Suchergebnisse

Transition to re‐entry (aftercare) is a stressful event for therapeutic community residents. While several authors agree on the importance of social support during reintegration, few studies have focused on the experiences of re‐entry clients themselves and their significant others during this period. Using a case‐study design, the present study examines the re‐entry process of four TC‐residents and three of their social network members during a six‐month period, starting at the time of their transfer to the halfway house. Clients and their significant others have mixed feelings about the reintegration period, although both are mainly positive. Clients report difficulties in leaving behind the TC‐mentality and building up a stable social network; they are surprised about the frequent contacts with substance (ab)use in mainstream society. Significant others misjudge clients' feelings about transition and relapse. Many significant others have a positive attitude towards the use of substances. The tendency in mainstream society to increasingly accept the use of substances intensifies clients' need for early guidance in building up stable supportive networks. Significant others need well‐grounded information on the reintegration process and on relapse.

<i>Aims:</i> It is the goal of this study to investigate the first development of the drug-free therapeutic community (TC) in Europe. The paper aims at systemizing information, scattered all over Europe and is the first stage in an ongoing study to record the development of the European TC movement and its influences. <i>Design:</i> After a study of the grey (hidden) literature, TC pioneers and experts per country were contacted to further elaborate the first findings. Subsequently, a preliminary summary of our findings was published in the Newsletter of the European Federation of Therapeutic Communities (EFTC), inviting additional information and corrections. The authors completed the results for this article with relevant first-hand information, obtained through interviews with European pioneers. <i>Findings:</i> The findings are summarized under three topics: chronology, interconnections and European identity. It was found that from 1968 until 1989, a new therapeutic approach arose all over Europe, modeled after Synanon, Daytop and Phoenix House, New York, through Phoenix House, London and Emiliehoeve in the Netherlands. Therapeutic communities were established in Belgium, Finland, Germany, Greece, Ireland, Italy, Norway, Spain, Sweden and Switzerland as well. These communities were closely-knit and interconnected in their reaction against psychiatric and methadone treatment. The European TCs developed an own identity compared to the American ones. <i>Conclusions:</i> The European TCs adapted the model of their American predecessors to their own culture, influenced more by milieu-therapy and social learning. Instead of harsh behaviorism, more emphasis was placed on dialogue and understanding. Professionals occupied a more pivotal role and took over the dominant position of ex-addicts. Research, executed by TC professionals gradually entered the TC. A generic network of TC connections, through which the development evolved, was uncovered, and clear regional trends can be observed.

By statistical analysis of client data it is shown how past or current network information together with other knowledge assesses treatment needs. The main findings are as follows. The client's previous exposure to addicts in the family has almost no influence on his or her present contacts with addicts in daily life. About 30% of the clients have experienced addicts both in family and among friends, about 30% have only family exposure, about 20% have neither kind of exposure, and about 20% have no family exposure but have current exposure to addicts. Exposure to addicts in family implies a higher risk of severe need for professional intervention than no such exposure. For the clients with no family exposure but with current exposure to addicts there is, somewhat surprisingly, a lower risk than for the other three categories of clients. This effect seems to be mainly because the psychiatric status of these clients is somewhat better than for those in the other three categories. The effect disappears if we look solely for drug addiction intervention needs; then there is a clear increase in relative treatment needs for the categories with previous or present addiction exposure compared to those without.

This article describes the different phases of the development and implementation of the Videotaped Addiction Challenge Tool (VACT, initially termed the Video Addiction Challenge Test). This instrument employs a video depicting the `average life‐story' of a resident of a Therapeutic Community for substance abusers. The video film is used as a clinical method for assessment and individual treatment planning, and as a research instrument that gives care‐givers a deeper insight into the residents' personal characteristics and treatment requirements at any given moment in the Therapeutic Community.The article reports the results of administering the VACT to 38 residents (31 male and 7 female) at the De Kiem Therapeutic Community in Belgium. Detailed description of the procedure and its principles assures reliability and makes accurate reproduction possible. The validity of the instrument was tested by comparing, characteristic by characteristic, the results of the VACT, life‐story and social anamnesis. The correspondence between the VACT and the life‐story was 94% and between the VACT and the social anamnesis, 98%. The VACT has also contributed new information not measured by other instruments. Content analysis of this information shows that TC residents are characterised by negative communication between parents, negative communication with father, an unhappy childhood, child maltreatment or abuse, and relational problems due to drug abuse. Residents reported feelings of inferiority and suicidal thoughts and/or suicide attempts. Many new residents also reported sexually related problems such as abortion, sexual abuse, prostitution and shyness. There were no specific female problems; men reported sexual abuse as often as women. The implementation of this new instrument leads to a more methodical approach. It is, however, also more time‐consuming and can be a problem for staff who tend to give priority to immediate action and direct problem‐solving.

Summary It is widely recognised that young people in out-of-home care are often involved in a complex process of culminating disadvantage and exclusion. Investing in the core ingredients of social inclusion (participation and interpersonal relationships) while still in care can counterbalance ongoing exclusion processes. In this article, we explore how early work experiences (before the age of 18) can play a role in this. Findings A thematic analysis was performed on interview data from 74 young adults in six countries. Several elements promote community participation (gaining financial autonomy, gaining a feeling of independence, and being able to contribute as a worker) and help to develop a sense of belonging (striving for normality and building long-lasting social connections). Early work experiences also contribute to personal growth (building capabilities and shaping the future). Applications This article highlights how early work experiences have the potential to promote social inclusion for out-of-home care-experienced young people and serve as gateway experiences for both educational and work trajectories. Entry into the world of work should not be postponed until the age of 18. Caregivers can play a role in motivating young people to work while still being in care and helping them to find a job. The experiences gained during these early work experiences can also have a place in the care process.

AbstractThis article draws attention to the relevance of young care leavers' exercise of agency as one possible key ingredient in overcoming barriers to engagement in work. Several previous studies show difficulties in entering adult life, both in relation to higher and further education as well as entrance into work life. The article analyses interviews with young adults from six countries, who have spent at least part of their childhood and youth in out‐of‐home care and the results indicate that the care leavers have the ability to make plans and set up goals for the future that they in many cases are able to achieve or at least are striving for over time. In many instances, they show a strong motivation, for example, to educate themselves pursuing their goals. To support this transition of young care leavers, it is important to listen to 'successful' cases such as the ones presented.