TITLE: Educational-therapeutic Approaches to Addiction at the therapeutic community "Magdaléna" AUTHOR: Bc. Zuzana Matějů DEPARTMENT: Department of Special Education SUPERVISOR: Doc. PaedDr. Šotolová Eva, Ph.D. ABSTRACT: The aim of this thesis is to analyse the educational therapeutic approach in the therapeutic communities, especially those which are provided in Magdalena's community. The thesis consists of two parts- the theoretical and the practical part. The theoretical part is focused on the therapeutic community connected with drugs Abuse and Addiction. The thesis briefly describes the history of the therapeutic communities all over the world and also the situation in the Czech Republic and the last part consists of the various targets and means of particular therapies. In terms of the practical part is to map the way of living of the TK Magdalena's clients - the way of life before joining Magdalena's community, reasons for their motivation for treatment and expectations of clients from the treatment process, through their own perceptions. A qualitative research shows something what connects all Magdalena's clients: it is mainly the way of percerving themselves and their own lives in various views. Key words: therapeutic community, history of therapeutic communities, aims and mens of treatment in...

Rituals can be described as ceremonial acts, that have typical rules and own significance. They have their place not only for substance abusers within therapeutic communities, but in a daily life also. Usually, rituals are bonded to traditions of a specific community and they provide a possibility for an individual to identify with this community. They provide also strong emotional experience and they concern spiritual parts of the individual as well. The main objective of this study is to provide a possible view of clients of each stages of final ritual in specific therapeutic community and to find out how it is perceived and valued in a case of a given attitude on their process of own treatment. The elaborated work is focused on emotions which are experienced by clients, whether and in a case how they sense the person, to whom is the ritual addressed, and how they sense therapists and objects which are used during the ritual. In the elaborated work is used a qualitative approach. Data were collected by individual semi-structured interviews. The sample was chosen by a method of intended choice via an institution, it is consisted of therapeutic community White Light I clients, which were present in the community at that time and simultaneously participated on the leaving ritual in this community....

In the thesis I focused on a process of residential treatment in a therapeutic community. Such a process is mostly divided into four stages in all therapeutic communities in the CR where different needs and tasks are required from clients. The procedure in the treatment process is evaluated by the group as well as by staff. The fulfillment of criteria in each phase is a condition needed for shifting the clients in the treatment process towards successful completion of treatment. These phases are clearly defined by therapists and clients are acquainted with them through the operating manual. The aim of the thesis is to describe the process of treatment and common elements with regard to how it is perceived and experienced by the clients during the treatment in the therapeutic community WHITE LIGHT I. Using methods of prospective study helps to describe the process of treatment and then divide it according to the common elements into ,,phases" as they are perceived by the clients themselves, and compare them with formally stated phases of treatment in the TC. The thesis is based on a qualitative approach. Data collection was conducted through prospective monitoring, ie. a different method from the previous research, which was focused retrospectively. In addition, the research used other sources of...

This thesis is focused on therapeutic communities in the treatment system of drug addicted clients and on their methods, programs and mission of employed therapists to achieve better restoration of the drug addicted clients. The aim of this work is to widely describe the treatment process in therapeutic communities and zoom in an enviroment and whole treatment system which creates safety place for each member of the community. The thesis is divided into a theoretical and practical part. Theoretical part describes today's czech experience in therapeutic communities, whereas the importance is laid on introducing therapeutic methods and programs effectively used in social work with drug addicts.Practical part forms own qualitative research, precedented with intership in the therapeutic community Karlov.

The aims of this study were to examine the relationship between symptoms of ADHD (Attention deficit/Hyperactivity disorder) and motivation for change, to explore their role in the prediction of treatment completion and to identify domains in psycho-social characteristics which can affect the motivation. The sample was composed of 250 illicit-subsatnce users, treated in therapeutic communities for drug addicts. Motivation for change was assessed with the Change Questionnaire, the presence of ADHD symptoms was assessed with DIVA2.0 (Diagnostic interview for Adult ADHD). Respondents indicated strong motivation to change the problematic behavior, but the study struggled with high rate of premature dropping out of the treatment, so the hypothesis about the effect of measured motivation for successful completing of the tretment could not be confirmed or disconfirmed. The relationship between ADHD and motivation could not be confirmed as well. The most important finding is probably the positive correlation between rate of psychopathology and ADHD, and it's negative influence on motivation. The work also gives a report about the problem of measuring of motivation, and reports some suggestions for the improvement. Powered by TCPDF (www.tcpdf.org)

