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Use of mind-altering substances may result in an array of adverse, especially health and social, consequences for drug users as well as for their close persons. Help to solve mentioned problems provide various types of drug services. The vast majority of drug services in past did not take into account the fact that relatives might suffer due to drug use of their family member too and thus they also might need specific professional help. The aim of this work is to capture and describe the process of therapy with regard to the perception and experience of the close persons of clients of therapeutic community. In order to adequately understand the situations, we must first determine what elements constitute them. The work is based on a qualitative approach and research group consists of close persons of clients of the therapeutic community WHITE LIGHT I. The results show that it is possible, based on the analysis of data, to define each stage of the therapeutic process from the perspective of family members and name them according to chronology and important characteristic. The inclusion of persons close to drug users into treatment process contributes significantly to improvement of their lives and relationships quality. Findings bring into practise the ideas for therapeutic teams and help to improve...

This thesis is about clients who are in treatment in therapeutic communities for drug addicts and suffer with a mental illness alongside drug addiction. The theoretical part summarizes the definition and description of dual diagnosis, the prevalence of people with dual diagnosis and discusses the possibilities of therapeutic approaches to clients with these specific demands. Finally, attention is paid to the theory of self-medication for symptoms of mental illness through addictive substances which supports the theoretical model of addiction as a result of reactions to psychiatric illness. The research was carried out at the research group, which was formed by all clients currently in treatment in two therapeutic communities for drug addicts in July 2015. The research was conducted as a quantitative design through non-standardized questionnaire. This research shows that from the total number of respondents, 79% had a psychiatric diagnosis in addition to substance abuse. Most often these were methamphetamine users and multiple substance users. From psychiatric disorders were most strongly represented personality disorders, depressive disorders and disorders from psychotic spectrum. With respondents who reported substance abuse to suppress psychopathological symptoms occurred reduction of most of...

Purpose: While our modern society seems to have learnt how to accept and tolerate drug-addicted men, drug-addicted women on the other hand are even typically confronted with prejudice and contempt from the part of society. We should pay more attention to gender problematics despite the addiction background. We should map the motivation and circumstances that could on one side convince women to addiction treatment and on the other side prevent them from taking treatment and completing it. Goals: The first goal of this thesis was to map the circumstances and motivation that bring female clients - substance-using mothers with their children - to treatment in the therapeutic community. The second target was to find out which specific motivational determinants keep female clients in treatment. The third aim of this work was to find out which area of CMRS questionnaire is most involved in the motivation of clients. Research Methodology: Research data collection took place in July and August 2018 in one particular therapeutic community. A semi-structured interview was conducted with clients followed by two short CMRS and DAST questionnaires. Research Target Group: The target research group consisted of eight clients from the therapeutic community. All clients were mothers in the age of 24 - 35 years....

INTRODUÇÃO: O sucesso do tratamento de dependentes de álcool e outras drogas numa comunidade terapêutica (CT) depende fundamentalmente da adesão ao tratamento, ou seja, o tempo de permanência na comunidade. Sabe-se que pacientes que permanecem em tratamento por um período de pelo menos três meses têm uma evolução melhor do que aqueles que abandonam o tratamento precocemente. O ambiente emocional familiar tem grande influência na adesão ao tratamento, e pode ser medido por meio da emoção expressa EE). MÉTODOS: Foram avaliados familiares de 31 dependentes de substâncias psicoativas e/ou de álcool, internados involuntariamente, por meio da versão abreviada e traduzida para o português da Entrevista Familiar de Camberwell (EFC). A