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Substance Abuse Treatment, Prevention, and Policy

, 7:43

First Online: 11 October 2012Received: 21 July 2012Accepted: 05 October 2012DOI: 10.1186-1747-597X-7-43

Cite this article as: Goethals, I., Vanderplasschen, W., Vandevelde, S. et al. Subst Abuse Treat Prev Policy 2012 7: 43. doi:10.1186-1747-597X-7-43


BackgroundResearch on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community TC treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients’ early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument.

MethodsData was gathered among 157 adults in five TCs in Flanders Belgium. Descriptive statistics were used to explore clients’ early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change two indicators of TC treatment process.

ResultsClients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients’ ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients’ ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores.

ConclusionsSpecial attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients’ meta-cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of meta-cognitive training strategies in the pre-program and-or the induction stage of a TC program.

KeywordsTherapeutic communities Treatment process Motivation Psychological distress Demographics Electronic supplementary materialThe online version of this article doi:10.1186-1747-597X-7-43 contains supplementary material, which is available to authorized users.

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Autor: Ilse Goethals - Wouter Vanderplasschen - Stijn Vandevelde - Eric Broekaert


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