how therapeutic communities work (word)
TRANSCRIPT
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JOURNAL READING
How therapeutic communities work:
Specific factors related to positive outcome
Bagaimana terapi komunitas bekerja :
Faktor spesifik yang berhubungan dengan hasil yang positif
Disusun untuk Memenuhi ugas !epaniteraan !linik
Oleh:
Mia Puteri Rahayu 201420401011110
Harjuna Duta Nuswantara 201420401011122
M. Najib Abdullah 201420401011107
Nadia hilwiana 201420401011120
Nurul !ah"i 201420401011104
Ris#y u#uh $idadi 20142040101107%
"embimbing:
dr# $ka %urfarida& M#Sc#&Sp#!'#
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Puji syu#ur #ehadirat Allah &$' yan( telah "e"beri#an rah"at) hidayah) serta
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Penyusun "enyadari bahwa la+-ran journal reading ini belu"lah se"+urna.
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How therapeutic communities work: Specific factors related to positive outcome
Steve "earce and Hanna "ickard
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)bstract
Background: 'hera+euti, ,-""unities 8'9s are be,-"in( in,reasin(ly wides+read
as a /-r" -/ treat"ent /-r entren,hed "ental health +r-ble"s) +arti,ularly addi,ti-ns
and +ers-nality dis-rders) and are e;ually used in edu,ati-nal) +ris-n and learnin(
disability settin(s. Des+ite (r-win( e5iden,e /-r their e//e,ti5eness) little resear,h has
been ,-ndu,ted t- establish h-w '9s w-r# t- +r-du,e +-siti5e -ut,-"es. $e
hy+-thesi 8% draw less-ns /-r '9 +ra,ti,e>
and 84 su((est why they "ay ,-ntribute t- +-siti5e -ut,-"e.
Discussion: A sense -/ bel-n(in(ness is ,-rrelated with i"+r-5ed sel/*estee" and
-5erall well*bein(. 'he ,a+a,ity /-r res+-nsible a(en,y is ,entral t- beha5i-ural
,han(e. '9s are ty+i,ally used in /ields where +-siti5e -ut,-"e re;uires b-th
+ers-nal (r-wth and beha5i-ural ,han(e. $e su((est that '9s are uni;uely +la,ed t-
de"and su,h (r-wth and ,han(e -/ their "e"bers be,ause the sense -/
bel-n(in(ness en(endered by '9 "eth-ds +r-te,ts a(ainst the ris#s en(endered by
this de"and.
6onclusion: "+iri,ally in/-r"ed) e5iden,e*dri5en resear,h is ne,essary t-
understand h-w '9s w-r# and h-w '9 +ra,ti,e ,an be i"+r-5ed. 'his understandin(
"ay -//er less-ns /-r the i"+r-5e"ent -/ +sy,h-s-,ial as+e,ts -/ +sy,hiatri, ,are
"-re (enerally.
!eywords
thera+euti, ,-""unity) s+e,i/i, /a,t-rs) a(en,y) bel-n(in(ness) res+-nsibility.
$ntroduction
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Psy,h-thera+euti, a++r-a,hes are (enerally underst--d t- ,-"+rise b-th n-n*
s+e,i/i, and s+e,i/i, /a,t-rs that ,-ntribute t- +-siti5e treat"ent -ut,-"e. N-n*
s+e,i/i, /a,t-rs
are +resent in all ty+es -/ +sy,h-thera+euti, "-del. 'hey in,lude) /-r instan,e) the
thera+euti, allian,e) the thera+ist?s ,-"+eten,e) and adheren,e t- treat"ent +r-t-,-ls
89hat--r @ ur+ni,#) 2001. n ,-ntrast) s+e,i/i, /a,t-rs are n-t +resent in all ty+es
-/ +sy,h-thera+euti, "-del.
&+e,i/i, /a,t-rs re/er t- the set -/ distin,ti5e te,hni;ues and inter5enti-ns that
,hara,teri Hai(h) 1666>
Ra+-+-rt) 160. 'hese des,ri+ti-ns are ,-di/ied in the 9-""unity -/ 9-""unities
a,,reditati-n +r-,ess) a ;uality assuran,e netw-r# that "easures standards -/
(--d +ra,ti,e (i5en these +rin,i+les and "eth-ds 8Pa(et @ eenan) 200. 'hese
a,,reditati-n standards a++ly t- b-th de"-,rati, and addi,ti-ns '9s) the si"ilarities
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between whi,h /ar -utwei(h their di//eren,es 8Hai(h @ 3ees) 200B. M-re-5er) in the
/ields -/ health) +ris-n and addi,ti-n) there is e5iden,e that '9s +r-du,e +-siti5e
-ut,-"es 8/-r re5iews) see 3ees) Mannin() @ Rawlin(s) 2004> Mit,hell) $ils-n) @
Ma,en Prender(ast) P-dus) 9han() @ rada) 2002> &"ith) Cates) @
!-=,r-/t) 200. n ,-"binati-n) su,h resear,h su((ests that) des+ite di//eren,es
between +arti,ular '9s) and des+ite si"ilarities between '9s and s-,ial instituti-ns
"-re (enerally) '9s n-netheless ,-nstitute a distin,ti5e and uni/ied ty+e -/
+sy,h-thera+euti, "-del that ,an be +r-/itably in5esti(ated 5ia e"+iri,al "eth-ds
and e5iden,e*based resear,h +r-t-,-ls.
'his +a+er has tw- ai"s. !irst) and "-st substantially) we +r-+-se tw-
s+e,i/i, +sy,h-thera+euti, /a,t-rs in '9s that we su((est ,-ntribute t- +-siti5e-ut,-"e: the +r-"-ti-n
-/ a sense -/ bel-n(in(ness and the +r-"-ti-n -/ res+-nsible a(en,y. -th /a,t-rs
,an be /-und in -ther +sy,h-thera+euti, "-dels t- a de(ree> but we su((est that their
,-"binati-n) e=tent and e"+hasis are uni;ue t- '9s. $e s#et,h basi, resear,h -n the
i"+-rtan,e -/ bel-n(in(ness and res+-nsible a(en,y /-r +sy,h-l-(i,al health and
well*bein(. $e des,ribe the distin,ti5e set -/ te,hni;ues and inter5enti-ns that '9s
use t- tar(et the". !inally) we re/le,t -n h-w these /a,t-rs +-tentially -+erate
+-wer/ully in ,-"binati-n) t-(ether "a=i"i
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"-dels. n -ur 5iew) this is a #ey ste+ t- a,hie5in( a better understandin( -/ h-w '9s
are e//e,ti5e and) ,-rres+-ndin(ly) h-w '9 +ra,ti,e ,an be i"+r-5ed.
'he +r-"-ti-n b-th -/ a sense -/ bel-n(in(ness and -/ the ,a+a,ity /-r
res+-nsible a(en,y is li#ely t- be i"+-rtant t- the su,,ess/ul +r-5isi-n -/ the
+sy,h-s-,ial as+e,ts -/ +sy,hiatri, ,are ;uite (enerally) as they are i"+-rtant
ele"ents -/ healthy +sy,h-s-,ial /un,ti-nin(. Alth-u(h -ur dis,ussi-n /-,uses
+red-"inantly -n '9s) we als- there/-re h-+e that drawin( attenti-n t- these /a,t-rs
"ay h-ld a wider interest /-r all +ra,titi-ners ,-n,erned with +sy,h-s-,ial ,are.
Belongingness
el-n(in(ness ,-nstitutes a /unda"ental hu"an "-ti5ati-n. 'he bel-n(in(ness
hy+-thesis ,lai"s that:
Ehu"an bein(s ha5e a +er5asi5e dri5e t- /-r" and "aintain at least a
"ini"u" ;uantity -/ lastin() +-siti5e) and si(ni/i,ant inter+ers-nal
relati-nshi+s. &atis/yin( this dri5e in5-l5es tw- ,riteria: !irst) there is a need
/-r /re;uent) a//e,ti5ely +leasant intera,ti-ns with a /ew -ther +e-+le) and)
se,-nd) these intera,ti-ns "ust ta#e +la,e in the ,-nte=t -/ a te"+-rally stable
and endurin( /ra"ew-r# -/ a//e,ti5e ,-n,ern /-r ea,h -ther?s wel/are.
8au"eister @ 3eary) 166) +. 467
N-te that bel-n(in(ness re;uires "-re than "ere s-,ial ,-nta,t: /-r the dri5e t-
bel-n( t- be satis/ied) the ,-nta,t "ust be /re;uent) stable -5er ti"e) +-siti5e and
e=+ressi5e -/ "utual ,-n,ern.
"+-rtantly) reliable and 5alid "easures -/ bel-n(in(ness ha5e been
de5el-+ed as ,lini,al t--ls. 3e5ett*-nes) 3athlean) Hi((ins and M,Millan 82006
de5el-+ed su,h a s,ale a/ter a re5iew -/ +ri-r bel-n(in(ness s,ales) and used it t-
"easure bel-n(in(ness in nursin( students> their %4*ite" s,ale de"-nstrated hi(h
internal ,-nsisten,y and ,-nstru,t 5alidity. Fan Orden and ,-llea(ues 8200B
,-nstru,ted a ;uesti-nnaire t- "easure +er,ei5ed burdens-"eness and bel-n(in(ness
in a study -n the /a,t-rs in/luen,in( sui,idality) whi,h de"-nstrated (--d internal
,-nsisten,y and ,-nstru,t 5alidity. An e=a"+le ;uesti-n -n bel-n(in(ness /r-" this
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s,ale is: G'hese days -ther +e-+le ,are ab-ut "e.? 'hey /-und an ass-,iati-n between
thwarted bel-n(in(ness and sui,idal ideati-n.
Basic research on belongingness
el-n(in(ness has been /-und t- be ,-rrelated with +-siti5e adjust"ent 8h-+e in
ad-les,ents 8Da5ids-n) $in(ate) Ras"ussen) @ &lish) 2006. 'his ,-rrelati-n is
+arti,ularly str-n( in +eer*t-*+eer bel-n(in(ness) whi,h a++ears t- ha5e e//e,ts
distin,t /r-") /-r e=a"+le) studenttea,her bel-n(in(ness 8Ry $illia"s @ &-""er)
1667 8alth-u(h e=,luded indi5iduals "ay see# a//iliati-n with new s-,ial ,-nta,ts
rather than tryin( t- re*establish -ld b-nds 8Maner) De$all) au"eister) @ &,haller)
2007.
A,,e+ted +e-+le are (enerally better at sel/*re(ulati-n) but "ay n-t be willin(
t- e=ert the"sel5es in the interests -/ s-,ial a,,e+tan,e 8De$all et al.) 200B)
+-ssibly be,ause -/ a satiati-n e//e,t> why stri5e /-r s-"ethin( y-u already ha5eI
9-n5ersely) s-,ial e=,lusi-n has a deleteri-us e//e,t -n sel/*re(ulati-n 8au"eister)
De$all) 9iar-,,-) @ 'wen(e) 200. n /a,t) s-,ially e=,luded +e-+le tend t- be less
+r-s-,ial 8'wen(e) au"eister) De$all) 9iar-,,-) @ artels) 2007 and "-re
a((ressi5e 8'wen(e) au"eister) 'i,e) @ &tu,#e) 2001> $arburt-n) $illia"s) @
9airns) 200. 'hese /indin(s su((est a 5i,i-us ,y,le: s-,ial e=,lusi-n "ay lead
+e-+le t- en(a(e in beha5i-urs that "a#e subse;uent s-,ial a,,e+tan,e less li#ely.
Reje,ted +e-+le als- ha5e a tenden,y t- der-(ate th-se by wh-" they /eel they ha5e
been reje,ted 8-ur(e-is @ 3eary) 2001.
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'he e=+erien,e -/ bel-n(in( has an i"+a,t -n sui,idality. -iner 82007
hy+-thesi ,-n5ersely) in,reases in bel-n(in(ness lead t- a
de,rease in health +r-ble"s and an -5erall in,rease in ha++iness 8/-r a re5iew) see
au"eister @ 3eary) 166. A +sy,h-thera+euti, a++r-a,h that is able t- +r-"-te
bel-n(in(ness is there/-re li#ely t- ha5e a ran(e -/ bene/i,ial e//e,ts.
Belongingness and the TC environment and method
'he essential ele"ents ne,essary t- +r-"-te a sense -/ bel-n(in(ness are: 81
/re;uen,y -/ ,-nta,t> 82 l-n(itudinal stability> 8% +-siti5eness -/ the ,-nta,t> and 84
the +resen,e -/ "utual ,-n,ern 8au"eister @ 3eary) 166.
