Posted by Mitchell on December 28, 2002, at 13:51:31
In reply to Re: Court-ordered discussion » Mitchell, posted by Phil on December 28, 2002, at 11:29:06
Phil,
I understand your strong sentiments regarding the urgency of delivering behavioral health care to individuals whose lives are overwhelmed by self-titrated psychoactives.
It is somewhat difficult to unweave administrative issues, which is my primary interest in this discussion, from related issues involving efficacy and legitimacy of communication-based medical procedures. The difficulty is in comparison. If this approach (an asynchronous self-help group administered by a medical professional who arbitrates group rules) represents the better of any world, to discuss administration we need to consider the world against which this project is compared.
At least one commercial treatment program you mentioned issued a statement denouncing techniques it formerly embraced, and which are still in use among by many if not most providers of court-ordered group therapy. The common thread I identified here and in behavioral healthcare approaches shown less effective in qualitative meta analysis than other approaches is the element of authority.
But 12-step communities and some approaches recognized by research to be effective share one common element. Both discourage communities from shielding a person from the natural consequences of their behavior. The natural consequence of reliance on an authority to define matters of faith is that a person who does so will naturally encounter others who challenge their faith, or who propose faith in an other, perhaps conflicting authority. To create an environment where only affirmative statements may be offered about trust in an authority shields members from the natural consequences of placing too much confidence in authority. A comparison would be a group for all opiod users, prescribed or self-titrated in which only positive statements could be made about opiod use.
poster:Mitchell
thread:8516
URL: http://www.dr-bob.org/babble/admin/20021128/msgs/8627.html