There are a variety of substance abuse treatment programs available, but what makes therapeutic communities so successful? This type of residential treatment program has been around for many years, and there is research to support the idea that they are an effective way to help people overcome substance abuse. Let’s take a closer look at what makes these programs work and why they are becoming more popular than ever before in achieving a drug free lifestyle.
What does the term therapeutic community mean?
Therapeutic communities, also known as TCs, are a type of substance abuse residential treatment program that relies on peer support and communal living. Participants in these programs live and work together in a structured environment, and they are typically required to attend group therapy sessions and other treatments as well. There is evidence to suggest that therapeutic communities are an effective way to treat substance abuse disorders, and they have been shown to reduce the risk of relapse.
Roleplaying is a big part of what goes on in these groups – participants take turns in being the “therapist” and being the “client”. The nature of this set-up provide residents with a support system that is crucial in dealing with substance abuse treatment outcomes.
Clients of a therapeutic community
Just like in every working environment, there are certain principles that residents must adhere to. For example, in order to be a part of the community, residents must:
– Be willing to change
– Respect others in the community
– Take responsibility for their own actions
– Participate in group activities and meetings
These principles help create an environment that is conducive to change and break through the substance abuse. They also help residents build positive family and social relations outside the treatment program.
Key features of a therapeutic community
These are the key values and components that make what are therapeutic communities for addictions:
- The primary guidance comes from the community itself. Being a kind of self help groups, the rules are created by the residents, and they are enforced by the staff. It is based on the idea that everyone in the community is responsible for helping each other recover.
- Therapeutic communities typically have a hierarchical structure, and residents progress through different levels as they demonstrate their commitment to sobriety. There are those who have been in the program for a longer time and are considered to be more “experienced”, while new residents are at the bottom of the totem pole.
- There is a lot of structure and support in TC treatment programs, and residents are typically required to attend group therapy sessions and other treatments.
- Truthfulness and honesty are key values in therapeutic communities and are essential in the treatment process. All peers are perceived to be innately “good” but their behaviors can be “bad”.
- Each resident has a social responsibility as their brother’s keeper. He/she must believe on the power of change. Through honest confrontation and education, residents can overcome their bad behaviors.
- Personal accountability and responsibility are also key values. In order to progress, residents must take responsibility for their own sobriety and recovery.
- The staff in a TC is typically made up of people who have recovered from addiction themselves. They serve as mentors and role models for the residents, and they provide support and guidance throughout the program.
By observing and implementing these in the group, individual and group’s direction towards progress is being ensured.
Stages of Therapeutic Community Participation
The first stage of TC participation is known as the “honeymoon” phase. In this stage, residents are typically very enthusiastic about the program and their recovery. They may not have a full understanding of what is expected of them, but they are eager to learn and engage in treatment.
The second stage is known as the “working through” phase. In this stage, residents begin to face the reality of what it takes to recover from addiction. They may start to feel discouraged, but they continue to participate in treatment and work towards their goals.
The third stage is known as the “stabilization” phase. In this stage, residents have made significant progress in their recovery and they are beginning to feel more confident. They are able to stick to their substance abuse treatment plan and they are less likely to relapse. They slowly focusing more on rebuilding family and social relations outside the program and develop skills to help them with their reintegration to the society.
The fourth and final stage is known as the “maintenance” phase. In this stage, residents have fully recovered from addiction and they are working to maintain their sobriety. They may still attend group therapy sessions and other treatments, usually to as an alumni or part of the staff, but they are able to live a normal, healthy life.
These four stages help the client facilitate recovery oriented perspective and successful integration into the society after completing the residential treatment. Treatment retention programs may be implemented as necessary.
Other Conditions That May Benefit From TC treatment
Aside from drug abuse, there are other mental health problems evidently benefits from TC treatment:
- Criminal Behaviors
- Certain Personality Disorders
- Eating Disorders
- Those involving spiritual struggles
The common denominator between these related disorders are they are illnesses that heavily demands lifestyle changes and focus on social learning. There is some evidence to suggest that modified therapeutic community may also be helpful for people with other mental health conditions, such as schizophrenia, bipolar disorder, and other psychological dysfunction. However, more research is needed to determine whether or not TC treatments are effective for these populations.
Having more than 50% of US prison inmates possessing criteria for substance abuse disorder, the US Criminal Justice System prisons have integrated TC treatments in some prisons and after-prison-care programs. Integrating substance abuse treatments into criminal justice settings has shown to improve psychological symptoms, related positive outcomes, and public safety.
Therapeutic Community vs Other Treatments
There are many different treatment options for persons addicted to alcohol and drugs, including addiction detox programs, tainted substance use services, harm reduction services and long-term residential programs. Each person approaches substance abuse differently. But what makes TC, as a residential treatment, stand-out?
The selling point of therapeutic community, aside from its reputation on success rates, is that it is a long-term residential program that focuses on lifestyle changes and social learning. It is not a quick fix or a band-aid solution, but rather a comprehensive approach to addiction treatment that can last up to two years. Furthermore, TC has some important aspects which can be included in other programs.