Many '9s are residential> e5en the least intensi5e G"ini* '9s? in5-l5e at least
wee#ly ,-nta,t -5er a series -/ se5eral "-nths) the "-st n-r"al ti"e s+an bein( 1B
"-nths 8Pear,e @ Hai(h) 200B. n -ther settin(s) '9 treat"ent rarely ta#es less than
a year) and ,an ta#e ,-nsiderably l-n(er) +arti,ularly in +ris-ns 8Rutter @ 'yrer)
200%. Me"bers are n-r"ally e=+e,ted t- stay /-r the wh-le +eri-d -/ treat"ent) and
"e"ber turn-5er tends t- be sl-w. n residential '9s) "e"bers ha5e ,-nta,t with at
least a subset -/ -ther "e"bers daily. 'hus the re;uire"ent /-r 81 /re;uen,y -/
,-nta,t and 82 l-n(itudinal stability a++ear t- be "et. 'his is illustrated in the ,-re
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standards /-r '9s used by the 9-""unity -/ 9-""unities in the 8Pa(et) 200B)
whi,h re;uire ,-""unities t- "eet re(ularly) and that G,-""unity "e"bers s+end
/-r"al and in/-r"al ti"e t-(ether?> as ,-re standards) these ,-nstitute essential
/eatures
with-ut whi,h a +r-(ra""e is n-t ,-nsidered t- be a '9.
'9s re;uire "-re than "ere s-,ial ,-nta,t. Mutual ,-n,ern is +r-"-ted
bey-nd the +r-/essi-nal ,-n,ern that "i(ht be sh-wn by sta//. '9 relati-nshi+s are
,hara,teri
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n +rin,i+le) then) the re;uire"ents /-r 8% +-siti5eness -/ ,-nta,t and 84 the
+resen,e -/ "utual ,-n,ern are ,lear ai"s -/ '9s. O/ ,-urse) this ai" is n-t always
a,hie5ed in +ra,ti,e. $hether in /a,t the ,-nta,t is +-siti5e /-r a +arti,ular +ers-n) in
a +arti,ular '9) is n- d-ubt 5ariable) and is li#ely t- de+end -n the state -/ the
,-""unity and nature -/ the indi5idual?s +ers-nality and needs at the ti"e. 'he /a,t
that '9s 5ary in the e//e,ti5eness with whi,h they
-+erate -5er ti"e is re,-(ni "utual
,-n,ern between +eers is di//erent /r-" ,-n,ern sh-wn by a +r-/essi-nal /-r a
+atient) student -r ,lient) and a++ears t- +r-"-te h-+e in a way that ,are sh-wn by a
+r-/essi-nal d-es n-t 8Ry
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Ha5in( established that bel-n(in(ness a++ears t- be a thera+euti, /a,t-r
s+e,i/i, t- '9s) we ,an as# what '9 +ra,ti,e ,an learn /r-" bel-n(in(ness resear,h)
and whether the e//e,ts -/ bel-n(in(ness tally with the e//e,ts -/ '9 treat"ent.
hat lessons can be a!!lied to TC !ractice "rom belongingness
research#
&us+ensi-n) whi,h is widely used in '9s and in5-l5es the te"+-rary
withdrawal -/ +ri5ile(es -/ "e"bershi+ su,h as attendan,e at "eetin(s and use -/
su++-rt) is li#ely t- intensi/y
the need t- bel-n( and "-ti5ate the learnin( -/ new beha5i-urs 8De$all et al.) 200B.
H-we5er) sus+ensi-n is als- li#ely t- +r-du,e /eelin(s -/ reje,ti-n 8thwarted
bel-n(in(ness) whi,h "ay +r-"-te sui,idality 8Fan Orden et al.) 200B) and +--r
sel/*re(ulati-n /-ll-win( +er,ei5ed reje,ti-n "ay "a#e it "-re di//i,ult /-r the
"e"ber t- en(a(e in +r-s-,ial beha5i-ur and rej-in the ,-""unity. $hen de,isi-ns
t- sus+end a "e"ber are ta#en) the li#elih--d -/ hei(htenin(
ris#s -/ sui,idality and +--r sel/*re(ulati-n sh-uld be ,are/ully wei(hed a(ainst the
(ains in +r-"-tin( the need t- bel-n(.
&i"ilarly) "any '9s dis,har(e "e"bers i/ they are ,-nsistently unwillin( t-
(i5e u+ unhel+/ul ,-+in( strate(ies su,h as sel/*har" and dru( and al,-h-l "isuse)
and this "i(ht als- +r-"-te sui,idality in the sh-rt ter". 'his ar(ues /-r '9s ha5in(
a r-bust and a,,urate syste" /-r assessin( willin(ness t- ,han(e +ri-r t- j-inin( the
'9) +-ssibly in5-l5in( a trial -/ the '9 en5ir-n"ent su,h as thr-u(h the use -/ a
+re+arat-ry (r-u+ 8/-r a des,ri+ti-n -/ this a++r-a,h
see Pear,e @ Hai(h) 200B.
'here are li"its t- the +-wer -/ +-ssible sus+ensi-n -r dis,har(e 8Du5all)
2007. '9s sh-uld be realisti, ab-ut the li#elih--d -/ ,han(e in res+-nse t- the need
t- bel-n( and be ready t- ,all a halt t- e//-rts t- "-di/y beha5i-ur in the /a,e -/
li"ited en(a(e"ent /r-" a "e"ber. / a "e"ber /eels reje,ted they "ay then
der-(ate that is) deni(rate the ,-""unity -r its "e"bers) whi,h ,an "a#e it "-re
di//i,ult t- return 8-ur(e-is @ 3eary) 2001.
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&,a+e(-atin( and ass-,iated /ailures -/ bel-n(in(ness sh-uld be ,l-sely
"-nit-red. Resear,h ,-nne,tin( su,h +r-,esses t- +--r -ut,-"es in,ludin( sui,ide
8Fan Orden et al.) 200B ar(ues a(ainst e=,ludin( sta// /r-" in/-r"al -r G"ilieu? ti"e
when bullyin( -r s,a+e(-atin( "ay -,,ur.
&ta// sh-uld be /ully in5-l5ed in in/-r"al ti"e and s,ru+ul-us ab-ut brin(in(
s,a+e(-atin( and bullyin( +r-,esses t- the attenti-n -/ the ,-""unity. &ta// in '9s
sh-uld "aintain a balan,e between inter5enti-nis" and a laisse< /aire a++r-a,h.
Cr-u+ +r-,esses that are n-t ,-ntinually "-nit-red ,an +r-du,e ad5erse e//e,ts) and
i/ these lead t- a de,rease in the e=+erien,e -/ bel-n(in(ness) the e//e,ti5eness -/ the
"eth-d is li#ely t- be ,-"+r-"ised. On the -ther hand) i/ sta// be,-"e t-- a,ti5e it
will detra,t /r-" the e=+erien,e -/ +eer su++-rt.el-n(in(ness resear,h su++-rts the use -/ 5-tes /-r j-inin( '9s) s-"ethin(
that is widely used in de"-,rati, '9s. Only th-se wh-" the '9 /eel ,an bel-n( are
li#ely t- bene/it) and the a,t -/ 5-tin( a new "e"ber int- the ,-""unity starts the
+r-,ess -/ a,,e+tan,e with a "e"-rable ,ere"-nial a,t.
'9s ha5e been th-u(ht t- rely -n (r-u+ 8+eer +ressure t- a,hie5e their e//e,ts
8ate"an @ 'yrer) 2002. / true) this "i(ht "a#e the +ersisten,e -/ bene/i,ial e//e,ts
less li#ely -n,e the "e"ber has le/t the ,-""unity and the (r-u+ +ressure n- l-n(er
-+erates) as well as +redis+-sin( t- bullyin( and s,a+e(-atin( th-se wh- d- n-t
,-n/-r". $hether -r n-t bene/i,ial e//e,ts /r-" '9 "e"bershi+ +ersist bey-nd the
end -/ treat"ent) and whether si(ni/i,ant har" is d-ne t- s-"e "e"bers) are
e"+iri,al ;uesti-ns. H-we5er) an alternati5e e=+lanati-n /r-" bel-n(in(ness
resear,h is that) as -++-sed t- (r-u+ 8+eer +ressure) the need t- bel-n() and the
threat -/ n-t bel-n(in() are "-ti5atin( /-r,es. n '9s the e=+e,tati-n that "e"bers
desist /r-"
destru,ti5e ,-+in( "e,hanis"s su,h as substan,e "isuse -r sel/*har" is a basi,
(r-u+ n-r". 'his) t-(ether with the use -/ ,-ntra,ts t- /-,us attenti-n -n "e"bers?
beha5i-ur) and the su++-rt and +sy,h-*edu,ati-n a5ailable t- establish "-re healthy
,-+in( s#ills) are li#ely t- +r-5e +-wer/ul "-ti5at-rs t- ,han(e. 3astly) (r-u+ 8+eer
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+ressure di//ers /r-" the +r-,ess in '9s by 5irtue -/ the /a,t that "e"bershi+ is
always /ully 5-luntary> +r-,edures and n-r"s are
s+e,i/i,ally desi(ned t- be +r-s-,ial in re(ard t- the wider ,-""unity and all -ther
"e"bers -/ the '9> +-tentially destru,ti5e (r-u+ +r-,esses su,h as s,a+e(-atin( and
sub(r-u+ /-r"ati-n are ,-ntr-lled> and the +r-,ess is desi(ned t- in,rease
interde+enden,e and e5entual inde+enden,e
and res+-nsible a(en,y. All these as+e,ts are "-nit-red and when ne,essary "-di/ied
by +r-/essi-nals.
Do the e""ects o" belongingness tall$ %ith the e""ects o" TC treatment#
&-"e -/ the e//e,ts -/ '9s are +redi,ted dire,tly by bel-n(in(ness resear,hand +r-5ide dire,t e5iden,e -/ bel-n(in(ness bein( a ,entral as+e,t -/ su,,ess/ul '9
treat"ent. An in,rease in sense -/ bel-n(in(ness is ass-,iated with redu,ti-ns in
sui,idality and a((ressi-n) and an in,rease in /eelin(s -/ well*bein(. 'hese are areas
in whi,h '9s a++ear t- ha5e an e//e,t 8arr et al.) 2010> Diet De 3e-n) &a,#s) &taines) @ M,endri,#) 2000> &hu#er) &ulli5an) @ Ri5lin)
2010. Redu,ti-ns in a((ressi5e and disru+ti5e in,idents in +ris-n '9s 8Diet Newt-n 2010 tally s+e,i/i,ally with resear,h lin#in( la,#
-/ bel-n(in(ness t- a((ressi-n and +au,ity -/ +r-s-,ial s#ills.
n additi-n t- the s+e,i/i, e//e,t -/ an in,rease in sense -/ bel-n(in(ness)
se,-ndary e//e,ts are li#ely t- be due t- beha5i-ur "-di/i,ati-n as a ,-nse;uen,e -/
wantin( t- bel-n( t- the (r-u+. Redu,ti-ns in deliberate sel/*har" and "isuse -/
substan,es "ay /all in this ,ate(-ry. 'hese e//e,ts) al-n( with the bene/i,ial e//e,ts -/
in,reased bel-n(in(ness -n well*bein( while a "e"ber -/ the '9) +redi,t l-wered
use -/ health res-ur,es> this is a re+-rted -ut,-"e in '9s 89hiesa) a,-+-ni) @
M-rris) 166> 9-+as) O?rien) R-berts) @ $hiteley) 16B4> Da5ies @ 9a"+lin()
200%. &u,h resear,h als- su((ests that (ains +ersist bey-nd the end -/ treat"ent.
'his is li#ely t- be due t- the +ersisten,e -/ ad5anta(e-us beha5i-ural ,han(es
8+r-"-ted by in,reased sel/*e//i,a,y) see bel-w) al-n( with "-di/i,ati-n -/
,-(niti5e re+resentati-ns 8su,h as G a" n-t a,,e+table?. 'he answer t- ;uesti-ns
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used t- "easure bel-n(in(ness) su,h as G'hese days -ther +e-+le ,are ab-ut "e? 8Fan
Orden et al.) 200B 8n-ted ab-5e) is li#ely t- re/le,t a relati5ely stable ,-(niti5e
re+resentati-n ab-ut the sel/ as "u,h as the ,urrent s-,ial reality in whi,h a +ers-n
/inds hi"Jhersel/ a/ter lea5in( a '9. N-te t--) -/ ,-urse) that in s- /ar as '9s
+r-"-te +r-s-,ial s#ills) they +r-5ide t--ls by whi,h a +ers-n "ay in /a,t
su,,ess/ully ,han(e their s-,ial reality) rein/-r,in( the "-di/ied ,-(niti5e
re+resentati-n.
