Martin
I agree with the sentiment, I simply think that the European TC movement has probably gone too far down the professionalism route to turn back now and that what would be required would be some sort of new movement. In the UK, there is a rebirth of interest in recovery (after years of MMT being the principle treatment offered) and this has largely congregated around the 12-step fellowship (principally AA/NA) - mainly, I think because there was little else visibly on offer. This is because TCs and residential rehabilitation in general, have become marginalised (and thus, much less visible) in the past 2 decades.
Whbat might be required is something entirely new. In the USA, the Oxford House movement (http://www.oxfordhouse.org/userfiles/file/index.php) is a very extensive chain of self-managed sober houses lying entirely (or almost entirely) outside the normal state funding systems. Most Oxford Houses in the USA are 12-step oriented, but since the movement has yet to be established in Europe, there may be possibilities to encourage the growth of TC-oriented Oxford Houses, perhaps using the many TC-related after-care houses which already exist. Since I do want to maintain the integrity of our discussion thread around our potential campaign to save Phoenix Haga, I have re-named this message so that it will form a separate thread on the list. I do think this is something that might be worth discussing further and the EFTC list would be the place to do it. Leonard Jason and colleagues at De Paul University have studied the Oxford House movement for some years now and ight be able to offer interesting insights on this issue. Leonard is not a member of the EFTC list so I will forward this message to him and relay back any comments he is able to offer. But George De Leon IS a member of the list and I'm sure that he would have interesting perspectives to share (no pressure there then George!!).
Anyway, I think Martin has raised an interesting issue that we might like to discuss further - and of course that is precisely what this list is for.
Rowdy Yates
Senior Research Fellow
Scottish Addiction Studies
School of Applied Social Science
University of Stirling
Scotland
T: +44 (0) 1786-467737
F: +44 (0) 1786-466299
W: http://www.dass.stir.ac.uk/sections/showsection.php?id=4 (home)
W: http://www.drugslibrary.stir.ac.uk/ (online library)
________________________________________
From: Therapeutic Communities [[log in to unmask]] On Behalf Of Martin Lutterjohann [[log in to unmask]]
Sent: 24 May 2012 04:41
To: [log in to unmask]
Subject: Re: [EFTC] Sad News from Norway.
Rowdy,
of course you are principally right. We have that German "Synanon" which proved for decades that it does work, although this is a special case as it had been heavily supported by the Berlin Senate. We shall try here - maybe one last time - to convince the funding institutions that they can have the same success for much less money. We only need a few professional "coaches" as David Kerr puts it. As a psychologist I also profited from the present system. But too many different professionals tend to spoil the soup. We have developed TCs for chronic alcohol and substance abusers, some already dement and with Korsakoff syndrome, but they do not have a single doctor or psychologist on board. Anyway, it is again an interesting thread.
Cheers,
Martin
-------- Original-Nachricht --------
> Datum: Wed, 23 May 2012 15:07:11 +0100
> Von: Rowdy Yates <[log in to unmask]>
> An: [log in to unmask]
> Betreff: Re: [EFTC] Sad News from Norway.
> Martin
>
> Actually, it's an attractive idea. But I'm not sure the clock can be
> turned back. In order to get our hands on all that lovely Government money,
> we made a series of compromises long ago. Most significant amongst these
> was to move away from a totally self-help model to one which included
> professional staff. To go back to the original model would almost inevitably mean
> giving up all that official funding. I don't see many in the modern TC
> movement clamouring for that.
>
>
>
> Rowdy Yates
> Snr. Research Fellow
> Scottish Addiction Studies
> School of Applied Social Science
> University of Stirling.
>
> W: http://www.dass.stir.ac.uk/groups/showgroup.php?id=4 (home)
> http://www.drugslibrary.stir.ac.uk/ (library)
> T: +44 (0) 1786-467737
> M: +44 (0) 7894-864897
> F: +44 (0) 1786-466299
> E: [log in to unmask]
>
>
> -----Original Message-----
> From: Therapeutic Communities
> [mailto:[log in to unmask]] On Behalf Of Martin Lutterjohann
> Sent: 22 May 2012 17:57
> To: [log in to unmask]
> Subject: Re: [EFTC] Sad News from Norway.
>
> excellent proposal, Rowdy,
> but we should also fight for the right or chance to wind down therapeutic
> communities from what they typically are today to their true basics. I do
> not mean that we have to return to the TCs of the pioneering days in the
> 1960s and 1970s, but to a development of modern TCs that contain all the
> effective elements as we know them today but consequently stick to
> cost-effectiveness. If we compare David Kerrīs "Ten Competencies of the Therapeutic
> Community (TC)" that you sent around last week, especially competence 3 & 4,
> with the reality in many present-day therapeutic communities, we can see why
> TCs appear so expensive.
>
> Addiction treatment & rehabilitation in Germany is usually financed by
> social insurance and social welfare, while health insurance pays for
> detoxification. The social insurance institutions put very high demands on the staff
> composition of a "Fachklinik" (specialized residential addiction treatment
> and rehabilitation centers most of which are convinced they incorporate TC
> elements). To give you an example of staff composition at a Fachklinik for
> 100 residents where I worked in Southern Germany: 1 psychiatrist + 2
> additional medical doctors, 4 psychological psychotherapists (clinical
> psychologists)and about the same number of social workers, 3-4 ergotherapists, only
> one of them a recovering alcohol addict, 2 sport therapists. I may have
> ommitted one or two more professionals apart from administrative staff. Hard
> to avoid TC counter-productive dynamics with so many professionals.
> The cost of TCs in Scandinavia has traditionally even been much more
> expensive than in Germany I believe. I was amazed at the daily rate per resident
> in Swedish TCs, say 2 decades ago, but within a short period they
> disappeared one by one. I had always considered Phoenix House Haga a lucky
> exception in Scandinavia, possibly because of wealthy Norway that still could
> afford "the luxury of a TC". But obviously this is not the case any more.
>
> Martin Lutterjohann
>
> Hon.Vicepresident EFTC
>
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The Sunday Times Scottish University of the Year 2009/2010
The University of Stirling is a charity registered in Scotland,
number SC 011159.
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