Health Care in Prisons *
Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson in Health Care Needs Assessment, 2018
The term ‘therapeutic community’ is used to refer to a residential, multi-modal treatment programme for people with a variety of mental health problems. Programmes typically include some formal therapeutic components such as group psychotherapy and art therapy, but the key and unique component of the approach involves the observation and analysis of daily interactions within the community. It is a contract-based regime – the prisoner needs to recognise they have a problem, be motivated to do something about it and be capable of entering into a therapeutic contract. Alternative treatment options for people with personality disorder include a range of outpatient based therapies, some of which will occur as part of a typical therapeutic community treatment programme, or an intense period of in-patient psychotherapy in an open ward.
Residential Substance Abuse Treatment programming: What Do the Inmates Think?
Barbara Sims in Substance Abuse Treatment with Correctional Clients, 2012
The therapeutic community is “a residential-based, substance abuse treatment modality incorporating the use of a social learning model based on peer support for pro-social values and behaviors” (Hartmann et al., 1997:18). A key aspect of the TC is a recognition that a community can provide an individual with the strength, support, and insight to make needed changes that would be much more difficult if that person were on his or her own. In this TC setting each individual has the opportunity to grow, as a community member, in ways not possible by going it alone. A community environment also allows its members to fight a common enemy and reach a common goal. In the RSAT program the common enemy is an addictive and criminal lifestyle. The common goal is personal change by learning new ways of “Right Living.” (CompCare, 1998:4)
The Impact of Targeted Prevention Programs for Adolescents at High Risk for HIV Transmission
Susan Taylor-Brown, Alejandro Garcia in HIV Affected and Vulnerable Youth: Prevention Issues and Approaches, 2014
The program was first implemented in 1989 at four basic sites: the Essex County Youth Detention Center, “Teen Progress” (a welfare program for teenage mothers), the Essex County welfare offices, and the Essex County welfare hotels. While the original target group was adolescents, both adolescents and adults were present at the welfare offices and hotels. One of the salient elements that distinguished thi[illegible text in source]; program from prior educational efforts that typify other program: across the United States is that the counselors here used the confrontational style developed in the therapeutic community context. The therapeutic community model has been used with the drug-addicted population since the 1950s. The primary goal of the therapeutic community is to foster personal growth by changing the individual's persona lifestyle within a community of concerned people working together to help themselves and each other. Through the use of treatment community-imposed sanctions and penalties as well as earned advancement of status and privileges as part of the recovery and growth process members progress and begin to see changes in one another (DeLeon 1988).
Impact of early telephone contact on 3-month follow-up rates following residential drug and alcohol treatment: A randomized controlled trial
Published in Substance Abuse, 2019
Frank P. Deane, Russell Blackman, Peter J. Kelly
Participants were clients across 6 sites of The Salvation Army Bridge Program, an abstinence-based inpatient residential modified therapeutic community. The therapeutic community (TC) model provides a holistic, client-centered, and coordinated care approach, incorporating individual counseling, group work, case management, health care, and spiritual support, along with recreational, social, and family activities within the treatment center. Clients are responsible for their own and others’ recovery, and regimented daily routines with clear expectations of behavior and contribution to community work provide a structured environment.10 The programs are primarily designed to treat individuals with substance use disorders; however, there are high rates of comorbid mental health disorders (approximately 70% of participants), and the modified TC adjusts expectations to accommodate the different ability levels and needs of individual clients with co-occurring disorders.10,11 Typically, these 6 sites treat approximately 1400 clients per year, with an average length of treatment of 3.9 months.2,4
Therapeutic Community Then and Now
Published in Psychiatry, 2019
Therapeutic community work is a powerful form of psychosocial learning. It currently is provided in residential settings that focus on addressing comorbidity, underlying issues, and the impact of adversity and trauma that interfere with a patient’s capacity to use outpatient treatment optimally—which requires the ability to use the sessions and to function adequately between them. Immersion in a therapeutic community is an ideal way to help some people return to outpatient functioning and be better able to use the lessons learned to take charge of their lives. Contemporary therapeutic communities do not take an “either/or” (either biological or psychosocial) treatment stance but instead are based on an integrated “both/and” biopsychosocial approach to treatment. The task of achieving integration of disparate components mobilized in treatment is one taken on not only by patients but also by the staff who work in such settings. Contemporary therapeutic communities balance sealing-over with the integration that comes from learning to see ourselves as others see us.
Sealing-over in a Therapeutic Community
Published in Psychiatry, 2019
Thomas H. McGlashan, Steven T. Levy
Thus, the treatment goals or work tasks of the therapeutic community were explicitly stated as: (1) increased self-understanding, and (2) the restoration and further development of interpersonal skills. rrhe therapeutic assumption was that all members of the community, including patients, were capable of assuming rcsponoi bility for carrying out these treatment goals. We defined such responsibility in more graded terms than Maxwell Jones, who emphasized complete management of the unit by patients (1953). Final decisions about all aspects of clinical care on our unit rested with clinical staff. Patients and staff were expected to provide the necessary data relevant to any particular issue (e.g., passes) so that the identified staff ‟decision-maker” was accurately informed. Covert group resistances interfering with this process were explored by the therapeutic community according to Bion’s model of group behavior (Bion, 1961; Rioch, 1970). Several antitherapeutic forces and situations have been described, based upon observations of this unit (Sacks and Carpenter, 1974; Sacks et al., 1974).
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