Made available in DSpace on 2016-08-10T10:54:54Z (GMT). No. of bitstreams: 1 SONIS HENRIQUE REZENDE BATISTA.pdf: 1603106 bytes, checksum: c10d117643ba41dff9c8b693786b9c16 (MD5) Previous issue date: 2016-02-03 / This study aims to characterize the operation of therapeutic communities located in the Greater Goiânia-GO and the city of Anápolis-GO. This is a descriptive crosssectional study with a quantitative approach using a semi-structured questionnaire. They were surveyed 43 therapeutic communities located in Goiania, metropolitan area and Annapolis, using a semi-structured. The results were obtained through descriptive statistics. The results show that 41.9% of communities had the beginning of its operation between 2001 and 2010. They are usually away from the urban area, with documentation in order, routine activities, focused on religiosity - spirituality. The host of on-call time is nine months at 67.4%. The main source of funds is the donation of 58.1%. The screening (preliminary phase of the host) is present in 88.4%, with 14.0% allowing cigarette use sparingly. There is an average of 10.7 workers by communities, with 30.2% having a formal contract. During the survey period were detected 1,022 people welcomed from both genders. Leave addiction was motivated to join the community by 72.0% of respondents. Referral to the labor market appeared in 76.7% sporadically. All communities use the SUS to meet the welcomed. In relation to the CAPS, 48.8% had forwarded these people and 67.4% headed for continued treatment or monitoring. We conclude that there is a certain pattern of operation, with organizations focused on the reception of the clearance of the drug, varied activities that take time and resume the individual to their basic care in interaction with their peers. Meet a pent-up demand. They are misinterpreted by the other health facilities. Entities are organized and financed primarily by grants, but have indicated public funding and need to better adapt to multidisciplinary aspects. / O presente estudo tem por objetivo caracterizar o funcionamento das comunidades terapêuticas situadas na Região Metropolitana de Goiânia-GO e na cidade de Anápolis-GO. Trata-se de um estudo transversal descritivo com abordagem quantitativa utilizando-se de um questionário semiestruturado. Foram pesquisadas 43 comunidades terapêuticas localizadas em Goiânia, região metropolitana e Anápolis, utilizando-se um roteiro semiestruturado. Os resultados foram obtidos por meio de estatística descritiva. Os resultados mostram que 41,9% das comunidades tiveram o início de seu funcionamento entre 2001 e 2010. Estão habitualmente afastadas da zona urbana, com documentações em ordem, atividades rotineiras, focadas na religiosidade-espiritualidade. O tempo de permanência do acolhimento é de nove meses em 67,4%. A principal fonte de recursos é a doação em 58,1%. A triagem (fase preliminar do acolhimento) é presente em 88,4%, com 14,0% permitindo uso de cigarro moderadamente. Há uma média de 10,7 trabalhadores por comunidades, com 30,2% possuindo carteira assinada. No período da pesquisa foram detectadas 1.022 pessoas acolhidas de ambos gêneros. Deixar a dependência química foi motivação para ingresso na comunidade por 72,0% das respostas. O encaminhamento para o mercado de trabalho apareceu em 76,7% de forma esporádica. Todas as comunidades utilizam o SUS para atendimento dos acolhidos. Na relação com o CAPS, 48,8% receberam pessoas encaminhadas destes e 67,4% encaminharam para continuidade do tratamento ou acompanhamento. Conclui-se que há um determinado padrão de funcionamento, sendo entidades focadas no acolhimento visando o afastamento da droga, atividades variadas que ocupam o tempo e retomam o indivíduo aos seus cuidados básicos em convivência com seus pares. Atendem uma demanda reprimida. São mal interpretados pelos demais estabelecimentos de saúde. São entidades organizadas e financiadas basicamente por doações, mas que já sinalizam financiamentos públicos e que precisam melhor adequar-se a aspectos multiprofissionais.

Individuals who sell drugs are often mandated by legal forces to substance abuse treatment because of their criminal offenses and the belief they may have a drug problem. Previous researchers have noted this population may be disruptive in the treatment process, but it has not been explored in depth. The purpose of this phenomenological study was to learn the lived experiences of counselors who work with individuals who report a primary problem of selling drugs, not substance abuse, who are mandated to a substance abuse treatment program. Thirteen semi structured interviews were conducted with counselors who have worked with individuals who sell drugs that were mandated to participate in a correctional-based therapeutic community substance abuse treatment program. Interviews were transcribed and analyzed with the assistance of NVivo for meaning and themes. Data were examined through the theoretical lens of the social learning theory (SLT). The results of the study indicated counselors were prepared for their jobs through education and training to have longevity in working in a correctional environment and provided treatment services. The counselors found that individuals who sell drugs had a history substance use, which the individuals minimized. During treatment, counselors sought to challenge individuals who sell drugs to think and explore the effects of their behaviors. Counselors found individuals who sell drugs were able to engage in treatment to avoid negative consequences. The results of this research can encourage positive social change by initiating a discussion about assessments prior to drug treatment, characteristics of drug treatment program participants, and counselor training to improve quality of drug treatment services provided.

