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Michael G


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Michael G

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