[Development and evaluation of a therapeutic community model in Japan: Use of an encounter group method].

The purpose of the present study was to develop a therapeutic community (TC) model in the Drug Addiction Rehabilitation Center (DARC), the rehabilitation facility group managed by recovered drug users in Japan, and to evaluate the effectiveness of the model. The TC model is a drug-free self-help program that is significant for its use of the peer community to facilitate social and psychological change in individuals. Although the TC model has been developed around the world in a variety of settings, its use in Japan is not well known. We introduced the therapy group with an encounter group method representing the TC model at the Kawasaki DARC, and conducted pre- and post-evaluations using the modified Self-Actualization Scale (SEAS2000). Results showed that the scores of the subscale "sobering of self-affirmation" were remarkably high among those who experienced encounter groups for six months. However, the scores of the subscale "release from biased view" declined among the users at the DARC who have experienced encounter group. for a short-term, while .the scores increased among those who have a medium-term and a long-term experience. These results suggest that the encounter group may be effective especially for the medium- and long-term users in the DARC. The development of a more effective TC model is required.

[Reliability and validity of the Japanese version of the DAST-20].

OBJECTIVE: Assessing the degree of problems related to drug abuse is important in each treatment setting. The Drug Abuse Screening Test-20 (DAST-20) is a brief, simple 20-item instrument to measure the degree of problems related to drug use. The objective of the present study is to examine the reliability and validity of the Japanese version of the DAST-20. METHODS: We translated the DAST-20 into Japanese using back translation. The anonymous self-administered questionnaire was completed by 310 drug users at the Drug Addiction Rehabilitation Centers (DARC group, n = 113) and at HIV/AIDS regional hospitals (HIV group, n = 197) in Japan. RESULTS: The average DAST-20 score was 7.6 (DARC group = 14.7, HIV group = 2.8). Each item score was highly correlated with the total score (r = 0.45-0.88). A high internal consistency (Cronbach's α = 0.95) was observed (men = 0.95, women = 0.84). Overall test-retest reliability was 0.86 (men = 0.85, women = 0.90). The total DAST-20 score was strongly positively correlated with the Severity of Dependence Scale-J score (r = 0.85), but moderately positively correlated with the Alcohol Use Disorders Identification Test score (r = 0.41). In addition, confirmatory factor analysis indicated an acceptable fit to the data (goodness-of-fit index [GFI] = 0.893, adjusted goodness-of-fit index [AGFI] = 0.854, comparative fit index [CFI] = 0.948, root mean square residual [RMR] = 0.008, root mean square error of approximation [RMSEA] = 0.073). CONCLUSION: Our results clearly suggest that the Japanese version of the DAST-20 has sufficient internal consistency and acceptable levels of concurrent validity and construct validity.