an alternative for human and social development

Transcription

AN ALTERNATIVE FOR HUMAN AND SOCIAL DEVELOPMENT
XXIV WORLD CONFERENCE OF THERAPEUTIC COMMUNITIES
Lima, February 6 - 10, 2009
FOTO: PROMPERU
FOTO: Wilfredo Loayza / PROMPERU
FOTO: Domingo Garibaldi / PROMPERU
FOTO: Carlos Sala / PROMPERU
ABSTRACTS OF WORKSHOP PAPERS
Hosted by:
INSTITUTO MUNDO LIBRE
AN ALTERNATIVE FOR HUMAN AND SOCIAL DEVELOPMENT
XXIV WORLD CONFERENCE OF THERAPEUTIC COMMUNITIES
February 6 - 10, 2009
ABSTRACTS OF
W O R K SH O P P A P ERS
Hosted by:
Sponsors
Bureau for International Narcotics
and Law Enforcement Affairs
Criminal Justice Programs Division
MUNICIPALIDAD
METROPOLITANA
DE LIMA
INDEX OF WOKSHOPS ABSTRACTS
Child Sexual Abuse and its Relationship with the Disorder by Consumption of Psychoactive Substances, ................................................... 9
in Patients Hospitalized in the Department of Addictions - Victor Larco Herrera Hospital, in 2007
Alicia Chu & América Salazar
Drugs and Depression ................................................................................................................................................................................................................... 10
A. Villegas: Suicide
When Art Becomes Therapy ........................................................................................................................................................................................................ 11
Anahí Camero
Alternative Spaces of Coexistence for Street Children Educators ................................................................................................................................ 12
Anahí Camero
Emotional Factors & Personal Resources in Comorbidity Patients: Adapted TC Model for Dual Pathology .................................................. 13
Antonio Jesús Molina
Rehabilitating Street Children in a TC : Role Modeling in an Educative Environment............................................................................................ 15
Barnabé D´ Souza
Family Members’ Perception about the Drug-Consumer. A Resource to Explore during the Process of Rehabilitation............................ 16
Benito Rosas & Fabrega Fabrel
“Relation-Shipping” and Healing : Attachment, Trauma and Substance Misuse in Children and Young People .......................................... 18
Calum Hendrie
Vital Working Record in Therapeutic Community ............................................................................................................................................................... 19
Clara Brostow & Andrés Ghiorzo
Integration of MET, CBT an Self Help Approaches into the TC Model........................................................................................................................... 20
Cecilia Velasquez & David Stockton
Workforce Development Dilemmas: Integration of “Non TC staff” into a TC Milieu ............................................................................................... 21
Cecilia Velásquez & David Stockton
Dual Pathology “An Experience of Integral Therapeutic Community in Argentina” .............................................................................................. 22
Daniel De Angelis & Sebastian Rodríguez
Logotherapy: Methods and Tools to find a Sense of Life ................................................................................................................................................. 23
Efrén Martínez
Overcoming our Shadow ............................................................................................................................................................................................................ 24
Efrén Ramírez
TC and its New Challenges ......................................................................................................................................................................................................... 25
Elena Goti: 2009
The Human Prerogative: A Critical Analysis of Evidence-Based and Other Paradigms of Care in Substance Abuse ................................. 26
Eric Broekaert
Conduct Evaluation of Residents According to Their Phase of Treatment in the Therapeutic Community Institute Mundo Libre ..... 27
Esther Yaya
Reflections on the Appeasement and Rehabilitation Approaches and Their Influence in Street Children and .......................................... 28
Adolescents Consumers of Psychoactive Substances in Peru
Fabrizio Caciano
Therapeutic Approach to Teaching Teens and Young People: Skills for Life ............................................................................................................. 29
Fineke Janssen
A B S T R A C T S O F W O R K S H O P S PA P E R S
XXIV WOLD CONFERENCE OF THER APEUTIC COMMUNITIES
5
TC, Fidelity and Future of the Model ....................................................................................................................................................................................... 30
George De Leon
Combining Research and Clinical Methods for Improving Quality of Treatment in TCs ...................................................................................... 31
Gerasimos Papanastasatos
Codependency a Reality in Interventive Processes for Therapeutic Communities ................................................................................................ 32
Gloria De Salvador
The Dually Diagnosed and the Therapeutic Community ................................................................................................................................................ 33
Gregory Bunt
Risk Factors Associated with the Consumption of Psychoactive Substances in Patients Víctor Larco Herrera Hospital – 2008 .......... 34
Gustavo Sipán & Alicia Chu
Challenges on Recovery .............................................................................................................................................................................................................. 35
Hafizi Harun
Identity, Epigenesist and Social Learning .............................................................................................................................................................................. 36
Humberto Nicolini & José. D. Batista
Retention in Therapeutic Community in the First 30 Days: Qualitative Approach ................................................................................................. 37
Helen Anagnostou
Spirituality in the Treatment of Addictions ........................................................................................................................................................................... 38
Ileana Castro
The Essential Elements of Treatment: An European Therapeutic Communities Perspective .............................................................................. 39
Ilse Goethals
Quality in Services for Adolescent Users of Psychotropic Substances ......................................................................................................................... 40
Ioannis Mihalakoukos
Addictions: An Errant Search for Life Meaning .................................................................................................................................................................... 41
Jaime Torres
Meeting The Challenges through Workforce Development: Certification’s Central Role ..................................................................................... 42
Jeff Wilbee
Evolution of Therapeutic Communities in Spain. Answers from Proyecto Hombre ............................................................................................... 43
Jesús Hernández
The T.C., An Answer to Social Violence .................................................................................................................................................................................... 44
Jorge Blanco
The Power of the Words to Hurt or Heal in the T.C. ............................................................................................................................................................. 45
Jorge Blanco & Patricia Ackerman
Development and Proposal Evaluation of a Training Program in Counseling in Addiction ................................................................................ 46
Jorge Sánchez Mejorada
A Model for Social Therapeutic Community Implementation ........................................................................................................................................ 47
José Batista
A Journey to Hospitality to Self and to Others ..................................................................................................................................................................... 48
José Gabriel Piedrahita
Latino American Therapeutic Communities – A Short Study of Growth and Development ............................................................................... 49
Juan Palacios
Counseling In the Therapeutic Community ......................................................................................................................................................................... 50
Juan Facundo Cincunegui
Invitational Intervention: The ARISE Model ........................................................................................................................................................................... 51
Judith Landau y Gale Saler
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From Practices to the Theoretical Model of Therapeutic Communities ..................................................................................................................... 52
Kalevi Kaipio
Psychosocial Therapies, an Intervention and Attention Option for Adicctions ....................................................................................................... 53
Karol Vásquez y María Victoria Medina
Specialization of the Therapeutic Community in Complex Multifaceted Correctional Institutions ............................................................... 54
Ken Martz, Cecilia Velásquez , Patricia OĆonnor
Therapeutic Community and the Adolescent: Innovative New Interventions Based on Adolescent .............................................................. 55
Brain Development, Physical and Psychosocial Setting of the TC
Kevin McEneaney
A Structural/Systematic Family Therapy Approach for an Adolescent Therapeutic Community ..................................................................... 57
Kim Tedaldi & Cheryl Nazario
Aggression, Impulsivity and Object Relations in Adolescents with Antisocial Behavior ...................................................................................... 58
Mariana Flint
The Trauma of Drug Addiction: Measuring Impact on Drug Treatment Effectiveness........................................................................................... 59
Marta Fosteri
What is Therapeutic in a Therapeutic Community? .......................................................................................................................................................... 60
Martien Kooyman
Bonding Psychotherapy Groups at the Therapeutic Community ................................................................................................................................ 61
Martien Kooyman
Use of Acupuncture in the Treatment of Addiction, Trauma, and ADHD ................................................................................................................... 62
Michael Smith
The TC goes to Prison: Contributions and Unintended Consequences ...................................................................................................................... 63
Naya Arbiter & Rod Mullen
Child Welfare Certification: Keeping Children Safe ............................................................................................................................................................ 64
Neal A. McGarry
Adolescent , Drug Addict , Prisoner , Emigrant, All of the above? Drug Treatment in a Correctional ............................................................. 65
Facility for Young Offenders
Paraskevi Stagaki
Doing Interpretative Phenomenological Analysis (IPA) as Part of a Research Project Concerning Relapse .................................................. 66
Phaedon Kaloterakis
Designing and Implementing Interventions in Smaller Urban Settings: Some First Conclusions from ........................................................ 67
Kethea’s Expansion to Northern Greece
Phaedon Kaloterakis
Kethea Ithaca’s Percussion Group: A Case of doing Music as Part of the Treatment and Reintegration Process ....................................... 68
Phaedon Kaloterakis
Aspects of Economic Evaluation of Substance Abuse Treatment: Cost-Benefit, Cost-Effectiveness of Adolescent Programs ................ 69
Petros Triantos & Cristina Seryianni
Adolescents’ & Young Adults’ Profile & Retention in Greek Drug-Treatment Programs......................................................................................... 70
Petros Triantos & Cristina Seryianni
The Benefits of Healing Meditation and the Potential Expansion of the Therapeutic Community as a Vehicle of Change..................... 71
Portia Mereki
Epidemiological Indicators and Results in a Sample of Addicted Patients from the Ñaña Rehabilitation .................................................... 72
Center -Period 2002-2007
Rafael Navarro & Mauricio Benavente
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Body, Emotion and Voice in the Therapeutic Community ................................................................................................................................................ 73
Ramón Vega
What Works in Education within Drug Treatment? Qualitative Outputs on Motivating Addicted Persons ................................................... 74
for Effective Treatment
Remos Armaos
Spirituality and Recovery.............................................................................................................................................................................................................. 75
Richard Dunn
Integration of Mindfullness Based Cognitive Therapy (MBCT) into the Therapeutic Community: Implications .......................................... 76
for Trauma Treatment
Rod Mullen & Mary Stanton
Criminal Justice Treatment & the TC ......................................................................................................................................................................................... 77
Ronald Williams & Sandeep Varma
Cost and Recovery ......................................................................................................................................................................................................................... 78
Rowdy Yates
Quality of Interpersonal Relationships of Street Children Using Rorschach Psycho Diagnosis .......................................................................... 79
Sandra Abregú
The Approach to Family ................................................................................................................................................................................................................ 80
Sharif Hamid y Lambertus Somar
Post Disaster Crisis Counseling: Addiction and Disaster Trauma ................................................................................................................................... 82
Sheldon Rosenzweig
Prospective Risk Factors in Adolescent Substance Abuse Treatment: An Analysis of the Characteristics ..................................................... 83
of the Adolescents Who Approached the Therapeutic Program KETHEA STROFI During 2003 to 2007
Spyridoula Zotou
Sanctuary, Estructure and Safety: Therapeutic Community Approach to Effective Offender Rehabilitation ............................................... 84
Sushma D. Taylor
Trauma Informed Women’s Treatment: Guidelines and Standards of Care ................................................................................................................ 85
Sushma D. Taylor
Outwards – Inwards, from Inwards to Outwards ................................................................................................................................................................. 86
Ursula Piaggio
Experiences of Family Members after TC drop-out: A Qualitative Study .................................................................................................................... 87
Veerle Soyez
Coping Styles of Stress in Drug Dependent Patients ......................................................................................................................................................... 88
William Guevara
Spiritual and Cultural Values in TC Programs ........................................................................................................................................................................ 89
Yunus Pathi
8
CHILD SEXUAL ABUSE AND ITS RELATION WITH DISORDERS BY
CONSUMPTION OF PSYCHOACTIVE SUBSTANCES IN PATIENTS
HOSPITALIZED IN THE DEPARTMENT OF ADDICTIONS VICTOR LARCO HERRERA HOSPITAL IN 2007
By Dr. Alicia Chu Esquerre (Psychiatric MD)
& Lic. América Salazar Lino (Psychologist)
Lima, Peru
Dr. Alicia Chu Ezquerre is a Psychiatrist MD, Psychotherapist and former
United Nations fellow in the area of Addictions. She also has a Master Degree
in Public Health. Nowadays, she teaches at the “Universidad Nacional Mayor
de San Marcos” and at the “Universidad Cientifica del Sur”. She is the Addiction
Department’s Head at the Victor Larco Herrera Hospital. She has design the Victor
Larco Herrera Hospital’s Rehab and Treatment Program for Addicted Patients
established about 17 years ago.
America Salazar Lino is a Psychologist from the Victor Larco Herrera Hospital’s
Addictions Department, graduated in Addictions and with a Master Degree in
Family Psychotherapy.
ABSTRACT
Child sexual abuse, as a legal, medical and social problem, has been little studied in our environment. However,
its importance at areas such as the family and/or school has begun to be acknowledged during the last years. The
situation is often not reported on time by the victim and it is detected a long time later, after the development of a
physical or psychiatric disorder, such as depression, suicide attempt, drug consumption, etc.
Here, we review a hundred medical records of male patients with disorders due to the use of psychoactive substances
who are confined at the Victor Larco Herrera Hospital’s Department of Addictions in year 2007. The findings are
described and whether there is a correlation between the C.S.A.(Child Sexual Abuse) and the disorders due to use
of psychoactive substances, as other papers mention.
Our conclusion is that there might be a relation among both problems and suggestions to implement a more
thorough investigation during the clinical and psychopathological evaluations of these patients is established
enabling professionals to improve the type of intervention and subsequently contribute to prevention programs
in the different stages of life.
Key words: A.S.I. (Child Sexual Abuse), disorders by drugs consumption
Victor Larco Herrera is a public hospital specialized in mental health care located in the city of Lima, Peru.
9
SUICIDE, DRUGS AND MENTAL CONDITIONS
By Alejando Villegas Echeverri
Colombia
Experienced Clinical Psychologist in educational processes for young people
and adults and community intervention with different people. Adviser to WFCT
(World Federation of Therapeutic Communities – Drug Dependency Intervention)
regarding to drug consumption in open and closed settings. In his professional
experience he has developed skills at the formulation and execution of agreed
public policies on issues about drug prevention. He has worked with offenders
and violator minors in open settings with protection measures. Nowadays,
he is involved in the formulation of a family and minors public policy for the
Municipality of Medellin.
ABSTRACT
Suicide and drugs have been issues that have accompanied the existence of the human being itself, of the thinking
human being and the one with options to record its thoughts. In his search of freedom, development, achievement,
and enjoy, the Individual has found a set of meanings and special words, that has accompanied as impellers and
sometimes as obstacles of the said goals. Mental illness, personal, social as well as family malfunctions, some
specific and extraneous issues make their appearance and accompany the upset and have made the existence
and each time in particular a chance to evolve or to involve. To make judgments to see if they are convenient or
not, possible or not, right or not, is a task that seems not to be appropriate nor designed for the health and social.
Nevertheless, the co-morbilities among different pathologies generate interest and call for our attention in order
to intervene them aiming to defend the Being and its intimacy.
Issues such as depression, melancholy, loneliness, drugs and suicide interweave a set of questions and answers,
and invite us to keep on researching, and allowing us to get closer to the Being in its development and freedom
process. Suicide, drugs and mental conditions are undoubtedly a new field of our research in a world demanding
increasingly a social look.
10
WHEN ART BECOMES THERAPY :
BUILDING CREATIVE SPACES
By Anahí Camero
Peru
Art Therapist, graduated in Psychology at the Universidad Nacional Mayor de
San Marcos. She ha completed three years in Expressive Arts Therapy at the
European Graduate School (EGS), Switzerland and Peru TAE. She currently works
as Project Coordinator at Asociación Benéfica Prisma - LimaKids Program, and
General Coordinator at Asociación Niños del Río - French Association of Peru.
She works directly with people living on the streets creating alternative – creative
spaces in their social integration. One of her tasks is monitoring programs and
methodologies applied to vulnerable population.
ABSTRACT
This work explains an intervention with Arts Therapy in T.C. “Mundo Libre” - House of Girls (Program for
children and adolescents living on the streets).
This intervention shows how the lack of restraint and a sense of “no internal space,” which suffer girls and
adolescents living on the streets contribute to the process of social exclusion.
By providing a sufficiently healthy space, a different style of relationship, constitutes a propitious environment
to develop and strengthen protective factors facing the constraints of their environment. The construction of a
creative space that is clearly defined gives them the opportunity to achieve new identities and ways of relating to
enable them to integrate and aspire to interact positively with their families and their communities.
To construct supporter and consistent links will give the possibility to make healthy links among themselves and
a way to get away from a style of life different from the risky behavior and inappropriate relationships.
11
ALTERNATIVES SPACES OF COEXISTENCE FOR STREET CHILDREN
EDUCATORS
By Anahí Camero Herrera
Peru
Psychologist graduated at the “Universidad Nacional Mayor de San Marcos” and
third year student at a Masters Degree of Expressive Arts Therapy at the European
Graduate School in Switzerland and TAE Peru. She is the Project Coordinator of
“Asociación Benéfica Prisma - LimaKids Program”, and General Coordinator of
the Peruvian-French Association - “Asociación Niños del Río”. She works directly
with people living on the streets building alternative, creative spaces for their
social integration. She also monitors programs and methodologies applied at risk
population.
ABSTRACT
The practice of social educators, those in charge of taking of risk population, especially within institutions, needs
new inquiry methods. Our reference is not directed to solve better the daily problems in the administration of
social otherness (mentally ill, maladjusted, behaviour disruptions, protection needs in social risk situations,
confined minors). The essential thing is to provide alternative spaces for caregivers, who spend their days giving
support and safe spaces to people at risk. Children and adolescents with a total lacking, and therefore their their
demand is excessive and inappropriate.
Emotional exhaustion, depersonalization and lack of achievement are factors that may be present in caregivers
(labour stress and burnout, or vocational burned syndrome.)
To provide the necessary support, consistent and supporter links, leads us to present the need of finding spaces,
where educators can channel support what was conveyed to the people and be able to receive support, a constant,
creative space to build a better interpersonal relationship in the institution, an effective, assertive and timely
intervention with the residents as well as to generate self-care strategies.
12
EMOTIONAL FACTORS & PERSONAL RESOURCES IN COMORBIDITY
PATIENTS: ADAPTED THERAPEUTIC COMMUNITY MODEL FOR DUAL
PATHOLOGY
By: Antonio Jesús Molina Fernández
Spain
Antonio Molina has a degree on Psycology at Granada University and currently he
is studying Social and Cultural Anthropology. Since 2001, he works as therapist in
drug dependency at Proyecto Hombre – Granada and since 2005, he is the Head of
this Community. He is, also, a member of the National Committee of Evaluation of
Proyecto Hombre Programs.
