Dear Dave, thank you for expressing interest for the document I sent in the
mailing list.
Just in order to understand better the sense and the goals of the paper, you
can consider its framework and whose of the Conference.
Here in Italy we have still a strong debate on if Tcs are or not the magic
and total solution for every drug related problem. Such dabate is, mainly,
ideologically oriented and is quite difficult to reaffirm the supremacy of
evidence based interventions and the importance of integrated treatment.
Anyway, from my perspective and experience, I fully agree the stress you put
in the phase preceding the TC and the early phase of residential treatment.
Practically, all the predictive factors are there: motivation to change,
support to the residential treatment (community and family) and a good
start. These are, also, the factors NOT fully in charge of the staff and the
peers and the time when the drop out is more frequent.
Hope to hear from you soon
All the best

Maurizio Coletti


-----Messaggio originale-----
Da: Therapeutic Communities [mailto:[log in to unmask]]
Per conto di Dave
Inviato: mercoledì 2 marzo 2005 15.05
A: [log in to unmask]
Oggetto: Conferenza per un progetto delle Regioni sulle dipendenze"

Dear Maurizio

Thank you for giving us the translation of Conferenza per un progetto delle
Regioni sulle dipendenze. I wish I could write this in Italian, but it is
not possible. Maybe you can speak English, which will put me further to
shame, or someone can translate this for you.

I think the idea of an integrated pathway is good. It is important to have
balance between TC and community.

In my day, an example of balance would be in induction. A great deal of
thought was given to preparing a person for entry into a TC. This happened
in the community unless the person was in prison. The more orientation and
support a prospective resident received in the community,the more chance of
success,and the less fearful they were going to be.

It can be forgotten at times that for it is a massive step for someone to
take. Especially if they are withdrawing from drugs to enter a drug-free TC.

One idea I remember that worked quite well was the 'buddy principle'
The 'buddy' would be a very senior resident, who would be working with staff
in induction. They were given the task of becoming a special friend to a
prospective entrant, so if that person eventually made it into the
community, there would someone already in there that they knew. It would
also be positive re-inforcement and role-modelling for the 'buddy'  This is
not new and I know  has been successful in other models since.

It was a bonus if the resident had previous ' negative street cred'.
We worked on the idea that if you succeeded with one of the 'heavies' then
you would almost certainly bring in others. The principle being 'If they can
do it so can I'.


Anyway enough of my reminiscences, thanks again for a very interesting
article.

Warmest wishes
Dave