How therapeutic communities work: Specific factors related to positive outcome

Pearce, Steve; Pickard, Hanna

doi:10.1177/0020764012450992

Cited by 94 publications

(63 citation statements)

References 63 publications

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“…Second, healing individuals typically involves reintegration into community, often a community whose other members have also experienced the bewildering twin normative failures and the self-degradation that results, and who get, at a minimum, that this sort of thing can happen to otherwise decent, worthy people, and who have experience, strength, and hope to share about how to regain control of one’s self, one’s life. Eventually, actually at the same time, there is reintegration into the wider social community, doing school or one’s job as one is supposed to, being there for one’s friends and family in the way a good person is, an end to actual or psychological isolation and concealment that is a common accompaniment of addiction (2, 13, 16, 21, 24, 25). Self-esteem and self-respect return and shame dissipates, possibly pride grows.…”

Section: Social Capitalmentioning

confidence: 99%

The Shame of Addiction

Flanagan¹

2013

Front. Psychiatry

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Addiction is a person-level phenomenon that involves twin normative failures. A failure of normal rational effective agency or self-control with respect to the substance; and shame at both this failure, and the failure to live up to the standards for a good life that the addict himself acknowledges and aspires to. Feeling shame for addiction is not a mistake. It is part of the shape of addiction, part of the normal phenomenology of addiction, and often a source of motivation for the addict to heal. Like other recent attempts in the addiction literature to return normative concepts such as “choice” and “responsibility” to their rightful place in understanding and treating addiction, the twin normative failure model is fully compatible with investigation of genetic and neuroscientific causes of addiction. Furthermore, the model does not re-moralize addiction. There can be shame without blame.

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Section: Social Capitalmentioning

confidence: 99%

The Shame of Addiction

Flanagan¹

2013

Front. Psychiatry

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“…The first is that residents will react to peers in a more prosocial manner than to staff (Bell, 1994; De Leon, 2000; Stevens, 2013). The second is that TC residents interact in such a way as to maintain a cooperative and safe environment (Debaere, Vanheule & Inslegers, 2014; Pearce and Pickard, 2012). This is a salient issue for TCs; the heavy dependence on peer support means that trust in peers and the social climate of the unit are primary predictors of retention (Carr & Ball, 2014; Mandell, Edelen, Wenzel, Dahl & Ebener, 2008).…”

Section: Introductionmentioning

confidence: 99%

A network of helping: generalized reciprocity and cooperative behavior in response to peer and staff affirmations and corrections among therapeutic community residents

Doogan

Warren

2017

Addiction Research & Theory

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Background Clinical theory in therapeutic communities (TCs) for substance abuse treatment emphasizes the importance of peer interactions in bringing about change. This implies that residents will respond in a more prosocial manner to peer versus staff intervention and that residents will interact in such a way as to maintain cooperation. Method The data consist of electronic records of peer and staff affirmations and corrections at four corrections-based therapeutic community units. We treat the data as a directed social network of affirmations. We sampled 100 resident days from each unit (n = 400) and used a generalized linear mixed effects network time series model to analyze the predictors of sending and receiving affirmations and corrections. The model allowed us to control for characteristics of individuals as well as network-related dependencies. Results Residents show generalized reciprocity following peer affirmations, but not following staff affirmations. Residents did not respond to peer corrections by increasing affirmations, but responded to staff corrections by decreasing affirmations. Residents directly reciprocated peer affirmations. Residents were more likely to affirm a peer whom they had recently corrected. Residents were homophilous with respect to race, age and program entry time. Conclusion This analysis demonstrates that TC residents react more prosocially to behavioral intervention by peers than by staff. Further, the community exhibits generalized and direct reciprocity, mechanisms known to foster cooperation in groups. Multiple forms of homophily influence resident interactions. These findings validate TC clinical theory while suggesting paths to improved outcomes.

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“…The use of KDs contributes to reinforcing a culture of sharing [12,47] in which the clients are expected to be open about themselves [22]. By soliciting the clients to share personal information, the staff forward the therapeutic agenda of the meetings (e.g.…”

Section: Discussionmentioning

confidence: 99%