in, or using intellectual disability services, have experienced the Covid-19 pandemic, though a critical lens.
{"title":"The impact of COVID-19 on people with intellectual disabilities","authors":"Katie Warner, Cathryn Marrington","doi":"10.1108/tc-11-2021-0023","DOIUrl":"https://doi.org/10.1108/tc-11-2021-0023","url":null,"abstract":"\u0000Purpose\u0000As Clinical Psychologists working in a tertiary Intellectual Disability (ID) service in the UK, this paper aims to address the impact of Covid-19 – and the subsequent transition out of Covid-19 restrictions – on individuals with an ID, and the clinicians working alongside them. Additionally, the paper reflects upon how Covid-19 has shaped and manipulated therapeutic communities and environments.\u0000\u0000\u0000Design/methodology/approach\u0000This paper is reflective in nature and reviews current evidence associated with how people with an ID experienced the impact of Covid-19. Clinicians reflect upon their shared experience in line with this evidence.\u0000\u0000\u0000Findings\u0000This paper highlights perpetuating inequalities and injustices on people with an ID as a result of Covid-19. Further, it is indicated that that there should be consideration of how people with an intellectual disability experience transitions back to their day-to-day environments and encourages clinicians to widely consider how to shape therapeutic communities and environments.\u0000\u0000\u0000Originality/value\u0000Multiple themes have been addressed in this paper, and the reflections add to an understanding of how those individuals specifically working in, or using intellectual disability services, have experienced the Covid-19 pandemic, though a critical lens.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"47 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85784379","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}
Purpose This pilot study aims to assess the feasibility of conducting shared philosophical inquiry with women at risk of re-offending to improve motivation to change. The philosophy sessions aimed to give participants new ways to think about their lives and to help them have more control over their own mind by learning new ways to think differently. Design/methodology/approach The pilot study adopted a mixed-methods approach to collect and analyse data pre- and post-intervention. Ten women serving a custodial sentence at the Democratic Therapeutic Community (DTC) in HMP Send were recruited to take part in ten weekly sessions of philosophical discussion. The intervention was adjunctive and not meant to replace other treatments an inmate may already be receiving. Findings The results showed that most participants experienced improved levels of well-being and mental health post-intervention, and that the intervention has the potential to help participants better critically assess their own behaviour and ways of thinking. It also suggested that the intervention has the potential to help participants engage more effectively with the therapeutic process. Research limitations/implications The results of this study are limited by the small sample size and the lack of a control group. As such this study cannot rule out that the changes observed in participants were a function of time or the specific therapeutic environment they were in (or both). Originality/value This pilot study is innovative not just for introducing philosophy classes to the women’s prison estate for the first time in England and Wales, but also in its ambition to contribute to the “what works” agenda in offender rehabilitation.
{"title":"Me-thinking: report on a pilot intervention with women in custody","authors":"Isabel Góis, E. Kane","doi":"10.1108/tc-11-2021-0024","DOIUrl":"https://doi.org/10.1108/tc-11-2021-0024","url":null,"abstract":"\u0000Purpose\u0000This pilot study aims to assess the feasibility of conducting shared philosophical inquiry with women at risk of re-offending to improve motivation to change. The philosophy sessions aimed to give participants new ways to think about their lives and to help them have more control over their own mind by learning new ways to think differently.\u0000\u0000\u0000Design/methodology/approach\u0000The pilot study adopted a mixed-methods approach to collect and analyse data pre- and post-intervention. Ten women serving a custodial sentence at the Democratic Therapeutic Community (DTC) in HMP Send were recruited to take part in ten weekly sessions of philosophical discussion. The intervention was adjunctive and not meant to replace other treatments an inmate may already be receiving.\u0000\u0000\u0000Findings\u0000The results showed that most participants experienced improved levels of well-being and mental health post-intervention, and that the intervention has the potential to help participants better critically assess their own behaviour and ways of thinking. It also suggested that the intervention has the potential to help participants engage more effectively with the therapeutic process.\u0000\u0000\u0000Research limitations/implications\u0000The results of this study are limited by the small sample size and the lack of a control group. As such this study cannot rule out that the changes observed in participants were a function of time or the specific therapeutic environment they were in (or both).\u0000\u0000\u0000Originality/value\u0000This pilot study is innovative not just for introducing philosophy classes to the women’s prison estate for the first time in England and Wales, but also in its ambition to contribute to the “what works” agenda in offender rehabilitation.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"78 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79300936","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}