ABSTRACT:
Spanish situation is (in 2006 studies with clinical populations) prevalence rates of dual diagnoses range from 20 /
60% of all patients with a psychiatric disorder (even in some cases 85%). The data set and characters come to pose
a previous set of difficulties for its approach and treatment, some relating to the characteristics of these patients,
others, the lack of specific training for the devices and specific resources, as well as the absence of a model for
addressing specific and comprehensive.
Our hypothesis is: The working method Proyecto Hombre has proved to be a very effective response to all kinds
of addictions during the last 20 years in Spain (since 1984), because their approach multidisciplinary teams and
humanistic philosophy. So, this method may be useful for DP patients.
Action Plan (similar to the following):
- Initial Interviews Started: Emphasis on the medical and psychiatric issues. Instruments used: EuropASI
(Spanish version of Addiction Severity Index) and Global Assesment of Aunctioning (GAF) (Endicott, Spitter,
Fleiss&Cohen).
- Initial Phase of Reasoning: A combination between group therapy and individual therapy and assessment.
Stage Advanced Reasoning: Therapeutic Itinerary using ACT (Accept & Compromise Therapy). Groups
are working on Rational Emotive Therapy. Instruments: Therapeutic Itinerary, EuropASI (revisited), Irrational
Ideas Schedule, Personal Life Project (PPV).
- Socio-Reintegration specific targets in the areas of training and recreation / leisure, in addition to consolidating
the above objectives and performing a specific job in prevention and detection of relapses. Instruments: Personal
Life Project revisited.
Results with 2007 Data (N=75):
Improvement in quality of attention: None of the patients suffered any hospital internement or psychotic crisis
during 2007.
Improvement in adherence to treatment (only 20% of patients did not finished the treatment).
13
Improvement in relapse prevention (only 25% relapsed in the use of drugs and all of them returned to
treatment).
All the patients expressed their quality of life was improved and their own responsability about their medical and
social problems has been increased with the program.
KEY-WORDS
TC Model, Adaptation for Special Needs, Emotional Factors Therapy, (ACT, NIP, Rational-Emotive Therapy),
Group Treatment, Individual Attention, Therapeutic Itinerary, Psychological Assessment, EuropASI, Personal
Life Project.
LESSONS LEARNED
- Importance of the process, not just the outcome.
- Respect for other treatment strategies and other styles.
- Treatment interdisciplinary fundamental biosanitary objectives and biopsychosocial rehabilitation.
LESSONS FOR LEARNING
- Specific training for all professionals involved in addictions on dual diagnosis.
- -Continuous-Learning for Professionals: Each case is different, should be analyzed in different ways. There are
no miracles, but rather facilitates the continuous work.
14
REHABILITATING STREET CHILDREN IN A TC : ROLE MODELING IN
AN EDUCATIVE ENVIRONMENT
By Rev. Barnabe D´ Souza
India
Barnabe D´ Souza has more than years of experience working with marginalized
children and adolescents and the communities they live in. He is the director and
founder of the shelter Don Bosco, providing a home and therapeutic community for
street children, as well as alcoholism prevention and slum education . Fr. Barnabé
is alsot the director of Shelter Don Bosco´s Research and documentation Center
(DBRD). He has presented reserearch papers and lectures on chemical substance
abuse management, research methods, etc. at various conferences and universities.
ABSTRACT
The socialization history of substance abusers is replete with instances of negative peer influences. The TC model
seeks to reverse this by forging an essential therapeutic alliance between the client and the peer community. The
raison d’etre of every TC is the principle of mutual self-help, where the residents are continually engaged in the
transmission of the norms and expectations of the community. Hence an educative, value oriented environment
is an essential for the adolescent’s therapeutic recovery. Participation is a key ingredient to this and the most
comprehensive measure of change. The TC may therefore be viewed as a context for social learning, where the
number and quality of its role models becomes paramount.
Street adolescents globally in all continents are responsible for a sizeable consumption of cheap and readily
available drugs. Largely invisible, and subject to abuse and exploitation, these children distrust and are wary of
authority figures. For them, those addicts who have recovered are perceived as credible, supportive and protective.
This affords the TC an environment to bring about a behavioral change. Globally recovery can be associated with
peer role models in combination with an educative environment.
This paper demonstrates an educative environment and peer role modeling for street children in a TC. The
combination of the two is vital to rehabilitation that address multiple dimensions of recovery. Evidence based
research that traces this path to rehabilitation supports this claim.
15
FAMILY MEMBERS’ PERCEPTION ABOUT THE DRUG-CONSUMER. A
RESOURCE TO EXPLORE DURING THE PROCESS OF REHABILITATION.
By: Fabrega Febrel and Benito Rosas
Spain and Peru
Josep Mª Fábregas Pedrell begins his professional career in the Marmottan
Hospital of Paris, where he works with the professor Claude Olievenstein. Then, he
travels to New York and, after a lot of years of experience, he founds CITA, Centro
de Investigación y Tratamiento Adicciones (Addiction treatment and Reseach
Centre), in 1981, with the goal of developing a Professional Therapeutic Community
Model. Currently, he has the function of Director Medical Psychiatrist.
Benito Rosas García was born in Lima (Peru). He got his Clinic Psychology Degree
from Ricardo Palma’s University. At the same time, he studied in the Faculty of
Sociology of the Universidad Católica del Perú. At Lima, he has worked in many
well-known institutions such as: The Victor Larco Herrera’s Mental Hospital,
El Hogar de Cristo y la Escuela Naval del Perú. He specialized in psychotherapy
and psychosocial and family measurement, has a Master’s in Drug Dependencies
from Cayetano Heredia’s University and a doctorate in Dynamic, Clinic and
of development psychology from la Sapienza de Roma University. At Italy, he
worked as a therapist in the Italian Centre di Solidarieta, in the Therapeutic
Program aspect “Proyecto Hombre” of Rome. Since 2006, he has being a consulter
in the United Nations Research Institution (Instituto de Investigación de las
Naciones Unidas, UNICRI). Currently, he works at CITA, as a psychologist and
psychotherapist.
ABSTRACT:
OBJECTIVES:
The objective of the following study is to investigate the drug-consumer’s perception about his parents’ behaviour
and attitudes with regard to his childhood and adolescence, and also to perceive how his family of origin is
working.
METHODOLOGY:
The design is descriptive and is of cross section. Three groups were formed in order to make this investigation:
the first group made up of 107 drug-consumers (average age 32.38), put into two Therapeutic Communities
from Italy. We have supplied to this group with the following instruments: Socio-demographic and Toxicological
Questionnaire, the Parental Bonding Instrument (We have added to the PBI the low self-esteem and favouritism
scales of Gilbert) plus the Family Adaptability and Cohesion Evaluation Scale (FACES III).
16
The second group made up of 26 couples of parents of the above-mentioned patients who showed interest in
compiling the FACES III. Finally, the third group (“of control”) made up of 109 university students (average age
27.16) to whom we have applied the PBI plus Gilbert’s scales.
OUTCOMES:
The outcomes from the PBI demonstrate that the drug-consumers perceive their parents in a low way in caring
and in a high way in overprotection (control without affection); moreover, the father is seen by his son as a
devaluating person and that he favours his siblings. Also the mother’s devaluation is not so different for both
groups while there are meaningful differences with regard to the maternal favouritism.
Regarding the FACES III outcomes, the drug-consumers perceive their own family as if they were separated (low
cohesion) and chaotic (low adaptability), showing a problematic situation of the family system. The outcomes
obtained from the family members’ perception (father, mother, son) have shown how the drug-consumers
perceive their family system characterized by weak affective bonding. And also the difficulty to change, perception
that contrasts with the one of the parents. .
17
“RELATION-SHIPPING” AND HEALING : ATTACHMENT, TRAUMA AND
SUBSTANCE MISUSE IN CHILDREN AND YOUNG PEOPLE
By Mr Calum G. Hendrie
Counselling Psychologist
CAYP, NHS Lanarkshire
Scotland, United Kingdom
As human beings, we are ever in relationship: with other, with self. The attachments we experience in the first
years of life are central to the creation of a vast range of our intrinsic cognitive, emotional and social abilities. Our
internalised view of self, others and the nature of reality, affect regulation, our core self-worth and our ability to
make sense of relationships and meet our needs are all influenced by our sense of core security or insecurity.
Children and young people within Local Authority residential settings display a disproportionately high level of
attachment difficulties and trauma related issues in comparison to the general population, as well as substance
misuse issues, reflecting the scale of adverse life experiences they have suffered.
The presentation considers the emerging significant relationship between individuals who have dis-ordered
attachment patterns, and substance misuse. It is argued that an understanding of attachment patterns and
history, as well as the role of trauma, is crucial in planning and delivering effective therapeutic work with those
who experience substance misuse issues. Such interventions involve process based relational ways of “being and
doing” with young people, which acknowledge and respect their fundamental struggle to be with self and other
in the here and now, and to build, maintain and repair healthy and meaningful relationships which are nurturing
and validating. The ongoing task of such therapeutic “relation-shipping” is to assist in the growth of core security
and value, autonomy and response-ability.
18
VITAL WORKING RECORD IN THERAPEUTIC COMMUNITY
Lic. Brostow Clara & Lic. Ghiorzo Andrés
“Andrés Program”
Argentina
Clara Brostow is a Professional Psychologist with a Master Degree in
Psychoanalysis. She serves as Institutional and Therapeutic Chairman from of the
Andres Program of the Rehabilitation Center of the Province of Buenos Aires.
Andres Ghiorzo is Professional Psychologist. He works at the Prevention and
Care Unit of the Andres Program. He is also a well-known photographer with
international exhibitions.
ABSTRACT
Considering that the problem that we commonly face with the patients when the leave a TC, we would like to submit
the description of a feasible model, which would be able to show the guidelines of a future working methodology
that could be applied to other TCs.
The Vital Working Record (HVT) is an accredited instrument for psychiatric treatment and adapted to the
admission treatment at the TC. It gives a chance to build coping strategies from an individual-addict replacement
along with our patients in order to find tools to face any decision-making situation in life with greater resources.
The transition through this device faces the patients in front of the decision of leaving, opening the conditions to
be able to elaborate the duel (not only leaving a rehabilitation program, but to run away from a place of addict,
criminal, lazy, etc.). Likewise, it allows people crossing the device to be able to own some resources to face
circumstances for selecting, choosing and deciding.
This device implementation is a group one, in patients with more than 4 months of admission and close to the
working departure. It is developed in 8 meetings, twice a week (during a month approximately). It is coordinated
by 2 psychologists and two assistants.
19
INTEGRATION OF MET, CBT AND SELF HELP APPROACHES INTO THE
THERAPEUTIC COMMUNITY MODEL
By: David Stockton and Cecilia Velasquez
Gaudenzia. Inc.
EEUU
Since 1968 Gaudenzia has been a leader in developing the Therapeutic Community (TC). The model has evolved
to meet the diverse needs of substance abusers, including those with co-occurring substance abuse and mental
health disorders (COD’s), offenders, substance abusers with HIV/AIDS, adolescents, homeless, and pregnant and
parenting substance abusers. The model addresses the substance abusers multiple needs – criminal thinking and
other cognitive distortions, mental health disorders, they may lack employment skills, they are generally undereducated, and they lack pro-social values, attitudes, beliefs, and behaviors.
Our model is a recovery oriented, evidence-based, highly focused program. Using the social learning TC model
as a foundation, and the stages of change as a focus, we integrate motivational enhancement therapy (MET),
cognitive behavioral therapy (CBT), 12-Step and other self help approaches, in a specialized program to meet the
needs of the specific treatment population.
The basic model modifies the traditional TC approach to be uniquely suited for varied populations. In addition to
focusing on SA and MH issues, the staff prepares the person for long-term stability and employment by providing
educational and vocational services, employment readiness training, and a range of other services.
Gaudenzia has become a leader in modifying the basic TC model to include MET, CBT and Self Help approaches
and activities in each of the four TC Phases. For example, during orientation, the counselor and person address
pre-contemplation and contemplation (stages of change), treatment readiness and resistance to change, and the
first three steps of the 12 step process.
20
WORKFORCE DEVELOPMENT DILEMMAS: INTEGRATION OF
“NON-THERAPEUTIC CUMMUNITY” STAFF INTO A THERAPEUTIC
CUMMUNITY MILIEU
(Presented at: Therapeutic Communities of America, Washington, DC.
David W. Stockton, May 19, 2008).
Cecilia Velasquez , Gaudenzia Inc.
David W. Stockton, Gaudenzia Inc.
This workshop will outline Workforce Development dilemmas that must be addressed in order to have effective
integration of Non-Therapeutic Community Staff into the Therapeutic Community Milieu.
The three key differences in Therapeutic Community Staff and Non-Therapeutic Community Staff will be explored
in this workshop. The three differences in Therapeutic Community and Non-Therapeutic Community Staff are: 1)
Engagement, 2) Professional Commitment, 3) Personnel Management.
To effectively immerse Non-Therapeutic Community Staff into Therapeutic Community Milieu focus must
be placed on five essential components. The components are; 1) utilizing research-based Training to develop
knowledge and understanding of Therapeutic Community Concepts, Principles, and Realities, 2) Identify and
secure core training areas such as Ethics, Confidentiality, and Community as Method, 3) Specific Orientation and
Training Plans, 4) Orientation at Other Therapeutic Community Facilities, 5) Constant Debriefing and Processing
by Director and Supervisor.
Dimensions of Effectual Therapeutic Community Practice are; Rational Authority, Anti-Addict/Criminal Modeling,
Pro-Social and Reinforcement, Concrete Problem Solving, Advocacy and Brokerage and Relationship Factors.
The levels of Therapeutic Community Competency will also be discussed (Roberts, Robin, 1998). In addition,
DiClemente Five Stages if Change, 2001 will be explored in terms of Job Development.
Finally, Four Stages of Staff Development according to DeLeon, George, 1998 will be reviewed.
21
DUAL PATHOLOGY “AN EXPERIENCE OF INTEGRAL THERAPEUTIC
COMMUNITY IN ARGENTINA”
Daniel De Angelis & Sebastian Rodríguez
Proyecto U.N.O. – Una Nueva Oportunidad, Argentina
Daniel D’Angelis is a social therapist, a social psychologist and has a degree in
psychology. He is a specialist in Relational-systematic Family Therapy, founder
and current president of U.N.O. Project “Una Nueva Oportunidad” (A new
opportunity) at the addictions and mental health therapeutic Community. He has
made various presentations about the treatment that kept on developing U.N.O.
Project in the approach to dual clients, specially, to those who have schizophrenia.
Sebastián Rodríguez has a degree in psychology and he is the Director of the
treatment of dual clients of U.N.O. Proyect “Una Nueva Oportunidad”(A new
opportunity).
ABSTRACT
In our daily practice in mental health centers and support centers in addictions, we see increasingly that the
consultation on a problem associated with drug abuse or dependence, (when it begins to investigate issues of the
personality of the same; or, when suspending the consumption of substances), the most varied symptoms of
appear.
Our therapeutic communities provide us with a daily eye on those points which are suffering following the situation
of consumption.
Along the therapeutic route on the causes that lead a person to dependence and / or systematic abuse of toxic
substances, we are going to encounter with specific mechanisms such as low tolerance to frustration, high levels of
impulsivity, the need for immediate gratification, lack of personal projects (product of the flattening of desire and
current social determinations), and also we are faced with patients in whom the substances have accelerated the
process of unleashing their psychosis, or have started with consumption to alleviate the symptoms of psychosis
unleashed.
In these cases we talk about dual diagnosis patients, those in which there is a comorbility between serious mental
disorder and consumption of psychoactive substances.
Therefore, and in accordance with the vicissitudes of current events in the health process, is becoming increasingly
necessary to understand and integrate into the complex system of health, those people whose suffering is also
rooted in a psychiatric problem.
This paper comes as a need to access to an instrument in planning and therapeutic care of patients addicted to
consumption of toxic substances in comorbidity with psychiatric problems. In it, we will try to describe and work
on the technical, clinical and therapeutic sides of the rehabilitation program, and in each step treatment from
admission until the end of it, trying to account for the implementation of strategies to service this aim.
22
METHODS AND TOOLS TO FIND A SENSE OF LIFE
Efrén Martínez Ortiz, Ph.D
Colombia
EFREN MARTINEZ ORTIZ, Ph.D. in Existential Cognitive Psychology, drug
specialist, post graduated in logotherapy and existential analysis. He is currently
Scientific Director of the Foundation Colectivo Aqui y Ahora in Colombia and
coordinator of postgraduate training in logotherapy and existential analysis
(University of Florida / FCAA), professor magister in addictions at the Veracruz
University in Mexico. He is author of nine books and differents articles. He has
presented papers in Spain, Chile, Brazil, Argentina, Costa Rica, Colombia, Peru,
Ecuador, Dominican Republic, El Salvador and Mexico.
ABSTRACT
THE LOGO-TERAPEUTIC TOOLS TO FIND THE PURPOSE OF LIFE
This workshop intents to offer the conception of life purpose that proposes logo-therapy, offering concrete tools
of work to the interior of the therapeutic communities, developing group function, contextual and individual
approach that favor the intervention centered in the purpose of life.
METHODS OF LOGOTHERAPY FOR THE DEVELOPMENT OF SPIRITUALITY AND THE THERAPEUTIC
CHANGE
The present workshop has the intention of raising the fundamental principles of Víctor Frankl’s thought applied
to the area of the therapeutic communities in practical terms, exposing different group techniques (existential
group, group of telling stories, group of the sense, group of reflexion) and realizing modelling that allow the
assistants to take concrete tools of work that foment the therapeutic change, as well as the unfolding of spirituality
in the residents of a therapeutic community.
23
OVERCOMING OUR SHADOW
Por Efrén Ramírez MD
Ocean Park Therapeutic Ambulatory Community
Puerto Rico
Dr. Ramirez currently directs the Center for Integral Healing, an outpatient
therapeutic community for ADD children and adults. He has also been an
International Therapeutic Community Program Consultant in the United States,
Puerto Rico, Latin America and Europe.
ABSTRACT
Attention deficit disorder syndromes (ADDS) have reached a pandemic level. The results are global: distress,
functional impediments, and chronic mental and physical health disorders which have sunk humanity into a state
of denial, and incapacity to face reality.
Since the Second World War psychiatry has been moving away from a narrow attention to individual medicalpsychological practice, towards a holistically based community psychiatry. An example of the above is the drugfree therapeutic community which arose in Puerto Rico in 1960, and became a model for the over 9,000 programs
of the WFTC.