*esponsible agency
'he +r-"-ti-n -/ res+-nsible a(en,y is ,entral t- any +sy,h-thera+euti,
"-del that ai"s n-t si"+ly at the a,;uisiti-n -/ sel/*#n-wled(e and re/le,ti5e
,a+a,ity) but at beha5i-ural ,han(e. eha5i-ural ,han(e is ,ru,ial t- i"+r-5e"ent)
let al-ne re,-5ery) when the +r-ble" t- be tar(eted in5-l5es a,ti-ns and -"issi-ns:
5-luntary beha5i-r -5er whi,h the +ers-n has at least a de(ree -/ ,-ntr-l 8Pear,e @
Pi,#ard) 2010. =a"+les -/ su,h +r-ble"s ,an be /-und within addi,ti-ns) eatin(
dis-rders and +ers-nality dis-rders) as well as an=iety and de+ressi-n) where ,-re
sy"+t-"s -r "aintainin( /a,t-rs in,lude a,ti-ns and -"issi-ns. Re,-5ery -r
i"+r-5e"ent thus re;uires the +ers-n t- ta#e a,ti5e ste+s t- ,han(e unhel+/ul habits
-r entren,hed +atterns -/ beha5i-ur: t- ,h--se t- d- thin(s di//erently) and t- /ind the
will t- e=e,ute this ,h-i,e. uite -/ten) this re;uires a basi, shi/t in attitude:
beha5i-ur that "ay /eel ,-"+ulsi5e and -ut -/ ,-ntr-l ,-"es t- be re,-(ni
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"+-rtantly) alth-u(h there is n- "easure /-r Gres+-nsible a(en,y? itsel/)
reliable and 5alid t--ls ha5e been de5el-+ed t- "easure a nu"ber -/ /a,t-rs +lausibly
,-nne,ted with it. Perha+s the "-st (eneral "easure -/ res+-nsible a(en,y is the
Cenerali
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ter" ,-ntr-l -/ eatin( and wei(ht) and adheren,e t- +re5entati5e health +r-(ra""es
8O?3eary) 16B. n,reased sel/*e//i,a,y has als- been lin#ed t- l-wered re,idi5is" in
se=ual -//enders 8P-ll-,#) 166 and hi(her edu,ati-nal a,hie5e"ent 8Ki""er"an)
andura) @ Martine
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unrelated d-"ain) until -ne has had the -++-rtunity t- rest the /a,ulty) all-win( it t-
return t- n-r"al le5els. On the -ther hand) re(ularly e=er,isin( the +-wer -/ the will
leads t- a l-n(*ter" in,rease in the ability t- d- s-) whi,h will in turn lead t- an
i"+r-5ed ability t- resist te"+tati-n t- a,t a(ainst y-ur l-n(*ter" interests.
G'a#in( res+-nsibility? de"ands the ,a+a,ity t- re/le,t -n -ne?s beha5i-ur)
"a#e de,isi-ns ab-ut h-w -ne wants t- d- thin(s di//erently) /-r" res-luti-ns and
,-""it t- ,han(e. t als- re;uires that -ne has the will+-wer t- stay the ,-urse t-
see thr-u(h -ne?s ,-""it"ent t- ,han(e) des+ite te"+tati-ns t- re5ert t- /a"iliar
habits and entren,hed beha5i-ural +atterns. ut) /r-" a ,lini,al +ers+e,ti5e) it is
natural t- +-stulate that the "-ti5ati-n t- e"+l-y these ,a+a,ities and /a,ulties t-
,han(e -ne?s li/e de"ands a +ri-r a//e,ti5e ,-""it"ent: -ne needs t- belie5e in -nesel/ and ,are ab-ut -nesel/ en-u(h) -therwise -ne will n-t be "-ti5ated
t- assess -ne?s li/e -bje,ti5ely and e"bar# -n what is -/ten a 5ery di//i,ult +ath
t-wards ,han(e) hen,e the lin# between sel/*e//i,a,y and sel/*estee" identi/ied by
ud(e et al. 82002. "+r-5ed sel/*estee" "ay thus be a ,ru,ial ,ausal a(ent t- the
+r-"-ti-n -/ res+-nsible a(en,y. 'hat "ay be -ne reas-n why '9s are e//e,ti5e: in
s- /ar as a sense -/ bel-n(in(ness i"+r-5es sel/*estee") it is an essential +re,-nditi-n
-/ the e//e,ti5e +r-"-ti-n -/ beha5i-ural ,han(e. $e return t- the intera,ti-n -/ these
tw- /a,t-rs bel-w.
Res!onsible agenc$ and the TC environment and method
A 5ariety -/ +sy,h-l-(i,al "eth-ds i"+li,itly ai" t- en,-ura(e res+-nsible
a(en,y and +r-"-te beha5i-ural ,han(e. 'hese in,lude:
L M-ti5ati-nal inter5iewin( te,hni;ues) t- en(a(e ser5i,e users and /-ster the
desire t- ,han(e 8R-llni,# @ Miller) 166.
L Farieties -/ 9') su,h as diale,ti,al beha5i-ur thera+y 8D' 8Di"e// @
3inehan) 2001) &yste"s 'rainin( /-r "-ti-nal Predi,tability and Pr-ble"
&-l5in( 8&'PP& 8lu" et al.) 200B) and Gst-+ and thin#? trainin(
8M,Murran) !y//e) M,9arthy) Du((an) @ 3atha") 2001) t- hel+ "ana(e
sel/har" and -ther ,-unter+r-du,ti5e beha5i-urs.
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L "-ti-nal intelli(en,e t- de5el-+ the #n-wled(e and ability t- identi/y
tri((ers) understand e"-ti-ns and "ana(e beha5i-ur 8C-le"an) 166B.
L Mentali
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dis,ussi-n -/ the reas-ns why the "e"ber did n-t adhere t- it) and h-w they will d-
thin(s di//erently ne=t ti"e) but ,an in,lude sus+ensi-n and) at the e=tre"e)
dis,har(e.
Al-n(side the e=+li,it use -/ ,-ntra,ts) '9s en,-ura(e res+-nsible a(en,y in
a nu"ber -/ ways that ,-lle,ti5ely all-w ,-""unity "e"bers t- ta#e -wnershi+ -/
the (r-u+ and thus res+-nsibility /-r h-w it is run. n de"-,rati, '9s) new "e"bers
are -/ten a,,e+ted int- the (r-u+ thr-u(h a 5-tin( +r-,edure: the (r-u+ has the +-wer
t- de,ide wh-" t- in,lude. Alth-u(h ,ertain b-undaries and rules are n-nne(-tiable
in -rder t- "aintain (--d thera+euti, standards
and a str-n() stable) sa/e ,-""unity) "any as+e,ts -/ ,-""unity li/e are de5-l5ed t-
the "e"bers) wh- "ay ta#e ,-lle,ti5e de,isi-ns ab-ut what the b-undaries) rules andeth-s -/ their (r-u+ are t- be) but in5ariably ha5e the res+-nsibility t- see that the
b-undaries and rules are res+e,ted. Alth-u(h these de,isi-ns are ab-ut the (r-u+) this
-//ers +ra,ti,e /-r the #ind -/ res+-nsible a(en,y '9s ai" t- en,-ura(e in the
indi5idual: the (r-u+ "ust re/le,t -n what #ind -/ (r-u+ it wants t- be) wei(h
e5iden,e) hear di//erent 5iews and -+ini-ns) ,-"e t- a de,isi-n and ena,t it. '9
"e"bers are als- res+-nsible /-r nu"er-us day*t-day as+e,ts -/ ,-""unity li/e)
su,h as ,--#in() ,leanin() h-stin() ad"inistrati-n and ta#in( -n res+-nsible r-les in
the ,-""unity. 'here is an e=+e,tati-n -/ res+-nsibility /-r 5ari-us r-les and tas#s
within the ,-""unity> i/ "e"bers d- n-t ta#e +art in these res+-nsibilities) they
re,ei5e /eedba,# /r-" the ,-""unity) al-n( with su++-rt and en,-ura(e"ent t-
/ul/ill their res+-nsibilities and r-les.
Hen,e) with res+e,t b-th t- indi5idual "e"bers and t- the ,-""unity) '9s
en,-ura(e res+-nsible a(en,y 5ia the (eneral ,a+a,ity t- re/le,t) de,ide and ena,t
,han(e. &el/re/le,ti-n) -ther*re/le,ti-n and (r-u+*re/le,ti-n are an i"+-rtant +art -/
the ,-""unity +r-,ess) whi,h +r-"-tes the-ry -/ "ind s#ills and sel/* and -ther*
e"+athy. Di//erent "e"bers in the (r-u+ -//er di//erent +ers+e,ti5es and desires)
whi,h need t- be e;ually res+e,ted and wei(hed) and de,isi-ns ta#en in ,-lle,ti5e
and /air ways. !inally) the ,-""unity has the +-wer t- ena,t de,isi-ns ta#en.
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'hr-u(h-ut these +r-,esses) there is a standin( e=+e,tati-n that "e"bers are ,a+able
-/ ta#in( res+-nsibility /-r the"sel5es and the ,-""unity. 'hey are e"+-wered t- be
re/le,ti5e) res+-nsible a(ents.
$ith res+e,t t- the ,a+a,ity /-r will+-wer) 5ari-us as+e,ts -/ '9 +ra,ti,e
au("ent it. '9s -/ten re;uire "e"bers t- st-+ unhel+/ul habits and +r-ble"ati,
beha5i-ural +atterns) su,h as dru( and al,-h-l use) bin(e*eatin( -r deliberate sel/*
har"> there is a standin( belie/ that su,h
,-ntr-l is +-ssible) whi,h "ay itsel/ ,-ntribute t- "e"bers? ,a+a,ity t- /ind the will
t- d- s- 8andura) 1667. ut al-n(side the re;uire"ent -/ abstinen,e is ,-lle,ti5e
+r-ble"* s-l5in( and su++-rt t- "a#e this abstinen,e easier: re+la,e"ent a,ti5ities
are identi/ied) alternati5e) healthy,-+in( strate(ies +ut in +la,e) ,-ntra,ts are ena,ted and) des+ite ne(ati5e
,-nse;uen,es /-r brea,h) an attitude -/ su++-rt and ,-"+assi-n +re5ails. 'hese
as+e,ts -/ '9 +ra,ti,e tar(et and au("ent will+-wer thr-u(h the de"and that it be
e=er,ised) the +r-5isi-n -/ better -+ti-ns) and ,-nsistent) stable) (--d re(ard) ,-n,ern
and su++-rt.
hat lessons can be a!!lied to TC !ractice "rom research on
res!onsible agenc$#
'he (eneral ,a+a,ity /-r re/le,ti-n -n -ne?s "ental state and beha5i-ur
in5-l5es the-ry -/ "ind s#ills. &i"+ly bein( a "e"ber -/ a re/le,ti5e ,-""unity that
5alues su,h s#ills is n- d-ubt bene/i,ial) but '9s sh-uld ,-nsider e"+iri,al resear,h
-n the nature -/ the de5el-+"ent and i"+r-5e"ent -/ "entali
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'9s ha5e hi(h e=+e,tati-ns -/ their "e"bers> ar(uably) that is +art -/ why
"e"bers a,ti5ely w-r# t- ta#e res+-nsibility /-r their beha5i-ur and "eet th-se
e=+e,tati-ns. ut /ailures and la+ses are n-netheless /re;uent) and it is ,ru,ial that the
i"+-siti-n -/ ne(ati5e ,-nse;uen,es) whi,h is +art -/ h-w '9s h-ld "e"bers
a,,-untable) is b-th ,-"+assi-nate and /air. $ith res+e,t t- ,-"+assi-n) '9s "ust
a,ti5ely stri5e t- retain an e"+atheti, stan,e and ,learly distin(uish the +ra,ti,e -/
h-ldin( "e"bers res+-nsible /-r beha5i-ur /r-" that -/ bla"in( the" 8,/. Pi,#ard)
2011. $ith res+e,t t- /airness) the "us,le "-del -/ will+-wer
su((ests that '9s "ust be ,are/ul t- bear in "ind the /-ll-win(:
L 'he tas# (enerality -/ will+-wer. / a "e"ber is e=er,isin( will+-wer in -ne
d-"ain) that "ay te"+-rarily a//e,t their will+-wer in an unrelated d-"ain)de+letin( the" -/ res-ur,es that they and the ,-""unity ta#e /-r (ranted.
L 'he +-ssibility -/ (enuine de+leti-n. $ill+-wer is a li"ited res-ur,e>
alth-u(h we sh-uld be ,auti-us -/ t-- literal an inter+retati-n -/ the G"us,le
"eta+h-r? it is ,lear that will+-wer ,an be,-"e run d-wn. s+e,ially durin(
the +eri-d when abstinen,e /r-" unhel+/ul beha5i-ur -r ,-+in( "e,hanis"s
is re;uired) but +-siti5e alternati5es ha5e n-t yet been learned and ,e"ented)
the ris# that will+-wer is se5erely ta=ed is hi(h. '9s "ust a,#n-wled(e the
reality -/ that ris# and n-t i"+-se e=+e,tati-ns -n "e"bers that they ,ann-t
be reas-nably as#ed t- "eet.
Does %hat is &no%n abo't the e""ects o" the !romotion o" res!onsible
agenc$ tall$ %ith the e""ects o" TC treatment#
'here is (--d reas-n t- hy+-thesi
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-/ res+-nsible a(en,y within '9s) it is natural t- ,-nje,ture that this is 8+art -/ the
,ause -/ the +-siti5e e//e,ts that '9s ha5e -n these dis-rders.
Ci5en the e5iden,e that in,reased sel/*e//i,a,y) l-,us -/ ,-ntr-l and
will+-wer) al-n(side de,reased i"+ulsi5ity) +redi,t the ,a+a,ity t- initiate
beha5i-ural ,han(e and sustain it -5er ti"e 8see ab-5e) -ne way -/ testin( this
hy+-thesis w-uld be t- "easure ,han(e in these +sy,h-l-(i,al attributes -5er the
,-urse -/ '9 treat"ent as -++-sed t- alternati5e "-des -/ treat"ent. &u,h a study
,-uld +r-5ide e5iden,e that '9 +ra,ti,es that +r-"-te res+-nsible a(en,y d- indeed
e//e,t i"+r-5e"ent in attributes already identi/ied as ,-rrelated with sustained
beha5i-ural ,han(e.
