Liberty H J, Johnson B D, Jainchill N, Ryder J, Messina M, Reynolds S, Hossain M
National Development and Research Institutes, Inc., New York, NY 10048, USA.
J Subst Abuse Treat. 1998 Sep-Oct;15(5):401-23. doi: 10.1016/s0740-5472(97)00287-0.
The Dynamic Recovery Project examined relationships between homelessness, substance abuse, and recovery, and investigated the effectiveness of the therapeutic community (TC) treatment model in helping homeless drug users move toward stable, drug-free living. This project compared two short-term TCs that were situated within pre-existing homeless shelters with a clean and sober dormitory. In a separate condition, peer counselors and staff were provided additional training in TC philosophy and practice to reduce program dropout. Dramatic decreases in drug and alcohol use at follow-up were verified by urinalysis. Length of time in treatment rather than specific program accounted for decreased alcohol and drug use. Important decreases in posttreatment criminality for both treatment programs were documented. The comparison group, starting with low criminality, experienced smaller, nonsignificant decreases unrelated to type of program or time in treatment. Major declines in Beck Depression Scores were evident, but were unrelated to groups or time in treatment. Training had no measurable impact on client retention or outcomes and there were no significant differences between TCs and the comparison group on posttreatment drug use, criminality, or depression. This report documents that short-term therapeutic communities can be successfully implemented in public shelters for homeless men.
动态康复项目研究了无家可归、药物滥用与康复之间的关系，并调查了治疗社区（TC）治疗模式在帮助无家可归的吸毒者走向稳定、戒毒生活方面的有效性。该项目将两个位于现有无家可归者收容所内、带有干净且戒酒戒毒宿舍的短期治疗社区与一个对照组进行了比较。在另一种情况下，为同伴辅导员和工作人员提供了关于治疗社区理念和实践的额外培训，以减少项目退出率。随访时通过尿液分析证实了药物和酒精使用的显著减少。治疗时间的长短而非具体项目导致了酒精和药物使用的减少。两个治疗项目治疗后犯罪率均有显著下降。对照组起初犯罪率较低，其犯罪率的下降幅度较小且不显著，与项目类型或治疗时间无关。贝克抑郁量表得分有显著下降，但与组别或治疗时间无关。培训对客户留存率或结果没有可衡量的影响，治疗社区与对照组在治疗后药物使用、犯罪率或抑郁方面没有显著差异。本报告证明，短期治疗社区可以在为无家可归男性提供的公共收容所中成功实施。