The Ocean Park Therapeutic Ambulatory Community has developed a drug-free treatment program for ADDS,
based on the principles of micro-nutrition (including non-toxic chelated lithium), therapeutic dialogue, “tertulia”,
community action and meditation. This program has proved to be .effective in helping persons surmount their
tendency to addictive behavior and to accumulate toxic beliefs and experiences in what Carl Jung called the
Shadow, thus allowing them to overcome diverse observable patterns of mental dysfunction (Axes I and II of
DSM-IV-TR), and multiple other psychosomatic conditions, through a process of Jungian individuation. The
program includes techniques for developing home-based therapeutic communities, geared towards rehabilitating
the family and the wider neighborhood.
24
2009: TC AND ITS NEW CHALLENGES
By: M. Elena, Goti C.
She is a Consultant Psychologist of Dianova International, Barcelona; and
Prevention Consultant of the TC, Asociación Proyecto Hombre, Barcelona; she was
the Scientific Committee Coordinator for the 22nd World Federation of Therapeutic
Communities’ World Conference 2004, Palma de Mallorca; M. Elena, Goti is also
Member of the board of directors of The International Council on Alcohol and
Addictions, Suiza. In addition she has developed research papers for the World
Health Organization, Fundación Cedro and the UNFDAC.
ABSTRACT:
Currently we live in a globalized World, which produces changes in speed along. This general framing set the TC
in front of two interconnected challenges: the first one is to answer to changes without modifying its essence,
protecting its fundamental values and; respecting the differences and singularities of those who are assisted by it,
in a standard and globalized context.
The Challenge is to continue being oneself after the change has flexibility and be innovative in order to don’t be
stagnated since this processes is very complex it could not be performed in loneliness and isolation for the 2009
TC to form groups and work in networks has become a necessity and not a election.
In this paper we will deal with this processes and challenges, we are going to that the key for have success in its
performance is the integration; the key for this is to share ideas, promote the creativity and the innovation and do
this keeping unaltered values and standards.
This associative movement was undertaken by the WFTC at the end of the 80’s, now we see it in the function of
many active regional networks.
25
THE HUMAN PREROGATIVE: A CRITICAL ANALYSIS OF EVIDENCEBASED AND OTHER PARADIGMS OF CARE IN SUBSTANCE ABUSE
TREATMENT’.
(Lecture first held at “Society & Mental Health” Conference, Thessaloniki
(20 & 21st of October 2007)
(Lecture secondely held at “ 11th International Symposium on Substance Abuse
Treatment.Växjö, Sweden.(6 - 8 October 2008)
By Eric Broekaert,
Wouter Vanderplasschen,
Kathy Colpaert,
Mieke Autrique
Belgium
Dr. Eric Broekaert is a professor in Special Education (Orthopedagogy), at the
Ghent University Belgium. He has a long experience in the field of substance
abuse treatment and research, both nationally and internationally. Prof.
Broekaert founded the first TC (‘De Kiem’) in Belgium. He is the Chairman of
the Orthopedagogical Observation and Treatment Centre, a school for children
with emotional and behavioral problems. He is also Chairman of the European
Workshop on Drug Policy Oriented Research and co-founder and Honorary Vice
President of the European Federation of Therapeutic Communities. He is actively
involved in a variety of national and international research projects on Substance
Abuse Treatment. He has authored numerous scientific publications, and is coeditor of the ‘Therapeutic Communities – The International Journal for Therapeutic
and Supportive Organizations’.
ABSTRACT
It is the aim of this lecture to clarify under which conditions evidence based research can be part of a move
towards integration of at first sight contradictory paradigms that underpin different approaches in substance abuse
care, and which should be the essential conditions of such integration. The actual dominance of Evidence Based
Medicine in substance abuse treatment leads to a hierarchy between care approaches such as Pharmacological,
Behaviour Based Treatment; Therapeutic Communities, Self Help; and Harm Reduction. Those distinct methods
of working are underpinned by scientific paradigms such as the empirical analytical, the phenomenological and
the social critical that all at their turn can form a critical platform to criticise Evidence Based Medicine. It is the
position of this paper that he dialectical integration of these approaches could benefit the human prerogative of
care. Within this vision the different approaches alternatively go together in a never ending dialectical search for
unity that combines evidence, existence and social emancipation. It attunes the concepts of Recovery and Harm
Reduction and enhances Quality of Life. This lecture will so consequently examine Evidence Based Medicine
and the hierarchy that it imposes on the different approaches of care, the paradigm’s that underpin the distinct
working methods, the criticism they inflict, and the conditions for their further integration and a better human
quality of life.
26
CONDUCT EVALUATION OF RESIDENTS ACCORDING TO THEIR PHASE
OF TREATMENT IN THE THERAPEUTIC COMMUNITY OF INSTITUTE
MUNDO LIBRE
By:
Elena Esther Yaya Castañeda, Patricia C. Daza Velásquez
Luís E. Jáuregui Aguirre, Javier Víctor Medina Velazco
Esther Yaya is the Coordinator of the Psychology Area in the TC Institute
Mundo Libre. She has a degree in Psychology at the Universidad National
Federico Villarreal in Lima – Peru, with a Master’s degree in Clinical Psychology
in the specialty of Child and Adolescent Psychotherapy at the Universidad
Cayetano Heredia. She has experience in treating addictive behaviors, design of
methodological proposals and management techniques in behavioral, in developing
guidelines for effective accompaniment, the approach in crisis and counseling
for adolescents. She trains at the issue of Psychological Intervention in Drug
Dependence, in various institutions. Currently is researching in the quality of life in
children and adolescents addicted to psychoactive substances.
ABSTRACT
This article is based on observation of the behavior of children and adolescents during the period of their treatment
as residents, in the therapeutic community Institute Mundo Libre.
It was used the Card of Evaluation according to the treatment phase, the same one that was created to realize
the record and follow-up of the variety of behaviors and state of mind of the resident of the variety of conducts
and frames of mind of the resident. The card is organized in the following thematic axes: Behavior (addictive, in
workshops and social), Self Organization and Organization of the House, Problem-Solving and Decision Making,
diagrams or conceptions, negative thoughts, and Family
The results show favorable changes in the different axes that allow predicting that the organized and systematical
observation of the conducts favors the incorporation of new learning’s in the children and adolescents
27
REFLECTION ON THE APPEASEMENT AND REHABILITATION
APPROACHES AND THEIR INFLUENCE IN CHILDREN AND
ADOLESCENTS CONSUMERS OF PSYCHOACTIVE SUBSTANCES OF THE
STREET IN PERU
By Fabrizio Caciano
Instituto Mundo Libre
Peru
Currently Fabrizio Caciano is in charge of the Administration Area and is the
Director of Prevention and Street Work of the NGO Instituto Mundo Libre, a TC
for street children drug consumers , entrusted on managing better opportunities
of life for street children, girls and teenagers, from an approach of rights. His
studies in Administration and Marketing have helped him to develop models of self
sustainable workshops being able to be included in rehabilitation programs.
ABSTRACT
After having seen the Peru’s socio-economic aspect, we expect to discover the source of child and adolescent drug
addict problems in the streets. In this case we have two approaches: the appeasement approach which suggests
immediate solutions and the rehabilitation approach which considers the individual’s recovery in a therapeutic
community respecting his rights and dignity and acknowledging his role as an individual responsible for his
recovery. The relationship self-esteem and victimization will be outlined. The life plan and the option of staying
at the street will be discussed. Also, the society and state role will be described. We aim to achieve change from
the street.
28
THERAPEUTIC APPROACH TO TEACHING TEENS AND YOUNG PEOPLE:
SKILLS FOR LIFE
By Fineke Janssen
Bolivia
Born in the Netherlands, Fineke has lived almost 20 years in Bolivia. Training
in the area of psycho-pedagogy with creative dynamic approach, she has a
Diploma in Domestic Violence and Paradigms for working with adolescents. Work
experience with children and people with addictive behaviour of over 25 years. She
is the Founder of Therapeutic Communities Adulam for adolescent boys, Talita
Cumi for young women and others. She has being in charge of the Development of
leaders in subjects of leadership and management of CT, leadership at national and
international levels with Therapeutic Communities and dissertation on the subject
of the problems of consumption and addictive behaviour.
ABSTRACT
The insight of this model is that the participant, after concluding with the material, he/she is able to do things in
an independent way and to undertake the process of educative and socio-labour reintegration. Even though we
treat adolescents who have consumption problems and addictive behaviours, it is not the emphasis. In fact, we
put the emphasis on the person.
This model starts since the vision of the hidden problems by the consumption and the addictive behaviours
deserve an integral attention of quality, and it stresses two pedagogical sources: the constructivism and the
cognoscitive. On the educative processes, the participant builds his ideas in an active way, directly based on the
previous acquired knowledge and on his aspirations for the future.
We define some strategies for three phases (1st phase: getting to know each other, 2nd phase: building our
life project and 3rd phase: auto-dependency), selecting aspects of perceived necessities, focusing on 23 topics
which are taken into a group level during the staying on the Therapeutic Community. The material is very well
explained and has the concept of the topic. The problematization at a relational, emotional and cognitive level
plus the justification. Each segment of the topic has his development for every activity with goals, guidelines and
indicators.
By using this model you can learn different abilities for life by dynamizing integral learning processes in a
participative, inclusive and powerful way. The group builds processes beginning with different dynamics and
activities, and it provides opportunities to fill the gaps in the personal growth.
The outcomes obtained are highly encouraging because during all years of the application of this model, a 41% of
our participants are rehabilitated into society.
29
THE TC: FIDELITY AND THE FUTURE OF THE MODEL
By George De Leon
EE. UU.
George De Leon, PhD, is an internationally recognized expert in the treatment
of substance abuse and is acknowledged as the leading authority on research
in therapeutic communities. He is the director of the Center for Therapeutic
Community Research (CTCR) at National Development and Research Institutes,
Inc. (NDRI), funded by the National Institute on Drug Abuse(NIDA), and Clinical
Professor of Psychiatry at New York University. In addition to numerous
research publications, Dr. De Leon has made notable contributions in the areas of
clinical practice and professional education. He provides training in therapeutic
community practice to psychiatric fellows, psychologists, nurses, social workers,
and other health care professionals in treatment programs. He is also project
coordinator for Therapeutic Communities of America in developing national
standards for accreditation of therapeutic community programs in correctional
settings.. He is a founding member of the New York State Psychological
Associations Division on Addictions, as well as a founding member and past
president of the American Psychological Associations Division 50 on Addictions. Dr.
De Leon is a recipient of the most significant awards in his field.
ABSTRACT
The evolution of the contemporary TC for addictions over the past 45 years may be characterized as a movement
from the marginal to the mainstream of substance abuse treatment and human services. Currently TCs serve a
wide diversity of clients and problems; they have reshaped staffing composition, reduced the planned duration of
residential treatment, reset its treatment goals and to a considerable extent, modified the approach itself.
These changes are expected and consistent with the TC’s maturation, into a mainstream public health entity.
However, the future of the TC approach itself contains a profound and paradoxical threat—the loss of its unique
self-help identity which has defined its success. To convert this threat into an opportunity for advancement, the
TC must address key issues 3 of which are highlighted: clinical practice, workforce development and training.
30
COMBINING RESEARCH AND CLINICAL METHODS FOR IMPROVING
QUALITY OF TREATMENT IN TCS
Dr. Gerasimos Papanastasatos
Kethea
Research Department
ABSTRACT
Clinical trial inspired methods continue to be accepted as the most reliable research designs in order to evaluate
treatment effectiveness. Nevertheless technical and operational obstacles as well as ethical concerns influence
researchers’ approaches and perceptions when drug abuse treatment outcome evaluation is under investigation.
In this perspective, quantitative methods used in experimental or semi-experimental designs limit the possibilities
to interpret outcomes and better understand the treatment mechanism producing one kind of findings instead of
others. In addition, experimental designs appear inappropriate and, often, contra-indicated when control groups
in substance abuse treatment are included to studies. Naturalistic studies continue to be the most frequent studies
that can offer reliable effectiveness’ evidence. Due to the need of having answers originated by the confounds of
treatment’s black box researchers since few years promote the idea of mixing quantitative and qualitative data in
order to produce a more powerful and complete set of findings. Therapeutic Community treatment is presented as
the ideal field for implement mixed methodology evaluation research. Clinical practice on the other side recognize
the validity of combining treatment techniques that better fit to assessed client particular needs in order to provide
more effective treatment instead of selecting exclusive approaches. Treatment in TCs challenges with new needs
often requiring adaptation of tools and enrichment of treatment protocol combining approaches and procedures
that can broaden therapeutic system’s efficiency as well as treatment effectiveness. This paper discusses chances
and challenges in combining methods for both research and clinical practice in order to provide more effective
treatment and to elaborate more accurate designs in treatment evaluation.
31
CODEPENDENCY A REALITY IN INTERVENTIVE PROCESSES FOR
THERAPEUTIC COMMUNITIES
Gloria de Salvador
COLOMBIA
Clinical psychologist specialized in drug dependency and non-traditional treatment
and prevention programs. Therapist trained in the Italian Center of Solidarity.
Councelor by WFTC in Abuse of Psychoactive Substances. Scientific Director of San
Gregorio Short Therapeutic Communities Programs for Teenagers - Male Modality,
“El Girasol” Program”, Short Female Therapeutic Community and the Educational
Child Community “Crecer”. Member of the Local Unit of Advice and Training for the
Colombian Bishop Church Drug Addiction Prevention Project. External counselor
of the OAS-CICAD for Latin America. In charge of preparing the guidelines on
prevention and intervention of dysfunctional use of psychoactive substances for
the National ICBF to be used in the Transitory Homes and Youth Houses from the
“Instituto Colombiano de Bienestar Familiar” within the Program for Children and
Young People Untied to Illegal Armed Groups and the elaboration of scaling-up
material addressed to prevent the consumption of alcohol, tobacco and marihuana
within these programs.
ABSTRACT:
This report is oriented to be a revision on the concept of codependency and its repercussions on the people who
display this emotional affective condition, on the situation more and more frequent of intervening with people
who display compulsive problems, even among their closest relatives. The definition of the Johnson Institute of
Minneapolis 1.987 describes codependency as ä series of badly adapted compulsive behaviors that members of
a family learn to survive within a family which are subject of great amounts of emotional pain and stress which
pass on from one generation to another whether with the presence of alcoholism or not.¨ This view combined with
those of various authors such as Earnie Larsen (2.001) who defines it as ¨Those learned conducts or defects of self
destructive character which result in a diminished capacity to initiate romantic relations or participate in them.¨
Of which gives birth the interest to delve deeper into this new type of co-addiction if we analyzed it according to
the author, ¨People who do not take care of themselves or never have been in a relation with an alcoholic. Where
they are, the person has allowed the conduct of others to affect him and has the obsession of controlling the
conduct of other people.¨ It is for this reason why this affective emotional and behavioral situation is not only the
privilege for people in treatment programs for a different type of addictive conducts, if not an even more worrisome
pattern found by therapeutic helpers. From there it is a necessity to delve deeper in this phenomenon and the
possible repercussions at the personal and familiar level, as well as outlining some alternatives to prevention and
intervention.
32
THE DUALLY DIAGNOSED AND THE THERAPEUTIC COMMUNITY (TC)
Gregory Bunt
EE. UU.
GREGORY C. BUNT, MD serves as the Medical Director of Daytop Village, Inc.
in New York City, NY. He obtained his medical degree from the NYU School
of Medicine. He also serves in many different committees nationally and
internationally such as the International Society of Addiction Medicine. Dr.
Bunt has published over sixty articles in various professional journals and has
participated in more than a dozen research projects in dually diagnosis clients.
ABSTRACT:
Therapeutic communities (TCs) are a widely recognized treatment modality in over twenty states in the United
States, and in more than seventy countries worldwide. Approximately, one-third to two-thirds of the residential
population under therapeutic care in the TC is affected with some form of mental illness. Rehabilitation from
a community based approach and the most common coexisting psychiatric disorders will be discussed. The
successful adaptations of the TC approach for mentally ill chemical abusers and its specific interventions for
the dually diagnosed will be explained, along with the application, advantages and challenges of the integrated
modified therapeutic community.
33
“RISK FACTORS ASSOCIATED WITH THE CONSUMPTION OF
PSYCHOACTIVE SUBSTANCES IN PATIENTS VÍCTOR LARCO HERRERA
HOSPITAL - 2008”.
By: Alicia Chu
Gustavo Sipán
Lima, Perú
Dr. Alicia Chu Ezquerre is a Medical Psychiatrist, psychotherapist and an exscholar of the United Nations in the Addictions’ Area and has a master’s in Public
health. Currently, she teaches in the Universidad Nacional Mayor de San Marcos
and in the Universidad Científica del Sur. She’s the Head of the Addiction’s
Department at Victor Larco Herrera Hospital and creator of the Rehab and
Treatment for addicted clients program at Victor Larco Herrera’s hospital, which
already has 17 years serving.
Gustavo Sipán Valerio is a graduated nurse assistant of the Addictions’ Department
at Victor Larco Herrera’s hospital. He has a master’s in Public health and, also,
teaches at Universidad de Huacho.
ABSTRACT:
The present study aims to identify risk factors associated with the consumption of psychoactive substances
in patients who came to the Department of Addictions of our hospital, from September 2007 to April 2008.
Corresponds to a case-control study in which 75 male patients were selected with diagnosis of mental and
behavioural disorders due to psychoactive substances and 150 male patients who did not have this diagnosis and
attending as outpatients of the hospital by other mental health problems (controls).
The information was obtained using the Inventory DUSI (Drug Use Screening Inventory).
The results of the investigation identify a high degree of association between the risk factors and the consumption
of psychoactive substances for patients with this diagnosis. On the contrary there is a low association for patients’
controls.
34
CHALLENGES IN RECOVERY
HAFIZI HARUN
MALAYSIA
Mr. Harun is the Training Manager for PENGASIH, Malaysia. He has conducted
trainings and delivered presentations in Malaysia, Indonesia, Pakistan, India,
Maldives and Brunei. In 2006, he was elected the Malaysian “Youth Against Drugs
Ambassador.”
ABSTRACT
In the Journey to Recovery, relapse prevention is one of the main goals of all recovering persons. The same hope
is present in the hearts and minds of their loved ones.
However, during the journey, there are major challenges that former users may face. Some may find these
challenges as very frustrating and really difficult to cope with. The risks of falling back into the vicious drug life
are always there.
Le it be known to everyone, such challenges are entirely expected. The good news is , everyone in their journey to
recovery can overcome these challenges with proper tools.
To do so, we should identify the major challenges and understand the obstacles deeper and know ways how to
overcome them. This presentation will try to address these points further and help those in their journey to
recovery.
35
IDENTITY, EPIGENESIS, AND SOCIAL LEARNING
Por Dr. Humberto Nicolini, Psiquiatric
México
Y Dr. Jose D. Batista
Dominican Republic
The evolving development in neuroscience is moving toward the understanding of the epigenesis of human
relations and its impact on behavior.
