1. Therapeutic Community Approach to Drug Treatment
Therapeutic communities are drug-
free residential treatment programs
which have adopted a hierarchal
model (such as AA, Narcotics
Anonymous, etc) with increasing levels
of personal and social responsibility
(NIDA, 2005). Therapeutic
communities (TCs) use of the
community differs from many other
types of drug treatment approaches.Â
Staff and those in recovery are the key
agents of change (NIDA, 2005).
           According to
George deLeon (1986b:69):
                       âEURoeThe primary aims of the therapeutic
community are a global change in lifestyle
                                   reflecting abstinence from
illicit substances, elimination of antisocial activity,
                                 increased enjoyability, and
prosocial attitudes and values. A critical assumption
                            in TCs is that stable recovery depends
upon a successful integration of these                            social
and psychological goals. The rehabilitative approach, therefore, requires
                        multidimensional influences and training that, for
most clients, can only occur                           after an extended
period of living in a 24-hour residential setting.âEUR
           For individuals admitted to TCs âEURoerecoveryâEUR, part of their
treatmentâEUR, includes rehabilitation. This includes relearning or re-establishing healthy social
functioning, educational/vocational skills, positive family and community ties, values, and emotional
health. Some TC residents may have never had skills, values or ties. These residents will have to
be habilitated âEUR" or learn for the first time âEUR" these valuable social skills (NIDA, 2005).Â
Some people have come from a socially disadvantaged background where drug abuse was more
socially acceptable. The TC treatment perspective is such that drug abuse is a whole-person
disorder and the problem is the person, not the substance itself (Abadinsky, 2004).
           Therapeutic communitiesâEUR(TM) treatment is complete. Its purpose is to
âEURoefacilitate social and psychological change in individualsâEUR (Abadinsky, 2004). To be
successful a participant must be fully invested in the program, identify with other addicts including
staff, and resocialize themselves via drug abstinence. The withdrawal process is done without the
use of any other drugs âEUR" including detoxifying agents. Negative and positive reinforcement is
used. Shaming someone who messed up or left and came back to the program is common. All
residents of the community are kept engaged in a tightly structured environment and anyone who
2. does not meet expectations finds themselves in an âEURoeencounter sessionâEUR aimed at them.
           Nielson and Scarpitti (1997) state that:
                       âEURoeThe most important mechanism for change is
the community of peers who                        confront the client
when old values or behaviors are displayed, who provide
                                   positive and negative
reinforcements to elicit appropriate behavior, and who serve                   as
role models for lifestyle changes.âEUR
           NIDA had conducted studies on a sample of TC programs (as well as other
programs) for three decades. The studies turned up information that TCs had several positive
outcomes. The Drug Abuse Treatment Outcome Study (DATOS) showed that people who
completed TC treatment successfully had lower levels of heroin, cocaine, and alcohol use; crime
behavior; joblessness; and depression than they had before entering the TC (NIDA, 2004).
Â
References
Abadinsky, H. (2004). Drugs: An Introduction. Belmont, CA: Thomson, Wadsworth.
deLeon, George. (1986b). âEURoeProgram-Based Evaluation Research in Therapeutic
CommunitiesâEUR
           Drug Abuse Treatment Evaluation: Strategies, Progress, and Prospects.
Pg.69-87. Ed.
           Tims, F. and J. Ludford. Rockville, MD:NIDA.
NIDA, (2004). Therapeutic Community. Research Report Series, Retrieved 22 March 2007,
           from
http://www.nida.nih.gov/ResearchReports/Therapeutic/Therapeutic2.html
Nielson, Scarpitti (1997). âEURoeChanging the Behavior of Substance Abusers: Factors
Influencing
           the Effectiveness of Therapeutic Communities.âEUR Journal of Drug
Issues 27 (Spring):
           279-98.
