Therapeutic Communities The International Journal of Therapeutic Communities

Clarke, Annaley ; Royes, Michelle

2014 Therapeutic Communities The International Journal of Therapeutic Communities

doi: 10.1108/TC-09-2013-0029

Purpose – The purpose of this paper is to review the purpose of the Community Meeting and how it fits within the Sanctuary Model®, it will outline the tools theoretical underpinnings and finally how the tool is used in other trauma models specifically Therapeutic Communities. Design/methodology/approach – This paper draws the key literature together related to the Community Meeting within the Sanctuary Model®, making links to theoretical influences between the Community Meeting, Trauma Theory and Attachment Theory. Finally it provides a comparison of the Community Meeting within Therapeutic Communities and the Sanctuary Model®. Findings – The paper detailed how the Community Meeting tool is underpinned by the norms and theories of the Sanctuary Model®. It detailed the direct link between healing from trauma and building attachments to the Community Meeting. It found the similarities of the Community Meeting within both Therapeutic Communities and the Sanctuary Model® in that they always included all participants and occurring regularly in circular groups. However, it noted the distinct differences including in Therapeutic Communities the Community Meeting forms a significant intervention, whereas within the Sanctuary Model®, the Community Meeting supports the broader intervention of the model for all members of the community including staff and clients. Originality/value – The Sanctuary Model® is gaining international interest and as such, critical consideration of its theoretical influences, similarities and differences with existing models is critical to understanding the model.

William Best, David ; Byrne, Gerard ; Pullen, David ; Kelly, Jacqui ; Elliot, Karen ; Savic, Michael

2014 Therapeutic Communities The International Journal of Therapeutic Communities

doi: 10.1108/TC-07-2014-0024

Purpose – The purpose of this paper is to test the feasibility of utilising an Asset-Based Community Development (ABCD) model in the context of an Alcohol and Other Drug Therapeutic Community, and to use this as a way of assessing how TCs can contribute to the local communities in which they are sited. Design/methodology/approach – This is a qualitative action research project, based on an evolving model in which key stakeholders from participating sites were instrumental in shaping processes and activities, that is a partnership between a research centre, Turning Point in Melbourne, Australia and two Recovery Services operated by the Salvation Army Australia Eastern Territory (TSA). One of these is the Dooralong Transformation Centre on the Central Coast of New South Wales and the other, Fairhaven, is in the Gold Coast hinterland of Queensland, Australia. The project was designed to create “rehabilitation without walls” by building bridges between the treatment centres and the communities they are based in, and improving participation in local community life. This was done through a series of structured workshops that mapped community asset networks and planned further community engagement activities. Findings – Both of the TCs already had strong connections in their local areas including but not restricted to involvement with the mutual aid fellowships. Staff, residents and ex-residents still in contact with the service were strongly committed to community engagement and were able to identify a wide range of connections in the community and to build these around existing Salvation Army connections and networks. Research limitations/implications – This is a pilot study with limited research findings and no assessment of the generalisability of this method to other settings or TCs. Practical implications – Both TCs are able to act as “community resources” through which residents and ex-residents are able to give back to their local communities and develop the social and community capital that can prepare them for reintegration and can positively contribute to the experience of living in the local community. Social implications – This paper has significant ramifications for how TCs engage with their local communities both as a mechanism for supporting resident re-entry and also to challenge stigma and discrimination. Originality/value – The paper and project extend the idea of ABCD to a Reciprocal Community Development model in which TCs can act as active participants in their lived communities and by doing so can create a “therapeutic landscape for recovery”.

I. Hodge, Ashleigh ; L. Warren, Keith ; V. Linley, Jessica

2014 Therapeutic Communities The International Journal of Therapeutic Communities

doi: 10.1108/TC-11-2013-0033

Purpose – The purpose of this paper is to examine personal and social network characteristics that predict staff ratings of therapeutic community (TC) resident role model status. Design/methodology/approach – In all, 49 incarcerated female residents tracked interactions with peers, including verbal affirmations and corrections, during a 12-hour period. Two weeks later, staff members were surveyed about their view of participants as role models. Poisson regression was used to analyze resident interactions and demographics as predictors of role model status. Findings – The number of corrections given to peers was positively related to staff ratings of role model status ( B =0.234, SE=0.088, p =0.008). The number of affirmations given was negatively related to staff ratings ( B =−0.112, SE=0.051, p =0.028). Resident phase was positively related to staff ratings ( B =0.256, SE=0.102, p =0.012). These values did not significantly change when controlling for affirmations and corrections received from peers, non-programmatic interactions between residents, or resident demographics. Research limitations/implications – These results imply that TC staff judge role model status by resident actions in the community rather than demographics or peer reactions. External validity is limited by the single site, case study design, and the fact that only female TC residents were sampled. Originality/value – This study is the first to track resident peer interactions over the course of a day and to link those interactions to role model status.

Magor-Blatch, Lynne ; Bhullar, Navjot ; Thomson, Bronwyn ; Thorsteinsson, Einar

2014 Therapeutic Communities The International Journal of Therapeutic Communities

doi: 10.1108/TC-07-2013-0024

Purpose – The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes. Design/methodology/approach – A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues. Findings – Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed. Research limitations/implications – Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts. Practical implications – Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al. , 2012; De Leon et al. , 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al. , 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances. Originality/value – The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes.