NCJ Number
66814
Date Published
Unknown
Length
13 pages
Annotation
CLINICAL AND SOCIAL VARIABLES WHICH SHOULD BE REEVALUATED IN THE PRACTICE OF MILIEU THERAPY AS APPLIED IN THE DRUG ABUSE REHABILITATION FIELD ARE DISCUSSED.
Abstract
ONE OF THE MAJOR FAILURES OF MILIEU THERAPY IN RELATION TO DRUG ABUSE REHABILITATION PROGRAMS IS A LACK OF ATTENTION TO INDIVIDUAL DIFFERENCES. PRIMARY EMPHASIS IS PLACED ON THE PRESENTING SYMPTOM OF DRUG ADDICTION. THUS, AN ADDICT IS PLACED INTO A GENERAL CATEGORY WHICH IS DEFINED BY SEVERAL COMMON CHARACTERISTICS INCLUDING LYING, HUSTLING, AND MANIPULATIVE BEHAVIOR. DRUG PROGRAMS MAKE LITTLE ATTEMPT TO DEFINE CONCEPTS SUCH AS DEPRESSION, ANXIETY, AND LEARNING DISABILITIES. THEREFORE, THE CLINICAL TREATMENT PLAN IS NOT ALTERED TO TAKE INTO ACCOUNT SUCH FACTORS. SELF-HELP PROGRAMS RELY UPON CAREFULLY CHANNELED GROUP PRESSURE TO INDUCE BEHAVIORAL CHANGE WITHOUT ALLOWING INTRAPSYCHIC INSIGHTS TO DEVELOP. IN ADDITION, MOST CLINICAL PROGRAMS DO NOT STRESS THE IMPORTANCE OF CASE CONFERENCES AMONG STAFF MEMBERS. THE GREATEST WEAKNESS OF THE THERAPEUTIC COMMUNITY IS THE LACK OF CLINICAL STAFF TRAINING. REGARDING SOCIAL VARIABLES WHICH SHOULD BE EXAMINED MORE CLOSELY, CONFORMITY BEHAVIOR SHOULD BE ASSESSED BECAUSE ENACTING A SOCIALLY ACCEPTABLE BEHAVIOR AND ACTUALLY BEING COMMITTED TO THAT BEHAVIOR ARE NOT THE SAME PSYCHOLOGICAL EVENT. ANOTHER ASPECT THAT MUST BE RAISED IS THE DEGREE OF VERIDICALITY BETWEEN THE THERAPEUTIC COMMUNITY AND THE WORLD AT LARGE. FINALLY, THE EXTENT TO WHICH CLIENTS SHOULD BE INVOLVED IN DISCUSSIONS OF CURRENT EVENTS IS AT ISSUE. TO RAISE THE QUESTION OF WOMEN'S LIBERATION IN A SETTING WHERE THE CLIENT RATIO IS THREE MALES TO ONE FEMALE HAS SERIOUS IMPLICATION FOR THE FUNCTIONING OF THE PROGRAM ON A SOCIAL AND CLINICAL LEVEL. IT IS SUGGESTED THAT IN-SERVICE TRAINING SESSIONS CONDUCTED BY PSYCHOLOGISTS WOULD BE OF GREAT BENEFIT TO MOST TREATMENT STAFFS. (LWM)