Self-help groups. Introduction to the special issue.
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Humans↗
Biomedical subjects
T J Borkman
Publications and source records attributed to T J Borkman.
An organizational typology for self-help groups.
Those investigating the nature and functioning of self-help groups have been handicapped by the lack of a conceptual framework to bridge the diversity among such groups as well as to clarify the boundaries between consumer-owned and professionally owned groups. This paper describes a typology that classifies local units of these groups in terms of differences and similarities in their organizational structures. Rooted in organizational theory, it has two dimensions: external dependence upon resources and internal extent of experiential authority. Using it, the authors identified five types of groups, referred to as Unaffiliated, Federated, Affiliated, Hybrid, and Managed. The typology was validated with actual groups.
Adaptation, Psychological↗
An historical and developmental analysis of social model programs.
This review synthesizes the philosophy, development, history, and current status of the philosophy of social or community model of recovery and of Social Model Programs (SMPs) based on an analysis of the available literature, much of it outside traditional sources. The social-community model of recovery evolved out of Alcoholics Anonymous (AA), and has a distinctive program philosophy with different assumptions, knowledge, and practice than professionally based treatment models. SMPs began in the 1940s in California, evolving by the 1980s into a continuum of recovery services that are publicly funded, legally incorporated nonprofit organizations. The characteristics of SMPs are described and the range of services are presented, including social setting detoxification, residential recovery homes, non-residential neighborhood recovery centers and sober living houses. SMPs are staffed exclusively by recovering alcoholics and their structure is based on the 12 traditions of AA, which emphasize democratic group processes with shared and rotated leadership and a minimal hierarchy. Cost effectiveness data suggest that residential social model programs average approximately $2,700 per stay versus $4,400 for other residential approaches, yet may offer similar outcomes in terms of substance use and improvement employment or family function.
Alcoholics Anonymous↗
Measuring treatment philosophy: a scale for substance abuse recovery programs.
The assessment of the philosophy that guides substance abuse treatment programs has been a difficult subject to approach by those working in treatment research. Differing treatment philosophies are generally represented by multi-dimensional theoretical constructs that do not easily lend themselves to assessment by quantitative means. In the U.S., substance abuse treatment programs have been suggested as fitting into a disease (or medical) model, a social learning (or psychological) model, or a social community model in designing a treatment regime for clients. This paper presents a Social Model Philosophy Scale (SMPS) to classify the extent to which a given treatment program follows a social model approach to treatment. The final version of the SMPS (available from the first author) contains 33 questions for use in residential programs, divided into six conceptual domains: physical environment, staff role, authority base, view of substance abuse problems, governance, and community orientation. Overall internal reliability is high (alpha = .92), with subscale alphas ranging between .57 and .79. Test-retest analyses showed that the information obtained from the SMPS is consistent across time, administrators, and respondents. In addition, the SMPS is brief and easy to administer. Methodology used in item creation and final item selection is reported. Although not designed to distinguish philosophies other than social model, early results suggest that the SMPS may also be used to classify other program philosophies.
Humans↗
Is recovery planning any different from treatment planning?
Using process evaluation data, this paper compares the "recovery" planning process of the social model programs with the "treatment" planning process in a comparison medical model program. We consider how the planning process is actually conducted, the role of staff versus clients in the planning process, and how the implementation of the planning process is monitored and evaluated at the programs. Results point to major differences in the actual process of treatment planning and recovery planning. Professional staff at medical model programs generally direct and control the planning process and its implementation. In social model programs, clients are directly responsible for developing their own recovery plans, within a context of help from peers and recovering staff; the latter oversee the process. We conclude that both treatment planning and recovery planning are distinct and defining features of medical and social model philosophies. Treatment planning in medical model programs and recovery planning in social model programs serve similar administrative and programmatic functions. However, the impact on patients/residents is likely to be significantly different. Recovery planning becomes a skill acquired by clients, part of the experiential education characterizing social model programs. Future research is needed to assess whether these planning skills actually aid social model clients in structuring a sober lifestyle in aftercare, and whether differences are obtained by the more passive client role in planning taken at the medical model program.
Humans↗