partir de então, mediu-se a taxa de permanência na CT após seis, 12 e 18 meses. Foram avaliados os aspectos hostilidade, superenvolvimento e calor afetivo. A hostilidade foi abordada como ausente (pontuação igual a zero) ou presente (pontuação igual a 1, 2 ou 3). O superenvolvimento e o calor afetivo foram considerados de forma contínua (pontuação de zero a 5) e categorizada. Todos os possíveis pontos de corte foram estudados na procura de novas relações e significados dos componentes da EE para esta população específica e os achados da amostra. RESULTADOS: Foram considerados com alta EE para hostilidade 41,9% dos familiares entrevistados e 71% para superenvolvimento emocional; 25,8% destes familiares pontua ram para ambos os componentes da EE (hostilidade e superenvolvimento). Dos 31 pacientes, cinco (16,1%) desistiram do tratamento até os seis meses; dois pacientes desistiram entre o 6 o e o 12 o mês (25% de desistência em 12 meses) e quatro abandonaram o tratamento entre o 12 o e o 18 o mês (47,8% de abandono em 18 meses). Houve uma associação significativa entre a presença de hostilidade e o abandono do tratamento antes dos seis meses (p = 0,008, teste exato de Fischer). Houve diferença significativa na frequência de superenvolvimento familiar entre o grupo que permaneceu 18 meses e o grupo que abandonou o tratamento (p = 0,037, teste de Mann-Whitney). Os pacientes que permanceram em tratamento até os 18 meses tiveram uma freqüência maior de familiares com alto nível de superenvolvimento familiar (> 4) (p = 0,012; teste exato de Fisher). Não houve nenhuma associação entre o tempo de permanência e o calor afetivo. CONCLUSÕES: Alta EE tem influência significativa sobre o tempo de permanência do dependente químico ou de álcool na CT. A presença de hostilidade foi mais freqüente no grupo com o abandono prematuro do tratamento, enquanto o alto superenvolvimento do familiar foi mais freqüente no grupo de pacientes que permaneceu em tratamento até os 18 meses. Estudos com uma população maior são necessários para apoiar esses achados. / BACKGROUND: The success of treatment for alcohol and other substance dependence in a therapeutic community (TC) depends greatly on the treatment adherence, i.e., the length of stay at the TC. It is well known that subjects who stay on treatment for ate least three months have a better outcome, compared with those who early withdraw. The family emotional environment can be measured through expressed emotion (EE) and has great influence on treatment adherence. METHODS: 31 key-relatives of alcoholics and other substance dependents, who involuntarily began a treatment in a TC, were assessed through the Camberwell Family Interview (CFI) (shorter translated to Portuguese version). The proportion of subjects who remained on treatment in the TC was then measured after six, 12 and 18 months. Evaluated aspects included hostility, overinvolvement and warmth. Hostility was assessed as absent (score = 0) or present (score = 1, 2 or 3). Overinvolvement and warmth were considered as continuous and categorized values (scores 0 to 5). Every possible cutoff points were studied, in order to find new associations and meanings of EE components of this specific population and the length pf stay in a TC. RESULTS: 41.9% of the relatives were considered as having high EE for hostility and 71% for overinvolvement; among those relatives with high EE, 25.8% had presence for both hostility and overinvolvement. Among the 31 patients, five (16.1%) abandoned treatment up to 6 months; 2 patients abandoned treatment between 6th and 12th month (25% treatment abandon in 12 months) and four abandoned the treatment between 12th and 18th month (47.8% treatment abandon at 18 months). There was a significant higher frequency of presence of hostility in the group that abandoned before six months (p = 0.008, Fischer exact test). A significant difference of familiar overinvolvement was found between the group who remained in the treatment up to 18 months and the group that abandoned treatment earlier (p = 0.037, Mann-Whitney test). Families with score = 4 for overinvolvement were more frequent in the group that remained on treatment up to 18 months (p = 0.0012; Fischer exact test). No correlation was found between warmth and length of stay at TC. CONCLUSIONS: High EE has a significant influence over the length of stay of the alcoholic or other substance dependent in a TC. The presence of hostility is more frequent among families of patients who prematurely abandon treatment, while higher score of overinvolvement was more frequent in the families of the group that completed 18 months of treatment in the TC. Further studies with larger population are needed to support those findings.

