Abstract
Background: Welcome houses (WHs) have been introduced as a stage at the start of some European therapeutic communities (TCs) to improve treatment retention. In contrast to the structured, rule-bound approach of many residential therapeutic facilities (often described as ‘total institutions’ (TIs)), WHs provide a relatively ‘gentle’ introduction to residential life. This article explores the influence of WHs on treatment retention from the perspective of TC staff and residents.
Methods: Thirty-five qualitative interviews were conducted in two TCs with WHs in the United Kingdom. Participants included staff (n = 13), current residents (n = 13) and former residents (n = 9). Interviews were transcribed, coded and analyzed using framework.
Results: Participants reported that retention was affected by three core factors: ‘intensive care and support’, ‘rules and order’ and ‘time and space’. Each factor was described as influencing retention both positively and negatively, but via different mechanisms. WHs seemed to increase retention amongst people who had never been in residential treatment previously or who had complex needs, but decrease retention amongst those who were more stable at treatment entry.
Conclusion: WHs retain many of the core characteristics of TIs, but in an adapted ‘softer’ form. As such, WHs might be better described as ‘reinventive institutions’. WHs should not be a mandatory stage within TCs. Rather TC providers should consider each new resident’s need for WH as part of their assessment. Further research is needed to quantify the impact of WHs on retention and to test apparent associations between retention outcomes and resident characteristics.
Methods: Thirty-five qualitative interviews were conducted in two TCs with WHs in the United Kingdom. Participants included staff (n = 13), current residents (n = 13) and former residents (n = 9). Interviews were transcribed, coded and analyzed using framework.
Results: Participants reported that retention was affected by three core factors: ‘intensive care and support’, ‘rules and order’ and ‘time and space’. Each factor was described as influencing retention both positively and negatively, but via different mechanisms. WHs seemed to increase retention amongst people who had never been in residential treatment previously or who had complex needs, but decrease retention amongst those who were more stable at treatment entry.
Conclusion: WHs retain many of the core characteristics of TIs, but in an adapted ‘softer’ form. As such, WHs might be better described as ‘reinventive institutions’. WHs should not be a mandatory stage within TCs. Rather TC providers should consider each new resident’s need for WH as part of their assessment. Further research is needed to quantify the impact of WHs on retention and to test apparent associations between retention outcomes and resident characteristics.
| Original language | English |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | ADDICTION RESEARCH AND THEORY |
| Early online date | 26 Oct 2016 |
| DOIs | |
| Publication status | E-pub ahead of print - 26 Oct 2016 |