DOI - Mendel University Press

DOI identifiers

ISBN: 978-80-7509-707-1 | ISBN online: 978-80-7509-708-8 | DOI: 10.11118/978-80-7509-708-8

LÉČBA DROGOVÉ ZÁVISLOSTI V TERAPEUTICKÝCH KOMUNITÁCH

Případová studie z Peru, Nikaraguy a Česka

Miroslav Horák

OBJECTIVE: The primary objective of this case study was to create a grounded theory of drug addiction treatment in therapeutic communities and to find out what are the similarities and differences in the Peruvian, Nicaraguan and Czech contexts. The study also determines the factors that have seemingly had an influence on the efficiency of the therapeutic communities. The role of spirituality and religion in the drug addiction treatment is explained, and the results of previous research on retention are verified.
METHODS: The data for the study was collected during semi-structured interviews with inpatients/clients of 7 therapeutic communities, within the period between 2013 and 2016. The research was conducted in Peru (Takiwasi), Nicaragua (Centro de Especialidades en Adicciones, CARA, AMAR), and the Czech Republic (Renarkon, Sejrek, Kladno-Dubi). Similarly, 90 interviews with total duration 39 hours were recorded. All interviews were manually transcribed. Content analysis was performed for 765 standard pages of transcripts and codes were created. The codes were organized into a paradigm model of grounded theory, and the groundedness was determined. The selected codes were used to elaborate the grounded theory. Similarities and differences between therapeutic communities were identified based on the most grounded codes. The analysis of variance was used for some selected statistical characteristics of individuals in the research sample.
RESULTS: Content analysis showed that the two main codes in narratives of informants: "effective factors of TC" and "motivation". The analysis of variance confirmed that the length of abstinence and the length of previous treatment are strongly correlated. It was also found that the length of current treatment is not related to the length of previous treatment, length of abstinence, length of drug use, or type of primary drug. However, the length of current treatment is related to age, i.e. the older the inpatient/ client, the longer the treatment.
CONCLUSION: Considering the effective factors of the therapeutic community, treatment in Peru, Nicaragua and the Czech Republic is identical in the presence of a personal therapist, the use of psychotherapy, and the importance of group cohesion. In Peru, it differs in the administration of herbal medications and diet, in Nicaragua the difference is in spirituality and religion, and practicing 12 steps, while in the Czech Republic, emphasis is on the therapeutic program and leisure activities. In terms of motivation, no significant difference was found between the countries’ inpatients/ clients. There is a consensus that the greatest motivating factors are family and relationship of partners. In general, effective factors are: spirituality and religion, treatment rules, treatment support, group cohesion, gender differences, length of treatment, herbal medications, and model of addiction. In relation to spirituality and religion, it plays an important role in the Peruvian and Nicaraguan therapeutic communities. The results of previous research on retention have been confirmed.

Keywords: drug addiction treatment, substance use disorder, therapeutic community

1. edition, Published: 2020, online: 2020, publisher: Mendelova univerzita v Brně



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