The theory of the Identity provides a point of reference for healthy emotional interaction, in a moment of social
emotional fragmentation that could be acting as a trigger in the increment of mental health problems.
Research in the area of epigenetic and social learning is opening the new avenue to explore human behavior.
Dr, Humberto Nicolini will be presenting the concepts of epigenetic and its impact in psiquiatric studies, and Dr.
Batista the possibility that exist for human development.
36
RETENTION IN THERAPEUTIC COMMUNITY IN THE FIRST 30 DAYS:
QUALITATIVE APPROACH
By: Anagnostou Eleni,
Greece
Helen Anagnostou, has worked for KETHEA PAREMVASI for more than 15 years.
KETHEA PAREMVASI is a therapeutic program that belongs to the Therapeutic
Centre for Dependent Individuals (KETHEA) and provides services to drug
addicts over 20 years old and their families. The program provides detoxification,
education and social rehabilitation. She is currently the Director of this Program.
Helen Anagnostou has Master’s of Science in Counselling Psychology, from
Middlesex University, London. She earned also a Diploma of Addiction
Counselor Competencies – Management and Social Planning in the Addictions
from the University of California, San Diego and she is a Certified Addiction
Counselor ICRC/AODA. She has a extensive experience in family therapy. She
has been presenter in many seminars, trainings and conferences nationally and
internationally. She is a member of the European Association of Professionals
Working in the Field of Drug Dependence.
ABSTRACT:
In the therapeutic communities are recorded high drop out rates during the first period of drug-addiction treatment.
Τhe present qualitative study aims to investigate (i) reasons that drug addicts themselves provide as important
for their retention in therapeutic community in the first month and (ii) factors that are proved supportive or are
related with experiencing difficulties during the stay in the residential treatment. The sample of the study includes
32 subjects that had been admitted to KETHEA PAREMVASI΄s therapeutic community.
Findings suggest that retention in treatment in the first month is related with individual factors and with
the therapeutic environment too. Subjects’ motives for retention in treatment in the first 30 days result from
motivation for personal change and pressure from external factors.
Lack of contact with significant others, the previous lifestyle with drug use and previous experience in treatment
are pointed out as individual factors that impede the smooth adjustment to therapeutic environment. Smooth
adjustment is also impeded from factors that derive from therapeutic environment΄s characteristics such as the
structured programme of daily activities, the hierarchical model and limits in the behavior.
Personal changes that subjects have already experienced from drug use abstinence and persons that seem to
function as role models for them appear to strengthen subjects’ decision for retention in treatment. Findings also
indicate the positive role of: (i) the existence of a supportive therapeutic environment, (ii) the educational and
recreational activities and (iii) the therapeutic processes.
37
“SPIRITUALITY IN THE TREATMENT OF ADDICTIONS”
lleana Castro,
TC “Hogar Vida Nueva”
Venezuela
Ileana Castro, has a degree in Psychology and in Education at the Andres Bello
Catholic University, specializing in clinical psychology. She is currently the Head
of Treatment of the therapeutic community New Life since 2000. She has also been
co-founder of the rehabilitation service for alcoholics and Community Service and
Drugs, both of the Psychiatric Hospital of Caracas. She is also an instructor in the
field of drugs of various institutes.
ABSTRACT
In Hogar Vida Nueva (Hovin), the person is considered as an integral human being with a body, a soul and a spirit,
and so the treatment is applied to the following areas:
- Physical: to help physiological alterations.
- Social: to promote the practice of social, cultural and sport activities.
- Mental: group and individual interventions carried out by Psychotherapists.
-Spiritual: to promote the development of the inner being by teaching values, love, honesty, respect, friendship,
responsibility, work, solidarity, confidence and faith.
In our treatment, spirituality is the natural and conscious practice of the vigour or strength that encourages a
person to act, and it is expressed in inspiration, courage, support, vigour, effort, vivacity and talent.
In addition, Hovin’s spiritual program contemplates the AA’s twelve steps, which is improved by the bible’s lecture.
We consider that this is a very useful program that transforms the drug-consumer’s personality and allows him to
leave the addiction behind. The institution has used this treatment for ten years and with good outcomes.
38
THE ESSENTIAL ELEMENTS OF TREATMENT:
AN EUROPEAN THERAPEUTIC COMMUNITIES PERSPECTIVE
By Ilse Goethals
Veerle Soyez
Eric Broekaert
Ghent University
Belgium
Ilse Goethals has a master in psychological and educational sciencies with option
in Orthopedagogics – Ghent University, an currently is a doctorate/PhD student
developing a tesis on The impact of treatment processes on retention in therapeutic
communities for substance abusers. She works as Academic Assistant at the
University Ghent, department of Orthopedagogics.
ABSTRACT
Both adaptation and innovation have been the keys to survival for European drug-free, hierarchical, conceptbased therapeutic communities since their introduction in the 1970s. Although history clearly shows that the TC
approach is flexible enough to be implemented for a variety of populations, in different cultures and in various
settings, it does not give many details about the constant challenge to uphold what is essential in European TC
treatment.
The aim of this study is to illuminate the core elements of the treatment in European TCs. More specifically, the
goal is to investigate whether European agencies which are to date still identified as traditional TCs share common
beliefs of what is essential to the quality of treatment.
To answer previous questions, the ‘Therapeutic Community Scale of Essential Elements Questionnaire (SEEQ)short version’ will be administered to all members of the European Federation of Therapeutic Communities
(EFTC). The directors of these agencies will be asked to complete the questionnaire.
This research is important because it will facilitate comparisons of effect studies. Also, agencies will be better
informed about possible quality improvement issues. Finally and most importantly, specifying the core elements
of treatment will allow us to better understand the treatment processes which are responsible for client changes.
39
QUALITY IN SERVICES FOR ADOLESCENT USERS OF PSYCHOTROPIC
SUBSTANCES
By: Ioannis Mihalakoukos
Head of Financial and Administative Department
Greece
Ioannis Mihalakoukos, holds a BSc in Business Administration from the University
of Piraeus and is currently studying for a Master in HealthCare Management
in Department of Social Sciences of Hellenic Open University. Since 1993 he is
working in KETHEA in several financial and administrative positions. Since 2005
he is Head of Financial and Administrative Department. He has participated in
different training courses such as: Social Planning and Social Policy, Systemic
Consultation, Leadership, Group Dynamics.
ABSTRACT
The need for quality in mental health services for adolescent and consequently in services for adolescent users
of psychotropic substances it is nowadays beyond dispute. According to modern studies the measurement of
parental satisfaction regarding quality in these services for adolescent seems to be a powerful instrument for the
services’ improvement.
The main purpose of this paper is to focus both on reviewing the correlation between two factors: quality provision
of services for adolescent drug users and parental satisfaction. Data were collected from respondents (parents) in
KETHEA PLEFSI, an early intervention programme for adolescents in Attica, Greece, with a specifically designed
questionnaire. The questions referred to several dimensions of satisfaction with the services, along with several
demographic characteristics.
The findings points out that the people who received the services of KETHEA PLEFSI are very satisfied from the
clinical and administrative services, from the facilities provided and the environment of the programme. Under the
present circumstances which are characterized by the strong competition of the relevant services, the treatment
programmes ought to aim to the satisfaction of the adolescent and the parents approaching their services and
work for the continuous improvement of quality.
40
ADDICTIONS: AN ERRANT SEARCH FOR LIFE MEANING
By Jaime Torres
Peru
Jaime Torres has a degree in Psychology from the San Martín de Porres University
in Lima, and post graduate studies in Administration and Management of
Addiction Rehabilitation Centres, from Daytop International, and in Drug
Dependencies from the Garcilazo de la Vega Inca University. His splits his time
between administrating Takiwasi Centre, the therapeutic activities with in-patients
and teaching at Cesar Vallejo University in the Pharmacodependency course.
He regularly participates as lecturer in national and international meetings on
Amazonian Traditional Medicine and drug addiction rehabilitation.
ABSTRACT
Drug addiction is a very complex problem that goes beyond any psychological, sociological, economic and politic
analysis: it’s a problem of our modern western society.
From historian and anthropologist observations we know that addictive behavior did not exist in traditional
societies, even if the ingestion of psychoactive substances contained in certain medicinal plants was a widespread
and usual practice. It’s through the ritual use of these psychoactive plants that people could get into the spiritual
world looking for equilibrium between material and spiritual forces.
According to Traditional Medicine, addiction is created by a profanation transgressing the spirit of the plant, an
action that disrupts the equilibrium between man and Nature. In this way, the spirit of the plant takes possession
of the person inducing the wish to continue consuming and finally leading the person to the addictive behavior.
We are now in a society where important religious dogmas have been lost or deeply transformed. We observe
dissatisfaction with the world, facing a moralizing and extremely rational society, where people is forced to
productivity, where rituality and initiation rituals have no longer the importance and status that used to have
before in every human culture.
Addictions represent a way of searching “the sacred” through numinous experiences, transcending and finding
a meaning of life. However, while consuming the plant in a profane way the addict transgresses the spirit of the
plant and the action of consuming become a failed self initiation.
41
MEETING THE CHALLENGES THROUGH WORKFORCE
DEVELOPMENT: CERTIFICATION’S CENTRAL ROLE
By: Jeff Wilbee
President of International Certification and Reciprocity Consortium (IC& RC)
EE.UU.
ABSTRACT:
The most effective tool in meeting the global challenges of addiction and drug abuse is to ensure a competent
prevention and treatment workforce, At the July 2008 summit at the United Nations in Vienna Austria Beyond
2008, three resolutions were adopted. Within those resolutions to combat drugs and crime were three references
to workforce and professional development. The presenter will offer insights into how that development may be
accomplished in South America and across the world, particularly within a therapeutic community setting. This
presentation will outline the value and process of certification as practiced in North America and fourteen other
countries. The International Certification and Reciprocity Consortium have twenty-seven years of experience.
That experience will be shared and at the same time an interactive dialogue with the attendees will consider the
barriers and best approaches to take. The session will conclude with creating recommendations on a strategy to
move ahead the idea of a global workforce development plan.
42
EVOLUTION OF THERAPEUTIC COMMUNITIES IN SPAIN. ANSWERS
FROM MAN PROJECT
Jesus Hernandez, since the beginnings of “Proyecto Hombre Murcia” (1995) has
collaborated in that program in which he currently is Director and in addition, he
serves as the President of the “Asociación Proyecto Hombre de España”.
He has a degree in Ecclesiastical Studies, he also graduated from University of
Murcia as a Social Worker, and, in addition he is a Specialist in substance abuse by
the University Complutense of Madrid.
ABSTRACT
From the beginning and throughout the history of therapeutic communities in Spain, Association “Proyecto
Hombre” has developed the answers that seemed necessary in every moment for a better reception, rehabilitation
and social reintegration of those affected by the phenomenon of drugs.
“Proyecto Hombre” has been built from the reflection that arises from direct contact with the changing needs and
social realities created by the consumption of drugs. This has meant a gradual change on interventions and an
evolution in communities’ life to keep on giving more adequate responses to new demands.
At present “Proyecto Hombre” offers a wide range of treatment models within the model of therapeutic communities,
ranging from the gated community (residential) to the open community in which only a minimum number of
addicts require the residential model. The location also has developed various models: Correctional Communities,
urban communities, and so on. The diversity of profiles has also led to specific models: Communities for alcoholic
addicts, communities for women with dependent children, communities for dual pathology, and so on.
The versatility in the treatment, fruit of constant dialogue with users of our resources, with their needs and
specific problems, is one of the strengths that owns “Proyecto Hombre” and has allowed us to evolve towards
more effective responses to be the most important resource in Spain in the treatment of addictions.
43
THE T.C., AN ANSWER TO SOCIAL VIOLENCE
Por Jorge Blanco K., MA, CADC, CSW
Director of Research and CURA International
New Jersey - USA
Jorge Blanco, has a Masters Degree in Clinical Psychologist. He is a Licensed
Alcohol and Drug Counselor in the USA. He is currently the Director of Research
and International affairs in CURA Inc. a Therapeutic Community in the State of
New Jersey in USA . He is a professor in the Essex County College and an evaluator
for the Alcohol and Drugs Certification Board Inc. of New Jersey. He has more than
25 years of experience in the field of prevention and treatment of addictions. Mr.
Blanco presented his work in various conferences, symposiums and international
meetings and he is the author of various articles and papers in the field of
addictions.
ABSTRACT:
This presentation calls to reflexion regarding the importance of the Therapeutic Community, and its therapeutic
processes including the social re-entry process, as an alternative to social violence that triggers the use of alcohol
and drugs in modern society. This presentation covers, among other topics, concepts regarding the roots of
violence behaviour, anger management within the family, social and therapeutic environments, and the search
for an emotional balance.
Concepts such as ethics, values, spirituality, moral and dignity, as well as injustice, inequity, poverty, pain and
dependency, will be presented within the context of the social responsibility the T.C. has in its daily provision of
services to the population it serves.
This presentation hopes to inspire the participants to continue their commitment and motivation to answer the
challenge of the world conference’s main theme “an alternative for human and social development”.
44
THE POWER OF THE WORDS TO HURT OR HEAL IN THE T.C.
Presentors:
Patricia Ackermann, MA, LCADC, CSW
Clinical Director - CURA Inc.
New Jersey, USA
Jorge Blanco K.; MA, CADC, CSW
Director of Research and CURA International
New Jersey, USA
“Words” are the most important communication “tool” between people. What are the effects the have in the brain
and the behaviour? The answer to this question should be known in our T.C.’s as we approach treatment in a more
human and scientific way.
During this workshop, participants will learn about the value that words have in the therapeutic process in the
T.C.. This will allow us to understand our clients in a more holistic way, understand the function of the brain, the
memories, the emotional experiences and how all this manifests itself in the behaviour.
We will present examples and experiences in the T.C. as they relate to messages sent through words.
If the counselor, teacher, person in recovery, therapist, person in recovery, volunteer and/or any other person that
work in the T.C. is able to understand the power and the value of the words, this its capacity to hurt or the heal,
maybe he/she will be more responsible of how he/she speaks, and maybe this person will never speak the same
way.
45
DEVELOPMENT AND PROPOSAL EVALUATION OF A TRAINING
PROGRAM IN COUNSELING IN ADICTION
Dr. Jorge Sánchez Mejorada, Mexico
Dr. Jorge Sanchez Mejorada Fernandez is a Medical Surgeon graduated from
the UNAM (National Autonomous University of Mexico); he is a specialist in
Psychiatry, Public Health and Psychotherapy with Humanistic Direction. He has
previously worked as a psychiatrist in CIJ and as Therapeutic Coordinator of the
Centro Monte Fénix in Mexico City.
He is the Founder and General Director of the “Nueva Casa” Foundation a private
and non-profit institution in Xalapa, Veracruz Mexico. He is also the President
of the Mexican Federation of Therapeutic Communities and member of the Latin
American Federation of Therapeutic Communities Council. He works as researcher
for the University of Veracruz and coordinator of the Masters of virtual modality
in “Integral Prevention of Consumption of Drugs” in the same University, he works
in collaboration with the Office of United Nations against the Drugs and Crime
(ONUDD) and the National Council Against Addictions (CONADIC). He has an
ample experience in the fields of prevention, treatment and the formation of human
resources in the field of the drug dependency.
ABSTRACT:
Therapeutic communities traditionally use as a human resource the former - rehabilitated addict, who usually
trained in the same institution in which he was born and which he provides his services. This character has been
given the name of the operator, teacher or counselor in addiction.
Their training is not systematic and far less has been adequately evaluated. This paper describes a proposal for
evaluating operational changes through a monitoring process to the participating institutions in two states of
Mexico: Jalisco and Veracruz. It seeks to evaluate changes in methods of intervention and / or the application of
formal rules and codes of ethics in institutional programs.
This paper seeks to answer the questions:
- What is the impact of this mode of education?
- Is it worth investing financial and human resources for the gradual professionalization of therapeutic
communities?
46
A MODEL FOR SOCIAL THERAPEUTIC COMMUNITY
IMPLEMENTATION
DR. JOSE D. BATISTA
Dominican Republic
Ph. D. in Human Development Psychology and Culture System Development,
Fielding Institute, Santa Barbara, California. Consultant in strategic culture
and human change, strategic programs, assisting multinational corporations
and government institutions in Italy, Mexico, Venezuela, Dominican Republic,
Argentina, Puerto Rico, and United States to deal with complex changes. Training
on the Theory of Identity. Professor and invited professors from universities in
Europe, United States, and Latin America, in the area of human, organization, and
culture development.
OBJETIVE
To present the Therapeutic Community Program For Social Deterioration Prevention, as it is being implemented
in Tabasco, Mexico
Tabasco, México, is the center of the oil industry of the country. As many other societies that moved from
agriculture to manufacturing and service industries, with the imbalance between lack of job opportunities and cost
of living with a growing young population, is suffering from social instability characterized by an environment of
increasing:
•
•
•
•
•
•
•
•
Violence
Stress
Depression
Disorder of attention
Sexual promiscuity
Addiction
Suicide
Divorces and other mother social issues.
The actual situation has increased the differences among traditional social normative values and the emerging
global internet free norms system as more “blogs” communities are being formed.
This has created the need to implement a State Wide Prevention System, utilizing the Theory of Identity.
The program is being supported by the State Government through the Department of Health, and is lead by the
Director of the Hospital Escuela de Alta Salud Mental, and the President of the Non-Profit Organization Pasion
por la Vida.
This work is the result of the presentation of the program progress to the authorities of the State, and it was
selected to be presented as a Model for Social Transition, as part of the World Day Of Mental Health Forum,
celebrated in Villa Hermosa, Tabasco, in October 10, 2008
47
A JOURNEY TO HOSPITALITY TO SELF AND TO OTHERS
Jose Gabriel Piedrahita MA, LMSW
Colombia
Jose Gabriel Piedrahita MA, LMSW has a vast international experience on both
clinical and pastoral fields in Africa, Europe, South America and in the USA. He
worked for over 12 years in the South Bronx where he was able to build a coalition
of community organizations and churches to assure coverage and quality in
education, health, housing, and drug prevention/treatment for the most vulnerable
population. He has been connected to Daytop for the last 8 years particularly in
the area of Anger Management and also participated as a lecturer at the WFTC
in Palma de Mallorca back in 2004. He has worked in New York City for the
Children’s Psychiatric Crisis Intervention of the Visiting Nurse Service, as well
as at Beth Israel Hospital and recently at Mount Sinai Hospital in the Addiction
Recovery Services. Currently Rev. Piedrahita works in the Church of St. Peter in
Haverstraw NY where he is implementing a model for collaboration between clergy
and clinicians in the area of Rockland NY. He is also a member of the Partners in
Healing Group at Fordham University and regularly presents on Parenting and
Drug Treatment. The author is fluent in Spanish, English, German, Kiswahili and
Maasai.