6ombining belongingness with responsible agency: he uni7ue
power of 6s
'here is e5iden,e that '9s ha5e +-siti5e -ut,-"es with +r-ble"s that are
n-t-ri-usly resistant t- treat"ent) su,h as addi,ti-ns and +ers-nality dis-rders. $e
want t- ,-n,lude by su((estin( that the +-wer -/ the '9 "-del de+ends -n the
uni;ue ,-"binati-n -/ a sense -/ bel-n(in(ness with the +r-"-ti-n -/ res+-nsible
a(en,y.
$e ha5e already su((ested that these /a,t-rs "ay w-r# in ,-"binati-n 5ia
sel/*estee". A sense -/ bel-n(in(ness i"+r-5es sel/*estee") whi,h is then harnessed
t- initiate beha5i-ural ,han(e: y-u need t- ,are ab-ut y-ursel/ en-u(h t- (enuinely
want t- ta#e the di//i,ult ste+s ne,essary t- ,han(e thin(s /-r the better. ut the
"eth-ds des,ribed ab-5e that are used by '9s t- +r-"-te res+-nsible a(en,y and
e//e,t beha5i-ural ,han(e ,arry ris#s -/ "e"bers /eelin( a /ailure i/ they d- n-t
"eet e=+e,tati-ns set by the"sel5es and the ,-""unity) /eelin( reje,ted -r +unished
when they are held a,,-untable and /a,e ne(ati5e ,-nse;uen,es) and hen,e -/
sel/,riti,is") sel/*bla"e) l-ss -/ h-+e) disen(a(e"ent and rela+se. et) when
i"+r-5e"ent -r re,-5ery re;uires beha5i-ural ,han(e) it is di//i,ult t- see h-w it is
+-ssible with-ut su,h "eth-ds. el-n(in(ness) we su((est) +r-te,ts a(ainst these
ris#s. 'he e"+l-y"ent -/ su,h "eth-ds within a ,-""unity that is stable) "eets
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/re;uently and is ,hara,teri
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ate"an) A.) @ !-na(y) P. 82006. Rand-"i
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De$all) 9.) au"eister) R.) @ F-hs) . 8200B. &atiated with bel-n(in(nessI//e,ts -/ a,,e+tan,e) reje,ti-n) and tas# /ra"in( -n sel/*re(ulat-ry +er/-r"an,e.
Journal of ersonality and Social sychology) (+) 1%71%B2.
Diet
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Maner) . .) De$all) 9. N.) au"eister) R. !.) @ &,haller) M. 82007. D-ess-,ial e=,lusi-n "-ti5ate inter+ers-nal re,-nne,ti-nI Res-l5in( the G+-r,u+ine
+r-ble"?. Journal of ersonality and Social sychology) (.) 42.
Mannin() N. 82010. 'hera+euti, ,-""unities: A +r-ble" -r a s-luti-n /-r
+sy,hiatryI A s-,i-l-(i,al 5iew. /ritish Journal of sychotherapy) .* ) 4%444%.Mit,hell) O.) $ils-n) D. .) @ Ma,en
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Ryouth and )dolescence) -") 112.
&hu#er) R.) &ulli5an) .) @ Ri5lin) A. 82010. &ui,ide and sel/*injuri-us
beha5i-urs at HMP Crend-n. n R. &hu#er @ . &ulli5an 8ds)
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+atar belakang: 'era+i #-"unitas "enjadi se"a#in luas seba(ai bentu# +en(-batan +ada
"asalah #esehatan "ental se+erti #e,anduan dan (an((uan #e+ribadian) dan di(una#an +ula
dala" +endidi#an) +enjara) dan +e"belajaran +ada disabilitas. Mes#i+un telah ada bu#ti
e/e#ti/itasnya) +enelitian dila#u#an untu# "enunju##an ba(ai"ana ,ara #erja tera+i#-"unitas untu# "en(hasil#an hal yan( +-siti/. ita "endu(a terda+at 2 /a#t-r s+esi/i# yan(
ber#-"binasi "en(#-ntribusi #ee/e#ti/an tera+i #-"unitas : ya#ni rasa in(in "e"ili#i 8 /elongingness dan #a+asitas le"ba(a yan( res+-nsi/. Mes#i+un #edua /a#t-r tersebut
dite"u#an +ada +en,a+aian tera+i lainnya yan( +entin( ba(i as+e# +si#-s-sial dari
psychiatri care +ada u"u"nya) #ita ber+enda+at bahwa #-"binasi #eduanya "e"+erluas
dan "en(uta"a#an #euni#an tera+i #-"unitas.
Material: erdasar#an +si#-l-(i s-sial dan e#s+eri"ental) #a"i 81 "en(ulas +enelitian
tentan( rasa "e"ili#i 8belongingness dan #a+asitas le"ba(a yan( res+-nsi/> 82 "eneta+#an
"e#anis"e di"ana tera+i #-"unitas da+at "e"+r-"-si#annya> 8% "e"buat +elajaran
untu# +ra#te# tera+i #-"unitas> dan 84 "enunju##an "en(a+a #eduanya da+at "e"beri#an
hasil yan( bai#.
Diskusi: Rasa "e"ili#i 8belongingness ber#-relasi den(an +enin(#atan har(a diri dan#esejahteraan se,ara #eseluruhan. a+asitas untu# instansi yan( res+-nsi/san(at +entin(
untu# +erubahan +erila#u. 'era+i #-"unitas biasanya di(una#an dala" suatu bidan( di "ana
hasil yan( +-siti/ dibutuh#anba(i +er#e"ban(an+ers-nal"au+un +erubahan +erila#u. a"i
"enyaran#an a(ar tera+i #-"unitasdi(una#an untu#"e"bentu#+er#e"ban(an dan
+erubahan an((-tanya #arena rasa "e"ili#i 8belongingness yan( diti"bul#an -leh "et-de
ini "elindun(i terhada+ risi#- yan( da+at "un,ul.
!esimpulan: &e,ara e"+iris) bu#ti +enelitian dibutuh#an untu# "e"aha"i ba(ai"ana tera+i
#-"unitas be#erja dan ba(ai"ana +ra#te# tera+i #-"unitas da+at ditin(#at#an. Pe"aha"an
ini "un(#in "e"beri#an +elajaran untu# +erbai#an as+e# +si#-l-(i dala" +erawatan
+si#iatri se,ara u"u".
"(%D)H/+/)%
Pende#atan +si#-tera+i u"u"nya terdiri dari /a#t-r s+esi/i# dan n-n*s+esi/i#
yan( ber#-ntribusi terhada+ hasil +en(-batan yan( +-siti/. !a#t-r n-n*s+esi/i#
terda+at +ada se"ua jenis "-del +si#-tera+i. 'er"asu# didala"nya) "isalnya) aliansi
tera+i) #-"+etensi tera+is) dan #e+atuhan terhada+ +r-t-#-l +en(-batan 89hat--r @
ur+ni,#) 2001. &ebali#nya) /a#t-r*/a#t-r s+esi/i#tida# selalu ada di se"ua jenis
"-del +si#-tera+i. !a#t-r s+esi/i# "eruju# #e te#ni# #husus dan inter5ensi yan(
"en,iri#an suatu jenis "-del +si#-tera+i tertentu) yan( "e"beda#annya dari jenislain. Misalnya) +en((unaan te#ni# restru#turisasi #-(niti/ dala" +en(-batan #-(niti/*
+erila#u) dan inter+retasi trans/erensi dala" +si#-tera+i +si#-dina"i#.
Pada bebera+a "-del +si#-tera+i) /a#t-r s+esi/i#nya telah dijelas#an den(an
bai# dan #-ntribusinya terhada+ hasil +-siti/ yan( dibentu#. Na"un des#ri+si dan
+enelitian tersebut "asih #uran( ba(i "-del tera+i #-"unitas.
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Hal ini "un(#in disebab#an -leh bebera+a /a#t-r. Perta"a) as+e# budaya
sete"+at dari tera+i #-"unitas da+at "enyebab#an resistensi internal
8+en-la#an+ada u+aya yan( dila#u#an 8Mannin() 2010. edua) "un(#in ada
#esulitan dala" standarisasi +ada tera+i #-"unitas "en(in(at +ende#atan yan(
heter-(en 8Hinshelw--d) 2010. eti(a) tera+i #-"unitas da+at dian((a+ seba(ai
wadah di "ana "-del +si#-tera+i lainnya dii"+le"entasi#an) bu#an seba(ai "et-de
+si#-tera+i sendiri 8$arren et al.) 200%. A#hirnya) tera+i #-"unitas da+at dian((a+
"iri+ den(an inter5ensi s-si-l-(is) sebandin( den(an se#-lah atau #eluar(a) yan(
analisis redu#si-nis tida# sesuai atau yan( "an/aatnya sudah jelas 8Pear,e @
Autri;ue) 2010.
Na"un de"i#ian) bebera+a setuju dis#ri+si u"u" dari banya# +rinsi+ uta"a)
"et-de dan /itur dari tera+i #-"unitas 8e.(. De 3e-n) 2000> Hai(h) 1666> Ra+-+-rt)
160.Des#ri+si tersebut telah di#-de#an dala" 1ommunity of 1ommunities
accreditation process7 suatu jarin(an ja"inan #ualitas n((ris yan( "en(u#ur standar
+ra#te# yan( bai# den(an "enentu#an dasar dan "et-de yan( berla#u 8Pa(et @
eenan) 200. &tandar ini berla#u untu# tera+i #-"unitas de"-#ratis "au+un
#eter(antun(an) #eduanya "e"ili#i #esa"aan yan( besar 8Hai(h @ 3ees) 200B.
&elain itu) di bidan( #esehatan) +enjara dan #eter(antun(an) ada bu#ti bahwa tera+i
#-"unitas "en(hasil#an hasil +-siti/ 8ulasan +ada: 3ees) Mannin() @ Rawlin(s)
2004> Mi'era+i #-"unitashell) $ils-n) @ Ma,en Prender(ast) P-dus)
9han() @ rada) 2002> &"ith) Cates) @ !-=,r-/t) 200. ila di(abun(#an)
+enelitian tersebut "enunju##an bahwa) walau+un terda+at +erbedaan tertentu antara
tera+i #-"unitas) dan "es#i+un #esa"aan antara tera+i #-"unitas dan le"ba(a*
le"ba(a s-sial lebih u"u") tera+i #-"unitas teta+ "eru+a#an jenis yan( #has dan
"-del +si#-tera+i ter+adu yan( da+at "en(untun(#an bila ditinjau se,ara e"+iris
dan se,ara evidence$based?
'ulisan ini "e"ili#i dua tujuan. Perta"a) dan yan( +alin( substansial) #a"i
"en(usul#an dua /a#t-r +si#-tera+i #husus dala" tera+i #-"unitas yan( #a"i ya#ini
"e"beri#an hasil +-siti/: "e"ban(un rasa "e"ili#i 8belongingness dan
"e"ban(un le"ba(a yan( res+-nsi/. edua /a#t-r tersebut da+at dite"u#an dala"
"-del +si#-tera+i lainya> ta+i #a"i "enyaran#an bahwa #-"binasinya se,ara luas
dan dala" "e"ili#i #euni#an dala" tera+i #-"unitas. a"i "eru"us#an +enelitian
dasar tentan( +entin(nya rasa "e"ili#i dan le"ba(a yan( res+-nsi/ untu# #esehatan
+si#-l-(is dan #esejahteraan. a"i "en((a"bar#an suatu te#ni# #husus dan
inter5ensi yan( ditar(et#an dala" tera+i #-"unitas. A#hirnya) #ita "e"i#ir#an
ba(ai"ana /a#t-r*/a#t-r ini ber+-tensi se,ara #uat #eti#a di#-"binasi) bersa"a*sa"a
"e"a#si"al#an #e"un(#inan untu# +erubahan.
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edua) dala" "e"buat +r-+-sal ini) #a"i bertujuan untu# "enyaran#an
a(enda untu# +enelitian e"+iris di "asa de+an. Men(in(at #euni#an dari /a#t-r*
/a#t-r yan( di#-"binasi#an dala" tera+i #-"unitas) wajar untu# berhi+-tesis bahwa
ba(ian yan( e/e#ti/ +ada tera+i #-"unitas da+at di#lai" +ada "-del +si#-tera+i
lainnya) dibandin(#an den(an "asalah +si#-l-(is tertentu atau #el-"+-# +endudu#)
disebab#an #arena #-ntribusi "ere#a. 'a+i) sa"+ai +enelitian dila#u#an untu#
"en(uji hi+-tesis ini) #ita tida# bisa tahu bahwa justru /a#t-r*/a#t-r ini) dala"
#-"binasi atau sendiri*sendiri) yan( ber#-ntribusi terhada+ hasil +-siti/ dari tera+i
#-"unitas. &e,ara u"u") #ita berhara+ bahwa +r-+-sal #a"i da+at "e"a,u
in/-r"asi e"+iris) se,ara evidence$based +ada tera+i #-"unitas. 3ebih #husus) #a"i
berhara+ dis#usi #ita "e"a,u +enelitian tentan( sejauh "ana rasa "e"ili#i dan
le"ba(a yan( res+-nsi/) dala" #-"binasi atau sendiri*sendiri) dita"bah "elalui
+en(-batan tera+i #-"unitas berbeda den(an "-del +si#-tera+i lainnya. Dala"
+andan(an #a"i) ini adalah lan(#ah #un,i untu# "en,a+ai +e"aha"an yan( lebih
bai# tentan( ba(ai"ana tera+i #-"unitas e/e#ti/ dan) den(an de"i#ian) ba(ai"ana
+enera+an tera+i #-"unitas da+at ditin(#at#an.