Purpose The learning from action (LfA) workshop was born more than 20 years ago and held in various places in Italy. This study aims to provide a learning experience for therapeutic communities (TCs) workers. During these years, the LfA work has developed by creating a dialogue between the experiential conferences and the group relations conferences (GRC) run by the Tavistock Institute. In this paper, the author explores the dialogue between (the leadership-oriented) GRC and (democratic) TC culture. Design/methodology/approach The authors intend to show how this dialogue has developed in LfA, describing tasks, purposes and critical aspects of LfA specific events: decision-making plenary, decision-making, TCs, action, dialog between cultures, GRC, learning methodology, decision-making group, activity group, morning and evening community meetings. Findings The authors confirmed the idea that acting and working together is a way of learning and communicating with each other. The role activities and works the authors do together to provide for the community in LfA have a more authentic quality of life than the purely verbal reflective work of a GRC. Originality/value The paper describes how LfA has developed and consolidated over the years, constituting an original learning model inspired by the typical activities of the culture of democratic TCs and the learning methodology of GRCs.
{"title":"The learning from action (LfA) programme: reflections on how it has evolved","authors":"Giada Boldetti, Luca Mingarelli","doi":"10.1108/tc-12-2021-0025","DOIUrl":"https://doi.org/10.1108/tc-12-2021-0025","url":null,"abstract":"\u0000Purpose\u0000The learning from action (LfA) workshop was born more than 20 years ago and held in various places in Italy. This study aims to provide a learning experience for therapeutic communities (TCs) workers. During these years, the LfA work has developed by creating a dialogue between the experiential conferences and the group relations conferences (GRC) run by the Tavistock Institute. In this paper, the author explores the dialogue between (the leadership-oriented) GRC and (democratic) TC culture.\u0000\u0000\u0000Design/methodology/approach\u0000The authors intend to show how this dialogue has developed in LfA, describing tasks, purposes and critical aspects of LfA specific events: decision-making plenary, decision-making, TCs, action, dialog between cultures, GRC, learning methodology, decision-making group, activity group, morning and evening community meetings.\u0000\u0000\u0000Findings\u0000The authors confirmed the idea that acting and working together is a way of learning and communicating with each other. The role activities and works the authors do together to provide for the community in LfA have a more authentic quality of life than the purely verbal reflective work of a GRC.\u0000\u0000\u0000Originality/value\u0000The paper describes how LfA has developed and consolidated over the years, constituting an original learning model inspired by the typical activities of the culture of democratic TCs and the learning methodology of GRCs.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"66 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85795462","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}
Oluyinka Olutola Olajire, Isaac Akintoyese Oyekola;
Purpose The purpose of this study is to subject faith-based organizations (FBOs)-operated social reintegration programs for recovering drug addicts to scrutiny to understand their effectiveness in addressing the three-pillar social needs. Design/methodology/approach Using concurrent mixed methods research design, a sample size of 156 respondents, 15 in-depth interviewees and 12 key informants was selected purposely from three FBOs and three National Drug Law Enforcement Agency (NDLEA) State Command Areas in Nigeria. Data were collected using questionnaire survey, interviews, observation and document review, and then analyzed using descriptive and content analyses. Findings Findings showed nine different noncore social reintegration programs for recovering drug-addicts with different required rates of participation and diverse purposes. Also, the results showed that the three-pillar social needs of recovering drug addicts for successful reintegration into the society were not provided for by the FBOs. Finally, findings showed that majority of the respondents were only slightly satisfied with the overall services rendered at the selected FBOs, and these services were not properly monitored by relevant government agency. Social implications Appropriate regulations that will check and balance the activities of treatment providers involved in social reintegration is recommended to achieve optimal level of physical, psychological and social health for recovering drug addicts. Originality/value To the best of the authors’ knowledge ,this is a pioneer study that investigated faith-based social reintegration programs for recovering drug addicts in Nigeria.