ABSTRACT
This workshop reviews the dynamics of the Therapeutic Community as a mirroring process that empowers the
whole person to embark upon a journey of self-knowledge and personal growth. This workshop describes the
development of spiritual availability, as the willingness to be accessible to another person with one’s entire being
when others are in need. It illustrates how the more one is in touch with personal failures, weakness and limitations
the more one can express compassion and understanding. Finally this workshop describes the Therapeutic
Community as a living paradox that embraces the human condition as “both/and” (both a wounded warrior and a
healer) rather than “either/or” (either a wounded warrior or a healer) and that transcends its own boundaries as
compassion breaks through the boundaries of language, nations, race, rich and poor, pulling people into a larger
sphere where a sense of hospitality to self and to others is restored.
48
LATINOAMERICAN THERAPEUTIC COMMUNITIES –
A SHORT STUDY OF GROWTH AND DEVELOPMENT
By Juan Palacios
FLACT Vicepresident
Juan Palacios, has a degree as Social Worker, and post graduate studies in Social
Planning and Mental Health Social Worker – England. He worked as Director
of Psychiatric Social Service and Head of Inspectorate and Quality Control in
Social Services – Enfield- London , he also served as member of the Mental Health
Commission - England (1986). He is currently the Technical Director of Colina
therapeutic community in Chile and vice president of the FLACT. He is professor
in the Santiago University and in the Americas University – Psychology College.
Mr. Palacios has presented his works in various conferences and international
meetings.
ABSTRACT
Therapeutic communities are at large a new reality in Latin-American , the oldest one appearing within the last
20 years and each day numbers are increasing. How many they are? , where are they , how are they funded , who
work on them , questions until now are difficult answer due to speed in which they appear and develop .
It is clear nevertheless that CTs are in part the response of organized communities to deal with those problems
like drugs , war or poverty that governments are not duly interested in tackling or solving.
There is no doubt that drug problem are in the increase all over the world , Latin-America is not an exception to
this phenomenon and the slow response of governments and international agencies are pushing more and more
communities to find their own solutions to these problems , this study pretends to show only on a very graphic
way the importance to Latin-America of the appearance of CTs , the scope of problems they are tackling and the
responses they are getting from their communities and the government structures .This research is based on data
obtained from FLACT ( Latin-American Federation of CTs, OEA CICAD and Drug Control Agencies on Latin
american Countries)
49
COUNSELING AT THERAPEUTIC COMMUNITIES
By: Juan Facundo Cincunegui
Centro del Sol Association, CHOICE COUNSELING PROGRAM
Argentina
He is a member of the Latin-American Federation of Therapeutic Communities and
of the Argentina Federation of Therapeutic Communities. Since 2007, he is General
Manager of the CHOICE COUNSELING Program -from the CHOICE Foundationand of the “Centro de Medio Día” Program.
ABSTRACT:
The work that we are willing to present makes a brief period about what it means to do COUNSELING and
about which are the benefits brought to the addiction field and, specifically, to the Institutions we work from the
Therapeutic Community Model-in despite of psychotherapy and of other helping methods.
To talk about Counseling is to dialogue about Health Promotion. From the practice to the theory, we should follow
the motto of Creating Health before Treating Sicknesses. But, how can we do that? ; Where do we start working?
All of the Counseling practice is based on accompanying the consultant, under a specific Therapeutic Community
frame, to achieve different methods of coping to the ones used until arriving to the institution. As I have already
mentioned, the base of this line of work is to promote health and, for that matter, to infer to the idea that the
addiction is not as sickness and that it doesn’t have a cure that the persons have coping problems and, from that
concept, that the dialectic and practice towards those who come to us asking for help should change.
The work conveys the experience of a program based on this conception and explains the model in detail to
see the differences that exist between the traditional model and the new paradigm of the healthy and positive
psychology.
We should keep on nourishing the Therapeutic Community and a model that emphasizes on health leaves aside
the famous “muestre la pata enferma” (feel sorry for your problem instead of solving it) to light up the healthy
aspects blocked by the consumption of substances.
50
THE ARISE MODEL
Using ARISE to Harness Family Motivation to Change for Early Detection,
Prevention and Long-Term Recovery of Substance Abuse, process
addictions, poor self-care or health behaviors, and chronic physical or
mental health issues.
By Judith Landau, Linking Human Systems and Gale Saler, Gaudenzia Inc.
ABSTRACT
More and more families are reaching out to addiction professionals and treatment agencies to help them get a
troubled loved one into treatment and long-term recovery. Invitational Intervention™ uses the research-based
“best practice” protocols of A Relational Intervention Sequence for Engagement (ARISE) to guide families and
members of the support system to motivate the troubled individual to enter, maintain and complete treatment.
What surprises most professionals is that when families and support systems are mobilized, nearly 60% of the
troubled individuals attend the 1st meeting when invited, regardless of their prior resistance to family efforts to
engage them in treatment. In the study using ARISE for substance abuse, 83% of the addicted individuals become
engaged in treatment or self-help through this method of Intervention. The ARISE Model is a continuum of care
from treatment engagement, through treatment support and on to relapse prevention and long term recovery. It’s
parallel tracks address issues of individual and family with the ultimate goal being healing and recovery of both
individual and family.
This workshop will present an overview of the cost-effective ARISE model and its relevance for treatment programs
with specific attention to Therapeutic Communities. Participants will learn about this “family friendly” method
and how it capitalizes on Family Motivation to Change.™ They will gain an understanding of how the family is
empowered to take charge of the situation rather than relying on professionals to do the work. Outcome results
from the research study funded by the US National Institute on Drug Abuse (NIDA) will be presented. Examples
of substance abuse, mental health and process addictions will be discussed as well as how to use ARISE to get
loved ones to take better care of their mental and general health. A combination of didactic and experiential
methods will be used.
51
FROM PRACTICES TO THE THEORETICAL MODEL OF THERAPEUTIC
COMMUNITIES
By: Kalevi Kaipio
Doctor of Education
Mikkeli community
Finland
KALEVI KAIPIO has a Master of Arts (Sociology) from the University of Jyväskylä
and is, also, a Doctor of Education (Ph.D., Special Education), from the same
University. He started to create Therapeutic Community as Director in the Boys´
Reformatory of the city of Jyväskylä in the 70´s. He has been a Researcher for
the National Board of social welfare. He is Founder, chairman, trainer and
consultant in Jyväskylä Educational Centre. Co-founder and director in Mikkeli
Community, a Therapeutic Community for Drug Addicts. He has been a lecturer
in different universities in Finland, Sweden, Estonia and Russia, and has more
than 50 publications and articles about Therapeutic Communities, management,
development of communities and education and rehabilitation.
ABSTRACT
The development of the practices and theory of therapeutic began in the early 1970’s in the Boys’ Reformatory
in Finland. Later on practices of therapeutic community gained a wider scope in Finland and found application
in psychiatry, schools, vocational training, daycare centers, rehabilitation of mentally retarded and drug abusers
among other things. The first book from therapeutic communities was published in Finland in 1977 and taken
to degree requirements to many universities. This led to criticism towards theoretical basis of therapeutic
communities. It is understandably because the tradition of different therapies and helping methods are based on
individual, psychological and psychocultural thinking and theory which means that professionalism of helping
and interpretations are committed to psychodynamic approach. There are over 2000 methods of therapies on
psychological and social psychological basis and theory. There are very few helping methods on community basis.
For that reason it is difficult to find a common social reality and a common language with traditionally educated
professionals and people working and understanding therapeutic communities. It is important to analyze and
strengthen theoretical basis of therapeutic communities. In this paper theoretical analysis of therapeutic community
is developed. It is created a community-pedagogical model that combines the individual and the social approach,
the psychological and sociological theory. The development of the individual is examined simultaneously as an
activity of the peer group, of the educating community and its individuals, of administering the community and
the organizational level and of the social level.
52
PSYCHOSOCIAL THERAPIES
AN INTERVENTION AND ATTENTION OPTION FOR ADICCTIONS
Maria Victoria Medina M.
Medical Doctor MG. Political Sciences
Dean Psychosocial Therapies Faculty
Karol Marcela Vasquez Rodriguez
Psychosocial therapy, MG. In Education,
CandidatePhD in Integration and Sustainable Human Development
Psychosocial Therapies Faculty´s Coordinator
Universidad Antonio Nariño, Bogotá, COLOMBIA
PSHYCOSOCIAL THERAPIES defined as a set of outfitters processes for the change, with a holistic view and
comprehensive psychosocial prospect addressed to a sustainable and self-sustained Psychosocial Rehabilitation
of psychosocial systems, victims of catastrophic events with trauma condition and/or psychosocial disability. Its
methodology is defined by the attention and psychosocial intervention. Their leading framework of its horizon are
the processes of acceptance, adaptation, and rehabilitation, intervention strategies of eco-relational and systemictherapeutic cut are used, the reality from the systems complexity and multidimensional in discordant or non
balance status are understood, while focusing the psychosocial rehabilitation, as an empowerment process to be
complex adjusted systems, that is, systems learning and improving with the experience within a functionability
setting. The Human Being is acknowledged as potential, rational, resilient, comprehensive, multidimensional
being in constant relation with others, immersed in a complex economic, politic and psychosocial reality, able to
go beyond the limits and extending its influence by itself.
From this point of view, the addiction is the most catastrophic impact where the catastrophic event is the personal
determination to use substances. It is evident that unlike other catastrophic events – such as earthquakes, warswhere the individual is not able to prevent or to avoid the event effect, the risk assessment of the determination
plays a key role in the addiction.
From them on, the psychosocial system will experiment a lack of continuity and turns into a discordant system
with functional, structural and qualitative affectation.
Therefore, the process proposed by Psychosocial Therapies as an attention and intervention choice for addictions
aims to be something attractive entering into the system to be a company and guidance for the harmony or balance
recovery helping to build skills and abilities from the system strengths to let them go beyond the catastrophic
event. It is to construct and to deconstruct a new life plan, re-meaning their vital horizon from its strengths, from
their exercise of freedom with responsibility conscious and its potential development, being therefore an axis of
the wide concept of the human development and health.
53
SPECIALIZATION OF THE THERAPEUTIC COMMUNITY IN COMPLEX
MULTIFACETED CORRECTIONAL INSTITUTIONS
By:
Cecilia Velasquez, M.S., Regional Director of Correctional Services, Gaudenzia Inc.
Pat O’Connor, M.S., Division Director of Prison Services and Program Operations
Ken Martz, Psy.D., Division Director of Psychology, Maryland Prison Services
ABSTRACT
Gaudenzia Inc. has developed specialized therapeutic communities within correctional institutions which have
been nationally recognized with effective outcomes based on evidence based practices. These programs have been
evaluated as being highly effective by the Correctional Program Checklist, the standard evaluation of effectiveness
in correctional programs developed by Edward Latessa of the University of Cincinnati, as well as accredited by
state and national reviewing organizations. This presentation will review unique specializations for this setting.
This presentation will also examine issues relating to effective partnerships and collaboration between treatment
providers and correctional institutions. Also discussed will be the randomized evaluation of a prison-based drug
treatment program, a comprehensive research project completed by Temple University for the Pennsylvania
Department of Corrections in collaboration with Gaudenzia Inc., and presented at the National Institute of Justice.
Specifically, these approaches and modifications have been found to yield significant reductions in criminal
recidivism. Implications for program design, skills based training and recruitment will also be discussed.
54
THERAPEUTIC COMMUNITY AND THE ADOLESCENT: INNOVATIVE
NEW INTERVENTIONS BASED ON ADOLESCENT BRAIN
DEVELOPMENT, PHYSICAL AND PSYCHOSOCIAL SETTING OF THE TC
By: Kevin McEneaney
EE. UU.
The principal in Hopeworksltd, a management consulting, program design,
training and leadership development firm, specifically designed to foster healthy
environments and meet the needs and challenges of government and human service
organizations. Recent Projects include the building and development of the most
recent adolescent treatment center in New York City, Center for Living and a new
Innovative project for the New York City Health Corporation’s 2000 bed nursing
facility.
Mr. McEneaney has served as the Chief Operating Officer for over ten years of the
Phoenix House Foundation. Prior to this appointment, he served as Senior Vice
President/Director of Clinical Services from 1983 to 1994. From 1972 to 1983, he
served as Director of Public Relations, during which time he developed several key
programs for Phoenix House, including Phoenix House Academies for adolescents.
Mr. McEneaney is Past President of Therapeutic Communities of America and
has many years of clinical and research experience as the manager of the major
national substance abuse treatment agency.
He holds a B.A. from Fordham University in New York, and completed an Executive
Education Program at The Business School, Harvard University
ABSTRACT
Given the context and prevalence of substance abuse in adolescence, it is an ongoing task for the Therapeutic
Community treatment practioners to promote adolescent resiliency and health through continuously extending
and refining our understanding of the consequences of substance use and abuse. This workshop is intended to
help a wide range of treatment personal review and discuss recent scientific evidence and clinical practice in the
three major domains of influence for adolescents in the TC: (1) the neurobiological development of the adolescent
brain, (2) the physical and psychosocial setting (the “environment”) with its protective and risk factors, and
(3) innovative prevention and treatment interventions that are based on cutting edge science and the ability to
incorporate those into new strategies for TC practice. It will also look at the issues of recovery in the short and
long term, including the role of self-help groups, spirituality and the maintenance of recovery into and through
young adulthood based on decision making models.
Recent technological advances have shown that during the adolescent years the brain undergoes significant
developmental changes on multiple levels. The most under-developed part of the adolescent brain -- the prefrontal
cortex -- is the area responsible for rational, non-impulsive, informed and well planned decision making behavior.
The greatest amount of maturational change in the brain during adolescence, therefore, occurs in those areas
55
involved in risk-reward behavior, fear and anxiety, impulse control, executive functioning and organizational
ability (Durston and Casey, 2005; Casey, 2007).
Although adolescent alcohol and other drug prevention and treatment programs such as TC’S have long been
aware of the need to take the unique developmental process of their target population into consideration, the
integration of recent findings into practice has all too often not taken place on a timely basis. This workshop is
intended to advance that conversation, leading to the possibility of a refinement and improvement of interventions
and models that provide the adolescent with opportunities to direct their behaviors in more constructive directions
while not ignoring their need for peer interaction, risk-taking, exploration, and even conflict over their need to
separation from authorities. Researchers and practitioners will be invited to share their innovative TC treatment
interventions with each other and with the broader conference community.
Treatment models need to provide a continuum of care that encompasses the promotion of protective factors and
the prevention of dysfunctional development; the selection of adolescent-appropriate TC interventions; and the
implementation and operation of post-treatment recovery groups ( those based on peer support, A.A. self-help
and/or spirituality) that are appropriate for adolescents and duplicate there experience in the TC.
56
A STRUCTURAL/SYSTEMATIC FAMILY THERAPY APPROACH FOR AN
ADOLESCENT THERAPEUTIC COMMUNITY
By:
Cheryl Nazario, MS, CASAC, Daytop Village, Inc., New York, USA
Kim Tedaldi, MSW, CASAC, Daytop Village, Inc., New York, USA
ABSTRACT
Treating adolescents in a Therapeutic Community (TC) environment has it own unique challenges, most notably
the difficulty of engaging the entire family in treatment.
Adolescent Treatment Programs should not only focus on the adolescent but also the family since the substance
abuse and teen drug addiction problems affect the entire family. Because the whole family is troubled, it is crucial
and beneficial to outcomes that the adolescent’s family be highly engaged during the recovery process.
To overcome these challenges, effective engagement of the family in a parallel treatment process requires a welldefined approach and trained staff.
Structural/Systems Family Therapists believe that problems are maintained by dysfunctional family organization.
Therefore, the goal of therapy is directed at altering family structure so that the family can solve its problems.
The structural family therapist joins the family system to help its members change their structure by altering
boundaries and realigning subsystems the therapist changes the behavior and experience of each family member.
Therapeutic techniques include:
1.
Joining and accommodating
2.
Working with interaction
3.
Highlighting and modifying interactions
4.
Boundary making
5.
Unbalancing
6.
Challenging unproductive assumptions
Structural family therapy’s popularity is based on its theory and techniques of treatment: its central position in
the field has been augmented by its research and training programs.
57
AGGRESSION, IMPULSIVITY AND OBJECT RELATIONS IN
ADOLESCENTS WITH ANTISOCIAL BEHAVIOR
Lic. Mariana Flint
Venezuela
Clinical psychologist for the Central University of Venezuela. Diploma in the
Treatment of Addiction by the Institute of Higher Studies Dr. Arnoldo Gabaldon.
Training in Psychoanalytic Psychotherapy at the Venezuelan Association of
Psychoanalysis. She works with drug addicts and patients with personality
disorders, also in the area of prevention.
ABSTRACT
The research describes the relationship between aggression, impulsivity and Object Relations in 22 adolescents
with antisocial behaviour as a reason for consultation in two psychiatric institutions in Caracas.
A-D Questionnaire (Seisdedos, 1998), the Stroop Test (Golden, 1975), the “MOA” Object Relations Scale (Urist,
1977), the Aggression Scale (Gacono and Meloy, 1992) and Exner´s Comprehensive System indicators (2001) to
the Rorschach Scoring System, were used.
This descriptive research used a cross sectional non-experimental design, with a treatment based on statistical
correlations and unvaried descriptive. We found that antisocial behaviours were related to ambivalent object
relations (MOA 2 and MOAptotal), high levels of aggression and few emotional resources to process high
amounts of tension and dysphonic feelings, valuable factors to consider when establishing the psychotherapeutic
intervention with this type of patients.
58
“THE TRAUMA OF DRUG ADDICTION: MEASURING IMPACT ON DRUG
TREATMENT EFFECTIVENESS”
Martha Fosteri, Assistant Director of KETHEA
Sociologist - Psychologist – Family Therapist
Greece
Martha Fosteri is one of the co-founding members of KETHEA, in Director Position
from 1983 until today, in therapy as well as in management. She is Counselor in
Drug Abuse, Family Therapy and Psychotherapy, also PhD Candidate in Panteion
University of Greece, in the Psychology Department. Work as an Assistant Director
in KETHEA (THERAPY CENTER FOR DEPENDENT INDIVIDUALS), in Greece.
She participated in Congresses of the WFTC and other organizations (European
Federation of Therapeutic Communities, European Family Therapy Organizations)
since KETHEA were established.