Pr-"-si untu# "e"bentu# rasa "e"ili#i dan le"ba(a yan( res+-nsi/
"enjadi +entin( untu# #eberhasilan as+e# +si#-s-sial +en(-batan +si#iatri se,ara
u"u") #arena #eduanya adalah ele"en +entin( dari /un(si +si#-s-sial yan( sehat.
Mes#i+un dis#usi #ita ber/-#us +ada tara+i #-"unitas) #a"i ju(a berhara+ da+at
"enari# +erhatian yan( lebih luas terhada+ /a#t-r*/a#t-r tersebutba(i se"ua +ra#tisi
yan( ber#aitan den(an +erawatan +si#-s-sial.
Belongingness 8*asa ingin memiliki9
Rasa in(in "e"ili#i "eru+a#an "-ti5asi +alin( "endasar yan( di"ili#i -leh
"anusia. Hi+-tesis %he /elongingness "enyata#an bahwa :
Manusia "e"ili#i #ein(inan untu# "e"bentu# dan "e"+ertahan#an
setida#nya #uantitas dari hubun(an inter+ers-nal yan( +entin() dan bertahan untu#
wa#tu yan( la"a. ntu# "e"enuhinya dibutuh#an 2 #riteria yaitu : Perta"a)
dibutuh#an /re#uensi) hubun(an yan( "enyenan(#an den(an bebera+a -ran() dan
yan( #edua hubun(an ini harus "eru+a#an hubun(an yan( stabil dan bertahan dala"
#eran(#a a/e#ti/ #e+edulian terhada+ satu sa"a lain. 8au"eister @ 3eary) 166) +.467
Perhati#an bahwa Rasa in(in "e"ili#i "e"erlu#an lebih dari se#edar #-nta#
s-sial : untu# "e"enuhi tujuan ) #-nta# yan( terjadi harus serin() stabil) +-siti/) dan
e#s+resi/.Hal yan( san(at +entin() u#uran yan( 5alid dan da+at diandal#an dari
belongingness telah ber#e"ban( seba(ai alat #linis. 3e5ett*-nes) 3athlean) Hi((ins
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dan M,Millan 82006 "en(e"ban(an beru+a s#ala setelah "ere5iew s#ala uta"a
Rasa in(in "e"ili#i) dan "en((una#an hal tersebut untu# "en(u#ur Rasa in(in
"e"ili#i di "ahasiswa #e+erawatan> %4 jenis s#ala telah dide"-nstrasi#an den(an
#-nsistensi dan 5aliditas yan( tin((i. Fan Orden d## 8200B "e"bentu# #uesi-ner
untu# "en(u#ur hal*hal yan( "enjadi beban dan belongingness dala" studi +ada
/a#t-r yan( "e"+en(aruhi +er,-baan bunuh diri.) di+era(a#an den(an #-nsistensi
dan 5aliditas yan( bai#. 9-nt-hnya : &aat ini Oran(*-ran( +eduli +ada#u. Mere#a
"ene"u#an hubun(an tin(#at #e(a(alan +er,-baan bunuh diri den(an adanya te-ri
%he belongingness.
"enelitian yang mendasari the belongingness
Rasa in(in "e"ili#i 8%he /elongingness didu(a "e"ili#i
+enyesuaian diri 8hara+an +ada re"aja 8Da5ids-n) $in(ate) Ras"ussen)
&lish) 2006. Hubun(an ini teruta"a #uat +ada /elongingness antar te"ansebaya) yan( "e"ili# e/e# berbeda*beda) seba(ai ,-nt-h) hubun(an
/elongingness antara Murid*Curu 8Ry se+erti "en(a+a berjuan( untu# sesuatu
yan( sudah #a"u "ili#iI &ebali#nya) +en(u,ilan s-sial "e"+unyai e/e#
+en(rusa#an +ada #e+er,ayaan atau har(a diri sese-ran( 8au"eister)
De$all) 9iar-,,-) @ 'wen(e) 200. !a#tanya) +en(u,ilan s-sial "e"buat
indi5idu "enjadi #uran( +r-s-sial 8'wen(e) au"eister) Dewall) 9iar-,,-) @
artels) 2007 dan lebih a(resi/ 8'wen(e) au"eister) 'i,e) @ &tu,#e) 2001>
$aburt-n) $illia"s) @ 9airns) 200. Pene"uan tersebut "e"i,u terjadinya
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lin(#aran setan> bahwa +en(u,ilan s-sial "en(arah#an indi5idu untu#
ber+erila#u yan( "e"buat +eneri"aan s-sial beri#utnya ,enderun(
ber#uran(. Oran( yan( tida# diteri"a -leh lin(#un(annya ju(a "e"+unyai
#e,enderun(an untu# "erusa# -ran( yan( "en-la# "ere#a 8-ur(e-is @
3eary) 2001.
Pen(ala"an dari #esertaan "e"+unyai da"+a# +ada +er,-baan bunuh
diri. -iner 82007 "e"beri#an hi+-tesis bahwa terda+at % /a#t-r yan(
dibutuh#an untu# -ran( yan( "en,-ba bunuh diri yaitu "erasa "e"ili#i
beban berat) (a(al "enda+at#an #asih sayin() dan tida# adanya hara+an
hidu+. erba(ai studi telah dila#u#an untu# "eneliti hal ini. Pada Mahasiswa)
Da5ids-n et al.82006 "ene"u#an bahwa beban berat dan halan(an
"enda+at#an #asih sayin( 8 /elongingness "en(arah +ada +er,-baan bunuh
diri. &elain itu) "ere#a "ene"u#an hubun(an antara tida# adanya hara+an
hidu+ den(an terhalan(nya belongingness ju(a "eru+a#an /a#t-r yan(
"e"+en(aruhi +er,-baan bunuh diri.
'ida# adanya i#atan s-sial dihubun(#an +ada #etida#baha(iaan) dan
+en(u,ilan s-sial atau +en-la#an lin(#un(an dihubun(#an den(an #ejadian
ansietas dan de+resi. Rasa bersalah) rasa #ehilan(an) dan #esendirian
se"uanya "en(arah +ada ba(ian uta"a yan( di+eran#an -leh belongingness
yan( bai#. Menurunnya #ebutuhan ,inta dan #asihsayan( dihubun(#an
den(an "enin(#atnya stress dan "asalah #esehatan "ental) sa"a halnya
den(an +enya#it s-"ati# se+erti +enya#it jantun( 8Haw#ley) urles-n)
ernts-n) @ 9a,i-++-) 200%> sebali#nya) "enin(#atnya #ebutuhan ,inta dan
#asihsayan( a#an "enurun#an "asalah #esehatan dan "enin(#at#an
#ebaha(iaan 8untu# lebih len(#a+nya) ba,a au"eister @ 3eary) 166. Oleh
#arena itu) +ende#atan +si#-tera+i yan( "a"+u "enin(#at#an rasa Rasa in(in
"e"ili#i dan #asihsayan( 8 /elongingness ,enderun( "e"ili#i berba(ai e/e#
yan( "en(untun(#an.
Belongingness dan lingkungan erapi komunitas serta metodenya#
-"+-nen dasar yan( dibutuh#an untu# "e"+er#enal#an
+en((unaan /elongingness antara lain : 81 /re#uensi hubun(an> 82 stabilitas
l-n(itudinal> 8% hubun(an yan( +-siti/> dan 84 adanya salin( "e"aha"i
8au"eister @ 3aery) 166.
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ebera+a 'era+i #-"unitas adalah beru+a sebuah area #edia"an>
bah#an setida#nya G'era+i #-"unitas "ini? intensi/ "e"ili#i #-ne#si setia+
"in((unya atau dala" bebera+a bulan) wa#tu n-r"al yan( biasa dibutuh#an
yaitu 1B bulan 8Pear,e @ Hai(h) 200B. Dala" aturan lain) +en(-batan dala"
'era+i #-"unitas jaran( yan( terjadi dala" #urun wa#tu #uran( dari setahun)
dan da+at terjadi dala" wa#tu yan( lebih la"a) uta"anya dala" +enjara
8Rutter @ 'yrer) 200%. An((-ta 'era+i #-"unitas biasa bertahan untu#
"enjalani se"ua +en(-batan sa"+ai selesai) dan +er(antian an((-ta
#-"unitas "enjadi lebih la"bat. Dala" area 'era+i #-"unitas) an((-tanya
"e"ili#i #-nta# atau hubun(an den(an setida#nya sub set dari an((-ta lain
setia+ harinya. Hal ini di+erlu#an untu# 81 /re#uensi #-nta#Jhubun(an) dan
82 stabilitas l-n(itudinal setia+ #ali berte"u. Hal ini "en(ilustrasi#an inti
dari standar 'era+i #-"unitas yan( didiri#an -leh hi"+unan #-"unitas di
n((ris 8Pa(et) 200B) yan( "e"erlu#an +erte"uan re(ul>er dari #-"unitas)
dan untu# suatu #eadaan G"en(habis#an wa#tu /-r"al dan in/-r"al bersa"a
an((-ta #-"unitas?> #arena +ada standar +usat) ini "eru+a#an /itur yan(
di+erlu#an tan+a harus di+r-(ra"#an -leh 'era+i #-"unitas.
'era+i #-"unitas "e"butuh#an lebih dari se#edar hubun(an s-sial.
&alin( +eduli dan "e"aha"i diaju#an di luar urusan uta"a yan( "un(#in
ditunju##an -leh sta//. Hubun(an 'era+i #-"unitas terdiri dari tantan(an)
du#un(an) dan berba(i tan((un(jawab. anya# 'era+i #-"unitas "e"a#ai
sebuah G#risis? atau Gs+esial? dala" "en(hada+i +ersyaratan) di"ana an((-ta
#-"unitas da+at "enuai du#un(an setia+ wa#tu saat 'era+i #-"unitas
ber-+easi-nal 8dala" area #edia"an #-nuitas tera+i telah di#e"ban(#an
siste" tele+-n dan #adan( du#un(an G/isi#?) di"ana an((-ta #-"unitas da+at
"en(hubun(i satu sa"a lain lewat tel/-n atau "en(unjun(i satu sa"a lain
untu# "e"beri#an du#un(an #eti#a 'era+i #-"unitas tida# dala" jadwal
+erte"uan 8Hi((ins) 1667. ebutuhan untu# #-nta# untu# hal +-siti/ se,ara
#eseluruhan tida# dianjur#an adla" +ed-"an #-"unitas) ta+i du#un(an yan(
diberi#an "en(indi#asi#an bahwa salin( +eduli dan salin( du#un( se+ertinya
"enjadi hal yan( "en-nj-l dala" 'era+i #-"unitas yan( ber-+erasi ,u#u+
bai#. A+a yan( "enjadi standar inti ju(a "e"butuh#an an((-ta #-"unitas
yan( berba(i tan((un(jawab satu sa"a lain) "e"wujud#an #e+utusan bersa"a yan( "e"ber e/e# /un(si-nal +ada #-"unitas) dan untu#
"e"+erti"ban(#an serta "endis#usi#an si#a+ dan +erasaan "ere#a terhada+
satu sa"a lain 8Pa(et) 200B. Mes#i+un #e+edulian satu sa"a lain tida# da+at
di"un,ul#an #eluar tan+a su#arela) lin(#un(an 'era+i #-"unitas den(an
te(as dibentu# untu# "e"+er#enal#annya. Perte"uan rutin) a#ti5itas /-r"al
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dan in/-r"al dala" +e#erjaan) +er"ainan dan tera+i dii#utserta#an den(an
#--+erati/) dan terstru#tur di"ana hubun(an antar an((-ta di+erti"ban(#an
dan an((-ta "endu#un(a untu# berba(i tan((un(jawab satu sa"a lain)
#eduanya seba(ai indi5idual dan seba(ai an((-ta #-"unitas) se"ua dila#u#an
untu# "en(e"ban(#an si#a+ salin( +eduli. -"+-nen*#-"+-nen ini adalah
inti dari "et-de 'era+i #-"unitas. 'entu saja ,ara hidu+ bersa"a) "eru+a#an
satu dari e"+at #-"+-nen +-#-# dari "et-de 'era+i #-"unitas "enurut
Ra++-rt 8160) +.2) di"ana "en(arah +ada jarin(an Gbersatunya #e"bali)
salin( berhubun(an) han(at dan "endala"? dari suatu hubun(an) "ewa#ili
sebuah (a(asan tentan( lin(#un(an yan( "endu#un( belongingness.