{"title":"Inquiry into faith-based social reintegration programs for recovering drug addicts in Nigeria","authors":"Oluyinka Olutola Olajire, Isaac Akintoyese Oyekola;","doi":"10.1108/tc-09-2021-0020","DOIUrl":"https://doi.org/10.1108/tc-09-2021-0020","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to subject faith-based organizations (FBOs)-operated social reintegration programs for recovering drug addicts to scrutiny to understand their effectiveness in addressing the three-pillar social needs.\u0000\u0000\u0000Design/methodology/approach\u0000Using concurrent mixed methods research design, a sample size of 156 respondents, 15 in-depth interviewees and 12 key informants was selected purposely from three FBOs and three National Drug Law Enforcement Agency (NDLEA) State Command Areas in Nigeria. Data were collected using questionnaire survey, interviews, observation and document review, and then analyzed using descriptive and content analyses.\u0000\u0000\u0000Findings\u0000Findings showed nine different noncore social reintegration programs for recovering drug-addicts with different required rates of participation and diverse purposes. Also, the results showed that the three-pillar social needs of recovering drug addicts for successful reintegration into the society were not provided for by the FBOs. Finally, findings showed that majority of the respondents were only slightly satisfied with the overall services rendered at the selected FBOs, and these services were not properly monitored by relevant government agency.\u0000\u0000\u0000Social implications\u0000Appropriate regulations that will check and balance the activities of treatment providers involved in social reintegration is recommended to achieve optimal level of physical, psychological and social health for recovering drug addicts.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge ,this is a pioneer study that investigated faith-based social reintegration programs for recovering drug addicts in Nigeria.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"48 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91256022","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}
Purpose 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. Design/methodology/approach 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. Findings In this conceptualization, the authors explained that the TC becomes a co-agent in between the phrases 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. Originality/value 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.
{"title":"Unboxing the therapeutic community for addictions: a locus-of-hope theory perspective","authors":"Sixtus Dane A Ramos, Allan B. I. Bernardo","doi":"10.1108/tc-03-2021-0009","DOIUrl":"https://doi.org/10.1108/tc-03-2021-0009","url":null,"abstract":"\u0000Purpose\u0000The 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.\u0000\u0000\u0000Design/methodology/approach\u0000This 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.\u0000\u0000\u0000Findings\u0000In this conceptualization, the authors explained that the TC becomes a co-agent in between the phrases 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.\u0000\u0000\u0000Originality/value\u0000This 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.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"67 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82852759","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}
Purpose COVID-19 pandemic is affecting the well-being and the psychological resilience of different populations, particularly in the addiction field. This study aims to assess anxiety and its severity among patients and staff from different types of addiction services in Israel during this emergency. Design/methodology/approach The study was conducted during the period from March–July 2020. Participants included patients and staff (N = 282) from three different types of addiction services, were administered the State-Trait Anxiety Inventory, the multi-dimensional scale of perceived social support and demographic variables. In addition, a logistic regression model was applied to identify predictors of state anxiety by using statistical package for the social sciences software. Findings The results show that therapeutic communities clients reported more social support compared to other subjects. State anxiety has a positive strong correlation with trait anxiety both among patients and staff, and it was found as a crucial predictor of state anxiety in the regression equation. There is no statistically significant correlation between state anxiety and social support, gender or education among clients and staff as one. The state anxiety remains relatively stable and characterizes most people, staff and patients, men and women, medical staff members and other professionals. Research limitations/implications The current study has some contributions to the addiction field by understanding the psychological distress of a vulnerable population: substance users in treatment settings. The study population relied on convenient samples and future studies should be planned using a cross-sectional design and should take into account substance use measures. The findings are reinforcing the assumption that state anxiety was likely to increase during the coronavirus pandemic. Practical implications Adequate services should be planned to avoid relapse or mental deterioration of people who use drugs during health emergencies. Originality/value The research points out the unique and real difficulties of SUD clients, as well as the complexity and risks in their staff members’ works. The authors also saw that staff members need attention and maintenance; they are in the front line.