ABSTRACT
Addiction is deemed a traumatic fact both for the individual drug addict as well as their families. This trauma
produces adversity and causes discomfort affecting the mental balance of the drug addict. The modern therapeutic
approaches focus on the personal development of the drug addict and their broader families by activating that
adversity. Such adversities prompt the person to reach their limits and to launch “new perspectives”, establishing
new perceptions for themselves (identity), regarding their relationships and their meaning of life.
Research evidence suggests that trauma effects – negative, neutral, or positive - are highly associated with the
drug addict’s attitude and pace towards confronting their drug problem. A qualitative research focusing on
autobiographies of current TC members of diverse KETHEA services, aims to investigate the extent to which the
possible traumas are derived from the addiction affect, the drug addict motivation and readiness for treatment.
Motivation, as the transtheoretical approach to change emerges, is not considered to be a changeless attribute of
personality, but is an ongoing active situation, which is affected by the degree to which the drug addict experiences
their trauma of addiction. Research outcomes outlined that dealing positively with the trauma of addiction forced
them to acquire their new identity, develop their social skills and attitudes as well as to improve their family
relationships.
59
WHAT IS THERAPEUTIC IN A THERAPEUTIC COMMUNITY?
Martien Kooyman, MD,PhD.
Netherlands
Martin Kooyman from the Netherlands is a renowned psychiatrist and neurologist.
He is the founder of several treatment centers for addiction in the Netherlands,
among them, in 1972, he founded Emiliehoee, the first therapeutic community
in his country. He is co - founder of the WFTC and the European Federation of
Therapeutic Communities of which is one of its honorary vice-presidents. He is also
the co-founder of the European Working Group on Drug-Policy-Oriented Research
(EWODOR). He is a Teaching Fellow in Bonding psychotherapy, also called the
New Identity Process, developed by Dr. Daniel Casriel. His book on therapeutic
communities for addicts is published in English and has been translated in the
Spanish, Polish and Tsjech language.
ABSTRACT
The philosophy of the original therapeutic communities for addicted persons is based on self-help and mutual
help, learning to help yourself with the help of others. There is a clear distinction from a medical model clinic. In
the medical model addiction is regarded as a disease. The addicted person is treated as a patient, not responsible
for his condition. Although this view has advantages over a moral view and makes medical treatment available, it
has also disadvantages. This is especially the case when addiction is called a chronic relapsing disease. This is not
only incorrect, as has been proven by research, it also gives doctors as well as the addicted persons an excuse for
failing treatments.
In therapeutic communities the residents learn to solve their problems in a drug free environment with the help of
their fellow residents. They learn to make mistakes without feeling themselves a failure as a person. Role models
of older residents are an important element of the system as well as a clear value system.
In the presentation, the fifteen therapeutic factors of a therapeutic community are described and also how a
therapeutic community can become anti-therapeutic by abuse of power or becoming a cult.
60
BONDING PSYCHOTHERAPY GROUPS AT THE THERAPEUTIC
COMMUNITY
Dr. Martien Kooyman
The Netherlands
Martin Kooyman from the Netherlands is a renowned psychiatrist and neurologist.
He is the founder of several treatment centers for addiction in the Netherlands,
among them, in 1972, he founded Emiliehoee, the first therapeutic community
in his country. He is co - founder of the WFTC and the European Federation of
Therapeutic Communities of which is one of its honorary vice-presidents. He is also
the co-founder of the European Working Group on Drug-Policy-Oriented Research
(EWODOR). He is a Teaching Fellow in Bonding psychotherapy, also called the
New Identity Process, developed by Dr. Daniel Casriel. His book on therapeutic
communities for addicts is published in English and has been translated in the
Spanish, Polish and Tsjech language.
SUMMARY
Bonding Psychotherapy is a Group therapy, a technique developed by Daniel Casriel a psychiatry doctor from the
USA, founder of the first Therapeutic Community in New York: Daytop Village.
The purpose is to overcome the fear of physical and emotional closeness, and of separation, also to improve the
patient’s self esteem.
The group focuses not only on the problems and painful experiences of the past and present, but also on the ability
of enjoying the pleasure of living. Most residents in Therapeutic Communities lived traumatic experiences in their
childhood with the result of lack of trust in themselves and in others and in negative attitudes like not being good
enough, not being loveable, not having the right to exist.
There will be three different activities: first a brief experience of the body work, second a DVD will be shown which
was filmed in group sessions in the Netherlands, subtitled in Spanish, and last questions and answers about this
method in Therapeutic Communities.
61
USE OF ACUPUNCTURE IN THE TREATMENT OF ADDICTION, TRAUMA,
AND ADHD
Michael O. Smith, MD
Michael O. Smith, MD, is the Medical Director of the Substance Abuse Division, of the
Department of Psychiatry at the Lincoln Hospital in the South Bronx, NY. He has worked
in the Lincoln Hospital since 1972 after completing his residency he went to work for
their outpatient methadone detoxification program. Dr. Smith was born in Pasadena,
California, he is a physician and psychiatrist. Dr. Smith has been a researcher and
associate professor of psychiatry and social work at the Universities of Cornell, Columbia
and New York Medical College. Dr Smith is a Certified Member of American Society of
Addiction Medicine and of the National Commission for the Certification of Acupuncturists
(NCCA).
Dr. Smith is the Chairperson of the National Acupuncture Detoxification Association
(NADA) he serves in several state wide advisory boards and commissions. He has received
many awards and recognitions in the United States and around the world.
ABSTRACT
More than 2,000 drug and alcohol treatment programs in the U.S. and forty other countries have added an
acupuncture component to their protocol during the past several years. This development is based on the 30year experience of Lincoln Hospital (Bronx, NY) which provides 100 acupuncture treatments per day as part of
its comprehensive program. The nationally recognized Miami Drug Court model is an outgrowth of the Lincoln
experience. Basic controlled studies will be presented as well as outcome evaluations based on various clinical
situations. For example, in patient detox units reports substantial improvements in retention. The average birth
weight for cocaine using women is 3140 gm at Lincoln. Retention and compliance for resistant criminal justice
and MICA clients are often dramatically improved.
Acupuncture provides a foundation for psycho-social rehabilitation. It is only an adjunctive, supportive
component of substance abuse treatment. Several characteristics enhance the benefits of acupuncture on overall
program functioning: (1) it is a nonverbal component which facilities access to resistant patients; (2) it reduces
level of anxiety and agitation program- wide ; (3) it facilitates calm, receptive behavior; (4) it helps developed
the inner meditative core of even trouble fearful persons. Acupuncture has been used to treat thousands of posttraumatic patients in lower Manhattan in 2001 and New Orleans in 2005. Acupuncture is regularly used with
other medications, including methadone, antidepressants, and neuroleptics. Magnetic beads (acupressure) have
been shown to be effective in children with attention deficit, hyperactivity, and borderline autism.
The Lincoln Hospital acupuncture program has led to the establishment of the National Acupuncture Detoxification
Association (NADA). NADA has established standards for training and certification of “acupuncture detoxification
specialists” on a widespread basis. According to New York State law, for instance, any clinician in an approved
treatment setting can complete the 70-hour training program and be able to provide ear acupuncture under
general supervision of a licensed acupuncturist. This law has allowed acupuncture to be part of more than 200
treatment programs in the state.
62
THE TC GOES TO PRISON: CONTRIBUTIONS AND UNINTENDED
CONSEQUENCES
By: Rod Mullen & Naya Arbiter
EE. UU.
Rod Mullen is the President and CEO of Amity Foundation
Naya Arbiter has spent four decades as a Therapeutic Community practitioner,
working initially for the original American TC; Synanon, and then with Amity
Foundation and Extensions. She has designed and implemented projects for
men, women, adolescents and children in both the free-world and behind prison
walls. Projects that she has developed with her colleagues have realized successful
outcomes and research has been published nationally and internationally. She
has testified extensively in the United States on behalf of policy change for the
disenfranchised, and written fourteen volumes of curriculum for the Therapeutic
Community designed to foster personal growth, emotional literacy and social
responsibility.
ABSTRACT
The essence of TC, “community as method” requires an environment that instills hope and confidence in
participants, and a staff/faculty that through their own role modeling of personal change and “right living” inspire
participants to follow their path. Correctional institutions (often a misnomer) have as their primary responsibility
protecting the public by imposing strict security regulations. Facility staff are trained to be distrusting of inmates,
to expect and deter manipulations, and commonly adopt attitudes towards inmates which are cynical and in
which continued criminal and anti-social attitudes and actions are expected.
Yet from the founding of the American TC in the 50’s, TCs have tried, with varying measures of success to bring this
powerful modality for holistic change (including criminal behavior) into often hostile criminal justice programs
and incarcerated settings. This presentation will briefly review the historical development of TCs in prison in
the US, current applications, and consider future applications. We will consider the “success stories” reflected
in outcome research over the past 30 years---beginning with Stay N’ Out. We will also consider the “downside”
of TCs that become enmeshed in the criminal justice system and how well meaning compromises can corrupt the
TC in these settings.
63
CHILD WELFARE CERTIFICATION: KEEPING CHILDREN SAFE
By
Neal A. McGarry
Executive Director
Florida Certification Board
U.S.A.
ABSTRACT
Session Overview: The Florida Certification Board (FCB) is a private, not-for-profit, third-party credentialing
agency with over 25-years of experience certifying health and human service professionals in Florida. The FCB’s
mission is to protect the health, safety, and welfare of the citizens of Florida by regulating our certified professionals
through testing, training, and compliance with professional and ethical standards of practice. Our approach and
mission allows for an objective measurement of an individual’s competency.
The state of Florida believes that maintaining the safety and well-being of children is of up most importance. Child
welfare is a highly technical field that requires practitioners to possess advanced knowledge and competency in
order to continually and consistently exercise discretion and judgment in complex and dynamic situations to
ensure child safety. The FCB established a Child Welfare Case Manager credential to assure that Florida’s child
welfare workforce is made up of competent and ethical staff.
The development of a credentialing program designed to measure an individual’s competence in a particular
area is a complex process. A formal, psychometrically sound Role Delineation Study (RDS) is the first step of
the credential development process and is the most commonly applied and accepted validation strategy used in
designing credentialing programs. In this session, you will learn how the Florida Certification Board implemented
the role delineation process to formally identify the performance domains, job tasks, knowledge, skills, and
abilities needed to be a competent Child Welfare Professional. .
Learning Objectives: After attending the Child Welfare Certification: Keeping Children Safe session, participants
will:
1. Understand the relationship between professional certification programs, organizational effectiveness, and
public safety.
2. Explain the purpose of, and steps in, the Role Delineation Study process.
Describe the results of the FCB’s Child Welfare Case Manager Role Delineation Study.
64
ADOLESCENT , DRUG ADDICT , PRISONER , EMIGRANT, ALL OF THE
ABOVE? DRUG TREATMENT IN A CORRECTIONAL FACILITY FOR
YOUNG OFFENDERS
Paraskevi STAGAKI
Head of Adolescent Counselling Centre at Juvenile Prison and
Juvenile Courts of Athens
Greece
Paraskevi Stagaki obtained a BA in Psychology at the American College of Greece, Deree College
and an MSc in Counselling Psychology at City University of London, UK. Her personal therapy,
training and specialized experience is in family therapy (systemic approach) with numerous
theoretical and experiential seminars and training in the therapeutic interventions with groups,
families and individuals. She works in Therapy Centre for Dependent Individuals (KETHEA)
since 1999. As a therapeutic personnel and later as head of Family Therapy and Counselling
Centre of STROFI (KETHEA’s Therapeutic Programme for Adolescents) her work included group
therapy, family therapy, and individual counselling with parents and siblings of young drug
addicts. Since 2007 her work as the head of Adolescents Counselling Centre in Juvenile Prison of
Avlona, a correctional facility for young offenders, aims at the support of imprisoned substance
abusers in penal institution.
ABSTRACT
Being an adolescent consists of it’s own a full-time occupation in the process of personal growth. It requires
building up an identity through stressful and often painful processes. Abusing drugs at the same time, builds up
confusion, hinders emotional maturity and pursue of personal meaning in life. On top of that, being a prisoner
escalates the aggravation. Institutionalization, detention and ‘behind the bars’ feelings place ‘request for therapy’
very high in the hierarchy of one’s needs; simple, sort term satisfactions –sometimes in the form of 24 hours
obsession- prevail, including drug use itself. Can it be harder? Low literacy, unemployment, diverse cultural
background, luck of family support, even not speaking the language are only some of the aggravating factors for
ethnic minority inmates.
So, how can one introduce TC’s principles and philosophy in a correctional facility for adolescents that share the
above characteristics?
This presentation outlines an in-prison drug treatment program for young offenders -starting as a pilot in 2004in the central juvenile state prison and the progress of the intervention ever since. Services are aiming at both
the therapeutic support of the inmates in day to day life inside the establishment (drug use, violence, juvenile
delinquency) and at establishing a continuum during release (connection with TCs and rehabilitation). The nature
of TC work in jail, socio-demographic characteristics of the inmates, encountered problems, as well as the ‘voices’
of the adolescent themselves encircle the presentation.
The project was based on KETHEA – Strofi’s experience, a network of services with twenty years of clinical work
in an adolescents’ TC –the first one in Greece- and ten years of cooperation inside the Juvenile Court of Athens.
65
DOING INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS (IPA) AS
PART OF A RESEARCH PROJECT CONCERNING RELAPSE
By Phaedon Kaloterakis, B.R.E., M.W.S.,
Greece
Phaedon Kaloterakis is the Assistant Director of KETHEA and has been involved
with the drug addiction field since 1981. He is a member of the Board of Directors
of the International Certification and Reciprocity Consortium (ICRC) for Greece,
Cyprus, Malta and Bulgaria. He is also the KETHEA representative at the
Economic and Social Council (ECOSOC) at the U.N. and a member of the Board
of the International Federation of Non Government Organizations (IFNGO). He
holds a Bachelor of Religious Education Degree, a Master of Worldview Studies in
Philosophy and Psychotherapy and is currently a Ph.D candidate at the School of
Health Sciences and Social Care at Brunel University, London Phaedon is also a
musician, a recording artist, a composer, a producer and a member of the Board of
Directors of “IRAKLIS” Sports Club.
ABSTRACT
The aim of interpretative phenomenological analysis (IPA) is to explore in detail the participant’s view of the topic
under investigation. This dynamic process is complicated by the researcher’s own conceptions and interpretative
ability. Hence the term interpretative phenomenological analysis is used to signal these two facets of the approach
(Smith, J.A.,1996).
In their research report “The Design and Effectiveness of Therapeutic Research in Europe : An Overview” (1999,
Karger),Broekaert, Raes, Kaplan and Koletti stated that “among the conclusions of the overview is the need for
more qualitative phenomenological research to complement the existing quantitative approach”.
Answering this call, a Ph.D. research project for the School of Health Sciences and Social Care, Brunel University
was undertaken by the presenter. The main question was why users of services of the Greek TCs relapse and how
we can prevent it.
Thirteen (13) focus group interviews were conducted with five (5) different groups of people and the collected data
was analyzed using IPA.
The presentation will deal with major methodological issues (e.g. is IPA suitable to focus groups?) and will
concentrate on a sample of the analysis thus demonstrating the IPA approach.
66
DESIGNING AND IMPLEMENTING INTERVENTIONS IN SMALLER
URBAN SETTINGS: SOME FIRST CONCLUSIONS FROM KETHEA’S
EXPANSION TO NORTHERN GREECE”.
Greece
ABSTRACT
Since 2002 Greece has had its first national action plan on drugs (2002-2006) and KETHEA being the oldest and
largest organization of its kind is one of the principal implementation bodies. Thus it has been setting up new
services to cover a broad range of geographic locations and groups. The aim is to meet needs of users who have
different places of residence, socio-demographic profile, life standards and use patterns.
KETHEA started investigating the need for counseling and rehabilitation services in North Eastern Greece following
some contacts with the municipal authorities in the region. Soon thereafter a formal request for the institution of
such services was made by local authorities, supported by the unanimous resolutions of the Management Board of
the Local Union of Municipalities and the respective Prefectural and Municipal Councils. KETHEA embarked on
the design and establishment of three intercultural centers in the cities of Kavala, Alexandroupolis and Komotini
providing services to both addicts and their families. As a result there was a rise in the proportion of people
that knocked at KETHEA’s door living in the specific region, from 1,2% in 2000 to 3,9% in 2006. Many of them
belonged to the Rom, Muslim communities and/or were economic refugees from Georgia, Armenia etc.
The interventions are designed in a manner that both staff training and delivered services are respectful of the
attendants’ linguistic, religious and cultural particularities meeting their individual needs.
67
KETHEA ITHACA’S PERCUSSION GROUP: A CASE OF DOING MUSIC AS
PART OF THE TREATMENT AND REINTEGRATION PROCESS
Greece
ABSTRACT
KETHEA ITHACA is the first therapeutic community in Greece (est. 1983). In 1997 the TC residents started a
percussion group with the assistance of two percussionists; since then, the ensemble has performed all over the
country, promoting KETHEA’s work. The group has also recorded an album with the participation of Dionysis
Savopoulos the most known Greek singer-songwriter.
In 2007, ITHACA’s percussionists performed with the world famous Japanese group YAMATO and also appeared
on the national TV with a rendition of a Greek folk song which they played using everyday objects (brooms,
garbage bins, plastic buckets etc).
The presenter, both a therapist and a musician, will demonstrate how music - and more specifically percussion
instruments – can affect the psychological, physical and spiritual domains of our human nature through the use
of various polyrhythmic patterns and motifs. To enhance the presentation, audio samples and a short video will
also be played.
68
ASPECTS OF ECONOMIC EVALUATION OF SUBSTANCE ABUSE
TREATMENT: COST-BENEFIT, COST-EFFECTIVENESS OF ADOLESCENT
PROGRAMS
BY PETROS TRIANTOS and
CHRISTINA SERYIANNI
Greece
Petros Triantos MSc is a social anthropologist. He has a Masters Degree in Applied Statistics from
Athens Economic University. He has been working in political research for 1 year at the research Center
of Pantion University for political and social Sciences as a researcher. Since 1998 he has been working
in KETHEA as head of Research Department in the Multiple Intervention Center. From July 2004 is the
head of evaluation department in KETHEA. His main tasks are qualitative and quantitative evaluation
of KETHEA programmes and interventions. He has participated in several European research
programmes such are Euro excludes, HERO, SCIP, ΕQUAL etc.
Christina Seryianni is a psychologist of the Panteion University of Social & Political Studies (Athens,
Greece). She has been a member of the Positive Emotions Research Team of the Panteion University
of Social & Political Studies as a PhD candidate. She has a Master’s degree in Health Psychology
from the University of Kent, UK. She has worked as a Research Associate for the Program “Open the
Doors” – Fighting the Stigma of Schizophrenia for three years, and has been working at the Research
department of KETHEA since 2006. Her main tasks are qualitative and quantitative data analyses,
presentation of empirical data, reporting of findings, and publication of research work. Her research
work has already been presented in a number of both European and international conferences. She
also works as a trainer at the Professional training in Cognitive Psychotherapy, run by the Academic
Research Institute of Mental Health, Eginition Psychiatric Hospital.
