Iudici Antonio, Berardelli Tobia, Fenini Davide, Neri Jessica, Subissi Emiliano
Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padua, Padua, Italy.
Institute of Psychology and Psychotherapy, Scuola Interazionista, Padua, Italy.
Front Public Health. 2024 Dec 3;12:1460985. doi: 10.3389/fpubh.2024.1460985. eCollection 2024.
The effectiveness of the interventions in the Therapeutic communities (TC) depends not only on the quality of the specialized knowledge and methodologies adopted, but also on the meanings consumers give to them. Building the therapeutic alliance is a key element in reducing high drop-out rates and predicting more favorable outcomes. This research investigated the discourses practiced by 45 people with substance use disorders who had been accessing a therapeutic community for less than 15 days, with the aim of delving into the meanings given to treatment and pathway goals in the service, to analyze what theories are used to explain consumption and therapeutic change. The study made use of Discourse analysis (DA) and Positional theory with a protocol of written open-ended questions. The results show how participants configure the community pathway adopting a passive role, underestimating the need to co-participate in treatment design and bringing in poorly formalized goals. The collected texts provide a better understanding of the perspective of community users, emphasizing the need to share spaces of co-design from the very beginning in order to promote empowering, reasoning about the implications of the various discourses produced by consumers to explain their autobiography and to envision paths of change.
治疗社区（TC）干预措施的有效性不仅取决于所采用的专业知识和方法的质量，还取决于服务对象赋予它们的意义。建立治疗联盟是降低高辍学率和预测更有利结果的关键因素。本研究调查了45名物质使用障碍患者的话语，这些患者进入治疗社区不到15天，目的是深入探讨他们赋予服务中治疗和路径目标的意义，分析用于解释消费和治疗变化的理论。该研究采用话语分析（DA）和定位理论，并设计了书面开放式问题协议。结果表明，参与者如何以被动的角色构建社区路径，低估了共同参与治疗设计的必要性，且提出的目标缺乏明确的形式。收集到的文本有助于更好地理解社区使用者的观点，强调从一开始就需要共享共同设计的空间，以促进赋权，思考服务对象为解释其自传和设想改变路径而产生的各种话语的影响。
