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Philosophy
The
Therapeutic Community
The therapeutic community
(TC) for the treatment of substance abuse has existed for over
40 years. In general, TCs are drug and alcohol-free residential
settings that use a hierarchical model with treatment stages that
reflect increased levels of personal and social responsibility.
Peer influence, mediated through a variety of group processes,
is used to help individuals learn and assimilate social norms
and develop more effective social skills.
TCs differ from other
treatment approaches principally in their use of the community;
comprising treatment staff and those in recover, as key agents
of change. This approach is often referred to as “community as
method.” TC members interact in structured and unstructured ways
to influence attitudes, perceptions and behaviors associated with
drug use.
Many individuals admitted
to TCs have a history of social function, education/vocational
skills, and positive community and family ties that have been
eroded by their substance abuse. For them, recovery means rehabilitation
– relearning or re-establishing healthy functioning, skills, and
values as well as regaining physical and emotional health. Other
TC residents have never acquired functional life-styles. For these
people, the TC is usually their first exposure to orderly living.
Recovery for them involves habilitation – learning for the first
time the behavioral skills, attitudes and values associated with
socialized living.
In addition to the
importance of the community as a primary agent of change, a second
fundamental TC principle is “self-help.” Self-help implies that
the individuals in treatment are the main contributors to the
change process. “Mutual self-help” means that individuals also
assume partial responsibility for the recovery of their peers
– an important aspect of an individual’s own treatment.
(To read the
rest of this NIDA Research Report, click
here
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