ABSTRACT:
Economic Evaluation is a relatively new field in Evaluation Research in Substance Abuse Treatment. So far focus
has been given in treatment’s efficiency and effectiveness. Special interest in adolescent programs is documented
on the debate about the effectiveness of the “traditional therapeutic community designed for adolescents”. Data
in Greek therapeutic programs show a continuous decrease on the average number of beneficiaries. At the same
time, government agencies both in national and European level put pressure on allocating resources based on
data and accurate goals and results. Health and social services have been experiencing these pressures over
the last 2 decades. Economic evaluation is a well known method in substance abuse treatment programs in the
United States. In Europe, however, quite few attempts have been made in this field. This study attempts first to
introduce a systematic review of economic evaluation of substance abuse programs designed for adolescents.
Then, milestones of a methodological frame for the economic evaluation of therapeutic communities in Greece are
introduced. Methodology focuses both in cost analysis and effectiveness findings. First stage is the cost analysis
of a therapeutic community based on an assessed tool. Then effectiveness is examined through Addiction Severity
Index. Specific dimensions of effectiveness are examined. Finally cost/benefit ratio is calculated.
69
ADOLESCENTS’ & YOUNG ADULTS’ PROFILE & RETENTION IN GREEK
DRUG-TREATMENT PROGRAMS
CHRISTINA SERYIANI,
PETROS TRIANTOS
Petros Triantos MSc is a social anthropologist. He has a Masters Degree in Applied
Statistics from Athens Economic University. He has been working in political
research for 1 year at the research Center of Pantion University for political and
social Sciences as a researcher. Since 1998 he has been working in KETHEA as
head of Research Department in the Multiple Intervention Center. From July 2004
is the head of evaluation department in KETHEA. His main tasks are qualitative
and quantitative evaluation of KETHEA programmes and interventions. He has
participated in several European research programmes such are Euro excludes,
HERO, SCIP, ΕQUAL etc.
Christina Seryianni is a psychologist of the Panteion University of Social & Political
Studies (Athens, Greece). She has been a member of the Positive Emotions Research
Team of the Panteion University of Social & Political Studies as a PhD candidate.
She has a Master’s degree in Health Psychology from the University of Kent, UK.
She has worked as a Research Associate for the Program “Open the Doors” –
Fighting the Stigma of Schizophrenia for three years, and has been working at the
Research department of KETHEA since 2006. Her main tasks are qualitative and
quantitative data analyses, presentation of empirical data, reporting of findings,
and publication of research work. Her research work has already been presented
in a number of both European and international conferences. She also works
as a trainer at the Professional training in Cognitive Psychotherapy, run by the
Academic Research Institute of Mental Health, Eginition Psychiatric Hospital.
ABSTRACT:
Although adolescent and young adult substance use remains a persistent and serious problem for society, the
treatment programs developed in response to this specific problem have received little attention with regard to
both outcome assessment, and factors that influence outcome, compared to adult addiction literature. Taking
into consideration the knowledge base, as well as the research gaps of the adolescent drug abuse treatment, the
present study aims at examining: (a) changes over an eight-year period in the psychosocial and drug-use profile of
adolescents and young adults who have applied at drug-treatment programs of KETHEA, and (b) the relationship
between these changes and retention in treatment. Results are interpreted in the framework of international
research findings and trends, while implications for treatment services and suggestions for further research are
discussed.
70
THE BENEFITS OF HEALING MEDITATION AND THE POTENTIAL
EXPANSION OF THE THERAPEUTIC COMMUNITY AS A VEHICLE OF
CHANGE
Portia Mereki
Ms. Mereki has over 20 years experience conducting meditations, group and
individual therapy and counseling and spirituality and addiction workshops. She
currently is affiliated with the Windana Drug Withdrawal House and the Windana
Community Centre in Melbourne, Australia. She has a Masters of Health Science
(Addiction Studies) and has presented papers at last 3 WFTC conferences.
ABSTRACT
Meditation is a valuable Therapeutic Community (TC) program component, which can increase inner peace,
promote responsibility, resolve personal issues and speed up the healing process. Group and one-to-one guided
healing meditation sessions facilitate exploration of the person’s inner world and offer solutions. Increased use
of this modality coupled with the basic principles that TCs stand for can strengthen the provision of a reliable
path to a positive shift in awareness. Such programs have the potential to expand into new community sectors,
which include those people who contribute to the causes of alcohol and other drug misuse and the associated
socio-economic problems. TC programs which include meditative practices can become a more powerful vehicle
of wider societal change in the areas of policy, wealth distribution, spirituality and Earth sustainability, among
others.
71
EPIDEMIOLOGICAL INDICATORS AND RESULTS IN A SAMPLE OF
ADDICTED PATIENTS FROM THE
ÑAÑA REHABILITATION CENTER -PERIOD 2002-2007
By Rafael Navarro, Mauricio Benavente
Peru
Rafael Navarro Cueva. Medical Psychiatrist, PhD in Medicine. He is the Director of
the Rehab Centre of Ñana, Lima – Peru and Main teacher of the Faculty of Medicine
of the Universidad Nacional Mayor de San Marcos. He is, also, Coordinator of the
Latin American Online Master on Drug dependencies, organized by the CICADOEA and by the Latin American Web of Universities with Postgraduate courses
about drug dependencies, at Cayetano Heredia’s University. Mr. Navarro Cueva is
Founder and Director of the School of Addictions Council, an active member of the
Asociación Psiquiátrica de América Latina (APAL) and international lecturer on the
Addiction Area.
ABSTRACT:
The author presents a sample of 430 patients treated in the Ñaña Rehabilitation Center in the period 2002-2007.
Emphasis is put on high comorbidity, the importance of mixed treatment and the stabilized application of the
´Modelo Ñaña de Tratamiento y Rehabilitacion de las Adicciones´ (Ñaña Model of Addiction Treatment and
Rehabilitation). Follow-up continues with this group and reports in different periods will be given in the future.
Unique characteristics of the sample, socio-demographic variables, previous treatments to this program, clinic
diagnosis (comorbidity) as well as other important aspects will be emphasized.
72
BODY, EMOTION AND VOICE IN THE THERAPEUTIC COMMUNITY
Ramón Néstor Vega
Argentina
Ramón Nestor Vega: is a specialist in emotional educational work and has an
ample formation and experience in the treatment of addictions. His formation
begins in 1986 with Psychodrama, Gestalt, Neurolinguistics, Bioenergetics,
Biosynthesis, and as an instructor in Body work, it continues as a Sociotherapeut (
he studied in Argentina and in Italy) he specialized in the work with New Identity
Process groups, now called Bonding Psychotherapy, in Italy ( Rome and Belluno),
and in Portugal.
He has led workshops in Argentina and in Brazil, Mexico and Spain, and at the
present time as co leader with Martien Kooijman in Italy in Belluno. He is founder
of the Therapeutic Community Ancoradouro in Brazil, and he is Fellow of the
International Association of Bonding Psychotherapy and president of the Argentine
Association of Bonding Psychotherapy called El Abrazo Primario
ABSTRACT
It was part of the conception that personal history is embodied in the body. Such history is entering from the
moment of conception, during pregnancy and throughout the development until the last moment of life. The
bodies accommodated in ways that have been touched, cared for, loved, rejected, hit ... While the time passes,
several memories physical, mental and emotional memories are an active and dynamic, as witnessed lived.
The personality is expressed through the body, which shows its vitality, its history, its healthy and sick, that’s
how the body language content complaints of mental and emotional people. Emotion and body are together, the
movement as a way to express in a great way because without it you can not talk, shout or gesticulate. What is not
expressed is accumulating in the body with different modalities such as muscle tension, blockades and various
physiological dysfunction which can develop itself and chronic or serious illness.
Then, it asserts the importance of being fully aware that life goes entirely in the body. That statement implies to
understand the complexity involved the concept of body and the importance of their approach in the process of
Therapeutic Communities as a growth and openness in the development of this process.
The presentation lasts 45 minutes of experiential exercises and approximately 45 minutes for questions and answers from
the experience and a synthesis of theory, a full hour and a half.
73
WHAT WORKS IN EDUCATION WITHIN DRUG TREATMENT?
QUALITATIVE OUTPUTS ON MOTIVATING ADDICTED PERSONS FOR
EFFECTIVE TREATMENT
By Remos Armaos
Greece.
Remos Armaos, PhD, Head of Staff Training & Education Department, KETHEA
is an educational researcher specialised in research about the implementation
of information and communication technologies in education. His current
position focuses on designing, developing and evaluating education and training
programmes for professionals within the field of drug addictions, networking
with academic institutions on aspects of drug education, research evidence and
evaluation. Since 2006, he is also working as an academic lecturer at the Open
University of Greece on adult education methodologies.
ABSTRACT
Drug abuse, a complex psychosocial phenomenon is highly associated with potential school dropouts and low
school achievement. Drug-free treatment within a therapeutic community, as viewed within a trans-theoretical
model of change, suggests an effective approach for the social rehabilitation of the addicted persons and potential
relapse prevention. In most cases, return to education as enhanced through treatment is achieved to a great extent.
This occurs as treatment reforms the broken links among the family and school systems with the individual.
The aim of this study was to explore the education strategies deployed in motivating drug addicts whilst in
treatment at various training units of KETHEA back in completing their education. It has been argued that
successful education provision provides considerable potential in maintaining the positive effects of psychosocial
treatment on substance addiction as well as maximising relapse prevention.
Aspects on drug education provision of health and education professionals forming a multidisciplinary team
and currently working at KETHEA services were investigated. In addition, aspects of drug addicts currently in
treatment over their motives back to education were analysed aiming at determining supportive factors and
education principles within this perspective. Focus group interviews were performed for both target groups
and important information on education strategies, the difficulties encountered and case management issues
were elicited. The study suggested that the nature and level of education received by those in treatment is highly
associated with the effect of education on treatment delivery in principle. Adult education methodologies are a key
variable in engaging former drug addicts in effective therapy.
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SPIRITUALITY AND RECOVERY
By Richard Dunn
Consultant & Staff Trainer – Daytop Village
EE. UU.
Dr. Dunn is a consultant for counselor training at Daytop and Veritas Villa. An
educator, author, counselor, researcher and trainer, he created one of the first
curricula in the US to award an accredited academic degree in substance abuse
counseling. His publications include Relapse and the Addict
ABSTRACT
This workshop will explore the role of spirituality in recovery from drug addiction. It will review
(1) C.G. Jung’s 3 major options regarding the spiritual,
(2) spirituality and religion compared and contrasted,
(3) the Spiritual vs. the Material and Faith vs. Reason,
(4) spirituality and crisis,
(5) the intoxicated state and spiritual experience,
(6) the role of surrender in spirituality,
(7) the dark side of religion and spirituality, and
(8) issues of meaning, purpose, suffering, guilt and forgiveness.
75
INTEGRATION OF MINDFULNESS BASED COGNITIVE THERAPY
(MBCT) INTO THE THERAPEUTIC COMMUNITY: IMPLICATIONS FOR
TRAUMA TREATMENT
Rod Mullen, President and CEO, Amity Foundation
Mary Stanton, M.Ed. LADAC
The pervasiveness of traumatic events and the increasing awareness of their persistent and often devastating effects
on individuals, families, and populations has elevated trauma to a critical subject of interest within the Therapeutic
Community (TC). As the Therapeutic Community evolves, we strive to implement strategies to help individuals
find renewal and wholeness. With this intent, Rod Mullen, President and CEO of Amity Foundation, and Mary
Stanton, Senior Counselor received intensive training in the practice of Mindfulness Based Cognitive Therapy
(MBCT), and have piloted these practices at Amity’s Circle Tree Ranch. We recognize the interconnectedness
that occurs among untreated trauma, depression, addiction, and relapse, and believe an integrative approach
is necessary to unravel the complex knots that addictions and trauma create. Modifications to traditional TC
confrontational approaches may be necessary to provide safe environments for individuals to explore the reality
of their experiences, and respond with empathy and compassion rather than judgment and shame. In this paper
we describe the theoretical basis of MBCT and outline methods of implementing this approach in a residential
TC setting while the basic tenant of “Community as Method” remains central to the healing process. Our initial
outcomes indicate that Mindfulness-based practices are not only effective in reducing anxiety, depression, and
chronic pain, but are a promising intervention in the treatment of trauma within the TC. Data collected is used to
evaluate effectiveness and to identify strengths and weaknesses in order to improve implementation and inform
future research.
76
CRIMINAL JUSTICE TREATMENT & THE TC
By Ronald Williams & Sandeep Varma
New York Therapeutic Communities, Inc.
USA
Ronald A. Williams has been the President/CEO of New York Therapeutic Communities, Inc.
since its inception in 1977. He began one of the founders and first graduates of the Phoenix House
organization where he held clinical and administrative positions, including facility and regional
directorships. He has served as an expert in demand reduction for the Federal Bureau of Justice
Assistance (BJA) and for the U.S. Department of State. He has assisted in the implementation
of in-prison treatment programs in 32 states and several foreign countries, including Malaysia,
Thailand, Colombia, Argentina, and Italy.
Mr. Williams has served as Vice President of Therapeutic Communities of America, and is
the former Chair of the Criminal Justice Task Force of that association. In the latter position,
he led the successful effort to develop and implement accreditation standards for in-prison
therapeutic communities through the American Correctional Association; these standards
have also been adopted by the US Federal Government. Mr. Williams is a board member of the
World Federation of Therapeutic Communities. Ronald Williams has received many awards for
outstanding contributions.
Sandeep Varma, joined New York Therapeutic Communities, Inc. in 1998 as Regional Director,
and became Executive Vice President in 2007. In this capacity he supervises all clinical programs
of the agency and ensures compliance with all regulations of the New York State’s Department of
Correctional Services and Office of Alcohol and Substance Abuse Services (OASAS).
Mr.Varma, a Licensed Clinical Social Worker and Credentialed Alcoholism and Substance Abuse
Counselor. He has a Master of Science degree from the Columbia University School of Social
Work and a Certificate in Non-Profit Management from the Harvard Business School.
ABSTRACT
In the treatment field, different modalities offer varying levels of treatment in combination with behavior
modification. For criminal justice clients, the therapeutic community has proven to be the most successful
modality in treating both the substance use disorder and associated criminal behavior.
In this presentation, there will be discussion relating to the success of various treatment modalities relative to the
criminally involved substance abuser. Specifically, what modalities offer the greatest chances at reducing rates
of recidivism and substance abuse. As addicts are re-integrating back into the community, what key therapeutic
concepts increase the chances of success? What are some of the key elements of an aftercare program?
This workshop will address 2 model programs in New York City, USA – the Serendipity Residential programs for
men & women and the NYTC Probation Out-Patient Programs and detail key elements for their operation and
success.
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COST AND RECOVERY
By Rowdy Yates
Scotland
Rowdy Yates is a Senior Research Fellow (Scottish Addiction Studies) at the
University of Stirling, Scotland. He has extensive experience of the alcohol
and drugs field having worked as a practitioner, service manager, trainer and
researcher over more than 35 years. Prior to his current appointment he was
Director of the Lifeline Project, one of the UK’s longest established drug treatment
and advice services. He was the UK partner in the research initiative, Improving
Psychiatric Treatment in Residential Programmer for Emerging Dependent
Groups, the largest-ever European study of psychiatric co-morbidity amongst drug
users presenting for treatment. Subsequent research activity has included a study
of drugs, alcohol and dyslexia and evaluations of both the pilot drug treatment
and testing orders in Scotland and of the drug courts piloted in the light of those
experiments. He is the Executive President of the European Working Group on
Drugs Oriented Research (EWODOR), Vice President (Teaching and Research)
of the European Federation of Therapeutic Communities and Chair, Addictions
Advisory Group, Royal College of Psychiatrists (Community of Communities). In
1994 he was awarded the MBE for services to the prevention of drug misuse.
ABSTRACT
Throughout much of developed world, during the past 18 months there has been a gradual rekindling of interest
in the concept of “recovery” in general and the validity and efficacy of abstinence-based treatment in particular.
Increasingly, politicians, the general public and drug users themselves are growing concerned that the current
dominance of substitute prescribing has led to a treatment network more readily characterised as a “corral”
within which to tame and manage drug users than as a “passage” from which drug users might emerge with
their behaviours changed. One, largely unspoken aspect of this re-emerging debate is the question of cost.
Some abstinence-based treatments – particularly residential rehabilitation – have been largely marginalised as
effective but prohibitively expensive interventions. This paper examines a sample of cost-benefit analysis studies
to consider what the comparative costs are and whether there is a sufficiently robust fiscal evidence base upon
which to base our current and future treatment priorities.
78
QUALITY OF INTERPERSONAL RELATIONSHIPS OF STREET
CHILDREN USING RORSCHACH PSICODIAGNOSIS
By Sandra Abregú
Peru
Sandra Abregu has a Bachelor Degree in Human Sciences with a mention in
Psychology given by the Peruvian Catholic University. This study is the subject of
her thesis which will be submitted to get her Degree. Nowadays, she is expanding
the study with the application of a comparative group. Therefore, the outcomes
achieved until now are not conclusive, since the research is still being done.
ABSTRACT
The study assesses the quality of interpersonal relations in a sample of 12 street young boys residing now in a
shelter. Therefore, the Rorschach psycho diagnosis was used according to the Comprehensive System of Exner
(2000) and the scale of Mutual Empowerment of Urist (1977). The Interpersonal Behaviour and Perception
cluster, some variables of the Emotional and Self perception cluster and the MOA indicators have been analysed.
It was found that minors have distorted representations about themselves and about the interaction with the
others. It was also found that these minors have a limited background of social skills being related to the tendency
for establishing superficial and immature interpersonal relations.
79
THE APPROACH TO FAMILY
By: Fr. Lambertus Somar and Sharif Hamid CSAC
Indonesia
Sharif Hamid has been actively involved in the work of therapeutic communities
since 1997 helping spearhead programs in Malaysia, Singapore, Indonesia and
Thailand. He serves on the executive counsel of both the WFTC and the AFTC.
ABSTRACT
Asian therapeutic community is facing challenges in dealing with substance abuse amongst across spectrum of
population especially young adult population and children. This is causing concern amongst TC providers in areas
such as clinical, behavioral health, families and spirituality. The challenges ahead is to look at TC as a methods,
and to understand the characteristic of its multidimensional component that requires multitudes of approach
without sacrificing the essentials (the community as a healer).TC methods requires staff that are committed to
implement TC approach model which is, self help mutual help, rules, structures, feedback mechanism, expected
behavior, role modeling, responsibility and therapeutic intervention.
