The document discusses the concept of a therapeutic community, a structured, drug-free environment for individuals dealing with addiction and mental health issues, emphasizing group-based approaches to promote accountability, self-change, and positive interactions. It outlines the historical development of therapeutic communities, starting from their emergence in post-World War II Britain to their application in various settings, including corrections and mental health facilities. Key principles include the importance of community engagement, role modeling by staff, and the establishment of a supportive, growth-oriented environment for residents.

1. THERAPEUTIC
COMMUNITY

2. The term "therapeutic community" has been used for several
different forms of treatment (sanctuaries, residential group
homes) and for several conditions, including mental illness,
drug abuse and alcoholism
 a drug-free environment in which people with addiction
problems live together in an organized and structured way
to promote changes towards a drug-free life in the outside
society
 a treatment modality found in a variety of populations and
settings including drug addicts, learning disabilities,
personality disorders and prisons
 a participative, group-based approach to long-term mental
illness, personality disorders and drug addiction
the approach is usually residential with clients and therapist
living together

3. • based on milieu therapy principles and includes group
psychotherapy, as well as practical activities
• a living learning situation which means that residents are
totally immersed in the treatment environment so that
all of their daily behavior and their emotional and physical
state can be observed and challenged as appropriate
through intensive group experiences
• utilizes community as method in addressing the
substance abuse and social and psychological problems of
the individual
• organized according to a daily regimen, during which
residents and staff members are expected to share meals
and attend meetings, such as the community meeting

4. • a treatment model in which participants are
taught to work with one another to
promote self-change by becoming positive
role models for one another under the
guidance of the staff
• a positive environment for learning how to
be accountable for one's choices in a
caring community where members can help
themselves and each other make positive
changes
• staff and resident work together to establish
and maintain a positive, growth-filled
environment
• community members focus on behavioral
change, accountability confronting attitudes,
behaviors and criminal thinking patterns

5. • it is a place to set goals,
develop discipline and
practice behaviors that
lead to successful living
• a place where you learn
to let go of "victim
mentality" and to develop
"accountability mentality"
• allows you a chance to
change, to confront
mistakes and accept
responsibility for your life

6. • the learning process comes from the
community itself; the community is
the agent of change.
• there is a common belief that
people can and do change for the
better if they so choose
• one of the longest standing
modalities for the treatment of
drug addiction.

7. MODALITY- the method used to
deliver a service or to perform
an action
COMMUNITY AS METHOD -
means the purposive use of
the peer community to
facilitate social and
psychological change in
individuals
MILIEU THERAPY
• a safe, structured, group
treatment method for mental
health issues
• involves using every day
activities and a conditioned
environment to help people
with interaction in community
settings
• a form of psychotherapy
(treating mental health
problems) that involves the use
of therapeutic community

8. 1. a group of people living together
2. intimate yet informal relationships (share their opinions,
experiences, problems, information with each other.)
3. regular and frequent sharing of information between all
group members
4. a shared commitment to the goal of learning from the
experience of living and/or working together
5. a shared commitment to the open examination and resolution
of problems, tensions and conflicts within the group
6. a psychodynamic awareness of individual and group process;
7. a clear set of boundaries concerning time, place and roles
CHARACTERISTIC OF THERAPEUTIC COMMUNITY

9. TYPICAL ROUTINE IN A THERAPEUTIC
COMMUNITY
• every day starts with the community meeting
• followed by morning activities
• during the day, seminars, encounter groups and other
• therapeutic sessions are organized
• lunch and free time
• afternoon activities
• dinner and some free time before going to bed
• the primary goal of the community meetings is to strengthen
community feeling and cohesion
• each member must become a positive role model for each other
• in order to become a positive role model, one must be willing to
learn about one's self first
• knowing one's self is the first step to understanding others

10. • a central part of the TC is a structure board or hierarchy
that has may job functions
• the lines of responsibility and the chain of command of
the structure board are clearly defined and must be
strictly followed
• having a well-run structure is critical to a successful
community the staff in the TC serve as positive role
models: they provide reasons for their decisions and
the meaning of consequences.
• staff facilitate and correct, rather than punish, bad
behaviors.
STRUCTURE IN THE THERAPEUTIC COMMUNITY

11. BRIEF HISTORY OF THERAPEUTIC
COMMUNITY IN THE WORLD SETTING
IN GREAT BRITAIN – BRITISH TC
• TC emerged primarily as a process for treating military veterans as they
returned from World War II with serious neurotic conditions from their
experiences in combat and as prisoners of war
• the term therapeutic community was coined by Thomas Main, a British
physician who pioneered a therapeutic model
combining community therapy with ongoing psychoanalytic psychotherapy
(a talking therapy based on saying whatever is going through your mind. This
helps you become aware of hidden meanings or patterns in what you do or say
that may contribute to your problems.) in 1946

12. another therapeutic model was developed by Maxwell Jones
in the 1940s at Belmont Hospital as a social rehabilitation
unit (provides 24- hour-a-day nonmedical care and supervision in
a group setting to adults recovering from mental illness who
temporarily need assistance, guidance, or counseling.)
• by 1954, TC ideas were already influencing British
psychiatric hospitals
• by the 1950s and 1960s, the TC movement shifted to other
settings, notably in corrections
• TC principles began to be used in corrections programs
• Grendon Prison was built in 1959 specifically with a
number of wings, or areas, within which TCs would
experimentally operate to provide treatment for
psychologically disturbed offenders

13. PRINCIPLES OF THERAPEUTIC
COMMUNITY IN BRITISH PRISONS
1. Enfranchisement and empowerment - every community member has a
direct say in every aspect of how the wing is run
2. Tolerance - every community member is allowed to make mistakes, accept
themselves and support each other
3. Encouragement, collective responsibility and accountability
4. Continuous, direct and candid presentation of interpretation of one
another's behavior to counteract any tendency to distort, deny or withdraw
from interpersonal difficulties or rule-breaking; and
5. Peer group influence -used to control and modify negative prison cultural
values with an important role for community elders
Community elders - members who have successfully completed the
transition themselves and who now play a supportive role

14. 1. Getting past denial (ignoring the reality of a situation to avoid
anxiety)
2. Relief of personal distress (anxiety)
3. Developing relationships with others, including authority
figures
4. Changing attitudes toward offending, specifically about one's
own offense
5. Building morality, victim awareness, contrition and
understanding of effects on victims
6. Relapse prevention (someone who is seeing the onset of their
symptoms once again.)
THERAPEUTIC IN BRITISH PERSONS

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