Substance Use Disorders Treatment in Therapeutic Communities : A Cross-Cultural Approach

This book presents an in-depth qualitative study carried out with inpatients under treatment for substance use disorders (SUDs) in seven therapeutic communities (TCs) located in three countries: Peru, Nicaragua and Czech Republic. By comparing the experiences in these different cultural contexts, the book presents a grounded theory of SUDs treatment in TCs from a cross-cultural perspective, identifying factors that influence the efficacy of SUDs treatment in TCs based on interviews carried out with inpatients. Based on rigorous qualitative research methods, this book presents not only a comparative analysis of TCs located in different cultural contexts, but also analyzes the cross-cultural nature of the therapeutic programs adopted in these communities, such as the combination of traditional Amazonian medicine based on the therapeutic use of ayahuasca with conventional psychotherapy and occupational therapy, among other approaches. Departing from the interviews carried out with inpatients, the authors present a comparative analysis of how the different TCs address important issues related to SUDs treatment, and complement this analysis with machine-generated summaries of relevant scientific papers. These summaries contain results of similar research projects conducted in other cultural contexts. Substance Use Disorders Treatment in Therapeutic Communities: A Cross-Cultural Approach presents the results of a unique comparative study with great translational potential which will be of interest to both researchers and practitioners working in TCs. This unique comparative study identifies factors affecting the efficacy of therapeutic programs and proposes a grounded theory which aims to serve as an important source of information for therapists and other professionals working with SUDs treatment and for the replication of applied therapeutic methods in other TCs. Acknowledgments 6 Contents 8 About the Authors 12 Abbreviations 13 List of Figures 19 List of Tables 24 Chapter 1: Introduction 25 Overview of the Research Projects 25 Outline of the Book 26 References 29 Chapter 2: Theoretical Approaches to SUDs 30 Introduction 30 Concepts Related to SUDs and Their Treatment 31 Theoretical Models of Substance Use 33 References 35 Chapter 3: Characteristics of Investigated TCs 38 Introduction 38 Takiwasi 38 Integrative (Syncretic) Model 41 Religious Model 44 Biosocial Model 45 Conservation Model 46 CEA, CARA, and AMAR 47 Renarkon, Sejřek, and Kladno-Dubí 50 References 52 Chapter 4: Qualitative Methods in the Research on SUDs 58 Introduction 58 Research Framework 59 Research Paradigms 60 Data Collection Method 61 Coding Method 62 Methods of the Statistical Data Analysis 63 Systematic Literature Review 63 References 64 Chapter 5: Results of the Data Analysis 67 Introduction 67 Model of the Grounded Theory Paradigm 68 References 71 Chapter 6: Effective Factors of the Treatment in TCs 72 Introduction 72 Takiwasi 73 CEA, CARA, AMAR 76 Renarkon, Sejřek, Kladno-Dubí 77 References 95 Chapter 7: Finding Motivation in Recovery 100 Introduction 100 Theories of Motivation 101 Takiwasi 104 CEA, CARA, AMAR 105 Renarkon, Sejřek, Kladno-Dubí 108 References 123 Chapter 8: Family and Substance Use 129 Introduction 129 Takiwasi 131 CEA, CARA, AMAR 134 Renarkon, Sejřek, Kladno-Dubí 136 References 150 Chapter 9: Spirituality and Religion in SUDs Treatment 154 Introduction 154 Takiwasi 156 CEA, CARA, AMAR 160 Renarkon, Sejřek, Kladno-Dubí 163 References 177 Chapter 10: Substance Use from the Cross-Cultural Perspective 181 Introduction 181 Takiwasi 183 CEA, Cara, Amar 184 Renarkon, Sejřek, Kladno-Dubí 184 References 197 Chapter 11: Previous Treatments 201 Introduction 201 Takiwasi 201 CEA, CARA, AMAR 203 Renarkon, Sejřek, Kladno-Dubí 204 References 219 Chapter 12: Etiology of Substance Use Disorders 223 Introduction 223 Takiwasi 225 CEA, CARA, AMAR 227 Renarkon, Sejřek, Kladno-Dubí 230 References 245 Chapter 13: Treatment Support 250 Introduction 250 Takiwasi 251 CEA, CARA, AMAR 253 Renarkon, Sejřek, Kladno-Dubí 255 References 270 Chapter 14: Treatment Rules 272 Introduction 272 Takiwasi 272 CEA, CARA, AMAR 275 Renarkon, Sejřek, Kladno-Dubí 276 References 290 Chapter 15: Group Cohesion 294 Introduction 294 Takiwasi 296 CEA, CARA, AMAR 297 Renarkon, Sejřek, Kladno-Dubí 298 References 311 Chapter 16: Impact of Substance Use on the Study or Work 314 Introduction 314 Takiwasi 316 CEA, CARA, AMAR 317 Renarkon, Sejřek, Kladno-Dubí 318 References 333 Chapter 17: Therapeutic Choice in the SUDs Treatment 337 Introduction 337 Takiwasi 337 CEA, CARA, AMAR 340 Renarkon, Sejřek, Kladno-Dubí 342 References 358 Chapter 18: Gender Differences in Treatment of Substance Use Disorders 360 Introduction 360 Takiwasi 361 CEA, CARA, AMAR 364 Renarkon, Sejřek, Kladno-Dubí 365 References 379 Chapter 19: Health Consequences of the Substance Use 382 Introduction 382 Takiwasi 384 CEA, CARA, AMAR 386 Renarkon, Sejřek, Kladno-Dubí 387 References 399 Chapter 20: Treatment Evaluation 403 Introduction 403 Takiwasi 404 CEA, CARA, AMAR 405 Renarkon, Sejřek, Kladno-Dubí 406 References 421 Chapter 21: Relapse Prevention 425 Introduction 425 Takiwasi 426 CEA, CARA, AMAR 428 Renarkon, Sejřek, Kladno-Dubí 430 References 444 Chapter 22: Duration of the Treatment 448 Introduction 448 Takiwasi 448 CEA, CARA, AMAR 451 Renarkon, Sejřek, Kladno-Dubí 453 References 466 Chapter 23: A Cross-Cultural Approach to Substance Use Disorders Treatment: Limitations and Challenges 469 Introduction 469 References 471 Index 472