Pada dasarnya) syarat untu# 8% #e+astian hubun(an) dan 84 adanya
si#a+ salin( +eduli adalah tujuan yan( jelas dari 'era+i #-"unitas. 'entu saja
tujuan ini tida# selalu terjan(#au dala" "e"+ra#te##annya. A+a#ah bah#an
#-nta# +-siti/ untu# -ran( tertentu) dala" 'era+i #-"unitas tertentu
"eru+a#an 5ariabel yan( tida# dira(u#an la(i) dan "eru+a#an #e+ribadian
ala"i indi5idu +ada suatu wa#tu. !a#ta bahwa 'era+i #-"unitas ber5ariasi
dala" e/e#ti5itas yan( di"ana "ere#a ber-+erasi dari wa#tu #e wa#tu sudah
dia#ui. 8lihat ,-nt-h 9a"+lin() 2001> 3ees et al.) 2004. Mes#i+un de"i#ian)
terbu#ti bahwa 8% dan 84 adalah as+irasi yan( jelas dari 'era+i #-"unitas )
dan den(an rutin dila#u#an.
Na"+a# jelas bahwa 'era+i #-"unitas "e"+er#enal#an
belongingness) ta+i "un(#in benar bahwa dida+at#an jara# +en,a+aian
+si#-l-(i) dibandin(#an den(an "en(uta"a#an "et-de 'era+i #-"unitas.
Dala" #-nte#s ini) hubun(an #e+e"ili#an 8belongingness te"an sebaya
"enjadi +entin(> si#a+ salin( +eduli antara te"an sebaya berbeda den(an
si#a+ +eduli antara +r-/essi-nal den(an +asien) "urid) atau #lien) dan
na"+a#nya "e"un,ul#an hara+an dala" "enunju##an #e+edulian yan( tida#
diberi#an -leh +r-/essi-nal 8Ry
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a#an "e"butuh#an syarat*syarat ini. Analisis jan(#a +anjan() hu"anisti,)
#e"a"+uan #el-"+-# untu# "en-l-n( diri sendiri 8se+erti 12 lan(#ah
+r-(ra" yan( serin( di(una#an "un(#in da+at terjadi) teta+i hal tersebut
tida# se+erti halnya "e"+er#enal#an #-nsen dan +erasaan atas
tan((un(jawab untu# te"an untu# "e"+erluas 'era+i #-"unitas) dan
an((-ta #-"unitas jaran( "en(habis#an seju"lah wa#tu untu# sesa"a. Oleh
#arena itu) "es#i+un +r-"-si dari belongingness "un(#in "enjadi /a#t-r
+enyu#ses dari bebera+a +en,a+aian) ini na"+a#nya a#an "en-nj-l dala"
"et-de 'era+i #-"unitas.
Mendiri#an belongingness ru+anya a#an "enjadi /a#t-r tera+i s+esi/i#
ba(i 'era+i #-"unitas.) #ita da+at bertanya a+a yan( 'era+i #-"unitas
+elajari dari +enelitian tentan( belongingness) dan a+a#ah e/e# belongingness
ter,atat den(an e/e# dari +en(-batan 'era+i #-"unitas.
"elajaran apa yang bisa diterapkan dari praktik herapy 6ommunity
pada penelitian belongingness
&us+ensi) se,ara luas di(una#an dala" %herapeutic 1ommunity dan
"enyebab#an +enari#an se"entara sese-ran( dari #ean((-taan se+erti
#ehadiran +ada +erte"uan dan +en((unaan du#un(an) dan #e"un(#inan
besar ju(a da+at "enin(#at#an #ebutuhan untu# "e"ili#i dan "e"-ti5asi
untu# belajar tentan( +erila#u yan( baru 8De$all et al.) 200B. Na"un)
sus+ensi ter#adan( ju(a "eni"bul#an rasa +en-la#an 8di(a(al#an
bel-n(in(ness) yan( da+at "eni"bul#an rasa in(in bunuh diri 8Fan Orden etal.) 200B) dan "is#in a#an +enataan diri "enyusul +en-la#an yan( dirasa#an
da+at "e"buat lebih sulit la(i ba(i an((-ta untu# terlibat dala" +erila#u
s-sial dan ber(abun( #e"bali "asyara#at. eti#a #e+utusan untu#
"en(henti#an seba(ai an((-ta telah dia"bil) #e"un(#inan a#an
"enyebab#an risi#- tin((i dari bunuh diri dan "is#in a#an +enataan diri yan(
harus diwas+adai dari+ada harus "elawan #ein(inan dala" "e"+r-"-si#an
#ebutuhan #e+e"ili#an.
De"i#ian +ula) banya# an((-ta dari tera+i #-"unitas ji#a "ere#a
se,ara #-nsisten tida# ber#ein(inan untu# "enyerah dan tida# "e"bantuuntu# "e#anias"e ,-+in( se+erti "enya#iti diri) nar#-ba dan +enyalah(unaan
al#-h-l) dan ini "un(#in ju(a da+at "end-r-n( #ein(inan untu# bunuh diri
dala" jan(#a +ende#. Penda+at ini untu# tera+i #-"unitas "e"ili#i siste"
yan( #uat dan a#urat untu# "enilai #e"auan untu# ber(abun( den(an tera+i
#-"unitas) "un(#in "elibat#an sebuah +er,-baan lin(#un(an tera+i
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#-"unitas se+erti "elalui +en((unaan +ersia+an (ru+ 8untu# +enjelasan dari
+ende#atan ini lihat Pear,e @ Hai(h) 200B.Ada batas #e#uatan dari sus+ensi.
8Du5all) 2007. 'era+i #-"unitas harus realistis terhada+ #e"un(#inan
+erubahan dala" "enan((a+i #ebutuhan untu# "e"ili#i dan sia+ untu#
"e"an((il dan "en(henti#an u+aya untu# "e"-di/i#asi +erila#u dala"
"en(hada+i +erjanjian yan( terbatas dari an((-ta. i#a an((-ta "erasa
dit-la# "ere#a a#an "un(#in "enyi"+an( den(an ,ara "erendah#an
"asyara#at atau an((-tanya) yan( da+at "e"buat lebih sulit untu# #e"bali
8-ur(e-is @ 3eary) 2001.
Pen(#a"bin(hita"an dan #e(a(alan ter#ait dari bel-n(in(ness harus
di"-nit-r se,ara se#sa"a. Penelitian "en(hubun(#an +r-ses tersebut den(an
hasil yan( buru# ter"asu# bunuh diri 8Fan Orden et al.) 200B ber+enda+at
terhada+ tida# ter"asu# sta/ dari res"i atau lin(#un(an saat inti"idasi atau
#a"bin( hita" da+at terjadi. &ta/ harus terlibat +enuh dala" wa#tu in/-r"al
dan harus teliti tentan( +en(#a"bin(hita"an dan +r-ses bullyin( "enjadi
+erhatian "asyara#at.
&ta/ di tera+i #-"unitas harus "enja(a #esei"ban(an antara
+ere#-n-"ian +asar bebas dan +ende#atan den(an i#ut ,a"+ur tan(an. Pr-ses
#el-"+-# yan( tida# di"-nit-r da+at "en(hasil#an e/e# sa"+in( dan
a+abila ini "enyebab#an +enurunan +en(ala"an bel-n(in(ness) e/e#ti5itas
"et-de ini "un(#in dira(u#an. Di sisi lain) ji#a sta/ "enjadi terlalu a#ti/ a#an
"en(uran(i dari +en(ala"an du#un(an sebaya.
Penelitian bel-n(in(ness "endu#un( +en((unaan +enilaian untu#
ber(abun( tera+i #-"unitas) sesuatu yan( banya# di(una#an dala" tera+i
#-"unitas de"-#ratis. Hanya -ran(*-ran( yan( "erasa tera+i #-"unitas
da+at di#el-"+-##an ,enderun( "en(untun(#an) dan tinda#an suara an((-ta
baru #e dala" #-"unitas "e"ulai +r-ses +eneri"aan den(an tinda#an
sere"-nial yan( ta# terlu+a#an.
'era+i #-"unitas telah ber+i#ir untu# lebih "en(andal#an #el-"+-#
untu# "en,a+ai e/e# "ere#a 8ate"an @ 'yrer) 2002. i#a benar) ini
"un(#in "e"buat #e(i(ihan e/e# "en(untun(#an ,enderun( se#ali an((-tatelah "enin((al#an "asyara#at dan te#anan #el-"+-# tida# la(i ber-+erasi)
serta +redis+-sisi bullyin( dan "en(#a"bin(hita"#an -ran(*-ran( yan(
tida# sesuai. A+a#ah e/e# "en(untun(#an dari #ean((-taan tera+i #-"unitas
+er* sist luar a#hir +en(-batan) dan a+a#ah bahaya yan( si(ni/i#an dila#u#an
untu# bebera+a an((-ta) +ertanyaan e"+iris. Na"un) +enjelasan alternati/
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dari +enelitian bel-n(in(ness adalah bahwa) seba(ai lawan #el-"+-# 8+eer
te#anan) #ebutuhan untu# "ili#) dan an,a"an yan( tida# ter"asu#) adalah
#e#uatan dari "-ti5asi. Dala" tera+i #-"unitas ada hara+an bahwa an((-ta
berhenti dari "e#anis"e #-+in( destru#ti/ se+erti +enyalah(unaan
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su"ber daya #esehatan> ini adalah hasil yan( dila+-r#an dala" tera+i
#-"unitas 89hiesa) a,-+-ni) @ M-rris) 166> Orien) R-berts) @ $hiteley)
16B4> Da5ies @ ,a"+lin() 200%. Penelitian tersebut ju(a "enunju##an
bahwa #euntun(annya bertahan sa"+ai den(an a#hir +en(-batan. Hal ini
"un(#in terjadi #arena terda+at #e"auan untu# +erubahan +erila#u yan(
"en(untun(#an 8+r-"-ted den(an +enin(#atan sel/ e//i,a,y) lihat di bawah)
bersa"a den(an "e"-di/i#asi re+resentasi #-(niti/ 8se+erti &aya tida# da+at
diteri"a. awaban untu# +ertanyaan yan( di(una#an untu# "en(u#ur
bel-n(in(ness) se+erti hari ini -ran( lain +eduli +ada#u 8Fan Orden et al.)
200B 8disebut#an di atas) "un(#in "en,er"in#an re+resentasi #-(niti/
relati/ stabil tentan( diri sebanya# realitas s-sial saat ini di "ana sese-ran(
"ene"u#an dirinya J dirinya setelah "enin((al#an tera+i #-"unitas.
Perhati#an ju(a) tentu saja) bahwa sejauh tera+i #-"unitas "e"+r-"-si#an
#etera"+ilan +r-s-sial) "ere#a "enyedia#an alat*alat yan( di(una#an
sese-ran( "un(#in sebenarnya berhasil "en(ubah realitas s-sial "ere#a)
"e"+er#uat re+resentasi #-(niti/ yan( di"-di/i#asi.
*esponsible )gency 8+embaga yang responsif9
Pr-"-si dari instansi yan( bertan((un( jawab san(at +entin( +ada berba(ai
"-del +si#-tera+i yan( tida# hanya bertujuan +ada berta"bahnya +en(etahuan dan
#a+asitas re/le#ti/) teta+i +ada +erubahan +erila#u. Perubahan +erila#u san(at +entin(
untu# +erbai#an) a+ala(i +e"ulihan) #eti#a "asalah yan( dihada+i "elibat#an
tinda#an dan #elalaian: +erila#u su#arela sese-ran( setida#nya "e"ili#i suatu #-ntr-l
8Pear,e @ Pi,#ard) 2010. 9-nt-h "asalah tersebut da+at dite"u#an dala" #asus
#e,anduan) (an((uan "a#an dan (an((uan #e+ribadian) serta (an((uan ,e"as dan
de+resi) di "ana (ejala inti atau /a#t-r di+ertahan#an "en,a#u+ tinda#an dan
#elalaian. Pe"ulihan atau +erbai#annya "en(harus#an -ran( tersebut "en(a"bil
lan(#ah*lan(#ah a#ti/ untu# "en(ubah #ebiasaan buru# atau bentu# +erila#u yan(
"endasar: "e"ilih untu# "ela#u#an tinda#an yan( berbeda) dan "enentu#an
ba(ai"ana dia "enjalan#an +ilihannya. iasanya hal ini "e"butuh#an +erubahan
si#a+ yan( "endasar: +erila#u #-"+ulsi/ dan di luar #endali yan( "un,ul harus
disadari seba(ai suatu /a#ta+ada e#s+resi yan( di+ilih dan berusaha di#-ntr-l.