Resident is exposed to right living. This may put them in a vulnerable position in relation with others and a
possibility being criticized and hurt. Stressing on clear boundaries is useful in maintaining a healthy relationship/
recovery. Resident is taught and equipped with tools that will help foster meaningful life.
Behind every problem there’s a maladaptive behavior, misunderstand, disagreement and system break down
(guilt and contract). If they fail to resolve it will grow into chronic problem. Usually rather than speaking directly
about the problem at hand, they drop hints and change the subject or withdraw from interaction.
Fear drives them to various forms of silent. Their point of view never heard except in a form of bad raping or
acting out frighten, the thought of not being heard they cut people off, overstate arguments which eventually
results to threats and insults.
One of the effective tools of TC is confrontation. The confrontation has been practice ever since the existence of TC
and it has been useful ever since. However in preparing client into mainstream society, the confrontation as a tool
can be developed and add values in the way people interact. In order to benefit from the confrontation is to expand
(not to re invent) and developed the confrontation as a crucial behavioral shaping tools. Crucial confrontation is
a skill towards effective communication, mastering it will empower one to deal or to confront every domain of life
problems. Once mastered a Crucial Confrontation, a person never have to walk away from problem again. Thus
improving accountability and morale. Crucial Confrontation consists of a face to face accountability discussion.
The first step is to choose what and if. Often we tends to look at things subjectively and not realizing that how
at times core issues were not been addressed. Selecting and choosing the problem and prioritizing they can help
assist both parties to mitigate the problems at hand. Most parents often become nervous as their kids begin
violating contract or rules i.e. breaking curfew. While waiting they can’t see beyond the hand of the clock. When
in truth what really concerned them is the fact that their kids didn’t have the courtesy to call them and let them
80
know he or she’ll be late and bring a merciful end to their tortured worries. The issues is what’s troubling them
(parents) is the nagging conscience, the inability to reduce an infraction and unproportional affects that entangle
the problem deeper. Here, a Crucial Confrontation is essential, while sorting through the issues they have to
decide what is bothering them the most or they will end up going after the wrong target or too many targets.
Crucial Confrontation here means the first time a problem crop up both parties need to talk about the contents of
what just happened.
The next time the problem occurs is to focus on the pattern, what has happening overtime. Pattern issues
acknowledge that problems have histories and that histories make a different. Frequent and continued violation
affects the others an eventually harmed respect and trust.
As problems continue, talk about relationship what happened to us. Relationship concerns are far bigger that
either the content or pattern. Most of the time the issues is not that other people have disappointed you repeatedly,
it’s that the string of disappointment has caused you to lose trust in them. Continuing this way would affect the
way you treat one another. In TC problems almost never contained in the behavior of the offenders, they are most
likely to be contained in what happened afterwards.
81
POST DISASTER CRISIS COUNSELING: ADDICTION AND DISASTER
TRAUMA
Sheldon Rosenzweig
USA
Mr. Rosenzweig is a Licensed Professional Counselor, a Certified Addictions
Counselor and has been a coordinator of Substance Abuse Services as well as
the Clinical Director of the Indian Rivers Mental Health Center in Tuscaloosa,
Alabama.
ABSTRACT
The response to a disaster often is focused on first responders and initial casualties and displacement. However,
there is growing recognition of the importance of having a system of training for crisis counselors in place to
provide community based supportive counseling services for 6 to 9 months after a disaster has occurred. Often au
increase in substance abuse is noted after a disaster occurs. Understanding the relationship between addictions
and substance abuse is of extreme importance in the training of community counselors. The possibility of addictive
behaviors among first responders and survivors as well as the threat to recovery that a disaster may represent
needs to be recognized and discussed.
Crisis Counselors are recruited from the indigenous community to provide support, a friendly shoulder,
appropriate referrals and group events to help survivors as they recover from the traumatic disaster that they
have experienced. The counselors are not necessarily professional personnel who were working at the time of
the disaster but are screened and recruited from within the local community in response to the extra demands
placed upon the human services agencies. They are trained to identify issues of importance to the survivors and to
provide support us survivors respond to life post-disaster. Often the trauma that is experienced by survivors leads
to increased substance abuse and special problems for both the recovering and the actively using addicts and the
crisis counselors need to be able to recognize and respond to this phenomenon.
This training is a power point presentation that has been crafted from materials provided by FEMA, Project
Rebound (the disaster response unit of the Alabama State Department of Mental Health), articles and information
available through he Internet and other sources and the Compassionate Coalition of Tuscaloosa, Alabama; a
collaboration of 42 Faith Based Organizations as well as the experiences of the trainer, Sheldon L. Rosenzweig.
Mr. Rosenzweig has participated in Critical Incidents Debriefing, coordinated services after the December 2000
tornado in Tuscaloosa, Al. and has trained Crisis Counselors after 9/11, Hurricane Ivan, Hurricane Katrina and
the March 2007 tornado that killed 9 people in Enterprise, Al. This presentation will reflect his work with many
diverse elements in the community with significant emphasis on how disasters impact substance abusers who
have survived a disaster. It is a widely held belief that by using indigenous counselors after the initial disaster
impact that the fabric of community life can be restored.
82
PROSPECTIVE RISK FACTORS IN ADOLESCENT SUBSTANCE ABUSE
TREATMENT: AN ANALYSIS OF THE CHARACTERISTICS OF THE
ADOLESCENTS WHO APPROACHED THE THERAPEUTIC PROGRAM
KETHEA STROFI DURING 2003 TO 2007.
By Spyridoula Zotou
Grecia
Spyridoula Zotou is licence in psychology in Birmingham University in the
United Kingdom. Research Master in Cognitive Psychology, in Bristol University.
Nowadays, is the chief of the Research Department of the Therapeutic Program
KETHEA STROFI
ABSTRACT
Aims: As adolescence is a critical age for the development of coping behaviors and responses, there is a great
possibility that the use of drug dependence may become a way for an adolescent to deal with stress, peer pressure
and emotional distress (Kandel & Logan, 1984). Therefore, we have to take into consideration that adolescent
substance abuse involves personality, biological, genetic, cognitive, attitudinal, social and environmental factors.
These factors can be critical in curbing adolescent substance abuse.
In this research, we examine these factors that play the most important role, in order for an adolescent to have
strong motive to admit in a therapeutic program.
Setting: The research was conducted at the therapeutic program KETHEA STROFI, which is the first treatment
program for adolescent drug users and abusers in Greece and was established in 1998.
Participants: All the adolescents who come in contact with the therapeutic program KETHEA STROFI during
2003 to 2007.
Measurement: The research was based on the questionnaire “First Treatment Demand Indicator” which was
administered to all adolescents during the first contact that they had at the therapeutic program. A second
questionnaire, Adolescent Drug Abuse Diagnosis (ADAD), was administered at intake into treatment.
Results: Results showed that there are specific risk factors which are playing a crucial role in order adolescents to
have strong motives and strengths to admit to the therapeutic community. These factors, which mainly associated
with education, criminality, family history, psychological problems and social factors, are discussed in light of
current scientific evidence.
83
“SANCTUARY, STRUCTURE AND SAFETY: THERAPEUTIC COMMUNITY
APPROACH TO EFFECTIVE OFFENDER REHABILITATION”
By Sushma D. Taylor, Ph.D.
Center Point Inc., CEO/President
Sushma Deva Taylor, Ph.D., has served as Chief Executive Officer of Center Point, Inc. (a private health and
social services agency in Marin County, California), since 1981. Dr. Taylor, a native of India, has a Master’s
in Public Administration, a Ph.D. in Clinical Psychology, is a licensed Marriage and Family Therapist, and
is a Certified Practitioner of Psychodrama and Group Sociometry. She is Vice-President of Therapeutic
Communities of America (TCA); she serves on several statewide advisory boards and commissions; chairs
the California Perinatal Treatment Network; co-chairs the Department of Alcohol and Drug Program’s
Access to Recovery Project; and serves on the Department of Corrections Office of Substance Abuse Program’s
Policy Advisory Committee. Dr. Taylor has previously served on the Center for Substance Abuse Treatment’s
National Advisory Council.
ABSTRACT
The California Department of Corrections has the second largest number of prison inmates in the United States.
Substance abuse has been identified as a major contributing factor to the increase in the prison population. The
California Legislature authorized the implementation of 9,000 in-custody treatment beds using the Therapeutic
Community treatment model.
California’s Correctional System houses 176,000 inmates and supervises 120,000 individuals on parole. The
correctional population has increased due to tough on crime penalties, public sentiments regarding community
safety and longer sentences for drug related crimes.
California embarked on a large scale treatment initiative to activate 9,000 in prison treatment beds using the
Therapeutic Community Model, and community aftercare for an additional 4,500 inmates on parole.
The In-Custody Therapeutic Community Model was linked with a continuum of care network of post-release
services. Cross site evaluation was conducted using standardized instruments and follow-up protocols. The
program model required a close collaboration between custodial staff and the T.C. staff. The In-Prison Therapeutic
Community uses three forms of therapy – behavioral, cognitive and emotional.
The T.C. intervention was viewed as effective in reducing recidivism and return to custody rates in the prison
setting. The Therapeutic Community method has evolved to become the most dynamic and widely accepted
approach for providing treatment services to substance abusing populations including those in the criminal
justice system. In working with substance-abusing offenders for thirty-five years, Center Point, Inc. has extensive
experience and evidence-based understanding of what is required in the development of a service delivery system
that is responsive to the needs of the criminal justice involved substance abuser.
Correctional personnel report that the T.C. housing units are the cleanest, safest and most trouble-free areas
of the prisons. Center Point has developed and refined a continuum of care that incorporates the essential
elements of the Therapeutic Community with cognitive-behavioral training to develop pro-social skills and target
criminogenic patterns. The structure of T.C. concepts such as accountability, community, active participation,
self discipline and mutual self help along with a service continuum from pre to post release promotes positive
community reintegration.
84
TRAUMA INFORMED WOMEN’S TREATMENT:
GUIDELINES AND STANDARDS OF CARE
By Sushma D. Taylor, Ph.D.
Center Point Inc., CEO/President
Sushma Deva Taylor, Ph.D., has served as Chief Executive Officer of Center Point,
Inc. (a private health and social services agency in Marin County, California),
since 1981. Dr. Taylor, a native of India, has a Master’s in Public Administration, a
Ph.D. in Clinical Psychology, is a licensed Marriage and Family Therapist, and is a
Certified Practitioner of Psychodrama and Group Sociometry. She is Vice-President
of Therapeutic Communities of America (TCA); she serves on several statewide
advisory boards and commissions; chairs the California Perinatal Treatment
Network; co-chairs the Department of Alcohol and Drug Program’s Access to
Recovery Project; and serves on the Department of Corrections Office of Substance
Abuse Program’s Policy Advisory Committee. Dr. Taylor has previously served on
the Center for Substance Abuse Treatment’s National Advisory Council.
ABSTRACT
Research indicates that addiction for women is a multidimensional issue involving complex environmental and
psychosocial challenges. Addiction patterns include social, cultural, economic, and political influences that shape
the initiation and trajectory of substance use. Women differ from men in many aspects, including relationships with
family, barriers to treatment, unique treatment services needs, risk of relapse and need for recovery support.
The incidence of traumatic experiences among women substance abusers suggest that treatment standards
address the full continuum of care needed by women throughout the lifespan. Services reflect multiple pathways
to recovery based on unique strengths, needs, experience and age of the women being served.
This workshop describes the core service elements required to address the multiple needs of women. Standards
for care recommend methods that are strength-based, trauma-informed, culturally fluent, family sensitive and
non-judgmental.
Guiding principles and interventions are described including assessment and engagement, case management,
trauma treatment, family relationships, skills building, parenting training, vocational planning, treatment
planning, and recovery management and maintenance.
85
OUTWARDS – INWARDS, FROM INWARDS TO OUTWARDS
By Ursula Piaggio Rubatto
Peru
After being trained in classical singing and music she studied alternative therapies.
She is Reiki Master of the Usui system and Floral Therapist. She facilitates crystal
quartz tools (CRYSTAL BOWLS), merging the crystal-clear sound with the voice,
a technology that has been internalizing for years. She also works with the sounds
of flutes, Tampura, djembee, always mixing it to the voice. She has studied in Peru,
Mexico, Argentina and Spain. She is vibration therapist and facilitator of group
workshops.
Nowadays, her work focuses on activating the CRISTAL VIBRATION from both
the sounds and the voice. She has established the “CRISTAL, VOICE AND FUSION
SOUNDS” for therapists and the “ASENCION 12 HARMONIC” which are being
shown in different cities of Peru, in Bogota (Colombia), and Marbella in Spain.
Once a week, she takes the crystal sounds to the Mundo Libre Girl’s House.
ABSTRACT
Sound has always been a frequency used as a healing vehicle. The human body is a marvellous instrument that
can be tuned by using sounds. The sound impulse vibrating from the quartz bowls activate a frequency of mental,
emotional and physical cleanliness. The patient RECEIVES the crystal sound and FREES all that bothers its
comprehensive harmony. The human voice, FROM INWARDS TO OUTWARDS is an energy that we ALL have,
Let us learn to use it in its full capacity in order to FREE, RESTORE and GIVE HARMONY from our inside.
86
EXPERIENCES OF FAMILY MEMBERS AFTER TC DROP-OUT: A
QUALITATIVE STUDY.
Veerle Soyez, Ph.D.
Loth Van den Ouweland, Ma. Ed.
Eric Broekaert, Ph.D.
Belgium
Eng. Veerle Soyez is currently a doctoral assistant at Ghent University and also
serves as a family counselor and therapist at the Therapeutic Community of
Kiem. She has conducted extensive research on substance abuse across variety of
populations.
ABSTRACT
Introduction: Family members of substance abusers are frequently confronted with multiple problems and
stressors on several life domains. Most of these stressors are persistent in nature; not surprisingly a lot of family
members are in need of support to (learn to) cope with these stressors. Usually such support (counselling) is given
–to a certain extent- to family members in treatment settings for substance abusers. However, this support is
mainly in favour of the substance abuser’s wellbeing and treatment process. In the case that the client drops out
of treatment prematurely, network members find themselves in a ‘support vacuum’.
Research questions: Little research has been focussing on the experience of family members of substance abusers
in such situations. In order to fill this gap, a qualitative study on the experiences of parents of TC-residents that
dropped out of treatment prematurely was set up. The research questions were clustered around three main
topics: (1) What is the impact of the early TC-dropout on parents? (2) What kinds of support do parents receive
in this period and what support do they feel to be the most valuable? (3) Which evolutions take place in the first
months after dropout?
Methodology: Seventeen parents of TC-residents that dropped out of treatment were interviewed (once or twice)
by means of an in-depth interview.
Results: The results show that most parents aren’t prepared for drop-out at all. Drop-out causes a lot of negative
emotions, of which the fear for relapse is most dominant. Parents are also afraid for the consequences of drug use
on the physical and/or psychological health and even the death of the substance abuser. Despite these negative
emotions, most parents still stay into contact with their child. The number of negative emotions reported by
parents remains relatively constant in the first three months after dropout; however, the number of positive
emotions increases in the mean time.
Parents mention to receive support mainly from informal networks (mainly family members, partners or other
parents of substance abusers); although some support has also been offered by formal networks, parents have lots
of complaints about formal support.
Discussion: implications of these findings in relation to treatment organisation will be discussed.
87
COPING STYLES OF STRESS IN DRUG DEPENDENT PATIENTS
Por Psi. WILLIAM GUEVARA
C.T. Escuela de Vida
Perú
William Guevara has a degree in Psichology in Universidad Nacional Mayor de
San Marcos, Peru. He is a postgraduate in Clinic Psychology and Certificated in
teaching higher education. He is the responsible of the social reinsertion in T. C.
Escuela de Vida.
ABSTRACT
This research explores the styles of coping stress used by drug addicts who are receiving treatment in Therapeutic
Communities in Lima. The sample consists of 88 people who have problems of dependence on psychoactive
substances such as alcohol, cocaine basic paste, cocaine hydrochloride and marijuana. The instrument used is
the COPE questionnaire, developed by Carver, Scheer and Weintraub, this quiz evaluates the ways of coping
styles used by people with stressful events. The psychometric analysis was conducted by the correlation item-test
corrected, and the internal consistency was established by using the coefficient of reliability of Cronbach Alpha.
The results show that drug addicts prefer coping styles: planning, active coping, postponement of confrontation
and turn to religion; also present as the styles of the last preference: behavioral disengagement, denial, suppression
of activities competent and mental disengagement. They also prefer the style of coping that focuses on the problem
and in last place preferences are other coping styles, which are forms of mental and behavioral disengagement,
mainly.
There were no significant correlations between the time of consumption and coping styles, which leads us to
assert that there is no difference between the two variables.
88
SPIRITUAL AND CULTURAL VALUES IN TC PROGRAMS
By Yunus Pathi
President of PENGASIH
Malaysia
Mohd Yunus Pathi Mohd, is the President and Founder of Association of
PENGASIH of Malaysia he is also the 2nd Vice President of the World Federation
Of Therapeutic Communities,1st Vice President of Asian Federation of Therapeutic
Community (AFTC). He has a Diploma in Substance Abuse from DAYTOP, NY.
Mohd Yunus Pathi Mohd has 18 years of experience in the field of treatment,
rehabilitation and prevention of substance abuse and 15 years of experience in the
field of HIV/Aids education, rehabilitation and prevention programs. He serves as
a member of many different Anti Drug boards and advisory boards in Malaysia.
He has been a presenter in many international conferences and has received many
awards including ‘Dr Siti Hasmah Award 2000’ for excellent work on HIV/Aids,
and a Special Category Award for Private Rehabilitation Organization in 2001 by
the Ministry of Home Affairs, Malaysia
ABSTRACT
PENGASIH is a Therapeutic Community that reaches out to all levels of society in Malaysia.
One of our projects is a Rehab Centre to help those who are still trapped by drug addiction and chemical abuse.
The rehab centre is a community-based learning group that encourages the growth of clients - spiritually and
culturally. We embed Positive Values taken from various cultures into all of our program structures.
Another important project by PENGASIH is the Family Support Group for family members of our clients. The
purpose is to understand issues better; to help dysfunctional families; to help family members cope trauma; as
well as to mend broken ties between them. With this important program, families are more comfortable to accept
former users and are better prepared to reduce risks of relapses.
PENGASIH believe that by embedding Spiritual and Cultural values in programs, will result in holistic healing
for former users. Such approach will EMPOWER them with positive life-styles and prepare them to fit back in to
their mainstream society.
89

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