Esta investigação trata da reinserção de pessoas com transtornos mentais, antes confinadas em Hospitais Psiquiátricos, no espaço da cidade em seu estilo contemporâneo de relações sociais. Inicialmente, realizamos uma trajetória da Saude Mental, desde a era dos manicômios, lugares para a contenção física e medicamentosa, em que as hospitalizações e internacoes em instituições asilares ocupavam um lugar central, até nos aproximarmos da Reforma Psiquiatrica brasileira, que, se inspirou na Reforma Psiquiatrica italiana. No Brasil, com a lei n 10216/01e a Portaria GM106/2000, que redirecionaram todo o modelo de atendimento a essas pessoas, a aposta nas Residências Terapêuticas tem sido fundamental para o processo de desinstitucionalização, na medida em que pretendem assegurar os direitos de pessoas, sem vínculos familiares, que deixam o hospital para viver em uma casa e, acima de tudo, acompanhar seu processo de reapropriação da cidade. No sentido de levantar subsídios para explicitar os obstáculos presentes nas relações de vizinhança implicadas nessa proposta foi efetuada uma análise de uma peticao inicial, inserida em um processo jurídico destinado a uma Residência Terapêutica, cujos vizinhos se mobilizaram para a expulsão dos moradores daquela casa. Foi possível observar o alcance da dificuldade implicada na reconstrução da cidadania dos egressos de Hospitais Psiquiátricos, o que nos permite destacar que, depois de tanta violência cometida pelo Estado em instituições e hospitais, esta análise evidencia como as Residências Terapeuticas são apenas o começo de um processo de reinserção complexa dessas pessoas, historicamente excluídas da paisagem urbana e da sociedade / The research considers the reinsertion of people with mental disorders in society and specifically their challenges adapting to urban life. It begins looking at the long hospitalizations and institutions designed to contain these people physically or through medication up to the development of the psychiatric reforms. In Brazil, law n 10216/01 triggered the discussion about the place and space needed to open up cities again to these people. Given the advances brought by the new model, the therapeutic community houses represent a relevant strategy in the deinstitutionalization process of people with mental disorders who lived long hospitalization periods and lost their family linkages. These people may now return to a house in the city, the main object of this research. Unwelcoming neighbors in a middle class area in Sao Paulo resisted resulting in a judicial process that this residence could not withstand, having to move elsewhere. As a result one might question the advances in mental health treatment given simple neighborhood problems strip people with mental health disorders from their citizenship. There is still a need to consider reparations for these people. After so much violence committed by the state in institutions and hospitals this analysis shows that the therapeutic community houses are just the beginning of a complex reinsertion process of these socially excluded people into the urban landscape and society

Made available in DSpace on 2016-04-28T20:39:05Z (GMT). No. of bitstreams: 1 Fabiana Coelho Fernandes.pdf: 1590397 bytes, checksum: 9c014cd64a6ad8b988a27ba42ac99438 (MD5) Previous issue date: 2015-05-20 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This research aimed to: (1) the development of an intervention proposal for addicts of both sexes in a therapeutic community in the metropolitan region of São Paulo, through training for their own personal planning and social rehabilitation from the work already done in the institution, on the recycling of solid waste and (2) the identification of the effects of this intervention proposal in the development of a personal planning for their lives after they leave the institution. Thus far, we used two proposals for data collection: thematic workshop consisting of four professional training sessions and thematic interview after the thematic workshop. The study included seven people, five men and two women, aged between 30 and 50 years. We chose a qualitative approach, and this was designed as a case study. Data collection was performed in a therapeutic community in the metropolitan region of São Paulo that admits men and women with drug addiction for treatment. The results suggest that training done through the four thematic workshop meetings brought elements, identified in the interview, that enable the development of personal proposals for the life of the participants as they leave the therapeutic community. The thematic workshop articulates information with possibilities of action in the labor market and brings a different view to the residents on the activities done in the institution with recyclable materials; the idea of this intervention is educational and creates in the participants the importance of planning a proposal for life covering mainly the social rehabilitation through working with recycling of solid waste. The work performed by