michael g
TRANSCRIPT
Help for the Quatra-Diagnosed: The Fourth Moment in the Evolution of the
Therapeutic Community
Democratic TC in the psychiatric context (UK: Maxwell Jones)
Concept-based, hierarchical model (US: Charles Dederich and Synanon)
Research-practice/evidence-based (Europe: EFTC, EWODOR; later US)
Holistic: e.g. serving quatra-diagnosed persons
Builds on evidence-based practices Emphasizes community as method Based on ecological dysfunction model of
behaviour and the “…reciprocal influence of personal and environmental variables instead of a disease model…” Broekaert, 1999 p. 33
Reflexive to diverse populations and problems in one therapeutic context
Research shows MTC success ranging from 30% -- 70%
Interweaving of homelessness, substance abuse, mental illness and criminal behaviour implies a holistic modified therapeutic model
Four problems lay on a continuum from less to more serious:homelessness->substance abuse->mental illness->criminal
MTC can serve the quatra-diagnosed persons starting with the least serious
Vision: To enfold our neighbours-in-need back into community, by giving them the support and the tools needed to reclaim their self-worth and gain self –reliance
78 hectare farm located15kms north of Victoria, BC Canada
Anticipate accepting clients in November, 2009
Approximately 800 people in the area fit quatra-diagnosed criteria (Cool Aid Society)
Existing services cannot cope with demands This population “troublesome” to business
and tourism Community support for Woodwynn strong
(63-80%), but some NIMBY issues
Administered by Creating Homefulness Society
Non-profit, primarily funded by non-governmental sources
Starting with 12 males but have capacity for 96 mixed gender residents when fully operational
Implementation of quatra-diagnosed model to occur over three stages starting with homeless and addicted persons
WF is loosely based on San Patrignano Several modules
◦ Organic fruits and vegetables Production of secondary goods
◦ Animal care/training◦ Production of hay
In addition to the City Effect WF will also provide a comprehensive therapeutic structure
Common TC structure◦ 24/7 attendance◦ Highly structured regime ◦ Meetings, education, therapy◦ Peer work structure/farm duties◦ Emphasis on reliability, responsibility,
accountability, consistency◦ Mutual positive regard (staff and residents)
Emphasis on the development of an Oral Culture
Acceptance of individuals’ unique biographic path (Guidicini & Pieretti, nd)
Long term residence anticipated (3+ years) Stages of treatment
◦ Affiliation with community◦ Primary treatment◦ Line-in re-entry◦ Live-out re-entry◦ Independent living (DeLeon, 2000; Sacks et al.,
1997)
Category 1◦ Daily meetings
e.g. morning, evening…◦ Seminars
e.g. health…
Category 2◦ Group activities
e.g. conflict management, gender-specific…◦ Individual treatment
e.g. counselling, relapse prevention…
Category 3◦ Community and clinical management ◦ e.g. personal boundaries, substance testing,
relationships, cardinal rules…
Category 4◦ Vocational training◦ Farm work
Promotion in the hierarchy based on evidence of successful treatment
WF is unique, particularly in Canada◦ It engages residents in the ongoing operation of
the farm and emphasises community as method and also provide individual and group treatment modalities
◦ Its holistic approach is well-suited to quatra-diagnosed persons
◦ Residents have the chance to regain or gain a healthy and self-reliant identity, and to help others to do the same
◦ An ongoing evaluation research program is being established
Thank YouPlease visit: creatinghomefulness.org