Treatment and outcomes at Takiwasi Center, a Peruvian therapeutic community: identifying patient-related indicators

Abstract

Purpose Substance abuse is a major public health concern, with over millions of people suffering from it worldwide. Although there is an abundance of treatment options, many of these rehabilitative trajectories are subject to “drop-out”. In addition, “drop-out” is a significant risk factor for relapse. There is an urgent demand for effective treatment, which would enable patients to reduce abuse and prevent relapse. Takiwasi is an addiction treatment centre that combines traditional Amazonian plant medicine with conventional western medicine and psychotherapy. The purpose of this paper is to explore whether socio-demographics factors, such as education level and occupation, psychiatric comorbidities and primary drug use, are associated with treatment non-completion of Ayahuasca (AYA)-assisted addiction therapy. Design/methodology/approach Data on the first treatment episode of 121 patients were collected from the patient database from the years 2012 to 2017. To determine whether there is an association between the variables of interest and treatment non-completion, a χ2 analysis and a logistic regression analysis were performed. Findings Of the 121 patients analysed, 48.2 per cent completed their treatment, whilst 51.8 per cent did not. Students compared to those who are employed showed significantly higher odds for treatment non-completion (p=0.006; OR=3.7; 95% CI=1.5–9.6). Other variables in the multivariable analysis showed no significant relationship with treatment non-completion. While several limitations restricted the study, the findings suggest that the AYA-assisted treatment in Takiwasi may benefit from additional support for patients who are students. Moreover, it is advised to conduct more long-term follow-up of patients in order to gain better insight into the outcome of treatment at an AYA-assisted treatment centre. Originality/value It appears that AYA-assisted therapy in a therapeutic community is a feasible type of treatment for addiction, for which further studies should elucidate the role of motivation in relation to socio-demographic factors and type of addiction in the risk of treatment non-completion.

Protocol for Outcome Evaluation of Ayahuasca-Assisted Addiction Treatment: The Case of Takiwasi Center

“…Research is unequivocal, however, in reporting very low rates of treatment completion due to a multitude of individual and program-specific factors ( Prangley et al, 2018 ). Previous research data reported for Takiwasi Center, the current study site, are consistent with this, with non-completion rates measured at 51.8% ( Defilippe, et al, 2019 ). Following their systematic review of European therapeutic communities, Malivert and colleagues (2012) found that, on average, participants stayed only a third of the planned time, with completion rates ranging from 9 to 56%.…”

“…Since its inception, Takiwasi has been supportive of more than 70 research studies, mostly master's and doctoral theses, across several disciplines including psychology/psychiatry, neuroscience, sociology, anthropology, musicology, and art. Researchers have investigated the inpatient population (Presser-Velder, 2000;Horák 2013;Cervi et al, 2019;Defelippe et al, 2019;Berlowitz et al, 2020;Giovannetti et al, 2020), seminar participants (Dupuis, 2018, Dupuis, 2021, and a mix of inpatients, seminar participants, and outpatient diet-retreat participants (Håland 2014;Marcus and Fotiou 2019). Although there are high rates of treatment non-completion (Defelippe et al, 2019), preliminary data are suggestive of short-term treatment efficacy (Giove Nakazawa, 2002;Mabit, 2002;Berlowitz et al, 2019;Giovannetti et al, 2020) and ethnographic inquiry has implicated the various aspects of the treatment context that may influence treatment outcomes (Bustos, 2006;O'Shaughnessy, 2017;Marcus and Fotiou, 2019).…”

Implementación y funcionamiento de un sistema de información clínica en una comunidad terapéutica

“…Una descripción detallada de estas prácticas terapéuticas puede ser encontrada en otros estudios (Politi et al, 2018(Politi et al, , 2020Berlowitz et al, 2019;Cervi et al, 2019;Giovannetti et al, 2020) Actualmente Takiwasi se ha convertido en una de las referencias a nivel mundial en el uso de la medicina tradicional amazónica para el tratamiento de adicciones y otros trastornos de salud mental (Berlowitz et al, 2018). Esto hace que muchos investigadores de diferentes disciplinas como antropología, etnología, medicina y psicología estén interesados en el modelo terapéutico que se desarrolla en la institución por su originalidad y eficacia (O'Shaughnessy, 2017;Berlowitz et al, 2019;Defelippe et al, 2019). La investigación es entonces uno de los pilares de la labor de…”

“…El sistema ha ido creciendo y afinándose en base a dos estímulos principales, por un lado, para responder a necesidades del equipo terapéutico y, por otro lado, para responder de manera más eficaz a las consultas puestas por la investigación. La información obtenida a través del sistema hace que este se convierta en una herramienta tecnológica con amplio potencial para la investigación y en los últimos años hemos observado como la información acumulada por el sistema Plus es aprovechada de maniera por investigadores internos y externos a la institución (Saucedo et al, 2018;Cervi et al, 2019;Defelippe et al, 2019;Politi et al, 2020), demostrando que estos datos son de interés para la comunidad académica internacional.…”

Effective factors of addiction treatment communities in Peru, Nicaragua and Czechia

“…Takiwasi is a strongly Catholic-oriented center, which incorporates traditional Amazonian medicine as one of the pillars of the treatment (Hor ak, 2013a(Hor ak, , 2013b(Hor ak, , 2013cDefelippe et al, 2019). Takiwasi thus uses a dramatically different approach, which is useful to contrast to other centers using non-drug assisted psychotherapeutic models.…”