clinical psychologists in therapeutic communities, from the environmental psychology point of view, should consider the health aspects of those admitted in these institutions, the context in which they operate (physical, cultural and temporal aspects of the institution), the social dimensions and local policy in which the institution operates, so that the performance is more consistent in promoting health and sustainability, as well as changes in values and behaviors. Support CAPES and CNPq / A presente pesquisa teve como objetivos: (1) o desenvolvimento de uma proposta de intervenção para dependentes químicos de ambos os sexos, acolhidos em uma comunidade terapêutica da região metropolitana de São Paulo, por meio de capacitação para planejamento pessoal e reinserção social a partir do trabalho já realizado na instituição, referente à reciclagem de resíduos sólidos e (2) a identificação dos efeitos dessa proposta de intervenção na elaboração de planejamento pessoal para a vida dos acolhidos após a institucionalização. Para tanto, foram utilizadas duas propostas para a coleta de dados: oficina temática, composta por quatro encontros de capacitação profissional e entrevista temática realizada após a oficina temática. Participaram deste estudo sete pessoas, cinco homens e duas mulheres, com idade entre 30 e 50 anos. Optou-se por uma abordagem qualitativa de pesquisa, sendo que esta foi delineada como um estudo de caso. A coleta de dados foi realizada em uma comunidade terapêutica na região metropolitana de São Paulo que acolhe homens e mulheres com dependência química para tratamento. Os resultados sugerem que a capacitação realizada por meio dos quatro encontros da oficina temática trouxe elementos, identificados na entrevista, que viabilizam a elaboração de propostas pessoais de vida dos participantes para quando estes saírem da comunidade terapêutica. A oficina temática articula informações com possibilidades de atuação no mercado de trabalho e traz um olhar diferenciado para os acolhidos sobre as atividades realizadas na instituição com materiais recicláveis; a ideia desta intervenção é educativa e suscita nos participantes a importância do planejamento de uma proposta de vida que contemple, principalmente, a reinserção social por meio de trabalho com reciclagem de resíduos sólidos. O trabalho realizado por psicólogos clínicos em comunidades terapêuticas, a partir do olhar da Psicologia Ambiental, deve considerar os aspectos de saúde das pessoas acolhidas nestas instituições, o contexto em que estão inseridas (aspectos físicos, culturais e temporais da instituição), as dimensões social e política do local onde a instituição funciona, para que a atuação seja mais coerente na promoção de saúde e sustentabilidade, bem como nas mudanças de valores e comportamentos. Apoio CAPES e CNPq

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Destaca-se a necessária tarefa da diaconia de produzir um movimento de mediação entre o polo da presença de Cristo na comunidade de seus servos e o polo da sua presença no sofrimento do mundo. O verdadeiro culto ao Deus encarnado é provado nas ações concretas de amor. Ações que constituem a ética pessoal e comunitária daqueles e daquelas que afirmam ser discípulos e discípulas do Kyrios-Diácono, através da hospitalidade que acolhe na comunhão e pela visitação que acode e caminha com a pessoa sofredora. São ações que protegem e promovem a vida e corroboram para que esta seja tão digna quanto possível. Assim, a diaconia se mantém em estreita relação com os demais serviços da comunidade de fé e evita que estes se tornem alienados da vida real, encarnando-os. Trata-se do olhar diaconia vida: responde a pergunta pelo fazer da diaconia pela vida. É a ética vivenciada. Através da fenomenologia da Vida de Michel Henry (1922-2002), tem-se um olhar complementar: a Vida que se apresenta na vida pela textura do sofrimento e do prazer. É o olhar que parte da perspectiva da Vida com suas implicações para a diaconia: Vida diaconia. A diaconia não se limita apenas a ações para a vida. É-o também ação da Vida na vida. Cuida no e ensina a viver o sofrimento. Dos sofrimentos, a investigação direciona o olhar para a problemática da dependência de substâncias psicoativas. Apresenta o desenvolvimento conceitual da dependência, importante para vencer os preconceitos. Aponta as principais características da pessoa dependente e do processo motivacional, para subsidiar uma proposta terapêutica. Analisa a proposta das Comunidades Terapêuticas, instituições de acolhimento terapêutico, com seus diferentes modelos. Os aportes da diaconia e da fenomenologia da Vida enriquecem a oferta destas instituições e apontam para a continuidade que se dá no acolhimento diaconal nas comunidades de fé. O quadro desta investigação diaconia fenomenologia da vida dependência Comunidades Terapêuticas recebe um colorido especial, através da leitura de relatos vivos de pessoas reais que vivenciaram de diferentes formas esta textura da Vida. A diaconia vivenciada pela fruição da Vida, torna-se