Times for healing: towards a typology of time-frames in Swiss alcohol and drug clinics.
OBJECTIVE
To translate theoretical dimensions of 'social time' and 'clock time' in addiction treatment settings into empirical measures and to develop a typology of institutional time perspectives.


METHODS
From November 2001 to February 2002, a mail survey was conducted with directors of 57 alcohol and drug clinics in the German-speaking part of Switzerland. Items measured the past and future orientation of the treatment programmes, elements of social time and clock time as part of organizational life and 'time bargaining' between therapists and clients.


RESULTS
Four clusters of temporal orientations emerged: 'clock time keepers' (who emphasize time control and future pessimism); 'nostalgic time riders' (focus on the 'good old days' but individualized planning); 'optimist speeders' (fast pacing, future control); and 'relaxed future optimists' (also future oriented but not sharing the idea of linear time). The time-frame also influences the negotiation of time in treatment between staff and patients: 'relaxed future optimists' most frequently report diverging views, while 'optimist speeders' seem to harmonize the views of patients and treatment staff more easily. Finally, the introduction of the harm reduction policy seems to covary with the ways in which time is viewed and used in treatment organizations.


CONCLUSIONS
Treatment programmes differ in their view and use of time. Organizational times with varying dynamics, future-past orientations and time control interact with the organizational structure and socio-environmental factors. The capacity of programmes to adapt to changes in treatment policy and in the treatment system depends to some extent on organizational time orientation.
Klingemann
Harald
H
University of Applied Sciences Bern, School of Social Work, Bern, Switzerland. Harald.Klingemann@hsa.bfh.ch
Schibli
Daniela
D
D001291:Attitude of Health Personnel; D006801:Humans; D011570:Psychiatry; D011613:Psychotherapy / Q000379:methods; D019966:Substance-Related Disorders / Q000628:therapy*; D013997:Time Factors