Suchergebnisse

Verbal interaction in therapeutic communities (TC's) for the treatment of drug addictions are explored here as a source of both the high rate of "conversion" among residents and the reported high rates of relapse to street crime and illicit drug use after leaving treatment. Residents enter TC's with values radically opposed to those of the TC's treatment philosophy but are gradually drawn into behavioral conformity with the TC code. Certain verbal performances demanded of clients appear instrumental to a conversion process in which clients develop self-concepts along the lines of program models, in spite of their frequent early efforts to "game" their way through therapy.In verbal performances, clients are pressured to use the distinctive language (argot) and implicit value system of the TC treatment philosophy to characterize their own and their fellow clients' behavior before the group. Major vehicles are confessions, confrontations and rituals of stigmatization mounted with the active participation of resident peers. The ways in which residents are drawn into actively playing expected roles in the resocialization of fellow clients are described.In TC's, dramatic verbal performances are highly compartmentalized in recurring discrete frames or occasions (Goffman, 1974). Each occasion is governed by a particularistic code which is learned experientially through the prompting of the TC peer group and staff. Specific codes of behavior are "learned by rote." Behaviors appropriate on one occasion meet with censure on different occasions. In TC's the elaborated code or "concept" which joins the dramatic occasions is described as unknowable and not reducible to intellectual understanding. As a result, the resocialization process in TC's appears to be a conversion to this specific institutional setting itself. Such context-tried resocialization is not likely to guarantee the long-term rehabilitation of clients when they leave the TC setting.

Evaluators often assume that outcome studies assessing agency effectiveness should pro vide the most relevant data for decision makers who must form judgments about treat ment in order to make policy, program, and clinical decisions. Yet evaluators have found that decision makers often fail to use results of evaluation studies. To shed light on the utilization problem, the research reported here was undertaken to learn about the criteria, information sources, and beliefs decision makers in the environment of nine drug treat ment agencies used to form judgments about treatment programs before evaluative data concerning outcomes became available. The results showed that decision makers in different occupations tended to use similar information sources (primarily informal verbal exchanges) yet used different evaluative criteria to judge treatment programs. The impli clations of these results for the design of evaluation studies and utilization of evaluation results are discussed.

In the United States, about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral (MEB) disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect one in five families and cost $247 million annually. Some strategies for preventing MEB disorders in young people have been developed, tested, and found to be effective in preventing the onset, persistence, and severity of psychological disorders, drug abuse, and delinquency. Unfortunately, tested and effective prevention policies, programs, and practices are not widely used. This article highlights recent advances in prevention science and describes some opportunities and challenges in advancing the use of science-based prevention in communities. The chapter concludes by exploring the potential role of social work education in developing a workforce ready to increase community access to effective prevention strategies.