{"title":"The difference between inpatient and outpatient programs regarding trait -anxiety, social support and state-anxiety in during the covid-19 pandemic in Israel","authors":"Amnon Michael, Paola Roska","doi":"10.1108/tc-03-2021-0008","DOIUrl":"https://doi.org/10.1108/tc-03-2021-0008","url":null,"abstract":"\u0000Purpose\u0000COVID-19 pandemic is affecting the well-being and the psychological resilience of different populations, particularly in the addiction field. This study aims to assess anxiety and its severity among patients and staff from different types of addiction services in Israel during this emergency.\u0000\u0000\u0000Design/methodology/approach\u0000The study was conducted during the period from March–July 2020. Participants included patients and staff (N = 282) from three different types of addiction services, were administered the State-Trait Anxiety Inventory, the multi-dimensional scale of perceived social support and demographic variables. In addition, a logistic regression model was applied to identify predictors of state anxiety by using statistical package for the social sciences software.\u0000\u0000\u0000Findings\u0000The results show that therapeutic communities clients reported more social support compared to other subjects. State anxiety has a positive strong correlation with trait anxiety both among patients and staff, and it was found as a crucial predictor of state anxiety in the regression equation. There is no statistically significant correlation between state anxiety and social support, gender or education among clients and staff as one. The state anxiety remains relatively stable and characterizes most people, staff and patients, men and women, medical staff members and other professionals.\u0000\u0000\u0000Research limitations/implications\u0000The current study has some contributions to the addiction field by understanding the psychological distress of a vulnerable population: substance users in treatment settings. The study population relied on convenient samples and future studies should be planned using a cross-sectional design and should take into account substance use measures. The findings are reinforcing the assumption that state anxiety was likely to increase during the coronavirus pandemic.\u0000\u0000\u0000Practical implications\u0000Adequate services should be planned to avoid relapse or mental deterioration of people who use drugs during health emergencies.\u0000\u0000\u0000Originality/value\u0000The research points out the unique and real difficulties of SUD clients, as well as the complexity and risks in their staff members’ works. The authors also saw that staff members need attention and maintenance; they are in the front line.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"79 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75296896","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}
Purpose This paper aims to present results achieved by the first, and to date only, Democratic Therapeutic Communities (DTC) quality improvement program developed in Italy, in the past 10 years, named “Visiting DTC Project.” Process of bottom-up identification, definition and evaluation of good practices of TCs for adult users with long term severe mental disorders will be described. In addition, a five-phase clinical care pathway will be presented for the same user category, developed by the “Visiting DTC Project” to comply with Italian National Health Service accreditation standards for TCs. Design/methodology/approach “Visiting DTC Project” involved 40 Italian TCs, since 2012 until 2020, in an action research on good practices developed throw a democratic and bottom-up methodology. Project’s methodology is the “Democratic Peer-to-peer Accreditation,” a kind of professional scientific quality accreditation and continuous improvement process for community mental health services. Scientific model for the definition of service standards and principles of treatment is the British “Democratic Therapeutic Community,” which the “Visiting DTC Project” is organizationally inspired by. Findings In the eighth annual cycle of the program for TC with adult users of mental health services a significantly effective good practice procedure (GPP), with good practical efficacy, was finally identified (for the first time after eight years), but still no best practice. GPP with the title “Multi-family Community Meeting” is the Good Practice of the year 2020. No Best Practice has yet been identified. An integrated clinical care pathway for Adult DTCs Users in five phases is also presented. This care pathway organizes advanced standards of Community Group Quality in a map, to support the description and planning of the five phases of the user’s clinical work in DTC treatment. Originality/value Cooperation with local community services, organizations and networks, as well as a therapeutic environment based on informal coexistence and cooperation between TC members, are thus, together with care of family relationships, the main characteristics of the Italian experience of implementing and developing the Italian DTC treatment model. These characteristics make it clear how fragile Italian DTCs are at this moment. They are still in an early stage of development. All the most applied and effective best practice procedures are dependent on a wide and dense network of relationships, formal and informal, which cross the therapeutic environment and interconnect TC members with all other stakeholders.