Hasilnya) da+at di+aha"i bahwa le"ba(a yan( res+-nsi/ "elibat#an dua #a+asitasdasar. an( +erta"a adalah #a+asitas #-(niti/ untu# "ere/le#si#an +erila#u
sese-ran() "e"buat #e+utusan tentan( ba(ai"ana sese-ran( in(in "ela#u#an
sesuatu yan( berbeda) res-lusi bentu#) dan ber#-"it"en untu# berubah.an( #edua
adalah #a+asitas +ra#tis untu# "elihat res-lusi ini atau #-"it"en den(an ,ara: tida#
(-yah dari +ilihannya) atau) ji#a berubah) da+at "ene"u#an ,ara untu# #e"bali #e
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jalurnya dari+ada ten((ela" dala" #e+utusasaan. &e,ara #asar) -ran( yan(
bertan((un( jawab se+erti yan( #ita a#an "en(ann(a+nya seba(ai +-la +erila#u
ber"asalah.
3ebih +entin( la(i) "es#i+un tida# ada u#uran untu# Ele"ba(a yan(res+-nsi/) alat yan( handal dan 5alid telah di#e"ban(#an untu# "en(u#ur seju"lah
/a#t-r l-(is yan( berhubun(an den(annya. Mun(#in u#uran yan( +alin( u"u" dari
le"ba(a yan( res+-nsi/ adalah
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"a#an dan berat badan) dan #e+atuhan terhada+ +r-(ra" #esehatan +re5enti/
8O3eary) 16B. Penin(#atan self$efficacy ju(a telah di#ait#an untu#
"enurun#an residi5is"e di +ele,ehan se#sual 8P-ll-,#) 166 dan +restasi
+endidi#an yan( lebih tin((i 8Ki""er"an) andura) @ Martine
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"enyebab#an +enin(#atan jan(#a +anjan( dala" #e"a"+uan untu#
"ela#u#annya) yan( +ada (ilirannya a#an "enyebab#an "enin(#atnya
#e"a"+uan untu# "elawan (-daan untu# bertinda# "elawan #etertari#an
jan(#a +anjan( anda.
Me"e(an( tan((un( jawab "enuntut #e"a"+uan untu#
"ere/le#si#an +erila#u sese-ran() "e"buat #e+utusan tentan( ba(ai"ana
sese-ran( in(in "ela#u#an sesuatu yan( berbeda) bentu# #e+utusan dan
#-"it"en untu# berubah. Hal ini ju(a "ensyarat#an bahwa sese-ran(
"e"ili#i #e"auan untu# teta+ saja * untu# "elihat #-"it"en sese-ran(
berubah) "es#i+un "en,-ba untu# #e"bali #e #ebiasaan awal dan +-la
+erila#u se"ula. 'a+i) dari +ers+e#ti/ #linis) wajar untu# "en(asu"si#an
bahwa "-ti5asi untu# "en((una#an #e"a"+uan dan #e,a#a+an untu#
"en(ubah hidu+ sese-ran( "enuntut #-"it"en a/e#ti/ uta"a: dia harus
+er,aya +ada diri sendiri dan +eduli tentan( diri sendiri) dala" #eadaan lain
sese-ran( tida# ter"-ti5asi untu# "enilai #ehidu+annya se,ara -bje#ti/ dan
"e"ulai a+a yan( biasanya sulit untu# dirubah) "a#a hubun(an antara sel/*
e//i,a,y dan sel/*estee" diidenti/i#asi -leh ud(e et al. 82002. Penin(#atan
har(a diri da+at "enjadi a(en +enyebab +entin( untu# +r-"-si le"ba(a yan(
res+-nsi/. tu "un(#in salah satu alasan "en(a+a tera+i #-"unitas e/e#ti/:
sejauh rasa bel-n(in(ness "enin(#at#an har(a diri) itu adalah +rasyarat
+entin( dari +r-"-si yan( e/e#ti/ untu# +erubahan +erila#u. a"i #e"bali #e
intera#si dari #edua /a#t-r di bawah ini.
+embaga yang responsif dan lingkungan terapi komunitas dan
metodenya
erba(ai "et-de +si#-l-(is se,ara i"+lisit bertujuan untu#
"end-r-n( le"ba(a yan( res+-nsi/ dan "e"+r-"-si#an +erubahan +erila#u.
Antara lain:
• 'e#ni# wawan,ara "-ti5asi) untu# "elibat#an +en((una layanan dan
"enu"buh#an #ein(inan untu# berubah 8R-llni,# @ Miller) 166.
• Fariasi 9') se+erti dialectical behaviour therapy 8D' 8Di"e// @
3inehan) 2001) Systems %raining for ,motional redictability and roblem Solving 8&'PP& 8lu" et al.) 200B) dan Gst-+ and thin#?
trainin( 8M,Murran) !y//e) M,9arthy) Du((an) @ 3atha") 2001) untu#
"e"bantu "en(el-la +erila#u selfharm dan +erila#u #-ntra+r-du#ti/
lainnya.
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• e,erdasan e"-si-nal untu# "en(e"ban(#an +en(etahuan dan
#e"a"+uan untu# "en(identi/i#asi +e"i,u) "e"aha"i e"-si dan
"en(el-la +erila#u 8C-le"an) 166B.
• 'entali#ation$based therapy 8M' untu# "en(e"ban(#an +i#iran yan(
tida# di"en(erti dan re+resentasi 8Allen @ !-na(y) 200) hal. 14%.
Pen(-batan ini "en(an((a+ bahwa #lien "a"+u "en(endali#an
+erila#u "ere#a dan "e"utus#an untu# berubah. 'a+i) tida# se+erti tera+i
#-"unitas) an((a+an ini di#ata#an se,ara terbu#a. Perhati#an) "isalnya)
wawan,ara "-ti5asi. D-#ter a#an bersi#a+ +asrah) tida# "enantan()
"en(e#s+resi#an e"+ati dan "end-r-n( #lien untu# "elihat #-nse#uensi
yan( tida# diin(in#an dari +erila#u "ere#a seba(ai "-ti5asi untu# berubah.
&a"a se+erti itu) 9' dan tera+i lainnya "endu#un( +erubahan +erila#u
den(an tida# "en(ha#i"i) "enyelidi#i) se,ara e#s+lisit diran,an( untu#
"end-r-n( re/le#si diri dan +e"e,ahan "asalah) teta+i tan+a risi#-
"enyalah#an diri sendiri 8untu# dis#usi tentan( ba(ai"ana tan((un( jawab
da+at did-r-n( tan+a "enyalah#an diri sendiri) see Pi,#ard) 2011.
e,erdasan e"-si-nal "en(ajar#an #lien untu# "e"beda#an e"-si dan
+erila#u) yan( "e"un(#in#an "ere#a untu# "en(-ntr-l +erila#u "ere#a
#eti#a dala" ,en(#era"an e"-si yan( #uat) bah#an ji#a "ere#a tida# bisa
"en(-ntr-l +erasaan "ere#a.
'era+i #-"unitas dibeda#an dari "et-de lainnya #arena du#un(an dari
le"ba(a yan( res+-nsi/. ahasa dari a(ensi dan res+-nnya "eresa+ dala"
tera+i #-"unitas: an((-ta tida# hanya diberi se"an(at) teta+i dihara+#anuntu# "enyadari diri "ere#a sendiri. ntu# lebih jelasnya) hal ini terbu#ti
#eti#a an((-ta dihada+#an satu sa"a lain se,ara lan(sun( untu# bertan((un(
jawab terhada+ +erila#unya dan salin( "endu#un( seba(ai suatu #-ntra#
antara an((-ta dan #el-"+-#) den(an #-nse#uensi ji#a #-ntra# dilan((ar
untu# teta+ "e"+ertahan#an tan((un( jawab an((-ta. Mes#i+un tera+i
#-"unitas "en(i"bau an((-tanya untu# "enulis #-ntra# "ere#a sendiri
seba(ai "ili#nya dala" +r-sesnya) #-"unitas se,ara terbu#a da+at
"e(ubahnya bila dian((a+ +erlu. Hal ini "eru+a#an hara+an e#s+lisit
le"ba(a res+-nsi/: #eya#inan bahwa an((-tanya "e"ili#i #e"a"+uan untu#
berubah) dan "e"inta "ere#a "ela#u#annya) bah#an ji#a an((-ta tida#
"en(un(#a+#an #eya#inan ini atau in(in "en(a"bil tan((un( jawab den(an
,ara ini. -nse#uensi #eti#a "elan((ar #-ntra# biasanya "elibat#an re/le#si
#el-"+-# dan dis#usi tentan( alasan "en(a+a an((-ta tida# "e"atuhi itu)
dan ba(ai"ana "ere#a a#an "ela#u#an sesuatu yan( berbeda wa#tu
beri#utnya) teta+i bisa ditan((uh#an dan) se,ara e#stri") di#eluar#an.
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Di sa"+in( +en((unaan #-ntra#) tera+i #-"unitas "end-r-n(
le"ba(a den(an bebera+a ,ara yan( se,ara #-le#ti/ "e"un(#in#an an((-ta
#-"unitas untu# "en(a"bil #e+e"ili#an #el-"+-# dan #arenanya
bertan((un( jawab untu# "enjalan#annya. Dala" tera+i #-"unitas se,ara
de"-#rasi) an((-ta baru serin( diteri"a #e dala" #el-"+-# "elalui +r-sedur
5-tin(: #el-"+-# "e"ili#i #e#uatan untu# "e"utus#an sia+a yan( diteri"a.
Mes#i+un batas*batas dan aturan tertentu tida# bisa dine(-siasi#an untu#
"e"+ertahan#an standar tera+i yan( bai# dan #uat) stabil) a"an ba(i
#-"unitas) banya# as+e# #ehidu+an #-"unitas yan( diserah#an #e+ada
an((-ta) yan( "ana da+at dia"bil #e+utusan se,ara #-le#ti/ tentan( batas*
batas) aturan dan et-s yan( diin(in#an +ada #el-"+-#) ta+i #el-"+-# harus
"e"ili#i tan((un( jawab untu# "en(har(ai batas*batas dan aturan tersebut.
Mes#i+un #e+utusan ini adalah #e+utusan bersa"a) #e(iatan ini "elatih si#a+
tan((un(jawab dari A(ensi 'era+i #-"unitas yan( bertujuan untu#
"e"besar#an hati indi5idu : el-"+-# yan( dibentu# harus "en((a"bar#an
#el-"+-# se+erti a+a yan( "ere#a in(in#an) "e"+erti"ban(#an /a#ta yan(
ada) "enden(ar berba(ai bentu# +erbedaan +enda+at) "enyi"+ul#an suatu
#e+utusan dan "eneta+#annya seba(ai suatu +eraturan. An((-ta 'era+i
#-"unitas ju(a bertan((un( jawab atas as+e# #ehidu+an #-"unitas dari hari
#e hari.) se+erti "e"asa#) #e(iatan bersih*bersih) "enjadi tuan ru"ah)
#e(iatan ad"inistrasi dan "en(a"bil tan(un(jawab ju(a dala" aturan
#-"unitas. 'erda+at e#s+e#tasi dala" +en(a"bilan berba(ai tan((un(jawab
ini> ji#a an((-ta tida# "en(a"bil ba(ian dala" tan((un(jawab tersebut di
atas) "ere#a "eneri"a ti"bal bali# dari #-"unitas) bersa"aan den(ansu++-rt dan du#un(an untu# "e"enuhi tan((un(jawab dan +eranan "ere#a.
Oleh #arena itu) den(an "en(h-r"ati an((-ta indi5idual dan
#-"unitas ) 'era+i #-"unitas "endu#un( a(en yan( bisa bertan((un(jawab
untu# "en((a"bar#an) "e"utus#an) dan "ele(al#an suatu +erubahan.
5aluasi diri) e5aluasi -ran( lain) dan e5aluasi #el-"+-# "eru+a#an ba(ian
+entin( dari +r-ses #-"unitas) yan( "en-nj-l#an te-ri s#ill a#al dan e"+ati
diri dan terhada+ -ran( lain. An((-ta yan( berbeda dala" suatu #el-"+-#
"enawar#an +ers+e#ti/ dan #ein(inan yan( berbeda ) yan( butuh untu# sa"a*
sa"a dihar(ai dan di+erti"ban(#an) dan a#hirnya #e+utusan dia"bil den(anadil. Melalui +r-ses ini) tersi"+an hara+an yan( tin((i bahwa an((-ta
#el-"+-# da+at "en(a"bil tan((un(jawab untu# diri "ere#a sendiri dan
#-"unitas. Mere#a dibiasa#an untu# "enjadi a(en yan( +enuh e5aluasi diri
dan tan((un(jawab.
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Den(an "en(andal#an #ete#unan) berba(ai as+e# dari 'era+i
#-"unitas "elatih untu# "en(e"ban(#annya. 'era+i #-"unitas serin(
"e"inta an((-tanya untu# berhenti "e"+ertahan#an #ebiasaan buru# dan
+-la +e"i#iran yan( ber"asalah) se+erti nar#-ba dan al#-h-l) binge$eating )
atau #ebiasaan "enya#iti diri sendiri> di+er,aya bahwa "e"un(#in#an untu#
"en(-ntr-l hal*hal tersebut) yan( da+at "en#-ntribusi#an #a+asitas an((-ta
untu# "ene"u#an #e"auan diri "ere#a untu# "en(henti#an #ebiasaan buru#
tersebut 8andura) 1667. 'a+i bersa"aan den(an hal itu harus ada #etentuan
untu# "e"buat G+uasa? #ebiasaan buru# tersebut "enjadi lebih "udah> yaitu
"en((antinya den(an "ela#u#an a#ti5itas rutin) seba(ai +ilihan suatu strate(i
"en(hada+inya. a(ian dari 'era+i #-"unitas ini "elatih dan "e"+erbanya#
tar(et "elalui #ete#unan dan #eya#inan yan( dibiasa#an) #eteta+an +ada
+ilihan hidu+ yan( lebih bai#) dan #-nsisten) stabil) an((a+an yan( bai#)
+erhatian) dan +enuh du#un(an.