terapêutica. / The necessary task of diakonia to produce a mediation movement between the center of the presence of Christ in the community of his servants and the center of his presence in the suffering of the world is highlighted. The true worship of the incarnated God is proved in concrete actions of love - actions which constitute the personal and community ethics of those who affirm that they are disciples of the Kyrios-Deacon, through the hospitality which welcomes into communion and through visitation which succors and walks with the suffering person. These are actions which protect and promote life and corroborate so that this life might be as dignified as possible. Thus, diakonia maintains a strict relation with other services of the faith community and avoids that these become alienated from the real life by incarnating them. It is about the diakonia-life perspective: it answers the question about diakonia for life. It is lived ethics. Through Michel Henrys phenomenology (1922-2002), one has a complementary perspective: The Life which presents itself in life through the weaving of suffering and pleasure. It is a look that stems from the perspective of Life with its implications for diakonia: Life-diakonia. Diakonia is not limited only to actions for life. It is also the action of the Life in life. It gives care and teaches to live in suffering. From the sufferings, the investigation directs its look to the problem of psychoactive substance dependence. It presents the conceptual development of dependence, which is important to overcome pre-judgments. It points out the main characteristics of a dependent person and of the motivational process, to substantiate a therapeutic proposal. It analyzes the proposal of the Therapeutic Communities, institutions of therapeutic welcoming in with their different models. The contributions of diakonia and of the phenomenology of Life enrich the offer of these institutions and point to the continuity which is propitiated by the diaconal welcoming in the faith communities. The framework of this investigation diakonia-phenomenology of life dependence Therapeutic Communities acquires a special coloring through the reading of live reports of real people who have experienced in different ways this weaving of Life. The diakonia experienced because of the fruition of Life becomes therapeutic.

The aim of this work is to find and to describe the importance of social workers in therapeutic community for drug addicts in the field of social rehabilitation. Using a quantitative method of data collection has been identified that the social worker in therapeutic community for drug addicts is an integral part of the process of client social rehabilitation. This finding is a confirmation of the theory of several experts who claim that social worker is an important part of the professional team and thus he also plays an important role in social rehabilitation process of the clients.

A investigação pontua o movimento da batalha espiritual, seu início, precursores, práticas, e teologia. Também o contexto social, cultural e religioso, análise das interfaces do contexto religioso-espiritual e psíquico. O trabalhado faz menção à visão de Sigmund Freud, Oscar Pfister e Karin Wondracek quanto à religião e psicanálise. O aspecto social do fenômeno religioso e a fenomenologia da Batalha Espiritual também ganha abordagem fundamental. A investigação pontua a contribuição que a fé reformada traz através da interpretação dogmática, do processo terapêutico que a igreja oferece através da liturgia e dogmática bíblica para seus seguidores. Na dogmática cristã, aborda-se a eleição, o arrependimento, a fé, a justificação, a regeneração, a adoção, a santificação e a certeza. Vendo a igreja no seu papel educacional, podendo educar através da liturgia como também a tendo como processo de cura dalmas. Enfim, a proposta da igreja como comunidade terapêutica, pode contribuir para o bem estar das pessoas e sociedade. / The investigation of the spiritual warfare movement, its beginning, early precursors, practices, and theology. Also the social, cultural and religious context, analysis of the interfaces of the religious, spiritual and psychical context. It was worked mentions of Sigmund Freud, Oscar Pfister and Karin Wondracek as religion and psychoanalysis. The social aspect of religious phenomena and phenomenology of Spiritual Warfare also gain fundamental approach. The research points out the contribution that the reformed faith brings through the dogmatic interpretation, of the therapeutic process through which the church offers liturgy and dogmatic biblical for his followers. In Christian dogmatic is discussed regarding the election, repentance, faith, justification, regeneration, adoption, sanctification and assurance. Seeing the church in its educational role, being able to educate through the liturgy as well as being part of the process of the soul cure. Finally the proposal of the church as a therapeutic community may contribute to the well being of individuals and society.