{"title":"Good practices in Italian therapeutic communities. Outcomes 2020 of quality accreditation program “Visiting DTC Project”","authors":"S. Bruschetta","doi":"10.1108/tc-07-2021-0013","DOIUrl":"https://doi.org/10.1108/tc-07-2021-0013","url":null,"abstract":"\u0000Purpose\u0000This paper aims to present results achieved by the first, and to date only, Democratic Therapeutic Communities (DTC) quality improvement program developed in Italy, in the past 10 years, named “Visiting DTC Project.” Process of bottom-up identification, definition and evaluation of good practices of TCs for adult users with long term severe mental disorders will be described. In addition, a five-phase clinical care pathway will be presented for the same user category, developed by the “Visiting DTC Project” to comply with Italian National Health Service accreditation standards for TCs.\u0000\u0000\u0000Design/methodology/approach\u0000“Visiting DTC Project” involved 40 Italian TCs, since 2012 until 2020, in an action research on good practices developed throw a democratic and bottom-up methodology. Project’s methodology is the “Democratic Peer-to-peer Accreditation,” a kind of professional scientific quality accreditation and continuous improvement process for community mental health services. Scientific model for the definition of service standards and principles of treatment is the British “Democratic Therapeutic Community,” which the “Visiting DTC Project” is organizationally inspired by.\u0000\u0000\u0000Findings\u0000In the eighth annual cycle of the program for TC with adult users of mental health services a significantly effective good practice procedure (GPP), with good practical efficacy, was finally identified (for the first time after eight years), but still no best practice. GPP with the title “Multi-family Community Meeting” is the Good Practice of the year 2020. No Best Practice has yet been identified. An integrated clinical care pathway for Adult DTCs Users in five phases is also presented. This care pathway organizes advanced standards of Community Group Quality in a map, to support the description and planning of the five phases of the user’s clinical work in DTC treatment.\u0000\u0000\u0000Originality/value\u0000Cooperation with local community services, organizations and networks, as well as a therapeutic environment based on informal coexistence and cooperation between TC members, are thus, together with care of family relationships, the main characteristics of the Italian experience of implementing and developing the Italian DTC treatment model. These characteristics make it clear how fragile Italian DTCs are at this moment. They are still in an early stage of development. All the most applied and effective best practice procedures are dependent on a wide and dense network of relationships, formal and informal, which cross the therapeutic environment and interconnect TC members with all other stakeholders.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"111 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79297082","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}
Purpose The purpose of this study is to investigate which emotions and difficulties in the emotional regulation of adolescents with illicit substance consumption. Design/methodology/approach In total, 41 adolescents undergoing treatment for the use of alcohol and drugs were recruited. The instruments used were the emotional rating scale and the difficulties in the regulation of emotions scale. Findings Emotional reactivity showed significant differences in the sadness dimension in relation to the number of cannabis cigarettes smoked daily and length of stay, and in the surprise dimension in relation to the number of cannabis cigarettes smoked daily. There was a significant correlation between happiness and age, surprise and number of siblings, sadness and school absenteeism and fear, school absenteeism and number of substances consumed. In regard to difficulties in emotional regulation, there were significant differences between the groups, in strategies regarding the gender of the participants and the number of substances consumed, in non-acceptance and impulses and in the number of substances consumed and in the awareness of the type and number of substances consumed. There was a significant correlation between strategies, non-acceptance, awareness and impulses and the number of substances consumed. Originality/value This study demonstrated that the emotional problems of adolescents admitted to a therapeutic community are predictors of illicit substance use.