"elajaran apa yang dapat diterapkan pada praktek terapi komunitas
dari penelitian lembaga yang bertanggung jawab
a+asitas u"u" yan( "en,er"in#an +ada #eadaan "ental dan
+erila#u "elibat#an te-ri mind skills. Hanya "enjadi an((-ta yan(
"en,er"in#an nilai*nilai #etera"+ilan tida# dira(u#an la(i da+at "ena"bah
"an/aat) teta+i tera+i #-"unitas harus "e"+erti"ban(#an +enelitian e"+iris
+ada si/at +en(e"ban(an dan +enin(#atan "ental dan #etera"+ilan +ers+e#ti/
untu# "e"+erbai#i lin(#un(an belajar. Dala" hal ini di,atat bahwa M'
se,ara #-nsisten "enunju##an e/e# +-siti +ada (an((uan #e+ribadian
8ate"an @ !-na(y) 200B) 2006. 'ida# dira(u#an la(i) jenis tera+i
lin(#un(an yan( ditawar#an -leh tera+i #-"unitas da+at dihara+#an untu#
"enin(#at#an #etera"+ilan "ental) ta+i salah satu ,ara untu# "e"asti#an
(an((uan #e+ribadian dan berhubun(an den(an tera+i #-"unitas a#an
di(una#an "et-de Eate"an and !-na(y?s /-r"al de5el-+"ent -/ a M'
+r-(a""e seba(ai ba(ian dari +erawatan.
'era+i #-"unitas "e"ili#i hara+an tin((i terhada+ an((-ta "ere#a>
"asih di+erdebat#an bahwa an((-ta se,ara a#ti/ be#erja untu# bertan((un(
jawab dari +erila#u yan( "ere#a la#u#an dan "e"enuhi hara+an "ere#a.
'eta+i #e(a(alan dan +enyi"+an(an teta+ serin( terjadi) dan san(at +entin(
+enan(anan #-nse#uensi dari hasil ne(ati/) yan( "eru+a#an bahwa tera+i
#-"unitas "e"+erla#u#an an((-tanya den(an adil dan erhubun(an den(an
welas asih) tera+i #-"unitas harus se,ara a#ti/ berusaha untu#
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"e"+ertahan#an si#a+ e"+ati dan se,ara +ra#tis "en(harus#an an((-ta
untu# bertan((un( jawab atas+erila#u "ere#a 8ruju# Pi,#ard) 2011.
• 'u(as #e"auan se,ara u"u". i#a se-ran( an((-ta ber-lahra(a di satu
te"+at yan( "un(#in se"entara "e"+en(aruhi #e"auan "ere#a)"enurun#an tin(#at #e"auan an((-tanya
• e"auan adalah su"ber daya yan( terbatas> Mes#i+un #ita harus berhati*
hati. Hal ini jelas bahwa #e"auan da+at "enjadi lari #e bawah. 'eruta"a
sela"a +eri-de #eti#a tida# "e"bantu adalah +erila#u atau "en(atasi
"e#anis"e alternati/ yan( di+erlu#an) tera+i #-"unitas harus "en(a#ui
realitas risi#- dan tida# "e"a#sa#an hara+an +ada an((-ta yan( "ere#a
tida# san((u+ "ela#u#annya
)pakah yang diketahui tentang efek "erkembangan dari lembaga yang
bertanggung jawab dengan efek pengobatan terapi komunitas
Ada alasan bai# untu# berhi+-tesis bahwa +r-"-si le"ba(a yan(
bertan((un( jawab adalah /a#t-r #un,i dala" hasil +-siti/ ter#ait den(an
tera+i #-"unitas. Menurut de/inisi) adalah +erubahan +erila#u Pusat
+erbai#an dan +e"ulihan) #eti#a "asalah ditar(et#an "elibat#an tinda#an dan
#elalaian) se+erti #e,anduan dan (an((uan #e+ribadian. 'era+i #-"unitas
ta"+a#nya "e"ili#i e/e# +-siti/ +ada (an((uan ini. arena itu "ere#a harus
"ein(#at#ann +erubahan +erila#u. Diberi#an tin(#atan dan hadiah dari
le"ba(a yan( bertan((un( jawab dala" tera+i #-"unitas) itu wajar untu#
"endu(a bahwa ini adalah 8ba(ian +enyebab e/e# +-siti/ tera+i #-"unitasyan( ter(an((u ini. Me"beri#an bu#ti bahwa +enin(#atan e/e#ti5itas) /-#us
#-ntr-l dan te#ad) bersa"a den(an +enurunan i"+ulsi/) "e"+redi#si
#a+asitas untu# "e"ulai +erubahan +erila#u dan "e"+ertahan#an itu dari
wa#tu #e wa#tu) salah satu ,ara untu# "en(uji hi+-tesis ini untu# "en(u#ur
+erubahan ini atribut +si#-l-(is sela"a +en(-batan tera+i #-"unitas seba(ai
lawan untu# "-de*"-de alternati/ +en(-batan. &ebuah studi da+at
"e"beri#an bu#ti bahwa tera+i #-"unitas +ra#te# yan( "e"+r-"-si#an
le"ba(a yan( bertan((un( jawab "e"an( e/e# +erbai#an dala" atribut yan(
sudah diidenti/i#asi seba(ai ber#-relasi den(an +erubahan +erila#u yan(
ber#elanjutan -"binasi dari #ei#utsertaan di +iha# +iha# yan( ter#ait.Da"+a# yan( berbeda dari tera+i #-"unitas.
Dari bu#ti*bu#ti yan( dida+at) tera+i #-"unitas "e"+unya hasil yan(
+-siti/ terhada+ (an((uan tersebut yan( biasanya sudah resisten terhada+
tera+i) se+erti #e,anduan dan (an((uan +ers-nality. ita in(in "enyi"+ul#an
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bahwa e/e# dari tera+i #-"unitas ter(antun( dari #-"binasi #ei#utsertaan
+asien dan si#a+ +ersuasi/ dari +iha#*+iha# yan( ter#ait.
!ombinasi dari keikutsertaan di pihak ; pihak yang terkait#
Dampak yang berbeda dari terapi komunitas#
Dari bu#ti*bu#ti yan( dida+at) tera+i #-"unitas "e"+unya hasil yan( +-siti/
terhada+ (an((uan tersebut yan( biasanya sudah resisten terhada+ tera+i) se+erti
#e,anduan dan (an((uan +ers-nality. ita in(in "enyi"+ul#an bahwa e/e# dari
tera+i #-"unitas ter(antun( dari #-"binasi #ei#utsertaan +asien dan si#a+ +ersuasi/
dari +iha#*+iha# yan( ter#ait.
ita sudah "en(usul#an bahwa tera+i #-"unitas da+at berjalan den(an bai#
diirin(i den(an #e+er,ayan diri yan( tin((i dari +asien. Perbai#an dari rasa +er,aya
diri +asien da+at "e"+en(aruhi si#a+ +asien) jadi ti" "edis +erlu "eya#in#an +asien bahwa tera+i #-"unitas da+at "enjadi#an #-ndisi +asien lebih bai#. 'eta+i
tera+i #-"unitas ju(a da+at "enyebab#an +erubahan si/at) dan "e"ili#i resi#- ji#a
+asien "erasa (a(al bila tida# sesuai yan( dihara+#an +asien dan tera+i #-"unitas.
Pasien da+at "enjadi "en(#ritisi diri sendiri) "enyalah#an diri sendiri) #ehilan(an
hara+an) dan #a"buh. Na"un #eti#a +r-ses +enye"buhan "e"butuh#an +erubahan
si#a+ +asien. Hal ini sulit untu# "elihat ba(ai"ana #e"un(#inan ji#a tida# den(an
"et-de se+erti ini. ita "en(usul#an "elindun(i dari resi#- tersebut. Pe#erjaan
dala" "et-de #-"unitas s+t ini den(an +erte"uan yan( intens dan si#a+ salin(
"en(h-r"ati dan tujuan yan( selaras) tida# hanya "e"beri#an "-ti5asi +ada setia+
an((-ta 8+asien untu# berubah #arena "ere#a in(in "enilai #-"unitas tersebut dan#-"unitas tersebut in(in "enilai setia+ an((-ta ju(a. 'eta+i "elindun(i setia+
an((-ta dari resi#- rasa #asihan dan "elawan si#a+ ne(ati5e.
Du#un(an antar #el-"+-# didala" tera+i #-"unitas san(at dibutuh#an) ta+i
le"ba(a yan( bertan((un( jawab "alah #uran(. #e"un(#inan +erubahan
+erila#unya terbatas: tan+a tantan(an da+at ber+-tensi lebih lanjut "enjadi #ebiasaan
buru# dan "eni"bul#an +-la ber"asalah. Di sisi lain) yan( "e"+r-"-si#an le"ba(a
yan( bertan((un( jawab di luar #-"unitas yan( "en,i+ta#an rasa "enyebab#an
#riti#*diri sendiri) "enyalah#an diri sendiri) #ehilan(an hara+an) +e"isahan diri dan
#a"buh. an( "un(#in "enjadi ba(ian dari "et-de se+erti 9') A+a#ah indi5iduatau #el-"+-#) san(at berhati*hati tentan( "e"+er#enal#an rasa tan((un( jawab)
dan hati*hati untu# "en(e"ban(#an si#a+ tida# "en(ha#i"i. Den(an
"en((abun(#an rasa #e+e"ili#an den(an "enin(#at#an le"ba(a yan( bertan((un(
jawab) 'era+i #-"unitas "enawar#an lin(#un(an yan( uni# untu# "endu#un(
+ertu"buhan dan +erubahan. Mere#a da+at "enuntut tan((un( jawab #arena
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+er"intaan berasal dari dala" #el-"+-# "endu#un( re#an*re#an sesa"e an((-ta
tera+i #-"unitas: -ran(*-ran( yan( se"ua sa"a dan -ran(*-ran( yan( +eduli.
B)B 2
(+))H '/*%)+
2.1 Faliditas
2.1.1 Faliditas Re/erensi
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urnal ini "en((una#an re/erensi yan( "endu#un( +enelitian tentan( 'era+i
#-"unitas dala" "et-de +en(e"ban(an belongingness dan Responsive )gency? '-tal
re/erensi yan( di+a#ai dala" jurnal ini seju"lah 70 jurnal yan( seba(ian besar
"e"bahas tentan( #ee/e#ti/an tera+i #-"unitas. Dari seju"lah re/erensi yan( di+a#ai
20 diantaranya "eru+a#an re/erensi yan( diterbit#an sebelu" tahun 2000) na"un
+en((unaan re/erensi tersebut "asih di#ata#an ber"a#na #arena diirin(i -leh
re/erensi yan( lebih baru. Ma#a dari itu) re/erensi yan( di+a#ai dala" +enelitian ini
"asih terbilan( up$date dan 5alid untu# diba,a.
&u"ber re/erensi yan( di(una#an seba(ian besar "eru+a#an hasil +enelitian
tentan( +si#-tera+i dan personality sehin((a "eru+a#an re/erensi yan( "endu#un(
+enelitian tentan( tera+i #-"unitas.2.1.2 Faliditas Met-de
urnal ini "eru+a#an jenis jurnal re5iew narati/ yan( ber/-#us +ada studi
#-ntr-l tentan( tera+i #-"unitas. urnal ini "en(u"+ul#an re/erensi beru+a
randomi#e trial e&perimental tentan( +si#-tera+i dan +er#e"ban(annya) sehin((a
dite"u#an unsur baru : %he /elongingness dan Responsible )gency) yan( dinilai
"a"+u "ena"bah #e/e#ti/an tera+i #-"unitas.
Met-de re5iew narati/ se+erti ini dinilai ,u#u+ untu# "e"bantu
"en(u"+ul#an in/-r"asi beru+a -+ini "au+un /a#ta yan( "endu#un( untu#
"enari# +e"aha"an dan "enin(#at#an #e"auan +ara tena(a "edis "enera+#an
tera+i #-"unitas den(an ta"bahan unsur the belongingness dan Responsible )gency.
&ehin((a dihara+#an tera+i #-"unitas dian((a+ seba(ai salah satu +si#-tera+i yan(
tida# hanya "iri+ den(an inter5ensi s-si-l-(is: sebandin( den(an se#-lah atau
#eluar(a> na"un ju(a "eru+a#an salah satu "et-de +si#-tera+i tersendiri yan(
"a"+u "e"beri#an hasil yan( +-siti/ terhada+ +en(-batan.
2.2 esi"+ulan