La présente recherche se propose d’examiner les multiples intérêts de faire intégrer l’approche psychanalytique dans un cadre spécifique de prise en charge pour des sujets toxicomanes : la communauté thérapeutique (CT). A partir de mon expérience clinique au Liban avec des sujets addictés, rencontrés dans une CT, j’expose les écueils de cette modalité de soin basée uniquement sur l’approche comportementale. Je décris aussi la clinique de la toxicomanie comme “clinique du semblable”. Cette clinique repose sur des processus identificatoires qui prennent appui sur un trépied : le regard social vis-à-vis du phénomène toxicomaniaque, un certain discours scientifique concernant les addictions, mais surtout sur le fonctionnement psychique propre aux sujets toxicomanes. Le point nodal de ma réflexion se trouve dans le fait qu’à la rencontre d’un soignant qui n’a pas nécessairement été usager de drogue lui-même, la plupart des patients addictés arguent qu’il n’est pas semblable à eux, donc il ne comprendrait jamais leur souffrance. Cette situation peut être considérée comme une forme de résistance, mais elle me permet de concevoir la fonction de la drogue sous l’angle de la problématique identificatoire. Je me propose donc, en me basant sur la psychanalyse, à déconstruire un pseudo-savoir constitué autour d’un phénomène complexe, savoir qui tend à figer les toxicomanes dans des notions qui mènent à des pratiques controversées (notamment en CT). J’essaye ainsi de recentrer la question de l’usage de drogue sur le patient addicté lui-même, avec ses failles et ses fantasmes identificatoires qui l’incitent à s’agréger aux communautés de personnes ayant des comportements bien codifiés. / This research intend to examine the multiple interests to integrate the psychoanalytic approach in a specific context of care for drug addicts : the therapeutic community (TC). Based on my clinical experience in Lebanon with drug abusers that I have met in CT, I expose the pitfalls of this form of care founded exclusively on the behavioral approach. I also describe the drug addiction as “clinic of the similar”. This clinic is based on identification processes that rely upon a tripod : the social opinions regarding the drug dependency phenomenon, some scientific discourse about addiction, but especially on the dependent subjects own psychological functioning. The central hub of my proposition is located in the fact that when they meet a caregiver who has not necessarily been drug user himself, most addicted patients argue that he is not similar to them, so he would never understand their pain. This situation can be considered as a form of resistance, but it allows me to conceive the function of the drug in terms of identificatory issues. I use psychoanalytic theory to deconstruct a pseudo-knowledge built around the complex phenomenon of drug addiction. This knowledge tends to freeze addicts in concepts that lead to controversial practices (including CT). I try to refocus the question of the substance abuse on the addicted patient himself, with his identification problems and fantasies that incite him to join a community of people having behaviors well codified.

The thesis deals with the role of a tutor in the Therapeutic community Karlov within a group of drug addicted mothers and their children. The thesis introduces the drug issue, including the general specification of a therapeutic community. The status of the non-profit organization SANANIM in the Czech Republic is described herein, as well as detailed characterization of its Therapeutic community Karlov which focuses on treating drug-addicted mothers along with their children. Another part of this thesis concentrates on the treatment of drug-addicted mothers along with their children and highlights the role of the tutor in the whole process. The last part of this work is dedicated to a qualitative research conducted within a group of abstaining mothers that received a treatment in this Therapeutic community. Over the course of this research a hypothesis that a tutor has positive influence on the relation of mother and her child/children during the treatment phase was confirmed.

Esta dissertação constitui-se em uma pesquisa sobre os efeitos da inserção das comunidades terapêuticas para o tratamento de usuários de drogas no Sistema Único de Saúde, a partir do Plano Integrado de Enfrentamento ao Crack, publicado pelo governo federal em 2010. Foram analisados os projetos de tratamento de quatro comunidades terapêuticas, disponíveis na internet. Para fundamentar a discussão da pesquisa, primeiramente, apresentamos um breve histórico da constituição das políticas públicas sobre drogas no país, tanto no âmbito da saúde como da segurança, a fim de visibilizar como se constitui a condição de possibilidade do entrelaçamento entre comunidades terapêuticas e a rede pública de saúde. Apresentamos, também, a estrutura e o funcionamento das instituições denominadas comunidades terapêuticas, bem como seu modelo de tratamento para os usuários de drogas, baseado na metodologia dos doze passos dos Alcoólicos Anônimos. Através dos projetos terapêuticos, analisamos quais as premissas para o tratamento dos usuários de drogas e em que saberes essas premissas se sustentam, bem como a articulação entre a moral religiosa e as tecnologias disciplinares e biopolíticas na conformação do modelo de atenção das comunidades terapêuticas e na produção de modos de subjetivação. Para a análise desta pesquisa, utilizamos os operadores conceituais de biopoder e governamentalidade de Foucault. / This dissertation it is a survey on the effects of the insertion of therapeutic communities for the treatment of drug users in the Health System from the Integrated Plan to Combat Crack, published by the federal government in 2010. We analyzed the treatment projects four therapeutic communities, available on the internet. To ground the discussion of research, first we present a brief history of the formation of public policy on drugs in the country, both within health and safety in order to visualize constuiu as the condition of possibility of entanglement between therapeutic communities and the network public health. Here also, the structure and functioning of institutions called therapeutic communities, as well as its model of treatment for drug users, based on the methodology of the twelve steps of Alcoholics Anonymous. Through the therapeutic projects, which analyzed the assumptions for the treatment of drug users and knowledge that these assumptions hold up as well as the link between religious morality and disciplinary and biopolitical technologies in shaping the model of care and therapeutic communities in the production of modes of subjectivity. For the analysis of this research, we use the operators concentuais of biopower and governmentality Foucault.