{"title":"Emotional reactivity and difficulties in emotional regulation in drug users: a study in adolescents undergoing treatment in a therapeutic community","authors":"Lídia Serra, Luís Silva, D. Vilar","doi":"10.1108/tc-08-2021-0018","DOIUrl":"https://doi.org/10.1108/tc-08-2021-0018","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to investigate which emotions and difficulties in the emotional regulation of adolescents with illicit substance consumption.\u0000\u0000\u0000Design/methodology/approach\u0000In total, 41 adolescents undergoing treatment for the use of alcohol and drugs were recruited. The instruments used were the emotional rating scale and the difficulties in the regulation of emotions scale.\u0000\u0000\u0000Findings\u0000Emotional reactivity showed significant differences in the sadness dimension in relation to the number of cannabis cigarettes smoked daily and length of stay, and in the surprise dimension in relation to the number of cannabis cigarettes smoked daily. There was a significant correlation between happiness and age, surprise and number of siblings, sadness and school absenteeism and fear, school absenteeism and number of substances consumed. In regard to difficulties in emotional regulation, there were significant differences between the groups, in strategies regarding the gender of the participants and the number of substances consumed, in non-acceptance and impulses and in the number of substances consumed and in the awareness of the type and number of substances consumed. There was a significant correlation between strategies, non-acceptance, awareness and impulses and the number of substances consumed.\u0000\u0000\u0000Originality/value\u0000This study demonstrated that the emotional problems of adolescents admitted to a therapeutic community are predictors of illicit substance use.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"103 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80636086","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}
Pub Date : 2021-12-02Epub Date: 2021-11-26DOI: 10.1108/tc-03-2021-0007
Keith Leverett Warren, Nathan Doogan, Uwe Wernekinck, Fiona Claire Doherty
Purpose –: While recent years have seen a number of studies of social networks in therapeutic communities (TCs) and other residential settings, these have primarily focused on male residents. This paper aims to conduct a longitudinal social network analysis of interpersonal interactions in a TC for women.
Design/methodology/approach –: The data consists of a longitudinal directed social network of instances of feedback between 56 residents of a 16 bed TC for women over a period of 611 days. Mean age of the participants was 33.1 years, mean length of stay was 133.9 days and 91% of the participants were female. Feedback consisted of written affirmations for prosocial behavior and written corrections for contravening TC norms. Data was analyzed using a latent factor longitudinal social network model.
Findings –: Residents react to peer intervention in complex ways. Residents reciprocated affirmations (B = 0.14, 95% confidence interval = 0.10, 0.18) and corrections (B = 0.20, 95% CI = 0.13, 0.25). Controlling for reciprocity, participants who received affirmations were more likely to affirm and correct peers (B = 0.10, 95% CI = 0.06, 0.15; B = 0.17, 95% CI = 0.10, 0.23), suggesting that the encouragement offered by affirmations leads to increased activity. Homophily by admission time occurred in both affirmations and corrections (B = 0.23, 95% CI = 0.10, 0.37; B = 0.51, 95% CI = 0.29, 0.74).
Originality/value –: While affirmations and corrections serve as vehicles for behavioral reinforcement and social learning, they also allow residents to interact in ways that strengthen social bonds.
