Therapeutic Communities:Management and Performance

Summary

Principal Investigator: Paul Roman
Abstract: DESCRIPTION: (provided by applicant) Therapeutic communities have shown great promise for producing significant behavioral changes and successful "habilitation" of substance abusers and addicts (DeLeon, 2000). In order to understand how therapeutic communities are differentially successful, a focus upon their organization and management is critical. Several aspects of therapeutic community management appear to be problematic in maximizing the effectiveness of these organizations. These include recruitment of clients, retention of clients, maintaining organizational funding, and characteristics of those in management and leadership positions. We propose a longitudinal study of organizational features and managerial practices in a nationally representative sample of therapeutic communities, excluding those based in prisons or other correctional settings. An initial part of the study design will center on the definition of the therapeutic community, using the established measures of the Essential Elements Questionnaires. The primary goal of the study is to discern the predictors of different patterns of organizational performance, stability and change in this sample of therapeutic communities as these organizations cope with the turbulent environment of substance abuse treatment. Using a representative national sample (N=450), this study would collect longitudinal data on the following sets of variables: organizational structure, organizational/therapeutic culture, organizational management, treatment inputs, treatment/clinical process, treatment/clinical management, characteristics of therapeutic community leadership and management, external environment and organizational performance.
Funding Period: 2001-09-30 - 2007-06-30
more information: NIH RePORT

Top Publications

  1. pmc Sustainment of smoking cessation programs in substance use disorder treatment organizations
    Hannah K Knudsen
    Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY 40536 0086, USA
    Nicotine Tob Res 15:1060-8. 2013
  2. pmc The implementation of tobacco-related brief interventions in substance abuse treatment: a national study of counselors
    Hannah K Knudsen
    Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 109 Medical Behavioral Science Building, Lexington, KY 40536 0086, USA
    J Subst Abuse Treat 38:212-9. 2010
  3. pmc Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations
    Hannah K Knudsen
    Department of Behavioral Science, University of Kentucky, Lexington, KY 40536 0086, USA
    J Addict Dis 29:294-305. 2010
  4. pmc Substance abuse treatment counselors and tobacco use: a comparison of comprehensive and indoor-only workplace smoking bans
    Hannah K Knudsen
    Department of Behavioral Science, University of Kentucky, 109 Medical Behavioral Science Bldg, Lexington, KY 40536 0086, USA
    Nicotine Tob Res 12:1151-5. 2010
  5. pmc Availability of nicotine replacement therapy in substance use disorder treatment: longitudinal patterns of adoption, sustainability, and discontinuation
    Hannah K Knudsen
    University of Kentucky, Department of Behavioral Science and Center on Drug and Alcohol Research, 109 Medical Behavioral Science Building, Lexington, KY 40536 0086, USA
    Drug Alcohol Depend 118:244-50. 2011
  6. pmc The implementation of smoking cessation counseling in substance abuse treatment
    Hannah K Knudsen
    Department of Behavioral Science, University of Kentucky, Lexington, 40536 0086, USA
    J Behav Health Serv Res 39:28-41. 2012
  7. pmc The availability of integrated care in a national sample of therapeutic communities
    Meredith Huey Dye
    Department of Sociology Anthropology, Middle Tennessee State University, Murfreesboro, 37132, USA
    J Behav Health Serv Res 39:17-27. 2012
  8. ncbi Counselor emotional exhaustion and turnover intention in therapeutic communities
    Hannah K Knudsen
    Center for Research on Behavioral Health and Human Services Delivery, The University of Georgia, 101 Barrow Hall, Athens, 30602 2401, USA
    J Subst Abuse Treat 31:173-80. 2006
  9. pmc Modified therapeutic communities and adherence to traditional elements
    Meredith Huey Dye
    Department of Sociology Anthropology, Middle Tennessee State University, P O Box 10, Murfreesboro, TN 37132, USA
    J Psychoactive Drugs 41:275-83. 2009

Detail Information

Publications9

  1. pmc Sustainment of smoking cessation programs in substance use disorder treatment organizations
    Hannah K Knudsen
    Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY 40536 0086, USA
    Nicotine Tob Res 15:1060-8. 2013
    ..Integrating smoking cessation services into SUD treatment may have substantial public health benefits, but few studies have examined whether organizations offering counseling-based smoking cessation programs sustain them over time...
  2. pmc The implementation of tobacco-related brief interventions in substance abuse treatment: a national study of counselors
    Hannah K Knudsen
    Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 109 Medical Behavioral Science Building, Lexington, KY 40536 0086, USA
    J Subst Abuse Treat 38:212-9. 2010
    ..These findings suggest that attempts to increase the implementation of best practices in substance abuse treatment may require attention to organizational contexts and the individuals responsible for implementation...
  3. pmc Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations
    Hannah K Knudsen
    Department of Behavioral Science, University of Kentucky, Lexington, KY 40536 0086, USA
    J Addict Dis 29:294-305. 2010
    ....
  4. pmc Substance abuse treatment counselors and tobacco use: a comparison of comprehensive and indoor-only workplace smoking bans
    Hannah K Knudsen
    Department of Behavioral Science, University of Kentucky, 109 Medical Behavioral Science Bldg, Lexington, KY 40536 0086, USA
    Nicotine Tob Res 12:1151-5. 2010
    ..While indoor smoking bans reduce employee tobacco use, less is known about whether comprehensive bans, which prohibit smoking in both indoor and outdoor areas, are associated with lower rates of tobacco use than indoor-only bans...
  5. pmc Availability of nicotine replacement therapy in substance use disorder treatment: longitudinal patterns of adoption, sustainability, and discontinuation
    Hannah K Knudsen
    University of Kentucky, Department of Behavioral Science and Center on Drug and Alcohol Research, 109 Medical Behavioral Science Building, Lexington, KY 40536 0086, USA
    Drug Alcohol Depend 118:244-50. 2011
    ..Previous research has not examined the organizational characteristics associated with NRT availability over time in SUD treatment programs...
  6. pmc The implementation of smoking cessation counseling in substance abuse treatment
    Hannah K Knudsen
    Department of Behavioral Science, University of Kentucky, Lexington, 40536 0086, USA
    J Behav Health Serv Res 39:28-41. 2012
    ..These results highlight the importance of organizational contexts as well as counselors' knowledge and attitudes for effective implementation of smoking cessation counseling in substance abuse treatment organizations...
  7. pmc The availability of integrated care in a national sample of therapeutic communities
    Meredith Huey Dye
    Department of Sociology Anthropology, Middle Tennessee State University, Murfreesboro, 37132, USA
    J Behav Health Serv Res 39:17-27. 2012
    ..TCs that offer integrated care show increased use of professional staff, individual psychotherapy, and a less confrontational milieu, but notably, retain many of the "essential elements" of the traditional TC model...
  8. ncbi Counselor emotional exhaustion and turnover intention in therapeutic communities
    Hannah K Knudsen
    Center for Research on Behavioral Health and Human Services Delivery, The University of Georgia, 101 Barrow Hall, Athens, 30602 2401, USA
    J Subst Abuse Treat 31:173-80. 2006
    ..Because these practices are not structural features of organizations, they may be targeted for intervention and change...
  9. pmc Modified therapeutic communities and adherence to traditional elements
    Meredith Huey Dye
    Department of Sociology Anthropology, Middle Tennessee State University, P O Box 10, Murfreesboro, TN 37132, USA
    J Psychoactive Drugs 41:275-83. 2009
    ..Short-term residential programs showed a similar negative trend. Findings suggest selected modifications are possible without significantly impacting the TC model's core technology...