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THERAPEUTIC COMMUNITIES - TREATMENT PRACTICES IN VIEW OF DRUG DEPENDENCY THEORY

NCJ Number
68730
Journal
Drug Forum Volume: 7 Issue: 1 Dated: (1978-79) Pages: 81-103
Author(s)
D C IVERSON; S S WENGER
Date Published
1979
Length
23 pages
Annotation
BOTH THE CLINICAL TRADITION AND THE THERAPEUTIC TREATMENT COMMUNITY FAIL TO HELP DRUG-DEPENDENT PERSONS BECAUSE BOTH HAVE INFLEXIBLE RATIONALES AND IGNORE DRUG TREATMENT RESEARCH AND THEORY ADVANCEMENTS.
Abstract
ALTHOUGH STRUCTURED DRUG-TREATMENT COMMUNITIES, BASED ON THE MODEL DEVELOPED BY SYNANON, HAVE BECOME A FAVORITE FORM OF HELP FOR DRUG-DEPENDENT PERSONS, THEIR POOR RECORD OF SUCCESS SUGGESTS THAT SOMETHING IS WRONG. THESE FACILITIES ARE PRESENTED TO THE PATIENT AS A FORM OF FLEXIBLE SELF-HELP. IN REALITY, THEY ARE HIGHLY STRUCTURED BEHAVIOR MODIFICATION ORGANIZATIONS WHICH PRESSURE THE PERSON TO BE 'GOOD' AND QUICKLY PUNISH 'BAD' BEHAVIOR. THEY DO NOT RECOGNIZE THE UNDERLYING NEEDS WHICH MAKE THE ABUSER TURN TO MOOD-ALTERING DRUGS. USUALLY THERE IS LACK OF ONE-TO-ONE COUNSELING AND NO RECOGNITION OF ALTERNATIVE WAYS OF DEALING WITH STRESS, SUCH AS YOGA, MEDITATION, BIOFEEDBACK, AND THE LIKE. TO BE SUCCESSFUL, CLINICAL TRADITION NEEDS TO SHED ITS RIGID PERCEPTIONS OF THE CAUSES OF DRUG ABUSE. MEANWHILE, THE PARAPROFESSIONAL THERAPEUTIC COMMUNITY MUST BECOME MORE AWARE OF THE ALTERNATIVE DRUG TREATMENT THEORIES AVAILABLE. THE COMMUNITY MUST BE AWARE OF THE DOUBLE-BIND SITUATION IT PRESENTS, WHICH MAKES PATIENTS UNWILLING TO STAY VERY LONG. INDIVIDUALIZED TREATMENT MUST BE USED TO HELP INDIVIDUALS STAY WITH THE PROGRAM FOR THE OPTIMAL PERIOD OF TIME IF COMMUNITIES ARE NOT TO JOIN THE EVER-INCREASING LIST OF PROGRAMS THAT HAVE FAILED TO HELP DRUG ABUSERS. A TABLE COMPARING THE RESULTS OF 10 STUDIES WHICH EVALUATED THE EFFECTIVENESS OF VARIOUS THERAPEUTIC COMMUNITIES, AND A BIBLIOGRAPHY OF 33 ITEMS ARE INCLUDED IN THIS ARTICLE.

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