Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium

Abstract

BackgroundResearch on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients’ early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument.MethodsData was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients’ early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process).ResultsClients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients’ ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients’ ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores.ConclusionsSpecial attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients’ (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the induction stage of a TC program.

Reasons behind Greek problem drug users' decisions to quit using drugs and engage in treatment of their own volition: sense of self and the Greek filotimo

“…The importance of addressing identity processes is taken into consideration by substance use treatment services in many countries , including Greece . It is supported here that the recovery field benefits from acknowledging that the notion of identity is a process, and that culture influences the construction of identity.…”

Music Therapy and Mindfulness: Treating Women with Addiction in a Therapeutic Community

“…24 The TC is a treatment environment that emphasizes clients' responsibility for the behavior and change process for themselves, their peers, and the emotional and physical safety and comfort of the treatment environment. 25 The treatment community can hold up to 12 residents at a time, plus children as space allows.…”

Knowledge displays: Soliciting clients to fill knowledge gaps and to reconcile knowledge discrepancies in therapeutic interaction

“…The term TC designates both a type of residential or semi-residential service that provides psychosocial rehabilitation for persons with diagnoses of mental illness [12][13][14] or drug addiction problems [15,16] and the therapeutic method employed therein [17,18]. The TC method emphasises prolonged interaction between staff and clients (the so-called "living-learning experience" [12] or "community as method" [19,20]), usually over a period of several months [21], in joint work, learning and leisure activities. Staff-led group meetings take place on a weekly basis and are occupied to a significant extent by clients' reports of their recent activities and experiences [22,23].…”