The length of stay in a therapeutic community can be flexible according to the needs of the patient. Some people may graduate faster than others from the residential treatment. Research has shown that therapeutic community treatment is an effective form of treatment for substance abuse, particularly for those who finds it difficult to have self-control while being part of the general population.
Success of Therapeutic Communities
The success rate of therapeutic communities in treating drug alcohol abuse and other types of addiction varies depending on the population, but overall they are considered to be successful. In one study, it was found that 74% of residents who completed a therapeutic community program remained abstinent from drugs and alcohol at follow-up.
Another study found that 67% of residents who completed a TC treatment program were employed or enrolled in school during follow-ups. With these numbers, anyone suffering seeking for a substance abuse treatment would be curious to learn what are therapeutic communities.
Why are therapeutic communities successful? There are many factors that contribute to the success of therapeutic communities, but some of the most important ones are the structure, support, and values that are emphasized in these programs. Therapeutic communities provide a safe and supportive environment for residents to heal and recover from addiction.
Research shows that the treatment time and follow-up after initial treatment are important factors that can improve recovery and reduce relapse rates. A study done by the National Institute on Drug Abuse (NIDA) found that therapeutic communities that provided long-term treatment (more than six months) and follow-up aftercare had better outcomes than those that did not.
Critics on therapeutic communities
Albeit therapeutic communities has shown effectivity in treating addiction, it is not an end-all-be-all solution. One of the main criticisms of therapeutic communities is that they are not as effective in treating other mental health conditions and may trigger negative consequences. This is because some conditions are much more complex that they require more individualized treatment to achieve own recovery.
Addiction vs Other Mental Illness
It is important to understand the significant differences between addiction and other mental illness. Addiction is a disease that causes changes in the brain, which leads to compulsive behaviors and psychological symptoms. Other mental illness, such as depression or anxiety, are disorders that cause changes in mood or behavior.
While both addiction and other mental illness can be treated with medication and therapy, addiction requires a different approach. This is because addiction is a disease that requires abstinence from substances in order to recover. Other mental illness does not typically require complete abstinence, but rather management of symptoms. In this case, a residential treatment may not be the best option.
Therapeutic communities are successful in treating addiction because they focus on the individual and their journey to recovery. The values of personal responsibility and accountability help residents to overcome their addiction and live a healthy, sober life. While TCs are not perfect, they are an effective and affordable substance abuse treatment option for the population.
Some disadvantages of therapeutic communities
It would be unfair to this discussion not to forward other issues that may arise from this type of mental health treatment. These are some disadvantages that a potential resident must be aware of:
- The environment can sometimes be chaotic.
- There is a potential for triggers and abuse.
- Residents may not have enough privacy.
- Group responsibility may be blurred and easily be no one’s responsibility.
- The program may not be the right fit for everyone.
- Other individual needs might be overlooked or cannot be addressed.
- Patient might find a hard time transitioning to the community and relapse.
A therapeutic community program is not always the best fit substance abuse treatment for an individual. It is important to consult with a professional to determine what the best course of action is for each person. However, for those who are seeking an effective and affordable treatment option, therapeutic communities are worth considering.
If you are looking for a substance abuse treatment for yourself or a loved one, make sure to factor in the above reasons why therapeutic communities do not work for the mentally before entering the program. Additionally, one’s mental illness can be a trigger for substance abuse, so it is important to address other underlying issues in treatment. Most importantly, always consult with a professional to help you achieve positive treatment outcomes.
How are therapeutic communities for drug abuse funded
Therapeutic communities for drug abuse are typically funded by government agencies and private foundations. Government funding typically comes from the Substance Abuse and Mental Health Services Administration (SAMHSA), which provides grants to support TC treatment programs. Private funding typically comes from foundations and donors.
Some TCs may also charge residents a fee for their stay. This helps to cover the cost of food, shelter, and other necessary expenses. In some cases, insurance may cover the cost of TC treatment.
Where to find therapeutic communities
There are therapeutic communities all over the world. In the United States, there are TCs in every state. The National Institute for Drug Abuse support this kind of substance abuse treatment and publishes more information about residential treatments in their website. You can also find a list of TCs in your area by searching online or contacting your local Substance Abuse and Mental Health Services Administration office. You can also find kinds of TC treatment that specialize in treating specific populations, such as veterans or adolescents.
For someone struggling with alcohol or drug addiction, treatment communities can provide support and structure that help residents recover and start living a healthy, sober life. While therapeutic communities are not perfect, compelling results published in a scientific world journal and internal journal are reason enough for you to give it a try.
The bottom line
Therapeutic communities are successful model of substance abuse treatment that has been shown to help people recover from substance abuse. They are based on the idea that everyone in the community is responsible for the sobriety of each member, and they use a variety of techniques to promote recovery. Despite not being an end-all-be-all solution for everyone, TC treatment is a credible and affordable option towards overcoming addiction problems. If you or someone you know is struggling with addiction, being in a TC may be a good option to achieve full recovery. Contact your national institute and local substance abuse treatment centers.
