Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium

BACKGROUND: Research 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. METHODS: Data 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). RESULTS: Clients 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. CONCLUSIONS: Special 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

Essential elements of treatment: a comparative study between European and American therapeutic communities for addiction

The purpose of this study was to investigate whether European and American therapeutic communities (TCs) for addiction, both traditional and modified, share a common perspective on what is essential in treatment using the Survey of Essential Elements Questionnaire (SEEQ). The European sample (N = 19) was gathered in 2009. For the American sample (N = 19) we used previously published research data. Despite comparable perspectives, European traditional TCs (N = 11) scored significantly higher than their American predecessors (N = 11) on 4 SEEQ domains. Cluster differences were more pronounced in Europe than in America

Participatie en kwaliteit van leven bij personen met een handicap of beperking : pilootstudie : stad Gent

B

21st century education, care and support for children and adults with a disability in Flanders (Belgium)

At the turn of the 2l st century, substantial changes are taking place in Flanders (Belgium) with regard to the organization of education, care and support for people with disabiliîies. Overall, these changes are the result of new theoreticat insighr ãnd changed perspectives on disabilities: shift towards q social-ecological approach, supports paradigm and quality of life. The so-called "M-Decree" and Perspective 2020 qre the two most important reforms currently taking place in Flanders. The "M-Decree", a reþrm plan for special education which was approved in the Flemish Parliament in 2014, now wants to make a radical shift and aims at mainstreaming students with special needs in primary and se:condary education. Untilt now, the r"gr"gãrcd rpecial school remained the dominant type of education. Second, Perspective 2020, a policy plan lounched in 2010, aims at the active inclusion andfull participation of peopte with disabilities in society. This plan contains a centralfocus on the client and his/her network, stimulates person-centered support processes and plans through more individualizedfunding and induces a shiftfrom a supply-oriented model of care and support towards a demand-oriented model. Both ìeþrms are currently being implemented and will result in important changes, opportunities and challenges during the coming years