{"title":"Resident interactions when affirming and correcting peers in a therapeutic community for women.","authors":"Keith Leverett Warren, Nathan Doogan, Uwe Wernekinck, Fiona Claire Doherty","doi":"10.1108/tc-03-2021-0007","DOIUrl":"10.1108/tc-03-2021-0007","url":null,"abstract":"<p><strong>Purpose –: </strong>While recent years have seen a number of studies of social networks in therapeutic communities (TCs) and other residential settings, these have primarily focused on male residents. This paper aims to conduct a longitudinal social network analysis of interpersonal interactions in a TC for women.</p><p><strong>Design/methodology/approach –: </strong>The data consists of a longitudinal directed social network of instances of feedback between 56 residents of a 16 bed TC for women over a period of 611 days. Mean age of the participants was 33.1 years, mean length of stay was 133.9 days and 91% of the participants were female. Feedback consisted of written affirmations for prosocial behavior and written corrections for contravening TC norms. Data was analyzed using a latent factor longitudinal social network model.</p><p><strong>Findings –: </strong>Residents react to peer intervention in complex ways. Residents reciprocated affirmations (B = 0.14, 95% confidence interval = 0.10, 0.18) and corrections (B = 0.20, 95% CI = 0.13, 0.25). Controlling for reciprocity, participants who received affirmations were more likely to affirm and correct peers (B = 0.10, 95% CI = 0.06, 0.15; B = 0.17, 95% CI = 0.10, 0.23), suggesting that the encouragement offered by affirmations leads to increased activity. Homophily by admission time occurred in both affirmations and corrections (B = 0.23, 95% CI = 0.10, 0.37; B = 0.51, 95% CI = 0.29, 0.74).</p><p><strong>Originality/value –: </strong>While affirmations and corrections serve as vehicles for behavioral reinforcement and social learning, they also allow residents to interact in ways that strengthen social bonds.</p>","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"42 4","pages":"137-148"},"PeriodicalIF":0.2,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to understand if the use of acute services was also affected via a service evaluation project. Design/methodology/approach The authors collected data from electronic records on the use of local services in the two years before, during and the two years after treatment in the TC. Specifically, the authors counted inpatient bed days, Emergency department (ED) presentations and days under home treatment team and liaison psychiatry; the authors used ANOVA to analyse the data. Findings The study included 25 adult service users, 17 female and 8 male, with an average age of 40. Whilst there were reductions in the use of inpatient beds and ED presentations, on analysis, these were not found statistically significant. The small size of the study is a limitation and may limit the generalisability of the findings. The study concludes there may be reductions in acute psychiatric service use during and after treatment in the TC. The findings were not statistically significant; the authors suggest larger multi-centre studies may be able to demonstrate statistical significance. Originality/value PD patients have a relatively high use of acute psychiatric services compared to other patient groups. The authors are not aware of any similar studies in the published literature.
{"title":"An acute change? Does treatment within a therapeutic community for personality disorders affect local acute service use","authors":"Vafa Pirjamali, D. Ivanova, A. Howe","doi":"10.1108/tc-04-2021-0010","DOIUrl":"https://doi.org/10.1108/tc-04-2021-0010","url":null,"abstract":"\u0000Purpose\u0000The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to understand if the use of acute services was also affected via a service evaluation project.\u0000\u0000\u0000Design/methodology/approach\u0000The authors collected data from electronic records on the use of local services in the two years before, during and the two years after treatment in the TC. Specifically, the authors counted inpatient bed days, Emergency department (ED) presentations and days under home treatment team and liaison psychiatry; the authors used ANOVA to analyse the data.\u0000\u0000\u0000Findings\u0000The study included 25 adult service users, 17 female and 8 male, with an average age of 40. Whilst there were reductions in the use of inpatient beds and ED presentations, on analysis, these were not found statistically significant. The small size of the study is a limitation and may limit the generalisability of the findings. The study concludes there may be reductions in acute psychiatric service use during and after treatment in the TC. The findings were not statistically significant; the authors suggest larger multi-centre studies may be able to demonstrate statistical significance.\u0000\u0000\u0000Originality/value\u0000PD patients have a relatively high use of acute psychiatric services compared to other patient groups. The authors are not aware of any similar studies in the published literature.\u0000","PeriodicalId":43236,"journal":{"name":"Therapeutic Communities","volume":"40 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88472388","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}
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